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Page six

away.
“From my vantage point
as a GP. ‘(general

practitioner) with a low to
middle income practice, |
wish to state that we no
longer have unidersality or

| equal access to medical

care in Ontario. While my
practice is limited to
Toronto, | know similar

conditions exist in most of
Ontario and, | suspect, in
most of Canada’’ - Dr.
Cynthia Carver, taken from
a letter to former federal
health minister David
Crombie.

Dr. Carver is not alone in
her suspicions. Although
the opinions of Canada’s
three major political parties
on the state of medicare

reactions from its in-
ception.

In 1957, after several
provinces had followed the
Saskatchewan lead, the
federal government passed
the Hospital Insurance and
Diagnostic Services Act.
which resulted in the
federal government sharing
the costs of provincial
plans. The four founding

-principles of the federal

hospital plan were univer-

sal coverage, public ad-
ministration, portability
between provinces, and

reasonable access to com-
prehensive care, the same
principles that our present
general health care plan is
based on.

 

Opinions range from
vocal anger to

practical ambivalence

Furthermore,

 

 

range from vocal anger to
practical ambivalence, not
one is willing to say that
medicare is functioning as
it should or once did.

Accusing fingers have been
pointed at doctors across
the country, especially at
those from Canada’s two
richest provinces, Ontario
and Alberta, but the origins
of the real problem run
much deeper; _ financial
support for medicare has

been shuffled aside by
federal and __ provincial
governments intent upon

cutting costs and balancing
budgets.

the growth of government
assisted health care plans
in Canada has been a slow
and laborious one. First
instituted by the Saskatch-
ewan CCF government of
Tommy Douglas in 1946, in
the form of compulsory
hospital insurance, the

 

concept has met with mixed

sable,

the Saskatchewan CCF
government took the lead
again in 1962 when it
instituted the country’s
first pre-paid medical care

insurance. Opposition by
the province’s medical
community’ was _ initially
very __ strong. Many

saskatchewan doctors or-
ganized a strike to voice
their dissatisfaction with
the bill’ a strick which
lasted 23 days and resulted
in the signing of the
“Saskatoon Agreement’’
which provided important
guarantees for the rights
and prerogatives of the
medical profession.

In 1966 the federal Liberal
government again followed
suit, introducing the Med-
ical Care Act, providing a
50 per cent federal share of
the cost of approved
provincial plans. The 50/50
cost sharing arrangement
for.medicare was extended

The Other Press

‘by Phil Hurcomb for Canadian University Press

Hospital beds are being eliminated: Deterrent fees are
lon the rise and claims of mismanagement of the Canadian “2ned's spend them in.
health system abound. Canada still has the cheapest
most easily available health care system on the continent transfer funds marks the
but the basic principles of Medicare’ reasonable access to
comprehensive health care for all’ is gradually eroding

to funding of several social
services, including post-
secondary education.’
Under this. arrangement,
spending in the _ social
services by the provinces
grew with the rate of
inflation because of the
federal support.

The 50/50 funding ar-
rangement provided an
incentive to provincial
governments to spend in
the areas of medicare and
education, and provided a
safety valve for capital
expenditures in the poorer

provinces. Under _ this
arrangement the poorer
provinces’ knew that_ if

major expansion projects
went over budget they
would only be liable for half
of the unexpected costs.
the federal
transfers had to be spend in
the area where the original
provincial expenditure was
made.

By the mid-1970’s the
federal Liberal government
had decided that it wanted
to shift the burden of social
services spending back to
the provinces. Social
services spending was
costing them too much and,
coupled with increasing
expenditures in a variety of
other areas, was contri-
buting to an _ exorbitant
national debt.

In June, 1976, the Liberals
passed legislation putting

’ would not

tax credits to the provinces
longer have
strings attached to them;
they could now be spent in
any area that the provinces

The implementation of the
transfer ceilings and the
freeing up of the use of the

‘Healthcare: Financial support f or

government this year.

The result of these
spending cuts made
possible by the Liberal
legislation are predictable.
Hospitals across the coun-
try are operating with
skeletal nursing staffs, the
number of hospital beds
per thousand is dropping,

 

 

Federal government

has reduced the amount

they are spending
on health

 

 

real turning point in the
quality and accessability of
Canadian medicare.

Through the use of the
ceilings the federal gover-
nment has reduced the
amount that they are
spending on health and
with the return of full
control over
support, the provinces
have, en masse, reduced
their commitment to a
universally accessible, high
quality medicare system.

Statistics Canada figures
for the first - year of
operation under establ-
ished programs funding
(1977-78) show that not one
provincial government
maintained the spending
relationship between fed-
eral and provincial tax
dollars that existed before
-1977. the trend set in the
program’s first year has
continued through to this
year. For example, P.E.I.
is contributing only 20 per

cent_of the cost of their

 

PEI is contributing only

20 per cent of the cost

of their personal plan

 

 

an end to the 50/50 cost
sharing arrangement and
replaced it with Established
Program Funding, a plan
which put ceilings on
increases in the federal
share of social services
spending. The transfers of

provincial plan this year
and Alberta only 39 per
cent. It is estimated that
Ontario’s Conservative
government’s expenditures
on health care will fall $74
million below the contri-
bution of the federal

medicare .

Likewise,

and doctors are billing their
patients above the level of
reimbursement provided by
provincial medicare plans.
In Ontario 18 per cent of
physicians have opted out
of the provincial plan
altogether, in Alberta 55
per cent of surgeons are
charging their patients
extra fees, and premiums
have risen drastically in the
richer provinces. In the
past five years, premiums
have increased 82 per cent
in Ontario, 50 per cent in
British Columbia, and 33
per cent in alberta.

- Hospital user charges are

now in effect in at least 23
hospitals in Canada.
Sixteen of Prince Edward
Island’s 115 doctors have
opted out of the provincial
plan since extra billing in
that province was outlawed
last summer and New
brunswick. hospitals are
now charging out patients
$10 extra per visit; the list
goes on and on.

Opting out and double
billing levels, as well as the
implementation of users
fees and increasing pre-

miums can all be linked to .

the provinces’ reluctance to
maintain funding of our
health system at even close
to the rate of inflation.

In Ontario, for example,
active treatment hospitals
are being allowed = an
increase of 4.5 per cent and
chronic care hospitals 5.3
per cent this year. Minimal
increases of this sort are
forcing hospitals to cut back

their operations and to look |

for funds in other areas.

the ‘Ontario
government is allowing for
a doctors’ fee increase of
6.6 per cent this year, well
below the rate of inflation,
and foctors have responded
by leaving the plan

Mari