It's Time for Canada to Finish Medicare's Job

Abstract

r D 0 one denies that medicare stands as one of Canada's finest achievements. Prime Minister Mulroney refers repeatedly to the plan as a sacred trust. No politician, IN z E 5 5including those who originally opposed the plan, today dares to advocate the system's dismantling. One of the > d most damaging allegations against the free-trade agreement insisted that our medicare system would be put at risk under free trade. Only the most elaborate promises by Tory Ottawa quieted, but never fully extinguished, that profound anxiety. Medicare represents one of those few social policies of which it can be truly stated there exists a publicly re-affirmed and near-universal consensus. But there are problems. Experts tell us the medicare system is in deep crisis. In I 9 8 8 Canada spent an estimated $ 5 I billion on health care, but even that was insufficient to fund the system adequately. An Ontario man died after months of delay of a coronary by-pass operation. A Saskatoon woman allegedly died because an emergency doctor could not get speedy enough access to a CT-scan. Stories of waiting lists and attendant tragedies, as well as calls for the strict rationing of some services, have become commonplace. Meanwhile, financially starved hospitals are forced to become health entrepreneurs or lottery operators in order to generate additional revenue. And various provinces seek ways to control the amounts paid out to doctors under the plan: B.C. tried denying billing numbers to shut out some physicians, other provinces have imposed a cap on the global amount available for payments to doctors, all provinces have become harder in the fee schedule negotiating process and more zealous in investigating cases of unusually high payments to particular doctors and partnerships. The evidence is clear, we are constantly reminded, we are