Canadian public health care and world trade

OTTAWA--The Canadian government must take decisive action now to halt the commercialization of health care, says the 2003 report of Social Watch Canada to be presented this week at the annual World Social Forum in Porto Alegre, Brazil.

The report focuses on how governments in Canada are promoting the privatization of health care services and institutions, and thus undermining the accessibility of care based on need rather than ability to pay.

The report, authored by Bruce Campbell and Armine Yalnizyan, is being presented by Bruce Campbell, executive director of the Canadian Centre for Policy Alternatives, and John Foster, senior researcher at the North South Institute. Both organizations collaborate in hosting Social Watch Canada, a branch of the Global Social Watch Network, a coalition of civil society groups in more than 60 countries.

"The public system of acute care in Canada has been starved for cash for the past decade," the report states, "and this chronic underfunding has led to both overt and covert forms of privatization." Cuts in services due to staff reductions and de-listing have rationalized the provision of for-profit services for those who can afford them. "Public funding is privatized through increased reliance on user fees and co-payment mechanisms. Delivery is privatized when public funds are shifted from not-for-profit to for-profit service providers."

The Social Watch report warns that stopping and reversing the commercialization of Medicare will become much more difficult if it is not done before international trade treaties make such a reversal prohibitive. The report refers to the proposed inclusion of health care in the services to be opened up for privatization in the WTO's General Agreement on Trade in Services (GATS) and the hemispheric Free Trade Area of the Americas (FTAA). If this happens, the rights thus granted to private health care providers will override the ability of Canadian governments to protect Medicare. "The choices to be made by our federal government in the coming year," the Social Watch report concludes, "will characterize what kind of nation Canada is. Public health care is the jewel in the crown of our social programs. It evokes the meaning of Canadian citizenship more effectively than does a passport, a currency, or a diplomatic corps. Whether our government sees it as a treasure or an asset to be liquidated remains to be seen."