Canadian Medical Association

Canadian Medical Association

June 07, 2006 13:30 ET

CMA: Seminal Report on Public/Private Interface in Health System Released

OTTAWA, ONTARIO--(CCNMatthews - June 7, 2006) - Almost one year to the day of the anniversary of the Supreme Court of Canada decision in the Chaoulli/Zeliotis v. Quebec case, the Canadian Medical Association (CMA) has produced the seminal "state of the system" report on the interaction between public and private financing and delivery of health care in Canada.

"Last year the Supreme Court Justices ruled on what the health care system shouldn't do. It's About Access! informs the debate on what the system is doing, and spurs discussion on what our society can decide it should do," said CMA President, Dr. Ruth Collins-Nakai.

The report provides an insider's look at the mix between public and private delivery and funding of health care services in our Canadian system. It also includes a review of international realities, a "toolbox" of 10 principles to help assess health proposals, and a set of scenarios that illustrate how the principles might be applied to policy options concerning the public-private interface.

As part of its consultation process with Canadians, the CMA has also undertaken a public opinion poll of four scenarios illustrating different options for health care reform contained in the document.

The illustrative scenarios can be described as:

- "The Status Quo", or continuation of current situation with highly-
limited access to private care and no commitment to timely access
to care beyond the September 2004 First Ministers' agreement on
health care;

- "Medicare Plus", which would include a care guarantee and a
separate, publicly funded safety valve to help patients get timely
access to care;

- "Medicare Complemented", which would maintain a strong public
system with a care guarantee and expand the range of privately
funded services;

- and, "Medicare-Plus-Private", where Canadians would continue to
have access to the same publicly funded services, but could
purchase private health insurance for a full range of hospital and
medical services.

The poll, done for the CMA by Ipsos-Reid, found that Canadians had no appetite for either the "Status Quo" or the "Medicare-Plus-Private" options. "Medicare Plus" and "Medicare Complemented" were the options that garnered the most positive responses in terms of overall impact, timely access to services, comprehensiveness of services and the equity of health care.

"Canadians recognize that the "quo" has no "status" when it comes to our current system," added Dr. Collins-Nakai. "But, Canadians also recognize that two-tier health care is not the way they want to go."

Dr. Collins-Nakai added that It's About Access! provides doctors, decision-makers and all Canadians with the information and framework to make choices on the kind of system that will best meet the needs of patients, but stressed that the responsibility to make those choices lies with the Canadian public and the governments elected to represent them.

"Canadians have agreed with us on those critical two points and the time has now come for our society to take a hard, honest look at where we go from here," said Dr. Collins-Nakai. "That direction, quite frankly, is not for me to decide, it's not even for our politicians to decide. It is up to Canadians to decide."

It's About Access! was developed based on direction from delegates to the CMA's General Council in Edmonton last August. The task force of doctors from across the country that produced the It's About Access! paper received input from more than 3,000 physicians.

The It's About Access! report will now be used to inform discussion at the CMA's upcoming Annual Meeting August 21-23 in Charlottetown when delegates will once again seek ways to ensure patient needs are put first in any discussion about health care reform.

The It's about Access! report and the Ipsos-Reid poll on public perceptions can be found at

Contact Information

  • Canadian Medical Association
    Carole Lavigne
    Media Relations
    (613) 731-8610 or 1-800-663-7336, ext. 1266