by Diana Gibson
In his 2002 Throne Speech Reply, Stephen Harper said: "A government monopoly is not the only way to deliver health care to Canadians. ...It (the federal government) must remove any barriers, any chill, to increase private capital investment plans that the provinces have for our health care system."
In the election campaigning over the past week, Stephen Harper announced that, if elected, he would "not tolerate a parallel private system."
Perhaps Stephen Harper thinks that the Canadian public has collective amnesia, or that we all have early onset Alzheimer's.
Not only is his new election position anathema to all he has said in the past, but it directly contradicts his actions today — specifically his alliance with the likes of Ralph Klein and the Alberta Conservative government.
 | | Aon Corp, hired by the Alberta government to look into the viability of expanding private health insurance, paid out a massive settlement in a fraud case. |
The Alberta Conservative government has already established private clinics, and has expressed an interest in allowing doctors to practice in both the public and private systems. There is already a parallel private system about which Stephen Harper has not complained. And now Alberta is taking greater leaps towards the American private health care model. The Alberta Conservatives have contracted a Canadian subsidiary of a US private insurance company to propose a system for private funding for not only supplementary but all non-urgent health care, including services currently covered by Medicare.
Again Stephen Harper is silent; in fact, according to Klein, he has spoken with Harper on this and "his response is that's fine."
Alberta is not the only province that is pushing forward with a parallel private system — initiatives are well underway in BC and Quebec. Stephen Harper and his party have not opposed those initiatives, either.
Health care is a key issue this election. Let us recall that the federal government did not fall because of Gomery or corruption scandals, despite what the opposition parties and some in the media would have us believe. It fell because of health care — the tenuous alliance between the NDP and Liberals fell apart over an inability to achieve agreement on what was needed to protect Medicare from the current onslaught.
The recent Supreme Court decision out of Quebec allowing private health insurance to compete with Medicare has also made this a critical juncture for Canada's health care system, and by extension a critical election.
Under the guise of wait times, there is great pressure from some quarters for a shift to increased private funding and private delivery in health care. This, in spite of there being overwhelming evidence that private funding or private delivery contribute to nothing but increased wait times.
And now, in addition to his empty promises on parallel systems, Stephen Harper is trying to reassure voters by promising to uphold the Canada Health Act. This is not going to make me rest easier at night. Partly because for the entirety of his political career, Stephen Harper and the parties he has been associated with have opposed the Canada Health Act and lobbied for the federal government to get out of health care.
Harper's relationship with Klein also calls into question his commitment to upholding the Canada Health Act. In fact, Klein has consistently said, "What we do may contravene the interpretation of the principles of the Canada Health Act and we ought to be ready for a firestorm."
But I am also not reassured because what is needed is far more than upholding the Canada Health Act. The act needs to be strengthened to achieve the goals it was set out to achieve: Establishing national standards for a public health care system that is publicly administered and universally accessible.
Private health insurance will not be accessible for those who cannot afford it or who have any existing health care issues — pre-existing conditions. It is also much more expensive — the areas where health care costs are increasing the most are exactly those that have the highest level of private involvement.
Finally, there is the issue of accountability. No one should be surprised that the US private consulting firm, Aon Corp, hired by the Alberta government to look into the viability of expanding private health insurance, paid out a massive settlement in a fraud case ($190 million settlement for alleged fraud and anti-competitive business practices). These kinds of settlements are not uncommon in the private health-insurance sector.
Public health care insurance does not discriminate against people who need health care: There is no concept of a pre-existing condition and access is guaranteed.
When we first established Medicare we replaced a patchwork of expensive, ineffective private insurance schemes with the one consistent, universal insurance program. This system was established as being more efficient, saving money and improving access for those in need of health care. And the public system is still all of those things.
Canada needs to elect a government with a true commitment to strengthening the public insurance program and public and non-profit delivery systems. Actually opposing the growth of the parallel system requires being willing to stand by the public system, invest in it, and look for public solutions to solve problems — commitments Stephen Harper has not made.
Diana Gibson is the Research Director of the Parkland Institute, a non-profit, non-partisan research network based at the University of Alberta. She is also co-authoring a forthcoming book with Colleen Fuller on health care and private insurance in Alberta.
Related addresses:
E-mail: parkland@ualberta.ca
URL 1: www.ualberta.ca/parkland
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