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News Release
Maintaining the principle of
universal access to health care
15 January 1995
Letters to the Editor
The Globe and Mail
Diane Marleau has acted with courage and integrity in insisting
that provincial governments maintain the principle of universal
access to health care. She has acted wisely when she has informed
provincial governments that they will be penalized for allowing
user charges, including private clinics. British Columbia has responded
appropriately in resolving to comply with the federal directives.
In contrast, in a series of editorials attacking Ms. Marleau, the
Globe and Mail has joined the ranks of those conducting an
assault on the principles of Canadian national health insurance.
What the Globe, in its editorial of January 11, characterizes
as "hoary philosophical grounds" is nothing less than
the principle of equal access to high quality care regardless of
income. When we tolerate health care in private clinics for those
who can pay, we are permitting two-tiered care. When governments
subsidize such clinics with public dollars, they are actively encouraging
the destruction of equal health care for all Canadians.
The Globe editorial suggests that private clinics can save
money. The experience in the United States, which spends over 14%
of its gross national product on health care, in comparison to less
than 10% in Canada, shows us the fiscal consequences of two-tiered
health care. A universal, single-payer health system is the most
efficient way of delivering medical services.
Further, the Globe suggests that private clinics, by siphoning
off some patients, can improve service in public facilities. Both
health personnel training and medical technology development are
funded from the public purse. Private clinics drain these resources,
and thus weaken the public system. Private clinics do indeed provide
an escape valve, but its effect is to reduce the pressure to maintain
high quality public health services.
The call for a two-tier system comes at a time when the Globe
and Mail, along with a number of other powerful voices, is advocating
a cut in social expenditures, including health. Those with higher
income who have the strongest political voice in our country will
benefit most from a two-tiered system and governments will have
little incentive to maintain the public tier that most Canadians
use. If those with privilege and political power much seek health
care within the public system, governments will find a way to ensure
continuing high-quality care within that system.
Congratulations, then, to Diane Marleau for working to save a magnificent
system under intense threat.
Sincerely,
Gordon Guyatt, M.D.
Ian Scott, M.D.
Medical Reform Group of Ontario
Subject Headings: Abortion
Rights – Community
Health – Community
Health Centres – Drug
Substitution – Epidemiology
– Epidemiology/Community
Medicine – Health
Administration – Health
Care Budgets – Health
Care Cost Containment – Health
Care Costs – Health
Care Delivery – Health
Care Finance & Fund-Raising – Health
Care in Canada – Health
Care in Ontario – Health
Care in the U.K. – Health
Care in the U.S. – Health
Care Myths – Health
Care Reform – Health
Care Resources – Health
Care Services – Health
Care Workers – Health
Clinics – Health
Determinants – Health
Economics – Health
Expenditures – Health
Issues – Health
Policy – Health
Policy/Seniors – Health
Service Organizations – Health/Social
Justice Issues – Health
Statistics – Health/Strategic
Planning – History
– Hospitals
– Labour
Medicine – Medical
Associations – Medical
Costs/Foreign – Medical
Education – Medical
Ethics – Medical
Human Resources – Medical
Personnel – Medical
Research Funding – Medicare
– Medication
Use – Medication
Use/Seniors – NAFTA/Health
– Occupational
Health & Safety – Patients'
Rights – Pharmaceuticals
– Physician
Compensation – Physician
Human Resources – Pro-Choice
Issues – Public
Health – Publications/Health
– Social
Policy – Women's
Health
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