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News Release

Private health facilities for the well-off
violate the principles of the Canada Health Act

December 13, 1994

Letter to the Editor
The Globe and Mail

The Globe, commenting on Health Minister Diane Marleau's declared intention to enforce the Canada Health Act in Alberta, questions whether private clinics constitute a violation of the Act (December 2).

The clinics charge a "facility fee" which buys quicker care for procedures such as cataract surgery or magnetic resonance imaging scanning than patients receive in public institutions. Quicker care is better care and no amount of wrangling about legal niceties can obscure the fact that private health facilities for the well-off violate the principles of the Canada Health Act.

The Globe defends private clinics because they relieve pressure on scarce public resources. That is exactly the problem. Events in the United States tell us that the poor do not have the political force to maintain accessibility and quality in a public system directed at their needs. If we put aside the Canada Health Act and allow the middle class to buy better care privately, the deterioration of public health care will follow quickly.

As long as public health care is the only health care, and the privileged have no where else to shop, health care has a chance of withstanding the current budget-cutting mania. We must maintain the pressure for high-quality, prompt public health care.

Finally, the Globe suggests that clinics may be a more efficient way than hospitals to deliver some aspects of care. Quite right, and we should explore this option. However, the exploration and implementation must be done within a comprehensive national health care system that maintains the principle of universal access.


Gordon Guyatt, M.D.
Murray Enkin, M.D.
Medical Reform Group of Ontario

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