I share these views as described below, as do most Canadians, I believe.
However, I think the urgency is there to do more than just criticise the
for-profit model in advocacy of non-profit and frame the discussion in a
more constructive format. We are well aware of the weaknesses that Medicare
has developed, but we seem to offer little advice or suggestions to reform,
especially when we exist in a pro-privatization political and economic
environment . You would think we would take this opportunity to offer more
constructive solutions based on this blatant intrusion by the likes of
Harris and Klein.

As a student of the health system and a municipal employee in Ottawa, I
think the obsession with federal funding as the most visible answer is
flawed. Instead, the focus must be on the constitutionally mandated
provinces and subsequently, municipalities, many of which have inherited
partial responsibility in health and social services. As we are all aware,
this is where decisions, real decisions are made on a day to day basis on
health and health-care spending.

Increasing federal funding through the CHST to unprecedented levels will not
restore efficiency and public confidence to Medicare unless the management
of these dollars is the central issue. That will require a stringent set of
rules and standards for Ottawa to enforce on the lower levels of government
and a working relationship and cooperation between them.

Is it a Utopia I am describing or the next confrontation between David and
Goliath ? This is a critical time for Medicare and the many aspects and
approaches that our health system has adopted. I do not share Professor
Raphael's assertion that we should not discuss options or alternatives,
regardless of my views, which favour his opinion that public non-profit must
be maintained. I do believe though, that it is important to articulate and
not merely criticise utilizing political language and strategies.

David Gourlay


-----Original Message-----
From: Dennis Raphael [mailto:[log in to unmask]]
Sent: March 8, 2000 8:34 AM
To: [log in to unmask]
Subject: Re: Canadian Health Care at a Crosswords...


Forgive me, my closing remark to you was unwarranted and unjustified.
There is little doubt however, that the Klein proposal is ideologically
driven.  There also is no doubt that for-profit health care has been a
disaster everywhere it has been brought in.  Why any Canadian would even
tolerate its discussion is an abomination. For profit care leads to
hardship and poor care; there is a reason that it has been resisted around
thye world -- the USA being exception.

I beleieve Canadians are also coming to realize that for-profit housing
leads us on the same path as for-profit health care:  a warping of
priorities, a weakening of values, and a descent into who knows what.

Perhaps this will be the tool that allows us to get rid of the likes of
Klein and Harris in Canada for ever!

At 07:05 AM 3/8/2000 -0500, you wrote:
>I don't think that the Klein proposal specifically mentions "shareholders."
>I think there is more to this than economics, Dennis. But I do wish you
>could respond to me without insulting me personally.
>
>Regards,
>
>Alana
>
>-----Original Message-----
>From: Health Promotion on the Internet [mailto:[log in to unmask]]On
>Behalf Of d.raphael
>Sent: Tuesday, March 07, 2000 6:24 PM
>To: [log in to unmask]
>Subject: Re: Canadian Health Care at a Crosswords...
>
>
>For-profit clinics and hospitals imply shareholders who benefit from
surplus
>value:  procedures are carried out in a manner to assure profit for
>shareholders.  Extendicare in Canada and the US is such an example of a
>large
>multinational for profit health care corporation.
>
>Has anyone bought shares in a Morgenthaler clinic lately?  Free-standing is
>not
>the same as for-profit! Learn a little economics before you make such
>statements.
>
>The best,
>
>Dennis R.
>
>
>
>Visit our Web Sites for information and reports from all of our Quality of
>Life
>Projects!
>        http://www.utoronto.ca/qol         http://www.utoronto.ca/seniors
>
>  ******************************************************************
>   Where a great proportion of the people are suffered to languish
>        in helpless misery,
>   That country must be ill-policed and wretchedly governed:
>   A decent provision for the poor is the true test of civilization.
>
>   -- Dr. Samuel Johnson, 1770
>  ******************************************************************
>
>Dennis Raphael, Ph.D.
>Associate Professor and Associate Director,
>Masters of Health Science Program in Health Promotion
>Department of Public Health Sciences
>Graduate Department of Community Health
>University of Toronto
>McMurrich Building, Room 101
>Toronto, Ontario, CANADA M5S 1A8
>voice:    (416) 978-7567
>fax: (416) 978-2087
>e-mail:   [log in to unmask]
>
Visit our Web Site for information about our Seniors Participatory and
Community Quality of Life Projects!  Free Reports Also.

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  ********************************************************************
  Long have I looked for the truth about the life of people together.
  That life is crisscrossed, tangled, and difficult to understand.
  I have worked hard to understand it and when I had done so
  I told the truth as I found it.

  - Bertolt Brecht
  ********************************************************************

Dennis Raphael, Ph.D.
Associate Professor and Associate Director,
Masters of Health Science Program in Health Promotion
Department of Public Health Sciences
Graduate Department of Community Health
University of Toronto
McMurrich Building, Room 101
Toronto, Ontario, CANADA M5S 1A8
voice:    (416) 978-7567
fax: (416) 978-2087
e-mail:   [log in to unmask]