Being Charged? Bust the Crooks!

Federal / Provincial Health Wars

Colleen Fuller

In 1940, the Royal Commission on Dominion-Provincial Relations was struck to examine constitutional responsibilities in Canada, including in the war zone known as health care. In the Constitution, noted the Commission, the provinces were given responsibility for most hospitals, while marine hospitals and public health – for example, quarantine – fell to the federal government. It was likely, the commissioners said, “that, in the course of time...conditions would warrant national Health Insurance or a national system of Workmen's Compensation. It would, therefore, seem desirable that rigidity in the matter of jurisdiction should be avoided."

“In the course of time” – that is, in the 1960s – the House of Commons passed legislation to establish a national health programme, something that Canadians had demanded since the early part of the 20^th century. The legislation was updated in 1984 when the Canada Health Act was passed prohibiting user fees and requiring provinces to remove barriers to access by people who need health services.

The only thing that Ottawa and the provinces seem to agree on is creating investment opportunities in the emerging “health industry.” When it comes to upholding the Canada Health Act, however, cooperation disappears. This is exactly contrary to what most Canadians have said they wanted since polling on the question began before WW II.

Beginning in the mid-1990s, public opinion polls probed Canadians to see how they were responding to the erosion of the health system and the welcome mat that governments were laying out for big business. Consistently, when asked, Canadians said that federal and provincial governments should cooperate in health care, with Ottawa taking a lead role. In one important survey done for the National Forum on Health in 1996, only two per cent said business should have a significant role in health care – suggesting that Canadians have more brains than the politicians pushing privatisation.

Cooperation is not just a demand of the overwhelming majority of those who insist we live in a democracy. It also is necessary to ensure that the Canada Health Act, the federal law that prohibits user fees, is enforced. Without it, the law isn’t worth the paper it’s printed on.

Mark “I'm-a-physician” Godley, co-owner of the False Creek Surgical Centre, said he doesn’t “see anything wrong with a system where an individual can use their own resources for their own health care.” But it doesn’t matter what Mark “he’s an investor” Godley thinks, it only matters whether his business conforms to the Canada Health Act or not.

Recently it was revealed that Godley’s surgical centre charged patients for knee surgery in May 2000, and again in January 2001. The federal government subsequently withheld over $4,600 in transfers to BC. Colin Hansen, the BC health minister, said he was glad, adding that the province itself doesn’t have the tools to enforce the CHA. (It does, however, insist it has jurisdiction…) Newspaper reports are filled with stories about patients paying a very high toll to queue-jump. In the meantime Health Canada insists it’s waiting for the calls to roll in from the sick and post-operative armed with evidence in the form of invoices, receipts and so on.

The only question about the Canada Health Act is whether anyone up there in the halls of government cares enough to enforce the law of the land. Every province in the country is violating it and consequently more and more Canadians are being denied access to the health care they need. If you are paying fees for health care – report it!