CASTONGUAY REPORT:
NEW ATTACK ON HEALTH CARE
(The
following article is from
the March 1-15,
2008
issue of People's Voice, Canada's leading communist newspaper. Articles
can be reprinted free if the source is credited. Subscription rates in
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PV Health Reporter
Big
business is launching another attack in the corporate "surge" against
Canada's public health care system, this time through the Castonguay
Report, Quebec patients rights groups and trade unions are warning.
Newspaper headlines have called it "a bombshell in the health care
system." The report, entitled "Getting Our Money`s Worth," was
commissioned as part of a working group established by the Quebec
Finance Minister to find new ways of funding health care.
From
the outset the report was expected to be an endorsement of privatized
medicine. Claude Castonguay was once described as the father of modern
Quebec medicare, a Tommy Douglas. In the 1960s and 70s, as Liberal
Health Minister, he travelled Quebec preparing the background for the
province's first health-insurance laws. But times have changed. After
leaving elected office, Castonguay went into the insurance business and
made a name for himself again, calling for a parallel private health
care system.
His
report, compiled with two appointees from the Parti Québécois and
the
ultra-right Action
démocratique du Québec, calls for sweeping
changes,
such as raising provincial sales tax by one percent to finance health
care, and creating a health care "premium" where people pay extra
income tax if they use the system more than a certain number of times.
Castonguay's insistence that this is not a "user fee" has been met with
incredulity by most. Within hours of its announcement, Quebec Health
Minister Philippe Couillard said the report was headed to the shredder,
while Finance Minister Monique Jérome-Forget dismissed the call
for
higher taxes.
Other recommendations, however, Jérome-Forget called "very
interesting [and] progressive."
"It is
the proposals that the government has not rejected immediately that are
the most dangerous and insidious," Pierre Fontaine, leader of the
Communist Party of Quebec, told People's
Voice. "It is not so clear
where the Charest Liberals stand on these recommendations!"
That
includes the suggestion that Quebec should be the first province in
Canada to legalize the sale of private medical insurance for areas
already covered by the Canada Health Act, and also to allow doctors to
practice in both public and private systems - and even be allowed to
rent hospital facilities after hours for private patients.
"If
you transfer resources like nurses and physicians to the private sector
you will have a two-tier system," Fontaine, who is also a front-line
health care worker, said. "We already have a lack of staff in the
public system. This will make it worse."
All of
Quebec's major labour centrals have come out against the report, as
well as Québec Solidaire.
The employer and business association Conseil
du Patronat du Québec, on the other hand, has called for
the rapid
implementation of Castonguay The two groups squared-off as over a
hundred protesters braved the bitter cold to stage a loud demonstration
outside the downtown hotel where Castonguay was addressing the Board of
Trade.
The
Coalition solidarité
santé (Health Solidarity Coalition) noted that it
is actually expenditures in drugs and medical technologies, where the
private sector dominates, which are out of control, and that Castonguay
had no recommendations to address these inflationary industries.
Castonguay "proposes a new commercial social contract in health" based
upon neoliberal policies, the group said.
Any
amount raised from the health care tax would only be equivalent to
recent tax cuts in last year's budget, the Coalition stated. "Our best
insurance is a public system of health" they added, noting that an
attack on the public delivery of health care is also an attack on
public insurance.
Commentators have noted that the government's vocal rejection of some
aspects of Castonguay was a calculated response, given the broad and
strong public behind public health care in Quebec - and an new
willingness of the minority Charest Liberals to distance themselves
from the opposition ADQ. (Mario Dumont, leader of the ADQ, originally
called the commission's creation "a move to respect the ADQ's ideas."
He has vowed to champion the cause of Castonguay.)
While
the PQ has criticized some aspects of Castonguay, all three parties in
the National Assembly supported his explicit criticism of the Canada
Health Act as an obstacle to the evolution of provincial health care
systems. Like the Chaoulli decision, which allowed for private
insurance for cataract, hip and knee surgery (highly profitable
operations), the Castonguay report reflects Quebec's indignation
towards national inequalities in the Canadian state, and the openness
to Quebec-driven solutions. No doubt this will resonate beyond Quebec's
borders providing, as the Toronto
Star said, "heavy artillery to the
proponents of privatization." The
National Post endorsed the report,
calling for its implementation Canada-wide.
Quebec
now has over 60 private clinics and, according to The Gazette, the
highest rate of private health care spending in Canada, at 30 percent.
While Ontario officially stopped allowing doctors to opt out of
medicare in 2004 after enormous public pressure around the Copeman
Clinics, Quebec has let the number of doctors going private triple in
the past decade. The Gazette says
the public sector is short 800 family
doctors and 650 specialists. In violation of the Canada Health Act,
Quebec refuses to give Ottawa data on extra-billing or user fees in
health care.
Clearly Castonguay is swinging a wrecking ball at the Canada Health Act
and the public delivery and insurance of health. His report makes the
continued call for federal enforcement of the Act, banning private
clinics and P3 privatization, and the expansion of public health care
urgent, timely and worth fighting for.
Found at:
http://www.peoplesvoice.ca/articleprint13/03%20CASTONGUAY_REPORT__NEW_ATTACK_ON_HEALTH_CARE.html