Monday, October 31, 2005

The opening offer

Word comes out that the Liberals are willing to tighten one loophole in the health care system - but it looks like there's ample reason for the NDP to continue to hold out for more:
Ujjal Dosanjh will meet today with NDP health critic Jean Crowder. He is expected to say he is amenable to tightening regulations that restrict for-profit health care.

Mr. Dosanjh intends to make it clear the provinces will not be permitted to turn over federal cash transfers to doctors who deliver the same services in both the insured public system and in the private sector for higher fees, a senior adviser to the Department of Health said yesterday.

While it is not a widespread phenomenon, Health Canada has been concerned in recent years that some physicians are in effect "double-dipping" by offering some patients faster, more expensive treatment in private facilities than they do in the public system, the adviser said.

Now, it's always a plus to make a dent in one problem that's been ignored to date. But the bigger problem all along has been that of entirely private clinics which make no pretense of involvement in the public system. Dosanjh's proposed reform would merely have the effect of legitimizing the spread of such clinics, and would apparently allow "double-dipping" in any event as long as the private fees matched the public ones.

That said, Dosanjh's offer is at least a useful starting point as long as some of the NDP's already-stated positions can be worked into the picture. A combination of the tightened regulation with the NDP's proposed ban on new private operations would go a long way toward preventing further privatization, even if it doesn't do much to undo past damage.

And it shouldn't be unrealistic to get at least that concession out of the government for now. The Liberals may need a deal on the issue in order to preserve PMPM's (however comical) claim to be the defender of public health care. And that should give the NDP a strong bargaining position to demand changes which will actually do something to preserve the system.

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