Five Things You Should Know About How Social Union Affects Medicare

Medicare is the cornerstone of our health care system. The five principles of the Canada Health Act -- universality, public administration, comprehensiveness, accessibility and portability - ensure that all Canadians receive needed health care regardless of their income or where they live in the country. Years of federal funding cuts, combined with calls for a two-tiered (public/private) system have undermined Canada's public health care system and threaten to ruin it. Paul Martin=s 1999 budget tried to undo some of the damage done in past budgets, a concern highlighted by the recent Health Accord signed between the Prince Minister and the provincial premiers. But the new Social Union deal, far from removing threats to Medicare, may actually serve to entrench them and ultimately destroy our most cherished social program..

1 It gives provinces more control

Since 1986, cumulative cuts in federal health transfers to the provinces have totalled almost $36 billion. This has led to a corresponding drive

among provinces to de-list services, slash hospital budgets and off-load functions to municipalities and the private sector. Finance Minister Paul Martin recently announced a reinvestment of $11.5 billion into health care over five years. This falls far short of restoring full funding. In addition under the new Social Union agreement, provinces may choose to spend any money designated for services not covered by the Canada Health Act, on either public nonprofit care, or private for-profit care.

2 It promotes privatization

The Canada Health Act covers only insured doctor and hospital treatment. Many areas of the burgeoning private health care industry, such as prescription drugs, are not covered. Home care, for example, is one of the fastest-growing areas of health care in the country. The Harris government

in Ontario has already moved to privatize home care, phasing in a system that favours for-profit companies B many of which pay low wages, offer no benefits and replace trained nurses with casual labour. As more and more Canadians require home care, health services may follow patients out of hospitals and into homes _ in effect, privatizing Medicare through the back door.

3 It increases corporate control

While the share of public spending on health care has gradually decreased, the share of private spending has steadily increased from 26.7% in 1986 to 32% in 1997. The growing market for private health care in Canada has attracted some of the giants of the industry, including Olsten Corporation, the largest provider of home health care in the United States. Olsten, which operates in Ontario, relies heavily on non_unionized, part_time employees. The growing corporate role in health care is leading more and more Canadians to be cared for by companies whose primary concern is the size of their profits, not the health of their patients.

4 It reduces the public role

Privatizing home care now could prevent govern- ments from ever introducing a publicly delivered home care program in the future. Under the North American Free Trade Agreement (NAFTA), U.S. companies such as Olsten could threaten to sue Canada for millions or billions of dollars in lost and future profits if a public program were introduced. Simply the threat of such a lawsuit could prevent governments from ever introducing a public home care plan.

5 What the federal gov't should do

First, bring home care and other health services under the Canada Health Act to ensure they are covered by the five principles of the Act. Second, restore the remaining tens of billions of dollars cut from federal health transfers since 1986. Third, uphold public delivery as well as public funding as a primary objective of Canada's health care system. Only publicly delivered and funded services can ensure that health care remains both cost_effective and accountable to the Canadian public. Fourth, get health care out from under NAFTA so that new public programs _ like home care - can be introduced. # CANADIAN PERSPECTIVES WINTER 1999

Information from Ont. Coalition for Social Justice.