The Undermining of the Canada Health Act
University of Alberta
In the past, Canada’s government-funded, universally accessible, health care system has been praised and admired both at home and abroad as one of the finest in the world. A great source of pride and comfort for many Canadians is that it is based on five fundamental principles. Principles that are a reflection of the values held by Canadian citizens since the formation of Medicare in 1966. These principles were reinforced in the Canada Health Act, (CHA), of 1984 and state that the Canadian system is universal, accessible, portable, comprehensive and non-profit.
With increasing concerns of debts and deficits, Canada’s publicly funded health care system has recently become the target of fiscal attack. Efforts to reform and restructure the system have produced few results. Currently, some governments throughout the country are looking towards a more radical approach. An approach that would see not only the reform and restructuring of the method of operation of the current system, but that would change the system entirely. The proposed idea? In Alberta, it is to increase the role of the private sector in the current system.
On December 29th, 1999, Nancy MacBeth leader of the Alberta liberal party was cited in the Edmonton Journal as saying: ” There’s ample evidence’ that the Alberta government’s plan to expand the role of private health-care will contravene the Canada Health Act.” This is the strongest argument against privatization. It reflects the fears of many Albertans and Canadians; the fear that a two-tier system similar to that of the United States will develop. The fear that the system which was built upon values reflected in five principles will be eroded and replaced and that they will be the ones left to suffer the consequences. Privatization of health care would undermine the principles of the Canada Health Act and as such would undermine the integrity of the health care system.
The evolution of Health Care
In 1966 one of Canada’s most prided achievements to date was introduced to the Canadian Health Care system. Medicare was a daring and innovative concept pioneered by Canadians for Canadians. It revolutionized health care. Canadians overwhelmingly supported the new system as it reflected their values and the import they placed on universality and equal access to health.
Now, in the dawn of the millennium, the ideals of the same system are in jeopardy. Albertans are at present feeling the effects of restructuring. Accessibility and quality are being threatened due to cutbacks coupled with a lack of funding. There is a consensus now between medical professionals, the public, and the government that the health care system is deteriorating. It is failing to provide the quality of care promised in the CHA and prided by so many Canadians.
Yet the strings on the public purse continue to tighten. Transfer payments from the federal government continue to decrease as provincial debt loads increase. And, although the minister of health and the premier assured them that the costs of health care were doubling or even tripling, Albertans have witnessed a steady decline in government spending on health care. The proportion of gross domestic product, (GDP), which Alberta allocates to health care is ranked last among the ten provinces, (Taft, 1997). Albertans now find themselves with a struggling health care system and a waiting list.
The proposed solution from current Alberta government would see the health care system incorporate the private sector. The government Most of all the government is looking to decrease cost, increase accessibility and efficiency. *****
Universality and Accessibility vs. Choice
Universality and accessibility go hand in hand. They are the principles that assure that each Canadian regardless of financial situation, will have equal opportunity to access the same level of care. The lack of a private market in the current system, some will argue, limits the individual’s freedom of choice. Supporters of privatization maintain that these principles conflict with Canadians’ right to choose; the patient’s autonomy to choose to pay privately, and the physician’s choice to provide preferential treatments to those payers ( Dirnfeld, 1996; Gordon, Mintz & Chen, 1998). Increasing choice in this manner would lead only to such detrimental practices as “cream skimming”, (Dirnfeld, 1996). Insurance companies