Ignoring the privatization debate at the CMA.

Guy Caron
August 27, 2007

If they don't say the word maybe the debate will go away. This must have been the plan for Canadian Medical Association (CMA) leaders as they held their annual general meeting in Vancouver this week.

The word is "privatization," and the debate is whether or not Canada's health care system needs privatization to be financially sustainable.

After releasing a lengthy policy document at the end of July extolling the supposedly urgent need for health care privatization, less than one month later, the CMA has barely broached the topic as doctors from across the country gather to set the CMA agenda for the next year.

Health Minister Tony Clement started the trend with his address to CMA delegates on Monday. In his view, the medicare system is financially unsustainable and is in need of "innovation". (In other words, watch for the federal government to endorse the idea of using public money to pay private, corporate-owned clinics for surgeries.) But that's as far as Minister Clement went. He switched topics to use his time to talk to doctors about the government's war on drugs.

When asked by a CMA delegate about the government's willingness to open up the Canada Health Act for revisions, presumably to allow what the CMA suggested in their policy paper - private clinics for surgeries, doctors working in both the public and private sectors and private health insurance, Minister Clement replied it was not on the government's agenda.

Even the delegates themselves backed away from the issue.

It wasn't until two days into the annual meeting, that the Ontario Medical Association put forward a motion that would have the CMA ask the federal government to open the Canada Health Act and allow co-payments (when people pay a fee to see their doctor) and health savings plans (where you save your own money to pay for things like home care, long term care and medications.)

Reports from inside the CMA meeting indicate that debate was brief and the media was not present in the room, having been called away to cover a press conference in another room. The motion was narrowly defeated by a vote of 50 per cent against and 48 per cent in favour.

Does this show that the CMA leadership is moving away from its privatization agenda? On the contrary. Dr. Brian Day confirmed how he sees the CMA should move forward in his inaugaration speech at the end of the conference. Like Minister Clement, he spoke of the need for "innovation" in health care delivery. He pushed for the government's use of private clinics to deliver services, and said people should be able to buy private health insurance. His entire speech focused on using private health care to "improve" the public health system.

What he didn't provide is the evidence supporting his claims. He didn't tell CMA delegates that studies show private health care has higher administration costs and lower health outcomes. He didn't say that other countries - New Zealand and Britain, for example - no longer see private health care as the solution to wait time problems. And he didn't tell delegates about examples all across Canada that show wait times can be reduced in the public system by centralizing wait lists, offering related health services in one location and using better technology.

If the CMA truly believes that health care privatization is the way to go, then it should allow its members to have an open and frank discussion about it. At this point, the debate has been restricted to a few medical politicians, and very little effort has been made to obtain the input of these Canadian doctors who have no time or interest in these politics.

It appears the CMA's privatization agenda is being led from the top with little to no input from the doctors the CMA purports to represent. There is no doubt we will be hearing more about privatization from Dr. Day.

Given the lack of discussion about health care privatization at the CMA annual meeting, however, you have to wonder if he truly represents the views of CMA members.

Guy Caron, Health Care Campaigner, Council of Canadians

Visit the Profit is not the Cure website for more information about public health care.