Canada's universal health care system has long been a point of pride within the country and a source of envy for our neighbours to the South. The prominence of health care's importance to Canada's citizenry has not been lost on provincial or federal politicians, as the issue has historically remained a high priority for voters. This has insulated Canadians from any abrupt deviations from the principle policy of universal accessibility to medically necessary health care services. Never the less, privatization has crept into the system.
Even at the Federal-Provincial-Territorial Health Ministers Meeting of September 1994 in Halifax, private clinics were not a novel topic- in fact it was the principle concern. Following this meeting and further consultations, the federal Minister of Health, Diane Marleau, sent a letter to all provinces and territories outlining the growth of a second tier private health care system offering medically necessary services and the dangers they posed to the public system. These dangers were summarized as:
• weakened public support for the tax funded and publicly administered system;
• the diminished ability of governments to control costs once they have shifted from the public to the private sector;
• the possibility, supported by the experience of other jurisdictions, that private facilities will concentrate on easy procedures, leaving public facilities to handle more complicated, costly cases; and
• the ability of private facilities to offer financial incentives to health care providers that could draw them away from the public system - resources may also be devoted to features which attract consumers, without in any way contributing to the quality of care.
The letter concluded with a call on provincial Ministers to introduce regulatory frameworks to govern the operation of private clinics. Despite this warning private clinics have proliferated throughout a number of provinces while the federal government has failed to uphold provisions of the Canadian Health Act in what was labelled a ‘non-intrusive approach' by the Auditor General.
These erosive legislative changes are now threatening services in New Brunswick, where Health Minister Michael Murphy has been investigating ways to allow private clinics to perform medically necessary services. It is because of Minister Murphy's proposals that the Canadian Health Coalition has launched its national campaign from Moncton to keep health care public.
The decision of the New Brunswick Government to seek a solution for the challenges of maintaining a public health care system by cultivating a second tier system seems to be in defiance of results where this scenario has already played out.
The Atlantic Human Rights Centre encourages Minister Murphy to critically weigh the risks involved in pursuing the integration of for-profit health care services into New Brunswick's public health care system. Namely, the AHRC asked Minister Murphy if the induction of private services enhances or degrades the five pillars of the Canada Health Act:
• Public Administration (section 8)
• Comprehensiveness (section 9)
• Universality (section 10)
• Portability (section 11)
• Accessibility (section 12)
Instead of looking to the private sector, the government is encouraged to investigate successful public health care models (which have been implemented in many countries) with the purpose of furthering the protection and promotion of Canada Health Act pillars.