Ottawa Must Move to Save Medicare
Toronto Star (September 17, 2002)
Ottawa must move to save medicare
LEAD EDITORIAL
Alberta has done what it has long said it would do and approved Canada's first private, for-profit hospital.
What's the reaction from our federal health minister, the person entrusted with safeguarding the Canada Health Act and the medicare system so beloved by Canadians?
Anne McLellan says she'll have her minions analyze Alberta's move to see if it contravenes the law, adding she wished Alberta had waited a few weeks until health commissioner Roy Romanow releases his report on medicare before making "major changes to the health-care system."
That pathetic response won't frighten Alberta Premier Ralph Klein or anyone else determined to introduce two-tier health care in this country.
Lawyers can debate forever if Alberta is breaking the letter of the law by allowing a private Calgary hospital to perform complex surgeries, such as hip replacements, that require overnight stays of up to five days.
But without doubt the province has broken the very spirit of the Canada Health Act by in effect giving some Albertans speedy medical service, at the expense of everyone else.
Already in Alberta it's possible to jump the queue and pay hundreds of dollars for a private MRI scans.
The latest move is just another in Alberta's shift toward privatization, one being watched closely by Ontario Health Minister Tony Clement.
The Calgary hospital will only accept patients from Workers' Compensation or the Armed Forces, who are exempt from Canada Health Act rules - at least for now.
Alberta Health Minister Gary Mar is already musing that he will consider expanding the hospital to other services in the future. Mar brags that the waiting time for patients at the hospital will be far shorter than for those in the public system.
Bit by bit, Alberta and other provinces, including Ontario, are chipping away at the universal medicare system. They are allowing - even encouraging - lawyers to find legal loopholes to permit private clinics and hospitals to expand their operations.
We all know what is really going on here. It's a thinly veiled march toward two-tier medicine - one for those who can pay and get faster service and one for the rest of us.
And it's time McLellan and the rest of the federal cabinet put a stop to it - and stop it now. Ottawa must also pump more money into health care to ease overcrowding and patient delays.
There is nothing new in Ottawa's failure to act. In 1999, federal auditor-general Denis Desautels blasted Health Canada's performance in monitoring the Canada Health Act, saying the department believed several provinces were violating the act but did nothing to punish them.
For some reason, Ottawa won't act. This refusal to rein in the provinces has reached such a state that some provinces, especially Alberta, repeatedly thumb their noses at the federal government and ignore Ottawa's feeble mutterings.
Alberta, for example, has so little time for McLellan and Ottawa that it didn't even have the decency to wait six weeks for the Romanow report before it approved the private hospital.
McLellan must act soon or other provinces will follow Alberta's example.
The very core of our universal health care is under attack.
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Toronto Star (September 17, 2002)
McLellan chides Alberta over clinic;
Timing could have been better, minister says
By Tim Harper
Federal Health Minister Anne McLellan said yesterday it would have been better if Alberta had waited until after the report on the future of medicare by former Saskatchewan premier Roy Romanow before approving a private clinic that will allow overnight stays.
But the minister said she didn't believe Alberta's timing was meant as a pre-emptive move against Romanow, allowing it to have a clinic up and running before he releases his report in November.
Another major study on the future of health care comes even sooner; a Senate committee headed by Liberal Michael Kirby is to make its report next month.
McLellan said her responsibility continues to ensure that the principles of the Canada Health Act will be respected and her officials have questions for their Alberta counterparts.
"Would I have preferred them to have waited? Yes," she said.
"I think it is fair to say that Commissioner Romanow and Senator Kirby will both have things to say about how we deliver health care in this country and the private-public mix.
"I think they will both have things to say about who will be covered under the Canada Health Act and how they will be covered."
McLellan made her comments as she and Ontario Health Minister Tony Clement announced Ottawa will invest $213 million for primary health care in this province.
The money will go toward several initiatives, including improving Ontario's Family Health Network, which is designed to improve access to primary health services 24 hours a day.
The program has been established in Guelph, Stratford, Mount Forest, Northumberland County and soon will be in North Bay.
The funding comes from the Primary Health Care Transition Fund which was set up in the February, 2000, federal budget.
McLellan said her main concern about the private Alberta clinic was the prospect of "queue-jumping" for insured services, but she would not elaborate.
"I've made it very plain that my officials will review the details and contact Alberta officials and if we have concerns at the end of that process, I will be taking them up with my counterpart," she said. "But it's way too soon to go down that road."
Clement, who is planning to open private MRI clinics in Ontario, would not comment on the Alberta move yesterday.
Less than two weeks ago, at a meeting of health ministers in Banff, Alta., McLellan said she has seen no evidence that the for-profit system is cheaper or better equipped to deliver medicare than the non-profit system.
Under pressure from Clement, she specified the following day that she was speaking only about private, for-profit hospitals, the very thing critics say Alberta has created with the clinic.
"This is the establishment of the first, for-profit hospital in Canada," said Mike McBane of the Canadian Health Coalition. "It is clearly against the spirit of the Canada Health Act.
"When you commercialize strategic services, there are huge national implications."
Private industry is looking for a signal that their investments are safe, and so far, Ottawa is indicating there is no problem there, he said.
The Alberta clinic would provide services that would require patients to stay two to five days.
The services would include knee, hip and back surgeries on people who are not insured by the provincial system.
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Toronto Star (September 16, 2002)
McLellan under attack over private health clinic:
Romanow report being "sabotaged"
By Tim Harper
OTTAWA - Federal Health Minister Anne McLellan is under growing pressure to block the opening of a private Alberta health clinic that critics say is "sabotaging" the report on medicare's future being prepared by Roy Romanow.
A spokesperson for McLellan said federal officials are reviewing the "details" of the private, for-profit surgical clinic that allows overnight stays of two to five nights.
"She will be guided by the Canada Health Act and if she has to act, she will act," Farah Mohamed said.
Alberta health minister Gary Mar gave the go-ahead to the Calgary clinic Friday, saying it would ease the strain on the public system. He authorized surgeries, such as knee, hip and back operations, on people who are not insured by the provincial system.
The Canadian Health Coalition said yesterday McLellan is complicit in the dismantling of public health care in this country.
"There is no question that this is a breach of the Canada Health Act," said spokesperson Mike McBane.
"We think at the very least there should be a halt to all moves toward privatization until we hear from Romanow and the first ministers have a chance to try to forge a consensus.
"Otherwise, McLellan is standing by and allowing Romanow to be sabotaged. If he comes out squarely against such moves, she will allow Alberta to say, `Too late, we already have our clinic up and running.'
"The timing of their announcement is clearly meant to pre-empt Romanow."
Liberal Senator Michael Kirby will release a major medicare study by his committee next month and former Saskatchewan premier Romanow is scheduled to release his landmark report in November.
Prime Minister Jean Chrétien, who will be in Calgary Wednesday, has promised a first ministers summit on the future of medicare, probably early in 2003.
McLellan will hold a press conference here this afternoon with Ontario Health Minister Tony Clement where she is expected to address the controversial clinic.
McLellan and Clement will jointly announce Ontario's share of some $800 million in federal funding available for primary health care.
The clinic's approval was paved by Alberta's Bill 11 - The Alberta Health Care Protection Act - which sparked a national controversy two years ago, led to huge rallies in the province and strained relations between Alberta and Ottawa.
Premier Ralph Klein accused then-federal health minister Allan Rock of a "drive-by smearing" when he spoke out against the bill before a select Calgary audience.
But Rock and his officials could never find a breach of the Canada Health Act under the provincial legislation and after much public posturing, did nothing more than appoint more inspectors - called "medicare cops" - to monitor the situation in Alberta.
Mar met with McLellan last week and informed her of the pending approval for the clinic. Federal officials confirmed she was concerned the clinic would allow queue-jumping but Mar assured her it would not. Alberta has interpreted that as Ottawa giving them the green light.
But a federal official denied that, saying it is not McLellan's role to give approval, but to monitor it for infractions of the federal act.
At a New Democratic Party leadership forum in Edmonton Saturday, all candidates slammed the decision to open the clinic.
Toronto councillor Jack Layton called the move "the beginning of the unravelling of the medicare system . . . ."
Since assuming the health portfolio in January, 2002, McLellan has come under periodic fire for leaving the door open to more privatized health care and for taking a too conciliatory view of health-care delivery in her home province of Alberta.