Last Updated: Friday - 09/24/2010
Week of May 8, 2000
Bill 11 violates spirit of medicare
By SHEILA HOGAN, STEPHEN HOGAN, LAURIE LANG, MAUREEN ADACHI
Special to the WCR
As psychiatric nurses and concerned individuals, we welcome the opportunity to contribute to the current discussion on health care.
We are concerned that the proposed Health Care Protection Act (Bill 11), instead of protecting the five principles of health care as set out in the Canada Health Act, will further the erosion that privatization has begun over the last number of years.
We ask that Bill 11 not be enacted. We have concerns about the purpose of, and who will benefit most from, this legislation.
Specifically, we believe that health care is a basic legal and moral right as defined in Canadian law. The rights of all Canadians under the Canada Health Act have been eroded in recent years by for-profit privatization.
In Alberta, we have experienced uninsured diagnostics, facility fees, service fees and extra billing. Bill 11 serves to further this process and erode our rights to a publicly administered, comprehensive, accessible, portable and universal plan.
For-profit health care siphons off limited resources from the system as a whole. The research does not back up the premise that for-profit health care is cheaper or reduces waiting lists.
If efficiencies are possible that allow for profit, use these innovations in the public system. Then savings are realized for the benefit of the public, not profits for the benefit of individuals and corporations.
If dedicated operating rooms, specialized and free-standing clinics lead to savings, set these up in the public system. Take a mothballed operating room, set up only the equipment needed for minor surgery, and see if this reduces waiting lists, or leads to efficiencies. If it does, open more of them. If they don't work, they can be discontinued. It will not be so easy to back down from private surgical clinics if they do not achieve savings or other benefits.
Expansion of home care, and alternative forms of home and long-term care are other useful areas for reform that will ease the strain on the hospital system.
Individuals coping with mental illness can be very vulnerable, often marginalized socially and economically. Bill 11 provides a blueprint for the selling of enhanced medical goods and services, and non-medical goods and services. Being subjected to enhanced fees, service fees and uninsured services will leave them at risk of exploitation.
The trust between the health care professional and the patient may be seriously compromised with the individual left to wonder if a service is being offered for the relief of suffering or for profit.
The move to for-profit health care raises a serious concern about conflict of interest, both in the potential for steering individuals to private clinics, and in the offering of services for profit in the way of enhanced or uninsured services. The mentally ill will require increased levels of protection and advocacy in this type of system.
A stated aim of the bill is to regulate existing private surgical clinics none of which currently have overnight stays. The provision allowing for overnight stays would suggest the result will be the creation of new and expanded private surgical clinics to allow for more serious surgeries requiring stays longer than 12 hours. Otherwise, why allow overnight stays?
Bill 11 gives the College of Physicians and Surgeons the right to accredit private surgical facilities that allow overnight stays. Bill 11 fails to detail why these private surgical facilities should be treated differently than public surgical facilities which have overnight stays, and which currently have a broader independent council to perform that function, not the College of Physicians and Surgeons.
A proposed amendment purports to prevent queue jumping by the purchase of uninsured services, which is a serious oversight in the original bill.
We question how queue jumping will be monitored, given that the College of Physicians and Surgeons only accepts written complaints by the wronged party. It is unlikely that the person allowed to queue jump by purchasing services privately will complain and those left behind on the waiting list have no way of knowing what is happening.
Bill 11 claims it is committed to the five principles of the Canada Health Act. For-profit health care may not technically violate the Canada Health Act, but it does violate the spirit of the act, which is to provide health care to all Canadians on an equal basis, on a non-profit basis, without the payment of out-of-pocket fees.
Adding to our sense of alarm is the fact that some prominent supporters of the bill, including Dr. Dennis Modry, are also on record as not supporting the principles of the Canada Health Act.
We believe the principle of accountability is eroded by the unelected nature of regional boards, and in the broad discretion given to the minister to make significant policy decisions, while prohibiting his decisions from being reviewed by court action. The proposed amendment does not go far enough to remedy this.
The bill fails to address how problems will be resolved, how decisions will be reviewed, and where an advocate will go to address potential abuses such as extra billing, and selling of unnecessary services.
Regulations not yet specified will affect many health care professionals in addition to the College of Physicians and Surgeons, as well as every member of the public. There should be an opportunity to provide input into regulations attached to the proposed act.
Tax dollars are given by all individuals to be administered in the most efficient and effective way for the benefit of all Albertans. For-profit enterprises unfairly benefit individuals or corporations to the detriment of the overall tax base and individual taxpayers.
We do not support the contention that the provision of the basic right to health care can be likened to the sale of alcohol or the provision of paperwork.
The future of our Canadian public health care system is too important to be decided by party politics, by closure and by the prohibition of free votes. We ask that the proposed Bill 11 be withdrawn and the opportunity for meaningful public consultation and a public referendum be provided.