I'll punish two-tier provinces: PM Goes much further than his health minister did: Chrétien targets Alberta, Quebec for letting clinics charge for medically necessary tests

Robert Fife, Ottawa Bureau Chief, with
files from Ian Jack, Sheldon Alberts
and Graeme Hamilton
National Post

TORONTO - Jean Chrétien contradicted his Health Minister yesterday by vowing to penalize provinces that allow private health clinics to charge fees for medically necessary services.

The Prime Minister singled out Alberta, the home province of Stockwell Day, the Canadian Alliance leader, and Quebec as targets of possible funding cuts, citing private clinics that charge for services such as MRI scans.

The threat sparked an angry response from Gary Mar, Alberta's Health Minister, who accused the Prime Minister of being an "arrogant bully" who is inflaming the health care debate for political gain.

Gilles Duceppe, the leader of the Bloc Québécois, said: "We don't need Jean Chrétien to come give us a moral lesson, with the pontifical Allan Rock, when they are responsible for what happened. They cut, without asking questions about the principles [of medicare]. These people are hypocrites, and it is purest cynicism."

After spending most of the election campaign portraying the Canadian Alliance as the champion of two-tier health care, Mr. Chrétien was caught off guard by Allan Rock's acknowledgement on Sunday that there are parallel systems of private and public health care in Canada.

Appearing on CTV's Canada AM yesterday, Mr. Chrétien was asked why he has not stopped the "private for-profit" clinics that Mr. Rock spoke about.

"No, we cannot," he said. "The management of that is provincial administration."

The Prime Minister then went on the attack, contradicting Mr. Rock's consistent position of not wanting to dictate province-by-province health needs from an office in Ottawa.

"There is $1-billion available to buy the [MRI] equipment. Perhaps they let that happen because they don't have the equipment," Mr. Chrétien said.

"Now we give them cash to buy the equipment this fiscal year so they have no reason anymore to do that. And if they keep that [for-profit] clinics we will withhold the money."

Three hours after the Prime Minister made his comments, Mr. Rock held a press conference in Ottawa in which he again appeared to be in conflict with the Prime Minister.

Instead of backing Mr. Chrétien's threat to impose financial penalties on provinces that allow clinics to charge fees for medically necessary services, Mr. Rock held to a more cautious position, saying he will wait for more information from Alberta and Quebec before deciding whether to withhold federal money from them. "Any time you allow someone to pay cash to get preferred treatment, that is inconsistent with the principles of medicare."

He also contradicted Mr. Chrétien, saying money was not the issue in Alberta. He told reporters: "Do you think the problem in Alberta is not having enough money? He [Ralph Klein, the Alberta Premier] has an $8-billion surplus this year. The issue in Alberta is not money."

Private clinics operate in many provinces, including Ontario, Manitoba and British Columbia, as well as Quebec and Alberta.

Mr. Chrétien suggested in the interview that Mr. Rock made a similar threat to withhold cash in a letter to his counterparts in Quebec and Alberta in September. In fact, the letter raises concerns about queue jumping for MRI tests but makes no mention of withdrawing federal funding.

Mr. Mar said the Liberal leader is singling out Alberta as a "whipping boy" in the election campaign. Mr. Mar asked why the Liberals have failed to target the Shouldice Clinic in Toronto, a private clinic for hernia operations.

"I find his threat to be outrageous for the Prime Minister to say and Canadians should be outraged. It demonstrates his willingness to use any tactic for political gain. He is a bully. He is arrogant and he will do whatever it takes to remain Prime Minister."

Mr. Mar also said Mr. Rock told him in early September that if a patient wants an "MRI today, instead of three weeks hence as scheduled by a physician ... such a person should be able to pay for such a service out of their own pocket."

...

He called it shameful that Mr. Chrétien is now portraying himself as the saviour of medicare. "It's like giving the Red Cross to Dracula."

[emphasis added]

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