Two-tier already here, Rock admits
After weeks of attacking Canadian Alliance, Liberals concede private care
built into system
Robert Fife, with files from The Canadian Press

OTTAWA - After weeks of accusing the Canadian Alliance of fostering a secret two-tier health care plan, Allan Rock, the Health Minister, conceded yesterday the Liberal government is allowing "private for-profit medicine" to exist in Canada.

Since the beginning of the election campaign, the Liberals have tried to force the Alliance on to the defensive with claims that the right-of-centre party favours two-tier care, prompting Alliance protests that the Liberals are misrepresenting the policies and statements of Stockwell Day and his closest advisors.

The Alliance has even threatened a lawsuit against the Liberal party over television advertisements that accuse Mr. Day of supporting private clinics and queue-jumping by those who can afford to pay.

Yesterday, however, Mr. Rock himself was forced on the defensive when reporters quizzed him about his government's failure to stop queue-jumping by Canadians who pay out of their pockets for essential services such as MRI scans.

Mr. Rock acknowledged "private for profit" care already exists in Canada but argued that the Liberal government is pouring more money into health care to buy equipment to make queue-jumping unnecessary.

"I believe that by putting $1-billion on the table for new equipment, we can get to the point where those MRIs are accessible in the public system and you won't have to go to a private provider to pay cash to get access to them," he told reporters after a mid-campaign cabinet meeting on Parliament Hill.

"In the meantime we have said to the provinces where these things are an issue ... we don't think that purchasing your way to the front of the line by going to a private MRI is consistent with the Canada Health Act ... but the best answer to private for profit medicine is a public medicare system that can truly provide timely access to quality care. That is what all governments have agreed to work on."

On the campaign trail, Jean Chrétien, the Prime Minister, has promoted his government as the true defender of universal medicare and threatened provinces with federal sanctions if they violate the five principles of the Canada Health Act.

But Mr. Rock said he did not want to take a hammer to provinces, such as Alberta or Quebec, which allow private clinics to operate for profit.

"The best answer there is to make sure they have the money to purchase the MRIs that they need in the public system," he said.

Rod Love, the Alliance campaign chief, said the Liberals have been hypocrites on medicare, pretending the system is completely publicly financed when they have been responsible for allowing 30% of the health care system to fall into private hands.

"So Allan Rock has finally admitted what everyone in the country has known for like 15 years. That's courageous," he said. "You can draw a straight line between the deterioration of these country's health care system and Jean Chrétien's health care cuts."

Meanwhile the Prime Minister seized on an Alliance policy paper yesterday that calls for user fees as concrete proof that Mr. Day has a secret agenda to create an American-style health care system.

The Alliance paper, prepared last spring by Bob Mills, the party's former health critic, paper suggested user fees be considered as an option to improve medicare. It also discussed a greater role for private business in the health system and outlined the possibility of giving individuals $2,000 a year to budget for their health care.

"They have a paper on that, they say they will study that," Mr. Chrétien told reporters. "So that means that they're thinking about it. The Liberal party has a very clear position on user fees. We're not studying it at all. We're opposed to that."

The Alliance said the document was prepared as a discussion paper by party researchers and intended to solicit opinions.

Mr. Chrétien also laughed off an Alliance threat to sue the Liberal party for deceptive advertisements stating that Mr. Day wants to impose two-tier health care. The Alliance chief has stated repeatedly he believes in universal health care. Mr. Day's platform promises to uphold the five principles of the Canada Health Act and to add a sixth - of guaranteed federal funding. In addition the party says it envisages dialogue with the provinces on health care based on arbitration rather than confrontation.

One of the television ads, which began running nationally late last week, displays a headline from the Globe and Mail saying "Alliance supports two-tier health care."

Following the display of the front-page headline, ad copy appears across the screen saying Mr. Day helped open the door to an American-style health-care system when he was an Alberta cabinet minister.

However, Bob Cox, national editor for the Globe, said the ad copy does not appear anywhere in its Oct. 31 story and "appears to be misleading."

Hal Danchilla, the party's national campaign manager, said the Liberal ads are a "complete and utter malicious deception" and go "beyond what is acceptable political behaviour."

Mr. Chrétien said: "They can take me to court, fine, I will have a good lawyer."

Liberal ads link Mr. Day to an Alberta law that allows private clinics to perform surgery although the service is publicly-funded and does not violate the Canada Health Act.

However, it was the Chrétien government which quietly struck a deal with Alberta in 1996 that opens the door to two-tier medicine. Under the Liberal agreement, Ottawa gave its blessing to a demand from Alberta that doctors working within medicare be allowed to operate private clinics where they sell non-insured medical services to patients.

Jason Kenney, an Alliance MP and campaign co-chair, accused Joe Clark, the Progressive Conservative Leader, of being "a complete hypocrite" on health care, noting he had surgery at a private clinic in the late 1980's. During the last week's TV debates, Mr. Clark accused the Alliance of favouring two-tier health care.

While campaigning in Calgary, Mr. Clark admitted he underwent a hernia operation at Shouldice Hospital, a private facility in the Toronto suburb of Thornhill, in 1987 or 1988.

"Had I needed to go to the public system I probably would've waited longer," Mr. Clark said, adding that he thought he would have received the same standard of care at a public facility.

Mr. Clark said a poverty-stricken Canadian would have been unlikely to have a hernia repaired at Shouldice, but he denied he took advantage of a second tier of health care.

"It's not a tier, it's a particular facility," he said. "If one redesigned the health-care system to have a whole series of Shouldice clinics then you'd be getting into a two-tier system."

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