Americanization Threat to Medicare in Ontario

By Caplan, Elinor | Canadian Speeches, October 1996 | Go to article overview

Americanization Threat to Medicare in Ontario


Caplan, Elinor, Canadian Speeches


A sharp attack on health care changes in Ontario is sounded by a former minister of health for the province. Criticized are reductions in government health care spending, centralized control of a systems approach to health care management, introduction of user fees, closing community college nursing programs, shifting costs from taxpayers to the private sector, and other measures. Prepared notes for a speech delivered to the annual meeting of the Registered Nurses Association of Ontario, Ottawa, April 18.

We are down a very different path than the one I envisioned as Ontario's minister of health.

The Tory Common Sense Revolution said "We will not cut health care spending, it is far too important." They promised to protect health care. People believed that.

I warned during the election that it is not common sense to believe that it is possible to balance the budget and cut income tax rates by 30%, without hurting people and without touching the one-third of government expenditures that fund health care.

The health of Ontarians is being sacrificed to ensure that the Harris government can deliver their pledge to cut income tax rates by an astounding 30%. That's a huge benefit for the most privileged in our society. Redistribution from the poorest to the best off is not healthy public policy.

Frankly, I am frustrated. Change is inevitable, but the Harris/Wilson restructuring approach is not, in my opinion, common sense, and is not good for our health.

Even with my skepticism, I would not have predicted the situation today. And I would never have predicted Bill 26, an omnibus bill, ridiculously called The Savings and Restructuring Act, which gives ministers, particularly the minister of health, unprecedented and absolute powers over every aspect of health care.

The health policy provisions in the bill are astounding. Cabinet has the power to define "medical necessity." The minister has the unilateral power to close or amalgamate hospitals, and the government cannot be sued for any decisions. The minister has the power to control all aspects of hospital operations; he can now decide what service, and what quantity of care. The minister has the power to reduce, suspend, withhold or terminate funding to a hospital if he considers it to be "in the public interest" to do so. Originally the bill did not include "access" to services as part of the minister's public interest test consideration. These are just a few examples.

The 18% transfer cut to hospitals will result in job loss and that means service cuts and Bill 26's powers and policy implications have the potential to dismantle and Americanize Ontario health care in the name of restructuring. So much for the Tories first and most important commitment.

These are cynical, difficult and challenging times of rapid change. A changing economy, changing demographics, and changing technologies will continue to place enormous pressures on Canadians, on our governments, our social safety net, our quality of life, and on our expectations and our values. The fiscal realities of deficit and debt are very real continuing pressures.

Provincial governments across Canada, of all political stripes, must deal with all of these realities. How they do will impact on every aspect of our life and health.

People are still reeling from the effects of the recession. The Common Sense Revolution fiscal strategy actually predicted slower economic growth. They called it an economic drag. Just what we need. I don't think so. Many of us realize that economic and social policies are not solitudes.

I believe that the Tory/Harris government's response to the fiscal pressures facing Ontario have lost sight of what is best for our health.

It is true than non-controversial housekeeping omnibus bills are common. But Bill 26 contained very significant and controversial changes. This massive bill affects or changes over 47 pieces of legislation. …

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