The Commission on the Future of Health Care in Canada is in full swing. So is the campaign against it. Industry representatives in government are working openly to preempt the Commission and set the terms of the public debate about the future of Medicare. Canadians are entangled in a sophisticated PR campaign to push Medicare's privatization. The tactics will get more manipulative and the debate will heat up in the coming weeks.

The attack on public Medicare is based on two assumptions that are used to justify the claim that Medicare is unsustainable.

1. Health care spending is out of control.

2. Public demand for health care services is out of control

Watch for new Ontario Health Coalition fact sheets on these issues coming soon.

The Ontario government has changed the way it reports health spending to make it look like it has gone "through the roof." Prior to last winter, the province reported health spending as a percentage of total operating spending. Now the government is reporting health spending as a percentage of program spending. Claiming that health spending went from approximately 37% of operating spending to 44% of program spending doesn't actually mean much since they are comparing apples and oranges. The bottom line? According to the Ontario Ministry of Finance's own figures, health spending as a percentage of total operating spending has remained fairly constant ranging from 35% in 1997 to 37.4% in 2001. Even this modest increase does not indicate major new spending. Instead it reflects reinvestment after the deep cuts of the mid-nineties and the effect of shrinking total operating spending as the government slashed education, the environment, social assistance and other programs.

Always a boost to health activists, poll after poll show that the overwhelming majority of Canadians support public Medicare. Recently, though, health care privatizers have commissioned several polls in an attempt to find soft spots in that support. Notably, a recent Environics poll commissioned by the Ontario Hospital Association and released in November classified respondents into categories reflective of the degree of their support for public Medicare and what types of privatization they might find palatable. The National Post commissioned a poll reporting on degree of support for "health choice" - an outrageously manipulative euphemism for privatization.

At a meeting in August the provinces agreed to begin work on their proposal for revamping the health system - looking at such items as equalization program funding, coordinated listing of treatments and procedures and pharmaceutical costs. Ontario, Alberta and British Columbia have taken a notably aggressive approach. Using a combination of behind-the-scenes rumour, public "musings" and more blunt statements, the country's most right-wing premiers are threatening to impose user fees, to engage in deeper delistings of covered services and to "declare war" on the federal government by directly attacking the Canada Health Act.

Headed by Senator Michael Kirby, Board member of private nursing home giant Extedicare Inc., aided by Senator Wilbert Keon, a bigwig at Worldheart corp. and Senator Yves Morin in charge of facilitating the commercialization of health research in Canada, this Senate committee rejigged the timing of the release of its reports conveniently preempting Romanow. In a report released in November, Kirby's committee sets out a list of ways to privatize the health care system, calls for an end to the archaic public Medicare model and suggests tossing out the "public administration" principle of the Canada Health Act. Without bothering to provide any evidence or support, and in contradiction to the committee's previous papers, the report suggests that the federal government consider such discredited notions as privatized service delivery, user fees and medical savings accounts in a bid to create "the 21^st century health service industry".

In a variation on Kirby's theme, Don Mazankowski, former Deputy Prime Minister under Brian Mulroney, released an Alberta government-commissioned report this month. Like Kirby, Mazankowski is involved in the private health industry, sitting on the Board of insurance company Great West Life. Increased provincial health plan premiums, delisting, and medical savings accounts featured prominently in his report. In interviews and public statements, Mazankowski is relentlessly repeating the health privatizer mantra of out-of-control health spending and the necessity for the "reform" - read "destruction" - of Medicare.

Provincewide Campaign to Defend Medicare

OHC Action Plan

Ontario Updates: Homecare, Private Cancer Treatment, Public Asset Sell-off, Homeless Survey

National Medicare Update: Kirby, Romanow and Mazankowski, provincial shenanigans and upcoming dates.

Standing Together for Medicare: A Call to Care