It's time for the Liberals to come clean on medicare user fees

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It's time for the Liberals to come clean on medicare user fees





I remember having the identical disappointing reaction to Ignatieff's comments as this Liberal MP had when I initially heard about this.


This is not good enough.


'Better late than never,' MP says as Ignatieff backtracks on health fees

There was concern today over recent remarks Mr. Ignatieff made concerning the Quebec budget in which Premier Jean Charest plans to make patients pay a $25 fee for each visit to the doctor. Rather than condemning this practice, Mr. Ignatieff had said provinces should be open to experimenting with health care as long as it doesn't contravene the Canada Health Act.

Well, that didn't sit well with some Liberals, especially after news reports criticizing Mr. Ignatieff for not being stronger on the issue.

"If we open the door to user fees we might as well all go home," said one Liberal MP, noting that others were surprised Mr. Ignatieff had not come out more forcefully against the Charest budget.






Ignatieff flip-flops on health-care user fees amid grassroots revolt

OTTAWA - A brewing grassroots revolt prompted an abrupt about-face from Liberal Leader Michael Ignatieff on Quebec's proposal to impose health-care user fees.

After first declaring Quebec's plan legal, Ignatieff has reaffirmed the long-standing Liberal position that user fees are a violation of the Canada Health Act.

The flip-flop follows mounting opposition to the proposal in Quebec and within his own party ranks.

"I want to make it very clear that our party, and I personally, am a passionate defender of the Canada Health Act," Ignatieff told reporters following a caucus meeting Wednesday.

"If the government of any province were to introduce user fees, it is our belief that that would be in contravention to the Canada Health Act and we would oppose it."

The act - something of a sacred cow for Liberals since it was introduced by the Trudeau government in 1984 - explicitly prohibits user fees and empowers the federal government to financially penalize provinces that impose them.

Ignatieff's comments were in stark contrast to the initial thumbs up the Liberal leader appeared to give Quebec's plan to charge $25 for each visit to a doctor's office.

Shortly after the proposal was floated in Quebec's March 30 budget, Ignatieff said: "In our opinion, what counts is maintaining universality of access to the system. We believe, and it's a question of details, that Quebec's propositions conform to the Canada Health Act."

His response privately stunned Liberal MPs, who were not consulted, and infuriated many rank and file Liberals, particularly in the party's youth wing.

It rankled all the more that only days earlier, at a vaunted thinker's conference in Montreal, Ignatieff had billed himself as a new-style, collaborative leader who consults widely with a vast network.

Samuel Lavoie, president of the Young Liberals, fired off a letter to party president Alf Apps, expressing his "shock" and "disappointment" over the leader's embrace of the "obscene" user fee proposal.

In the letter, obtained by The Canadian Press, Lavoie said the proposed fee amounts to an "utterly immoral" tax on disease. He said it would unfairly penalize the poor and chronically ill and potentially risk the lives of those who put off seeing a doctor to avoid paying the fee.

Moreover, Lavoie noted that support for Premier Jean Charest's government has nose-dived since the budget was unveiled. He questioned why the federal Liberal party would want to embrace "the most unpopular measure of a very unpopular budget," potentially alienating progressive voters it needs to win back from the NDP and Green party.

In a subsequent speech near Montreal, Ignatieff was somewhat more equivocal about the Charest budget. He said provinces need "room to experiment" with ways to cut health-care costs but said that should be within "the framework" of the Canada Health Act.

He called guaranteed universal access "the spine of Canadian citizenship" but did not mention user fees, much less specifically rule them out.

Dissatisfied, Lavoie spearheaded a motion, approved unanimously Tuesday by the Young Liberals' national executive, urging the party to "vigorously oppose health care user fees and any other actions which violate the law, purpose and spirit of the Canada Health Act."



Who is it again that is going to be defending medicare in Canada?


Ignatieff blows best opportunity

But four years from now, all bets will be off. Prime Minister Stephen Harper has pledged not to touch the accord while it exists. But he is a constitutional strict constructionist. If he is still in power in 2014, he will likely move swiftly to terminate Ottawa's role in health care, which he considers an exclusive provincial jurisdiction.

Every medicare investigation has ended up rejecting private delivery, even the Senate and Alberta commissions, chaired respectively by Liberal Senator Michael Kirby and former Conservative finance minister Don Mazankowski, whose premises were to prove privatization's benefits. They and all the others concluded two-tier or for-profit health care leads to inferior health outcomes and so ends up inherently more expensive.

The waffling from Ignatieff on what is a clear abridgement of the CHA could be because he believes, like the prime minister, that health care should be left to the provinces.

Or it could be because he agrees with the privatizers' arguments: spiralling health costs are driven by frivolous patient demands requiring deterrence by user fees; health care is too expensive to be universal and publicly financed; wealthy people shouldn't have the poor in their way when they want to see a doctor; doctors and hospitals should be free to charge whatever the traffic will bear.

A new Ipsos-Reid poll places the Ignatieff Liberals 10 points behind the Conservatives and only 12 points ahead of the NDP. With the NDP starting to nip at their heels, the Liberals are cementing their image as ideologically indistinguishable from the Conservatives by walking away from the most compelling election issue on offer in decades.