Hospital management for fun and profit

>> Opposition mounts nationwide to Alberta's proposal for health care privatization

by PHILIP PREVILLE

 When Lorraine Craig set up her placards, posters and other activist props in front of the Revenue Canada building on Tuesday afternoon, the RCMP moved in fast. They wanted to know who she was, where she came from and what she was doing there.

 She told them she was demonstrating against Alberta's Bill 11, officially called the Health Care Protection Act, which sets out rules and regulations for owning and operating "private surgical facilities" in that province. And before long, she says, they took an active interest in what she had to say.

 "They had a job to do, so they couldn't appear too sympathetic," Craig says. "But they certainly didn't turn a deaf ear to us. Everybody is interested in health care issues. Even on-duty Mounties."

 Craig's protest, attended by a dozen activists, was relatively small--but it was only a cog in a series of protests against Bill 11 held across Canada on Tuesday. The offices of Health Minister Allan Rock in Toronto and Industry Minister John Manley in Ottawa were occupied by demonstrators for most of the afternoon. Protesters performed "mock surgery" to give Rock a new spine, Ontario Premier Mike Harris a new heart and Alberta Premier Ralph Klein a new brain.

 Opposition to Bill 11 is widespread even in conservative, free-market-boosting Alberta. But the Klein government insists the bill won't create a two-tier health care system because the government will continue to pay for all medically necessary procedures. So what's the problem? "I've looked at the bill," admits Craig as she stands at the corner of Rene-Levesque and Jeanne-Mance, "and I admit I'm no expert. I just think this is the beginning of a slippery slope for medicare."

 Exploit the ill?
 Here's how Alberta's proposed system would work: the province has the power to approve the creation of a for-profit "surgical facility," which is essentially the same as a hospital, but without an emergency ward. No matter which facility people choose, the government will pay for all necessary procedures. The bill also stipulates that for-profit facilities cannot allow people to jump the queue in exchange for a fee: everyone goes to the back of the line, although people can choose where to get surgery done based on which facility has the shortest lineup.

 Think of it this way: right now, Alberta (like every province in Canada) not only pays for its citizens' care; governments are also in the business of building and operating hospitals, clinics and other facilities. Under Alberta's proposal, the government, while still running some public facilities, essentially gets out of the hospital business and becomes only an insurer, the entity that pays its citizens' medical bills.

 But according to Mike McBain of the Ottawa-based Canadian Health Coalition, that explanation doesn't tell the whole story. "The fact is that we already have privately run hospitals in Canada," he explains. "Right now, most hospitals are technically set up as independent, non-profit corporations. Why anyone would want to change them to for-profit corporations is beyond me. We don't exploit sick people for profits in this country."

 Afraid to get sick
 The definition of "medically necessary procedures" has also sparked debate. Bill 11 allows private facilities to sell non-medically necessary "enhancements," such as fibreglass casts instead of plaster ones, or steel pins to help mend broken bones.

 McBain also predicts that queue-jumping will be widespread in Alberta if the bill is passed. "Bill 11 allows doctors to work in both private and public facilities at the same time," he explains. "People will go to see a doctor in a public hospital, and the doctor will say, 'Well, if you perform your surgery here you'll have to wait six weeks, but if you come to my clinic you'll only have to wait three weeks.' The bill is set up to erode confidence in the public system."

 In Montreal, Lorraine Craig says her confidence is already eroded, but she refuses to give up. "I'm afraid to grow old in this country right now," she says, "but growing old in a U.S.-style private health system would be even worse." :

 

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