VANCOUVER, British Columbia — Canada’s universal access health care system is envied by many worldwide. However, Canada is moving in the direction of adopting the profit-driven U.S. health care model.
Since the 1990s, Canada’s federal and provincial governments have slowly been dismantling public health care. More recently, a Quebec Supreme Court ruling striking down the province’s ban on private health insurance threatens to further undermine the system.
Federal and provincial governments from 1996 to 2003 cut $250 billion (Canadian) in funding from public health care. As a result of the funding cuts and population growth, waiting lists for medical procedures have grown longer and there is now also a shortage of nurses and doctors. Emergency room doctors have warned that they are unable to cope with patient loads and that preventable deaths have occurred because patients could not get the attention they needed.
Furthermore, provincial governments are delisting medical services that were previously covered. For instance, in British Columbia, visits to chiropractors and physiotherapists as well as eye exams are no longer covered. Private, for-profit clinics are springing up across the country.
The latest threat to the system is the June 9 Quebec Supreme Court ruling against the province’s ban on private insurance for medically necessary services. Dr. Jacques Chaoulli, a physician, successfully challenged the ban in court. He soon thereafter flew to Washington, D.C., to meet with leaders of conservative think tanks, and invited U.S. health care corporations to come to Canada.
Scott Sinclair, a research analyst specializing in trade policy at the Canadian Center for Policy Alternatives (CCPA), warns the court ruling is a “Trojan horse” that will open the Canadian health care system to multinational corporations and create a two-tier medical system. Once this takes place, the health care system would be subject to the World Trade Organization’s General Agreement on Trade in Services (GATS) and NAFTA. The market-based rules of these trade deals will undermine the public, not-for-profit character of Canadian health care, says Sinclair.
“Multinational insurance companies could then challenge regulations that aim to ensure that Canadians’ access to health care services is based on need rather than the ability to pay,” writes Sinclair in the CCPA Monitor. “Provincial policies, guided by the Canada Health Act, deliberately discourage the growth of private insurance markets by, for example, setting fee caps, restricting direct and extra-billing, and preventing public subsidy of private practice. Such public policies will be viewed as illegal trade barriers.”
“The GATS rules and NAFTA’s tough expropriation provisions would work in tandem to accelerate the growth of private insurance markets and to make dislodging foreign insurers from the health sector next to impossible,” adds Sinclair.
The Quebec Supreme Court ruling has not yet been implemented, as the province’s government obtained an 18-month deferral.
While Prime Minister Paul Martin has reassured Canadians that there will be no two-tiered medical system and has committed $41 billion (Canadian) in new funding for health care over the next 10 years, critics say that this is not enough to make up for previous cuts. In addition, Martin’s government refuses to punish provinces that allow private, for-profit medical clinics. Toronto Globe and Mail health reporter Andre Picard points out that Martin prefers to use the private, for-profit system for his own health care instead of the publicly funded system.
The threatened destruction of the public health care system has spurred opposition parties into action. The left-leaning New Democratic Party (NDP) has warned Martin’s Liberal minority government to reverse the erosion of public health care if it wants continued NDP support in Parliament.
On Oct. 31 Canada’s minister of health told the NDP that he is considering restrictions on the transfer of federal funds to provinces that pay doctors who work in the public system and also offer private services for a fee.
Communist Party leader Miguel Figueroa is touring the country, speaking out against any efforts to undermine socialized health care.
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