"The interests of Islanders would not be well served by the introduction of a two-tier health care system," says Health and Social Services Minister Walter McEwen.
On Tuesday, representatives of the Canadian Medical Association passed a resolution calling for debate on the partial privatization of the national Medicare system.
"I think the concept is wrong for Canada generally, and Prince Edward Island in particular. However, I welcome the opportunity to discuss this issue. Given the public sensitivities that surround the financing of our health care system, the decision by the CMA to open a debate over privatization is somewhat courageous."
Generally speaking, there are three major reasons why the encouragement of a two-tier system is against Prince Edward Island's interests," Mr. McEwen said.
"First, I am concerned that two levels of care may allow user fees for basic and essential medical services to creep into the system. Ultimately, user fees treat people with low incomes unfairly by impeding their access to health care."
From 1968 to 1971, Saskatchewan experimented with a series of user fees. A world-famous study on the effects of this experiment showed that the elderly, the poor and people with large families dramatically decreased their use of the health care system. For example, use of services by poor people dropped 18 per cent. Meanwhile, those in the upper income brackets increased their use of the system.
"Clearly, this is not the direction we need to go in this country." Mr. McEwen said, "For instance, it has been shown by many studies that poor people need and use the health care system more than the affluent."
Mr. McEwen's second major concern revolves around the danger of a drain of medical talents from Prince Edward Island.
"Larger centres may be able to support two levels of health care, in which well-off people can afford to pay for services. However, Prince Edward Island simply does not have enough population or economic clout to support such a system. Therefore, I am concerned that it may get more difficult in a two-tier system for Prince Edward Island to attract and retain the best possible health professionals. By embarking on such a road, we may find ourselves with a health system that severely discriminates against provinces like our own."
"While a two-tier system may not be in the interests of Prince Edward Island," Mr. McEwen said, "the federal, provincial and territorial governments should work harder, in consultation with the public, to develop a vision of the kind of universal health care system the public wants and can afford. I am grateful to the CMA for pushing the debate a little further. We are committed to a public health care system on Prince Edward Island, but we do need more direction from the public on how this should evolve over the years to come."
"Finally," Mr. McEwen said, "the introduction of a two-tier system may foster an American-style approach to health care."
"When you include only hospital, medical and public health care, Canada spends roughly 10 per cent of its gross domestic product on services. The United States spends nearly 14 per cent. Despite the much higher costs in the United States, roughly 30 million Americans have no coverage for health care."
"To my mind, the universality of our Medicare system -- combined with lower costs -- suggest that our funding levels are in the appropriate levels. Here on Prince Edward Island, we spend a higher proportion of our gross domestic product on health care than the national average. In fact, we have been among the top four spenders proportionately since the 1980's.
"Again, I want to reiterate Prince Edward Island's commitment to a publicly funded system. Additionally, I welcome the debate on the nature of that system and its future by all affected groups and the public generally."