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From:
Mona Dupré-Ollinik <[log in to unmask]>
Reply To:
Health Promotion on the Internet <[log in to unmask]>
Date:
Tue, 5 Nov 2002 09:34:56 -0600
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Press Release 
**For Immediate Release**

 From the Atlantic Centre of Excellence for Women’s Health and the Canadian 
Women’s Health Network:

New Publication Claims Canadian Health Care Crisis Is About Values, Not 
Money
As recent reports from the Kirby Senate Committee and the Romanow Commission 
highlight, our Canadian Health Care System is in crisis. But this is not 
just a Canadian problem. All health care systems in the world are in 
crisis. The same forces and issues creating the crisis in Canada are 
operating elsewhere. In Europe, there is fear health costs could spiral out 
of control, even in countries that have not experienced much of an increase 
in health’s share of the GDP. Most European countries with two-tier health 
care, along with Australia and New Zealand, are experiencing erosion in the 
public portions of their systems along with escalating costs of private 
health insurance. That bastion of the free market ­ the Untied States ­ is 
in more turmoil than most. There the blame is on managed care but the 
crises are the same. While there are global social and economic forces at 
work here, each country will respond in its own way. The question for 
Canadians is what path will we choose?
The immediate crisis in our health care system is not just about money or 
inefficiencies. It is symptomatic of poorly articulated values regarding 
the meaning of health and health care, the place of health in society and 
the role of government in health and health care. The issues at stake in 
goal setting are not simply about creating new options for obtaining more 
money for health care. There are fundamental issues at stake regarding our 
core values ­ how we envision the relationship between health and human 
happiness, what we mean by health and what we imagine to be fair. In a 
sense, the pressing issues in health care are the issues about a just and 
caring society, not only in the here and now but for future generations as 
well.
The issues creating crises in modern health care cannot be addressed by 
simply throwing money at them. Our policy decisions are moral decisions. 
They are issues of justice, care and responsible citizenship. In a 
particular way, they relate to the troubling phenomena of the medicalization 
of life, the commercialization of care and of the power of the market to 
dominate the health care agenda.
How we frame the issues determines in large part our response. If health 
care is in crisis, what kind of crisis is it? We have defined the health 
care crisis as a resource allocation issue. Once the problem is cast in 
these terms the main questions revolve around funding. It’s an all too 
familiar litany: the cost of health care is more than the provinces can 
afford, there are unacceptable waits for access to technology, costly new 
drugs are not being provided for all who might benefit, and there aren’t 
enough hospital beds to meet demand. This way of thinking directs policy 
toward winners and losers in a grand allocation game. Because of the 
pervasiveness of technology and the almost unlimited potential benefit from 
medical science, framing the issue this way leads naturally to options that 
will increase the money available for these resources through private 
arrangements.
We need to reflect on deeper questions: What are the goals of health care 
and are the goals unlimited health benefits to all citizens? What kind of a 
good is health care? Is health care a private commodity to be purchased by 
those who can afford it or is it, in some way, symbolic of community itself? 
Is the sustainability of any health care system in a very real sense a test 
of the commitment to community? And if so, how do we test this commitment? 
What language do we use? What public spaces do we develop and nurture? How 
do we deal with the profound and often irreconcilable value differences such 
as a foray into public discourse will generate? What concepts of justice or 
citizenship do we embrace? Or has the commercialization of health and 
health care been so complete in this global world that the hoped-for public 
debate on these matters is only some idealistic ­ perhaps romantic ­ and 
nostalgic dream? Have the values of the market overrun those of justice and 
care?
The Canadian health care crisis is not primarily about resource allocation 
but rather about the future of health care as a good held in common and the 
possibility of just and compassionate decision making by citizens in a 
global world. The challenge is to develop new ways and debate in which 
citizens can act together to clarify the values at stake in the choices for 
our community.

These issues, and more, are addressed in the newly published book:

What Good Is Health Care? Reflections on the Canadian Experience 
By Dr. Nuala P. Kenny 
CHA Press, 2002 
http://www.cha.ca/publishing.htm

Dr. Nuala Patricia Kenny, OC, BA, MD, FRCP(C), received her BA, magna cum 
laude, from Mount Saint Vincent University in 1967, an MD from Dalhousie in 
1972 and completed postgraduate work and training in pediatrics at Dalhousie 
University and Tufts-New England Medical Center. In 1975, she became a 
Fellow of the Royal College of Physicians and Surgeons of Canada, and in 
1976 was certified by the American Board of Pediatrics. In 1995, she became 
the founding chair of the Department of Bioethics at Dalhousie University 
in the Faculty of Medicine. From February to November 1999, Dr. Kenny was 
seconded as Deputy Minister of Health for the province of Nova Scotia. Dr. 
Kenny has been the chair of the Values Committee for the Prime Minister’s 
National Forum on Health and is past president of both the Canadian 
Pediatric Society and the Canadian Bioethics Society. She was a founding 
member of the Governing Council of the Canadian Institutes of Health 
Research (CIHR). Dr. Kenny has been appointed an Office of the Order of 
Canada.

To interview Dr. Kenny contact:
Nuala P. Kenny, OC, MD, FRCP(C) 
Professor & Head, Department of Bioethics 
Dalhousie University, 5849 University Avenue, Halifax, NS B3H 4H7 
Tel: 902-494-3801; Fax: 902-494-3865 
Email: [log in to unmask]
Or:
Carol Amaratunga, Executive Director 
Atlantic Centre of Excellence for Women’s Health 
Email: [log in to unmask] 
Phone: (902) 470-6751 
Website: http://www.medicine.dal.ca/acewh/
Or:
Kathleen O’Grady, Director of Communications 
Canadian Women’s Health Network 
Email: [log in to unmask] 
Phone: (514) 886-2526; Fax: (204) 989-2355 
Website: http://www.cwhn.ca


Mona Dupré-Ollinik, BSW, BA
Coordonatrice de liaison/Outreach Coordinator
Canadian Women's Health Network/Réseau canadien pour la santé des femmes
419, avenue Graham, Suite 203
Winnipeg (MB) R3C 0M3

Tel: (204) 942-5500 ext,/poste 13
Fax/Télécopieur: (204) 989-2355
Toll free/Numéro sans frais: 1-888-818-9172
www.cwhn.ca 
e-mail/courriel: [log in to unmask]

TTY 204-942-2806 
TTY toll free number 1-866-694-6367

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