Michael Kirby is typical of the voices crying for more private health care - he's an influential man who is closely connected to the multinational private health industry. Health privatizers represent a tiny minority of Canadians, but they have fostered powerful connections in top legislative bodies across the country. All too frequently, like Kirby, they are our top legislators.

Kirby's Senate Committee - Social Affairs, Science and Technology - has won itself a mandate to look into Canada's health system, and specifically the federal government's role in it. It is rare for a Senate committee to be on the media's radar. It is a testament to Kirby's influence, his media savvy, and access to resources that he has managed to insert his committee into the middle of the current health care fray.

Why, you might ask, is a Senate Committee, headed up by a board member of a for-profit health corporation, working on the Medicare question just when a Royal Commission is travelling the country to seek input from ordinary Canadians on exactly that issue?

Kirby's original plan was to come up with five reports on different aspects of health systems in Canada and other countries. Now he's going to come out with six reports. The final, absolutely last report (he promises), will be released - not coincidentally - right before Roy Romanow comes out with his recommendations in November. This is not the first time Kirby has pre-empted Romanow. In September, Kirby changed the planned order of release of his reports. In what critics speculated was a clever manoeuvre to set the terms of the debate about the future of Medicare, he exploded into the headlines with a missive that reads like a "how to" list for health care privatization. Lots of media attention to Kirby's sideline job as a board member of for-profit nursing home giant Extendicare seemed to annoy the Senator but didn't knock the wind out of his sails. He has spent the ensuing months criss-crossing the country making speeches, meeting with editorial boards, and drumming up attention for his plan to further dismember Medicare.

Kirby's latest report - number five of six - sets out three options for Medicare, as against the four scenarios contained in Romanow's Interim Report. Delisting of the amount and type of services covered, two-tier health care and tax increases are Canadians' choices, according to the Senator whose main media message is that "Medicare is unsustainable."

The pro-privatization PR campaign has just begun. In the fall, Kirby's final report will pre-empt Romanow again. Those of us who care about our future will have to push to frame the discussion on our terms: that Medicare's sustainability relies on the enforcement of all the principles of the Canada Health Act; that public health care needs expanding and modernizing; and that user fees, two-tier health care and privatization will destroy medicare, not save it.