Tuesday, January 11, 2005

Private Klein

This blog's top newsmaker of 2004 is off and running in 2005, grabbing headlines with new talk about private health care.

He didn't reveal the details but he's said it will push the bounds of the Canada Health Act (well, duh...if we're talking private health care, that's a given). This raises a few questions:

1. What are the specifics of this plan?
2. When will the plan be revealed?
3. Will Albertans be consulted about this first, as Klein promised during the provincial election?
4. If the plan is judged to violate the CHA, will Klein still go ahead with it?
5. Will Martin "stand up to Ralph" as he promised during the federal election?

There's a lot of talk that Ralph is sticking around to enjoy the Centennial parties and will coast this year. I don't buy that for a second. Chretien's last year in office was his best, in my opinion. We saw Kyoto, marijuana decriminalization, no to Iraq, campaign finance reforms and same sex marriage. If 2005 is Klein's final year, we're going to see his attempt at a legacy agenda. What will this legacy agenda have in it? Apart from private health care, it's hard to say. But my prediction is that it will be true blue, the Alberta media is going to love it, and I'm going to hate it. As will most left of centre Canadians.


  • This seems to be a regular tactic of Ralph's. Hint at major changes, then guage the public reaction before outlining exactly what those changes will be. Whatever you think of his politics, he's a pretty good tactician.

    By Blogger Timmy the G, at 1:50 p.m.  

  • Actually, the Canada Health Act does not prohibit parallel private health care . I'm actually interested to see what comes out of this.

    The circus continues. Liberals pretend that they are opposed to private delivery, and the CPC and the Provinces pretend that the Canada Health Act prevents them from enacting private delivery. Both are wrong.

    By Blogger Sacamano, at 5:22 p.m.  

  • You can have some private delivery in the CHA, but it's pushing the public aspect of it:

    8. (1) In order to satisfy the criterion respecting public administration,

    (a) the health care insurance plan of a province must be administered and operated on a non-profit basis by a public authority appointed or designated by the government of the province;
    Once you bring for-profit centres into the mix or start charging user fees, it pushes the bounds of the CHA.

    User charges and extra-billing

    Health Canada is concerned about private surgical clinics that allow individuals to privately pay for medically necessary insured services and thus jump the queue. Following media reports indicating that the province was intervening to stop these charges, Health Canada asked Quebec to confirm that the matter had been resolved. Quebec officials have informed Health Canada that they were investigating this issue and that, if necessary, appropriate action would be taken. Under the CHA, any province that permits charges to insured persons for medically necessary hospital and physician services are in non-compliance and vulnerable to mandatory dollar-for-dollar deductions.
    In 2002, Health Canada learned that two specialist referral clinics in British Columbia had been established. These clinics offer consultations with physician specialists for a fee for patients who choose to bypass their family physicians to obtain a referral for specialized treatment. These clinics may also coordinate diagnostic and/or surgical procedures, which result from the consultations. In March 2003, a one-time deduction of $4,610 was made to British Columbia's Canada Health and Social Transfer (CHST) payment in respect of the two instances of user charges levied at a private surgical clinic during 2000-2001. Another patient reportedly paid $6,000 for surgery at a private surgical clinic in 2003. This issue is the subject of ongoing discussion with British Columbia officials.
    In 2002, Health Canada learned that a Saskatchewan doctor was performing bone density scans following donations to a foundation. Health Canada is concerned that patients may be required to make a donation in order to receive a medically necessary service. This issue is the subject of ongoing discussion with Saskatchewan.
    Tray or disposable materials fees are direct charges to patients by physicians for medical/surgical supplies in the provision of some medically required services. Legislation passed in Manitoba in 1999 and 2001 prohibits user charges in accredited surgical facilities, but continues to permit charging tray fees in physician offices and medical clinics. This issue is currently under review and the subject of ongoing discussion with Manitoba.

    By Blogger calgarygrit, at 11:06 p.m.  

  • Having parallel private health care only "pushes" the bounds of the CHA if the Provinces allow it to (by banning "opting out" for example). But this is NOT a result of the CHA itself.

    You comment illustrates the confusion perfectly:
    "Once you bring for-profit centres into the mix or start charging user fees, it pushes the bounds of the CHA".

    You conflate two (at least) issues and pretend they are one. 1) For profit centres do NOT push the bounds of the CHA unless (2) they charge user fees AND receive compensation from insurance plans.

    Quoting Coyne "The CHA only prohibits mixing of public and private funding, ie extra billing, and with good reason: while a free and fair society should never forbit people from paying for health care out of their own pocket, it is neither free nor fair for people to buy their way to the front of the line for public services. Which is what extra-billing amounts to."

    Private health-care delivery does not equal extra-billing, and it is disingenuous to imply that the later is a requisite of the former.

    By Blogger Sacamano, at 2:50 p.m.  

  • Yes, but if you have a for-profit clinic, obviously they're making profit. This profit comes either from:

    1. Individuals, in the form of user fees, which is illegal under the CHA.

    2. Insurance companies, which, once again, is illegal under the CHA.

    3. The government, in which case, we're spending more money.

    I'll admit I'm not an expert on the Act, but presumably, the only way a private clinic could fit under the CHA was if they were so much more efficient that they could do the job for less money and therefore could charge the same price to the insurance company...thereby keeping the profit. And I have yet to be convinced that they can do the same work as public health facilities for a cheaper price without putting the patient's health in jeopardy.

    By Blogger calgarygrit, at 5:31 p.m.  

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