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Politics and Health Care in Canadafrom MichUHCAN June 1999 Newsletter
Health care benefits in Ontario are a matter of public debate. That's why health care is an issue in the provincial election (scheduled for June 3) and why officials of the current government traveled the province in May announcing an additional $1.2 billion being budgeted to the program. Now parties are debating how best to spend the new health care money. So said Wayne Lessard, member of the provincial parliament from the Windsor-Riverside area. Lessard, a member of the New Democratic Party, visited the May meeting of Detroit MichUHCAN to discuss the status of the Canadian single-payer health system.
There have to be limits on what is spent on health care in Canada, says Lessard, just like in any other place. "Where to establish those limits is a political question in Canada," a question subject to democratic debate, not left to HMO boardrooms. Lessard's party is for taxing corporations fairly, and using the extra income for health care-in particular hiring more nurses. Provincial governments have taken a narrow interpretation of the law behind Canada's single-payer system; that's lead to an increasing privatization, some say an "Americanization," of the system, which the NDP says they'd stop.
The Canadian Medicare system has widespread support. That's why, a few years ago, the physician's organization voted against endorsing a proposal to allow more affluent citizens to opt out and pay for their own care. Many of the doctors would make more money with an opt-out option, but a majority thought guaranteeing access more important.
The Canadian system isn't perfect, Lessard says. Some services are more limited than they are for well-insured Americans. For instance, there is no facility in Windsor that can do bypass surgery; patients must travel to London, Ontario, or in some cases get permission to have the surgery across the river in the U.S.
There can be three- to six-month waits for an MRI (new MRI machines are one of the things promised by the current government). Still, says Lessard, "As a politician I'm listening for people's problems, and I rarely hear from people in Windsor" who have been harmed by waits for care.
"There is a very strong sense that it's public health care that identifies Canadians as Canadians. If [politicians] want to mess around with that, they're going to suffer politically."
Nurses Protest Health Care Cuts
Across Canada cuts to provincial health care budgets have taken a toll on hospital staffing levels, nurses' workloads, and their ability to provide quality care. The result has been a series of difficult negotiations and sometimes strikes by nurses' unions.
Since March, two provincial nurses unions, in Newfoundland and Saskatchewan, have gone on strike over staffing levels. The British Columbia Nurses Union won 1,000 new nursing positions in December after months of rallies, public outreach, an overtime ban, and rotating strikes. The United Nurses of Alberta are now in mediation after contract talks faltered in April; the UNA is asking the provincial health authority to hire 2,000 more nurses.
Quebec nurses passed a strike vote in April. Their slogan, "Enough is enough!" expresses members' frustration with the shortage of nurses and "outrageous" overtime requirements. By mid-May the nurses' union, known by its French acronym FIIQ, reported little or no progress in bargaining. The 40,000 hospital-based nurses of the Ontario Nurses Association have worked without a contract since April 1998; their leadership says of bargaining issues, "Ontario nurses' concerns are the same as nurses' across the country."