At the Heart of Justice blog continues the focus on Health Care in Canada with a series by Bill Blaikie, The United Church of Canada’s representative to the Canadian Health Coalition. We offer these personal reflections by Bill as an invitation to move deeper into the many important issues surrounding health care in Canada.

On May 3, 2016 representatives of the Canadian Health Coalition (CHC) were on hand in Montreal to show support for an application to the federal court of Canada [PDF] for a motion of “mandamus,” which is intended to force the federal government to enforce its own law, the Canada Health Act (CHA), and take steps to stop or at least deter the extra-billing going on in Quebec.

During the past 10 years monitoring of violations of the CHA was not a priority for the federal government. In combination with court decisions complimentary to a culture of extra-billing (like the Chaoulli case in Quebec), this led to a political context in which boundaries were pushed. In 2015 the Quebec government passed Bill 20 which effectively legalized and legitimated extra-billing. It is now common in Quebec to pay $500 for anesthesia when having a colonoscopy, or $80 for eye drops during the treatment of macular degeneration.

The Canada Health Act was passed by Parliament in 1984 - the culmination of a process that began with the appointment of Justice Emmett Hall to look into the effect on Medicare of the increasing reality of extra-billing by physicians and user fees. Justice Hall took the view that extra-billing needed to be stopped or it would destroy the basis of Medicare (that health care should be available regardless of ability to pay).

As the NDP Health Critic from 1980 to 1984 I worked with the CHC in urging the then Minister of Health, Monique Begin, to do something about the proliferation of extra-billing and user fees. The result was the Canada Health Act, which provides that federal transfers to provinces for health shall be deducted on a dollar for dollar basis related to amount of extra-billing and user fees in a particular province.  For many years the CHA had the desired effect.

The new federal government does not have the option of consulting Justice Hall for a third report on Medicare. It is time for the federal government to do the right thing and enforce the Canada Health Act to ensure all people in Canada can access the health care they need.

Health care advocates are committed to working to protect our precious public health care system. We invite you to join us in this important work.

Bill Blaikie

A United Church minister, the Hon. Bill Blaikie, was an MP from 1979 to 2008, during which time he served as Parliamentary Leader of the NDP, Deputy Speaker, and Dean of the House of Commons. Following his retirement from federal politics, he was a member of the Legislative Assembly of Manitoba (2009-2011), and served as Minister of Conservation and Government House Leader. His political memoir, The Blaikie Report – An Insider’s Look at Faith and Politics, was published by United Church Publishing House in 2011.