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A Canadian doctor diagnoses U.S. healthcare August 6, 2009

Posted by rogerhollander in Canada, Health.
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The caricature of ’socialized medicine’ is used by corporate interests to confuse Americans and maintain their bottom lines instead of patients’ health.
By Michael M. Rachlis
August 3, 2009
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Universal health insurance is on the American policy agenda for the fifth time since World War II. In the 1960s, the U.S. chose public coverage for only the elderly and the very poor, while Canada opted for a universal program for hospitals and physicians’ services. As a policy analyst, I know there are lessons to be learned from studying the effect of different approaches in similar jurisdictions. But, as a Canadian with lots of American friends and relatives, I am saddened that Americans seem incapable of learning them.

Our countries are joined at the hip. We peacefully share a continent, a British heritage of representative government and now ownership of GM. And, until 50 years ago, we had similar health systems, healthcare costs and vital statistics.

The U.S.’ and Canada’s different health insurance decisions make up the world’s largest health policy experiment. And the results?

On coverage, all Canadians have insurance for hospital and physician services. There are no deductibles or co-pays. Most provinces also provide coverage for programs for home care, long-term care, pharmaceuticals and durable medical equipment, although there are co-pays.

On the U.S. side, 46 million people have no insurance, millions are underinsured and healthcare bills bankrupt more than 1 million Americans every year.

Lesson No. 1: A single-payer system would eliminate most U.S. coverage problems.

On costs, Canada spends 10% of its economy on healthcare; the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don’t need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can’t charge as much when they have to deal with a single payer.

Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative costs and can negotiate lower prices.

Because most of the difference in spending is for non-patient care, Canadians actually get more of most services. We see the doctor more often and take more drugs. We even have more lung transplant surgery. We do get less heart surgery, but not so much less that we are any more likely to die of heart attacks. And we now live nearly three years longer, and our infant mortality is 20% lower.

Lesson No. 4: Single-payer plans can deliver the goods because their funding goes to services, not overhead.

The Canadian system does have its problems, and these also provide important lessons. Notwithstanding a few well-publicized and misleading cases, Canadians needing urgent care get immediate treatment. But we do wait too long for much elective care, including appointments with family doctors and specialists and selected surgical procedures. We also do a poor job managing chronic disease.

However, according to the New York-based Commonwealth Fund, both the American and the Canadian systems fare badly in these areas. In fact, an April U.S. Government Accountability Office report noted that U.S. emergency room wait times have increased, and patients who should be seen immediately are now waiting an average of 28 minutes. The GAO has also raised concerns about two- to four-month waiting times for mammograms.

On closer examination, most of these problems have little to do with public insurance or even overall resources. Despite the delays, the GAO said there is enough mammogram capacity.

These problems are largely caused by our shared politico-cultural barriers to quality of care. In 19th century North America, doctors waged a campaign against quacks and snake-oil salesmen and attained a legislative monopoly on medical practice. In return, they promised to set and enforce standards of practice. By and large, it didn’t happen. And perverse incentives like fee-for-service make things even worse.

Using techniques like those championed by the Boston-based Institute for Healthcare Improvement, providers can eliminate most delays. In Hamilton, Ontario, 17 psychiatrists have linked up with 100 family doctors and 80 social workers to offer some of the world’s best access to mental health services. And in Toronto, simple process improvements mean you can now get your hip assessed in one week and get a new one, if you need it, within a month.

Lesson No. 5: Canadian healthcare delivery problems have nothing to do with our single-payer system and can be fixed by re-engineering for quality.

U.S. health policy would be miles ahead if policymakers could learn these lessons. But they seem less interested in Canada’s, or any other nation’s, experience than ever. Why?

American democracy runs on money. Pharmaceutical and insurance companies have the fuel. Analysts see hundreds of billions of premiums wasted on overhead that could fund care for the uninsured. But industry executives and shareholders see bonuses and dividends.

Compounding the confusion is traditional American ignorance of what happens north of the border, which makes it easy to mislead people. Boilerplate anti-government rhetoric does the same. The U.S. media, legislators and even presidents have claimed that our “socialized” system doesn’t let us choose our own doctors. In fact, Canadians have free choice of physicians. It’s Americans these days who are restricted to “in-plan” doctors.

Unfortunately, many Americans won’t get to hear the straight goods because vested interests are promoting a caricature of the Canadian experience.

Michael M. Rachlis is a physician, health policy analyst and author in Toronto.

Canada’s Dirty Secret July 17, 2009

Posted by rogerhollander in Canada, Environment.
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Published on Friday, July 17, 2009 by The Guardian/UK

Canada’s dirty secret Despite its environmentally friendly reputation, Canada’s efforts on climate change rank last among the G8 nations

by Heather McRobie

Canada has come last on a WWiF scorecard of G8 countries’ efforts against climate change. That news would once have elicited at least a slightly surprised response. For several decades, Canada managed to present itself as the friendly giant of environmental issues. The 1989 Protocol on CFCs, an early turning point in combating the depletion of the ozone layer, was born in Montreal, and American environmental campaigners like Al Gore are always quick to heap praise on their northern neighbour.

But these days, Canada is looking increasingly like the dirty one of G8. The WWF report noted that Canada is one of the few countries on the scorecard whose emissions are still rising, and that Canada’s Conservative government isn’t doing enough to combat climate change.

Maybe some of Canada’s new bad-guy image on environmental issues is just a by-product of America’s new green image. Obama’s presidency was always going to bump the US up a few places on environmental scorecards, almost just out of gratitude that America has at least promised not to so flagrantly and unapologetically deplete the world’s natural resources.

But Obama isn’t why Canada is losing its green reputation. The real reason lies in the vast Alberta oil sands. In 2008, Alberta’s economically recoverable reserves were placed at 173 billion barrels, meaning that only Saudi Arabia outstrips Canada on oil reserves. But unlike Saudi Arabia, in Alberta the oil is literally in the sand. To dig it up and refine it is a process far higher in emissions than the processing of Saudi Arabian oil, and is destroying much of Alberta’s northern Boreal forest along the way.

The response to the report in Canada has been less hand-wringing than one might expect. Some dismiss the finding by pointing out that even other environmental organisations have problems with WWF. Others argue that surveys like the WWF’s are just penalising countries like Canada and Russia for their geographic realities – smaller countries keep their emissions down by importing oil from Canada, then criticise Canada for producing it, and so on.

On top of the recession’s effect on plans for the oil sands, defenders argue that Obama’s cap-and-trade proposals would severely impact Canadian oil production because the proposal will heavily penalise those who ship Canadian oil sand bitumen to the United States, given that refining the raw bitumen is so energy-intensive.

But Canada isn’t being punished for its geographic reality. It is finally being called out for presenting itself as environmentally friendly, while under the Conservative government green issues have been completely sidelined, if not derided. Before becoming prime minister, Stephen Harper implied that the science of climate change was “tentative and contradictory”, called the Kyoto accord a “socialist scheme” and ranted that an “army of Canadians” was needed to defeat it. While he has proposed “made in Canada” solutions to cutting carbon emissions, Harper’s main actions have been to cut programmes that promoted renewable energy like wind power. Even plans for the 2010 Winter Olympics in Vancouver risk causing environmental damage to rare forests in the nearby Eagle Ridge Bluffs.

Vancouver is consistently voted one of the world’s most liveable cities, and the Canadian government intends to use the Olympics to showcase Canada’s pleasant, fresh-aired way of life. But the price Canada is paying to maintain its “friendly giant” facade is increasingly being paid for by the environment.

The fact that Obama’s Clean Energy and Security Act will, if passed by Congress, disproportionately hurt oil companies working with Albertan oil sands may feel like American hypocrisy to Canadians who have long watched the US’s profligate environmental destruction go unchecked. But while Harper continues to disappoint on his commitments to the environment, someone has to play the bad cop to Canada.

© 2009 Guardian News and Media Limited

Heather is a writer and human rights worker based in the Middle East. Her first novel was published in 2008 and she is currently working on a novel on the Balkan thinker Vuk Karadzic

54% of Canadians oppose Afghan mission: EKOS poll July 16, 2009

Posted by rogerhollander in Canada, Iraq and Afghanistan, War.
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(Roger’s note: the headline for this article is somewhat misleading in that, as you will read, only 34% — barely one third — of the respondents, expressed approval for Canada’s involvement in Afghanistan.  That Canadian men and women are sent by their government to kill, maim, contribute to the social chaos and dysfunction; and to be killed, wounded and traumatized; is nothing less than criminal.  The civil war in Afghanistan has no relevance whatsoever to Canadian safety or sovereignty.  The Liberal and Conservative governments who made the commitment had no motive other than to support U.S. imperial geopolitics.  Prior to the U.S. invasion, Canadians and their government were well aware of the Taliban atrocities and did absolutely nothing about it.  It is interesting that the figure for popular support for the war — 34% — is just about the same percentage of electoral support that the ruling Conservative government received in the last election.  It is unfortunate that the parliamentary system allows for a government with such a small level of support to rule as if it had a majority)

Source: CBC News

Posted: 07/16/09 6:06AM

A slim majority of Canadians oppose the country’s participation in the war in Afghanistan, with the strongest opposition coming from Quebec, an EKOS poll suggests.

The poll, commissioned for the CBC and released Thursday, asked: “Do you support or oppose Canadian military participation in Afghanistan?”

Nationally, 54 per cent said they opposed it, while 34 per cent said they supported it, according to the poll. Twelve per cent were undecided.

Opposition was decisive in Ontario, Quebec and Atlantic Canada, while Western Canada had a narrower gap between those who support the mission and those who oppose it, EKOS found.

The survey suggests the strongest opposition exists in Quebec, with 73 per cent of those polled saying they didn’t support Canada’s participation. Fifteen per cent offered their support.

Alberta had the strongest support for the mission, at 42 per cent, while 45 per cent were opposed, the poll suggested. In British Columbia, opposition was at 49 per cent while 40 per cent offered support.

The sample size for Saskatchewan/Manitoba was considered too small to be conclusive.

Opposition was very high among women across the country, with 60 per cent saying Canada should not be involved in Afghanistan and 27 per cent saying it should.

When it comes to political leanings and support for the mission, Conservative voters were on top with 51 per cent saying Canada should be in Afghanistan. Liberal voters were second with 31 per cent, and Green voters were at 26 per cent.

Twenty per cent of NDP voters said they supported participating in the mission, while 11 per cent of Bloc Québécois voters did.

As EKOS was conducting the poll, Britain announced eight of its soldiers had been killed in Afghanistan during a 24-hour period, one of the worst days for British forces since the war started.

When Canada first sent soldiers to Afghanistan in 2002, public opposition to the mission hovered around 20 per cent, according to EKOS tracking data.

Since the mission started, Canada has lost 124 Canadian soldiers, two aid workers and one diplomat.

EKOS conducted the poll between July 8 and 14, 2009, surveying 2,713 Canadians from across the country over the age of 18. It’s the seventh in a series of weekly polls conducted by EKOS and released by CBC News.

The margin of error for a survey of this size is plus or minus 1.9 percentage points, 19 times out of 20.

Rich Cause the Crisis, Workers Get the Blame July 14, 2009

Posted by rogerhollander in Canada, Economic Crisis, Labor.
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Published on Tuesday, July 14, 2009 by The Toronto Star by Linda McQuaig

For a while, the Wall Street meltdown gave the rich a bad name.

Even they seemed embarrassed by their own excess. There were reports of designer shops packaging purchases in plain paper bags.

But as going downscale lost its novelty, the rich have grown weary of their own embarrassment. Gratuitous extravagance is making a comeback. I noticed a Tiffany’s ad in a Toronto newspaper last week for a “diamond solitaire on a platinum band of channel-set diamonds. From $3,550 to $1,000,000.”

Clearly the rich are feeling good in their own skin again. Public wrath, having briefly nipped at the heels of the well-to-do, has moved on to the heels of the less well-heeled – who also carry plain paper bags, but ones you can eat lunch out of.

And so, as the Wall Street-generated economic storm has squeezed public finances, Toronto’s city workers find themselves in the crosshairs.

The striking workers are demonized for wanting to hold onto their benefits, including the right to bank sick days, even though they won this fair and square at the bargaining table. It’s just one of dozens of concessions the city is now demanding from them.

Although the strike is a terrible drag for all of us, the city workers are in some ways doing us a service – holding the line against employers taking advantage of the recession to demand concessions (if unions simply give in, emboldened employers will go for more), and taking a stand against further erosion of public services.

Of course, in the media narrative, the workers are the villains. The role of the financial elite in triggering the economic storm is omitted, as is the elite’s relentless campaign over the past three decades for tax cuts, which set the stage for today’s financial shortfalls.

Responding to this campaign, Ottawa kept cutting taxes (more than $160 billion since 2003), rather than using its massive surpluses for public reinvestment. That meant cuts in transfers to provincial and municipal governments, even as extra responsibilities were downloaded onto them.

By August 2007, crash-strapped Toronto announced an array of cuts that threatened to diminish life in the city: less snow removal, shorter library hours, delayed openings for skating rinks, etc. Further down the food chain, struggling school boards were closing swimming pools.

In fact, the crunch could have easily been alleviated – if the Harper government had been willing to transfer the revenue from a planned one percentage point reduction in the GST, as municipal leaders across the country pleaded. His October 2007 budget gave the answer: no.

Business groups never mention that tax cuts necessitate cuts in public services. For the rich, it’s often a good trade-off; they can buy their own high-end services. But it’s rarely good for the rest of us.

As economists Hugh Mackenzie and Richard Shillington showed in a study last April, Canadian families typically get about $41,000 in public services for their taxes, which amounts to “the best bargain they’ll ever get.”

Meanwhile, provincial Conservative Leader Tim Hudak, sensing the frustrated public might be ready for a Mike Harris revival, has gone after the strikers, suggesting they should “get a grip.”

Hudak wants to direct your anger at the people who pick up garbage, rescue animals, run daycare centres – not at those who’ve spent years pushing for tax cuts that have left our public services underfunded and who now chase the recession blues with million-dollar shopping sprees at Tiffany’s.

© Copyright Toronto Star 1996-2009

Linda McQuaig’s column appears every other week in The Star.

We’ve Been Trapped Inside a Bad Health Care System So Long, We Don’t Even Know How Much We’re Missing June 26, 2009

Posted by rogerhollander in Canada, Health.
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By Sara Robinson, Campaign for America’s Future. Posted June 26, 2009.

www.alternet.org

Our current system has robbed us of the chance to save, educate ourselves, see the world and live to a robust old age.

Sometimes, when you’re up to your chin in alligators, it’s hard to focus on the fact that there’s a big, broad, alligator-free world waiting somewhere out there, beyond the edge of the swamp.

In this case, it’s hard for most Americans to even imagine that nobody in the rest of the developed world lives this way. We’ve been living inside the restrictions and making the trade-offs required to hang onto our all-important health care coverage for so long that we don’t even realize that we’re cutting those deals, or what we’re giving up, or how thoroughly those choices have come to dominate and limit our lives.

If you’re an American under 40, you can’t remember a time that the health care system didn’t work this way — or that keeping coverage wasn’t a dominant factor in making your life choices. If you’re older than that, the memory of another, happier era beyond the swamp is dim, and fading fast.

This was one of the things that struck me hardest when I arrived in Canada five years ago. The swamp-blindness was so dark and deep that it took a while to adjust to a world without alligators. It’s almost impossible to describe to folks back home how different life is when health insurance simply doesn’t factor at all into how you choose to live your life. There’s almost no language for it. Rather than even attempt it, I sometimes just ask my American friends and relatives to open up their imaginations, and answer the question for themselves:

  • How would your life be different if you never had to worry about getting, keeping, or affording health care again?
  • What other choices might you have made?
  • Where else would you be right now?
  • How would it change your plans for the future?

I’ve seen people reduced to tears of rage and frustration by these questions. When you really stop and think about it — pause for a few minutes to take it all in, past, present, and future — it becomes clear that the full absurdity and the sheer enormity of the sacrifices we have to make for an almighty health care card are the greatest obstacle to life, liberty and the pursuit of happiness that most of us are burdened with today.

Polls say most Americans who have health care are satisfied with it. But nobody ever asks them if they’re satisfied with what they’ve had to do to get it, keep it, or afford it.

What would you do differently? I watch my Canadian neighbors live their lives, and the world beyond the swamp comes into sharp and stunning focus.

My neighbors go to the doctor when they need to — and often, when they don’t. If they’re just feeling funky for a day or two, they go. If the splinter is too big to handle with a needle, they go. Anything goes a little bit sideways — they go.

By American standards, they’re probably overusing the system. (My husband once asked an employee who was nursing a cough, “Have you seen a doctor about that?” The guy just looked at him, confused. Of course he’d seen a doctor. Up here, only an American would ask such a stupid question.)

But the upshot is that the small symptoms of really big things — little lumps, creeping blood pressure, wounds that don’t heal right, coughs that don’t go away — are caught and diagnosed early in a GP’s office, instead of months or years down the road in a full-blown crisis at the ER, which is now the American way. And this is central to cost containment: getting emergent problems calmly headed off right away in a $30 office visit is a lot more cost-effective than having to deal with the full catastrophe later on in a $3,000 emergency-room drama scene. And it allows people to maintain their good health through the years, instead of delaying treatment until it’s too late to recover it and permanent damage is done.

My neighbors heal, recover, and go on with their lives. The U.S. disability rate last year was 19.1 percent, and rising fast. In Canada, it’s 14.3 percent — and Statistics Canada believes that the only reason their stats are creeping up these days is that people who once hid their disabilities are now more willing to admit them.

That disability rate affects the country’s economic competitiveness. Americans just don’t have the time or money to spend on a proper recovery after a major event, or get the full course of treatment that a chronic condition requires to be truly well-managed. Fearing for our income or our jobs, we hurry back to work too soon. Our insurance doesn’t cover necessary follow-up therapies, so things may not heal thoroughly or properly. We can’t afford the drugs, so we cut the pills in half, or stop taking them entirely.

The result is that too many of us end up far more impaired than we need to be — and may, in fact, never be quite right again. Deferred maintenance — which is what this is — takes a ferocious toll on the American workforce, which is now being forced to compete with workers around the world who get better care, make better recoveries, and are able to return to work at full strength.

My neighbors start small businesses. Americans routinely stay chained to jobs they hate because they can’t afford to lose coverage. Canada has an exuberant entrepreneurial culture, fueled by favorable tax structures for small business and a preference for Main Streets over malls. Canadians may bet the house and the kids’ college funds on a new venture; but they never think twice about whether or not they can afford to leave BigCo because they’ll lose their insurance, or what will happen to the new business if they get hit by a delivery truck, or how they’ll afford some kind of minimal coverage for their new employees. Unburdened by health care costs or concerns, their ventures are far more likely to thrive.

My neighbors go back to school. Low-cost government-subsidized universities combined with assured health care make it easy for people to make mid-course career adjustments, pursue their passions, and expand their horizons. The upshot is a better-educated, more capable workforce that’s constantly improving its skills.

My neighbors quit jobs they hate. “Take this job and shove it” is a lot easier — and sweeter — when your boss isn’t holding an almighty health care card over your head. Bosses know this, too, and working conditions are often better as a result.

My neighbors stay home with their kids. They can afford to do that, because they’re not wholly dependent on whichever breadwinner can manage to find a job with a decent health care plan.

My neighbors invest. They’ve got stable household budgets that aren’t being thrown off by surprise health events. Because Canada doesn’t have a mortgage interest deduction, most Canadians reduce interest costs by taking out 10- or 15-year mortgages. The payments really squeeze the family budget for that decade — but by their 40s a lot of them own their homes outright, something most Americans will never achieve. Home ownership, college savings and retirement funds are all big-money investments that you simply can’t commit to if you’re liable to be hit with five-figure medical bills at any moment.

My neighbors travel. Americans don’t get vacation time; and when they do get it, they tend to stay in-country. A lot of Canadians take three weeks off in the winter to go somewhere fabulous and warm (understandable, given the climate). The sheer variety of these escapes boggles me yet: They fly off to build schools in Guatemala, or take holiday jobs in New Zealand, or learn French in Morocco. Even the guy who paints my house can afford to do this, because he’s not spending half his annual income on health care premiums. That $15K-a-year savings will buy a whole lot of margaritas in Cancun.

The result is a population with broad global awareness, and extensive global ties — a necessary thing for a country whose economy depends completely on trade. And it may be an important factor in keeping Canada progressive. According to Diana Kerry, who ran her brother John’s overseas campaign in 2004, Americans who own passports vote Democratic three to one. So travel makes you liberal. Who knew?

My neighbors seldom go bankrupt. The Canadian bankruptcy rate has soared in the past year to 4.3 per thousand. In the U.S., it’s 11.1 per thousand. The entire difference between these two figures is accounted for by the fact that 62 percent of all U.S. bankruptcies were driven at least in part by medical expenses.

But tidy numbers like this elide a harder reality: Bankruptcy doesn’t just cost us financially. It also destroys the foundations of our social capital. When the house, the dreams, and the future are gone, very often the marriage is the next thing that goes, too. Bankruptcy travels in close company with domestic trouble, divorce, drug use, homelessness, and broken families. (After medical-bill refugees, the second most common people in bankruptcy courts are recently divorced women.) If, as conservatives like to remind us, the family is the basic unit of civilization, then our health care system is directly making its profits by pulling down our social foundations — and ultimately undermining our ability to hold our civilization together.

My neighbors have never seen anyone die because they didn’t have health care. With 22,000 Americans dying every year due to a lack of health insurance — that’s one every 24 minutes — there aren’t many of us who don’t know someone who lost a loved one because they couldn’t get the treatment they needed. (For me, it was my father.)

But when I share this factoid with Canadians, they invariably do a long double take. They lean back, squint, stare, and pause to reassess my credibility (if not my sanity). It’s literally unbelievable. They can’t even process it. I must be making it up, or at least exaggerating. It’s just beyond the realm of imagining that a rich nation like America would let that kind of thing happen — let alone let it happen sixty times a day, for years on end.

And yet, they know things are bad down here, because everybody who goes South buys travel insurance before they cross the border. Everybody has heard scary stories about people who got sick or hurt and ended up in an American ER with a five-figure bill to pay. It’s just a stupid risk, and they’re not willing to take it.

What would you have done differently if you’d never had to worry about health insurance? How would life be different now? How would it change your plans for the future?

Go ahead. Think about it. Let yourself get good and angry. The current system has robbed an entire generation of Americans of their full potential. It has made us serfs. It has narrowed our horizons. It has undermined our families and communities. It has deprived us of the chance to save, to own a home, to educate ourselves and our children, to see the world, to retire in comfort, and to live to a healthy and robust old age.

It has left us in this swamp, chin-deep in alligators. And the first step in getting back out is getting very clear in our own minds that there are other places where people don’t live this way — and then angry enough to lean on our leaders, and make it just as clear to them that we don’t intend to live like this any more, either.

Your representatives need to hear from you. Today.

Because your future is still out there — and the most important thing you need to get there is a health care plan nobody can ever take away.

 Sara Robinson is a Fellow at the Campaign for America’s Future, and a consulting partner with the Cognitive Policy Works in Seattle. One of the few trained social futurists in North America, she has blogged on authoritarian and extremist movements at Orcinus since 2006, and is a founding member of Group News Blog.

Healthy Opinions About Health Care June 21, 2009

Posted by rogerhollander in A: Roger's Original Essays, About Health, Canada, Health.
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Roger Hollander, www.rogerhollander.com, June 21, 2009

We Canadians know a good thing when we see, and live it and enjoy it and depend on it.  I’m not talking about maple syrup, although that might come in a distant second.  It’s our national health plan.  In the forty one years I have lived in Canada I have never once heard any politician from any political party suggest its abolition (not that the Tories do not do their best to defund and attempt to erode it).  It would be political suicide.  A few years ago a CBC poll asked Canadians who in their estimation was the greatest Canadian of all times.  The hands down winner was Tommy Douglas, the man who, as Premier of the prairie Province of Saskatchewan, introduced universal health care to Canada (he also happened to be Donald Sutherland’s father-in-law).

 

What Canada has is NOT government health care.  It is rather universal health insurance with a single insurer, the government (organized province by province).  Contrary to myth, and unlike HMOs and other private health insurance in the States, Canadians have an absolute right to choose their own physicians.  Furthermore, in all my years living in Canada not once have I walked into a doctor’s office, clinic, laboratory or hospital and had to open my wallet (other than to produce my plastic health card).  When my father was visiting from the States and needed to see my primary care physician, the office staff had to fumble around trying to figure out how to take a cash payment from him.  It had never happened before.

 

The Canadian health care provider, be it a physician, laboratory, etc., simply fills out a form and sends it to the government for payment according to a scale that is negotiated between the government a provider organizations such as the Canadian Medical Association.  There are no blood-sucking private health insurers to send costs through the ceiling and squeeze out bigger profits with co-payments and by denying treatment.  The Canadian plan is funded by employer and employee contributions. 

 

Despite massive disinformation campaigns about the Canadian health care system that are funded and promoted by the health insurance industry, the pharmaceutical industry and the Republican Party, a majority of Americans favor what is referred to as a single-payer system over the existing Rube Goldberg system in the States that passes for health care, a system that costs more, yields poorer results, and leaves tens of millions without coverage.

A CBS News/New York Times poll that was published in today’s New York Times (http://www.nytimes.com/2009/06/21/health/policy/21poll.html?_r=1&hpw) showed that 72% of respondents supported government health insurance with only 20% opposed (the poll did not refer to a “single-payer” plan, but rather a public plan that would compete with private plans; other polls have shown a majority in favor of single-payer).

Surprisingly, the poll showed 50% of Republicans in favor with 30% opposed.  87% of registered Democrats approved and 73% of Independents.

50% of all respondents thought government would do a better job than private insurance companies in providing medical coverage against 34% who thought it would do a worse job.  59% thought government would do a better job of holding down health costs while 26% thought they would do worse.

But here is what for me is the most interesting and telling statistic that arises out of the poll.  Respondents were asked if they were willing to pay higher taxes so that all Americans have health insurance that they can’t loose no matter what.  57% said yes and 27 % said no.  That’s better than a two to one ratio.  And here’s the kicker: of those who earn less than $50.000 annually, 64% are willing to pay more so fellow Americans are not denied health care and 27% are not.  For those earning more than $50,000, 52% are willing and 44% are not.  

Look at those numbers carefully.  While only 27% of poorer Americans are not willing to help their fellow citizens, a whopping 44% of those with greater means don’t give a damn.

This is what I call compassionate conservatism.

Debunking Canadian Health Care Myths June 7, 2009

Posted by rogerhollander in Canada, Health.
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Published on Sunday, June 7, 2009 by The Denver Post by Rhonda Hackett

As a Canadian living in the United States for the past 17 years, I am frequently asked by Americans and Canadians alike to declare one health care system as the better one.

Often I’ll avoid answering, regardless of the questioner’s nationality. To choose one or the other system usually translates into a heated discussion of each one’s merits, pitfalls, and an intense recitation of commonly cited statistical comparisons of the two systems.

Because if the only way we compared the two systems was with statistics, there is a clear victor. It is becoming increasingly more difficult to dispute the fact that Canada spends less money on health care to get better outcomes.

Yet, the debate rages on. Indeed, it has reached a fever pitch since President Barack Obama took office, with Americans either dreading or hoping for the dawn of a single-payer health care system. Opponents of such a system cite Canada as the best example of what not to do, while proponents laud that very same Canadian system as the answer to all of America’s health care problems. Frankly, both sides often get things wrong when trotting out Canada to further their respective arguments.

As America comes to grips with the reality that changes are desperately needed within its health care infrastructure, it might prove useful to first debunk some myths about the Canadian system.

Myth: Taxes in Canada are extremely high, mostly because of national health care.

In actuality, taxes are nearly equal on both sides of the border. Overall, Canada’s taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.

Myth: Canada’s health care system is a cumbersome bureaucracy.

The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn’t when everybody is covered.

Myth: The Canadian system is significantly more expensive than that of the U.S.

Ten percent of Canada’s GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada’s. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services.

What the American taxpayer may not realize is that such care costs about $45 billion per year, and someone has to pay it. This is why insurance premiums increase every year for insured patients while co-pays and deductibles also rise rapidly.

Myth: Canada’s government decides who gets health care and when they get it.

While HMOs and other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada to do so are physicians. In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.

There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI, you don’t get one no matter what your doctor thinks – unless, of course, you have the money to cover the cost.

Myth: There are long waits for care, which compromise access to care.

There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists’ care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health care needs.

Myth: Canadians are paying out of pocket to come to the U.S. for medical care.

Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care. Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is.

Myth: Canada is a socialized health care system in which the government runs hospitals and where doctors work for the government.

Princeton University health economist Uwe Reinhardt says single-payer systems are not “socialized medicine” but “social insurance” systems because doctors work in the private sector while their pay comes from a public source. Most physicians in Canada are self-employed. They are not employees of the government nor are they accountable to the government. Doctors are accountable to their patients only. More than 90 percent of physicians in Canada are paid on a fee-for-service basis. Claims are submitted to a single provincial health care plan for reimbursement, whereas in the U.S., claims are submitted to a multitude of insurance providers. Moreover, Canadian hospitals are controlled by private boards and/or regional health authorities rather than being part of or run by the government.

Myth: There aren’t enough doctors in Canada.

From a purely statistical standpoint, there are enough physicians in Canada to meet the health care needs of its people. But most doctors practice in large urban areas, leaving rural areas with bona fide shortages. This situation is no different than that being experienced in the U.S. Simply training and employing more doctors is not likely to have any significant impact on this specific problem. Whatever issues there are with having an adequate number of doctors in any one geographical area, they have nothing to do with the single-payer system.

And these are just some of the myths about the Canadian health care system. While emulating the Canadian system will likely not fix U.S. health care, it probably isn’t the big bad “socialist” bogeyman it has been made out to be.

It is not a perfect system, but it has its merits. For people like my 55-year-old Aunt Betty, who has been waiting for 14 months for knee-replacement surgery due to a long history of arthritis, it is the superior system. Her $35,000-plus surgery is finally scheduled for next month. She has been in pain, and her quality of life has been compromised. However, there is a light at the end of the tunnel. Aunt Betty – who lives on a fixed income and could never afford private health insurance, much less the cost of the surgery and requisite follow-up care – will soon sport a new, high-tech knee. Waiting 14 months for the procedure is easy when the alternative is living in pain for the rest of your life.

Rhonda Hackett of Castle Rock, Colorado is a clinical psychologist.

© 2009 The Denver Post

Gov. Gen. accepts three resignations from Order of Canada June 1, 2009

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(Roger’s note: this story stands as a minor and ironic counterpoint to the murder of Dr. George Tiller, who like Dr. Morgentaler had courageously and in the face of the consant harassment and threat of violence on the part of anti-choice fanatics, stood boldly for the welfare and rights of women.  As we mourn Dr. Tiller’s senseless death we are subjected to the likes of a Roman Catholic archbishop and two presumably co-religionists and their self-righteous gestures in support of religious dogma that directly yields nothing less that suffering and death.)

Source: CBC News

Posted: 06/01/09 4:40PM

Gov. Gen. Michaëlle Jean has formally accepted the resignations of three Montrealers from the Order of Canada, her office said in a brief news release Monday from Ottawa.

No reasons were given for the three René Racine, Jacqueline Richard and Cardinal Jean-Claude Turcotte returning the awards.

However, Turcotte, 72, who is Montreal’s archbishop, told CBC’s French-language service last September that he was renouncing his honour to protest Dr. Henry Morgentaler’s appointment to the order.

“I’m worried about how we treat life, from conception to death,” he said. “I decided to take a stance that clearly reflects my convictions.”

Turcotte, who has worked extensively with the poor while fulfilling his religious duties, was named an officer of the Order of Canada in 1996 by then governor general Roméo Leblanc.

Jean named Morgentaler, who fought to legalize abortion in Canada, as a member of the order last July for his services to women and for leadership in the fields of humanism and civil liberties. The controversial appointment was made on the advice of the independent Order of Canada selection committee.

Montreal astronomer Racine was made a member of the Order of Canada in 1999, while pianist and conductor Richard received the award in 2004.

Ecuador’s Future for Canadian Transnationals: An Exchange of Indigenous Perspectives May 24, 2009

Posted by rogerhollander in Canada, Ecuador, Environment.
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Jennifer Moore

www.upsidedownworld.org, May 20, 2009

“The sorrows are ours; the cows are not.”

Translation of a lyric written by Atahualpa Yupanqui (born Hector Roberto Chavero; died 1992), an Argentinian Communist exiled to Paris and who lived out his life there. The original Spanish is “las penas son de nosotros, las vaquitas son ajenas.”

Image“Welcome to the future,” says the sign behind the gated area where Vancouver-based Corriente Resources is developing an open-pit copper mine in Ecuador’s Southern Amazon. Bumping along in the back of a pick-up truck on her way to visit one of several communities slated to be displaced by the project, the idea that the future is fenced off with restricted entry for local communities that have lived on the land for years, even generations, hit home for Anne Marie Sam.

From the Nak’azdli First Nation in central British Colombia, Sam is one of two indigenous representatives who visited communities affected by Canadian-financed mining activities in Ecuador earlier this month. “We don’t even want Canadian companies in our territory, so we don’t blame Ecuadorians for not wanting them here either.” The Nak’azdli Nation opposes a proposed gold and copper mine on their territory that they have determined “would not strengthen them as a community” which includes about 1,700 members.

The trip was a critical response to President Rafael Correa’s recent invitation to the Canadian Embassy to help delegitimate the position of various indigenous leaders who are critical of his mining policy. The Embassy is still responding and will soon host a second delegation of indigenous leaders. This most recent visit was coordinated by the Quito-based Pachamama Foundation in cooperation with the Confederation of Indigenous Nationalities of Ecuador (CONAIE).

The CONAIE has criticized Correa for continuing with World Bank-backed policies to substitute the country’s dwindling oil reserves with metal extraction. Ecuador has been an oil producer for more than forty years, but no large scale mining project has yet entered production here. The CONAIE is worried about possible impacts on both water and local livelihoods. They further argue that indigenous peoples and other affected communities should have the right to consent over what projects take place on their lands or territories. A position substantiated by international law.

However, Correa is unequivocally opposed to local communities having “a veto” over what he sees as a matter of national interest. He calls his critics “infantile environmentalists” and the “greatest threat” to his political project.

Coming from Canada – the world’s principal source of financing for global mining activities – Robert Lovelace, a leader from the Ardoch Algonquin First Nation in Eastern Ontario, says his experiences in the Andean nation reveal that indigenous communities in both countries “share a heck of a lot in common.” Not only does Canada have its share of environmental disasters from extractive industry and not uphold the right to consent for indigenous communities, it also lags behind Ecuador for not having ratified international conventions that recognize these rights including the American Convention on Human Rights, Convention 169 of the International Labour Organization and the UN Declaration on the Rights of Indigenous Peoples.

“We need to see much more of each other and we need to compare notes,” Lovelace says. An ongoing relationship, he believes, could be mutually beneficial. “When people in Ecuador stand strong,” he says, “it also helps us because it tells the mining companies that nobody is going to take the stuff that they’ve been giving out regardless of where they are.”

Canada’s Glowing Reputation

While Correa hopes that indigenous leaders invited by the Canadian Embassy will drown out the CONAIE’s criticisms, the recent visit by Sam and Lovelace revealed that Canada’s story is not as harmonious as Correa would lead Ecuadorians to believe.

“[Canada] has understood how to respect and benefit its ancestral peoples,” said Correa during a national radio address. The first people to benefit in Canada from mining, he added, “are the ancestral peoples.”

But Lovelace, speaking during two events in Quito which included members of Ecuador’s Constitutional Court, the Ministry of Mines and Petroleum and an international group of lawyers, called Canadian mining a “two fold problem: for us and the rest of the world.” He insisted that within Canada it has to be seen within the context of colonialism and poor regulation.

The firm but soft-spoken leader explained that indigenous peoples are the most impoverished group in Canada, with high rates of suicide particularly for those who have lost their traditional ways of life, and that they have suffered official attempts to destroy their social and cultural fabric leading to rampant addictions and many broken homes. This, he explained, is a cost of the extractive and commercial mindset with which Canada was founded and continues to operate.

Lovelace has been opposing a proposed uranium mine on Ardoch territory, and shared his experience about how his community was sued for $77 million dollars by Frontenac Ventures and about his three and a half months in jail as a result of efforts to prevent mining activities on their lands.1 Radioactive contamination of lakes and rivers from uranium mining, occupational health hazards, and the uses of uranium for nuclear energy and arms are a few reasons why they do not support the mine.

Speaking to the national press, he added that the proliferation of Canadian mining companies can be explained by the fact that “we don’t have tough rules” and have poor infrastructure to enforce the rules that we do have. The Toronto Stock Exchange (TSX) lists almost 60% of mining companies worldwide with over 1,400 projects in Latin America and more than 8,000 around the globe.2

He thinks stronger regulation, backed up by good monitoring and enforcement, should be “the cost of doing business for companies that are invited into other countries and invited onto indigenous land, as a bare minimum. Canada has to acknowledge that and do that because it is immoral not to.” The United Nations Committee on the Elimination of Racial Discrimination (CERD) has also urged Canada to develop such legislation.

But Canada has been reticent. It took the government four years to respond to parliamentary recommendations to strengthen its mining legislation for extractive industry abroad, and its recent decision reinforces voluntary guidelines rather than tightening regulations.

Interestingly, Ecuadorians from the northwestern valley of Intag recently launched a lawsuit against the TSX with the objective that the case will help lead to stronger regulations in Canada. Inteños have broadly opposed open-pit copper mining for over twelve years, but this has not stopped current project owner Copper Mesa Mining (formerly Ascendant Copper) from trying to use forceful means to try to reach its concessions. The TSX was warned before the company was listed that further financing could lead to human rights violations and violence in the valley.3

ImageThe Environment, an Afterthought

However, Correa would have Ecuadorians believe that TSX-listed companies who are irresponsible, well, they are simply not Canadian. “Be careful!” he has warned on national radio. “There are some companies that try to pass themselves off as Canadian because they trade on the Canadian stock market, but they’re not Canadian. Canada has strict, very strict, environmental requirements.”

But the Canadian public does not even know how much pollution mining operations have generated.

Only several weeks ago, the Federal Court released a “strongly worded decision” ordering the Canadian government to “stop withholding data on one of Canada’s largest sources of pollution – millions of tonnes of toxic mine tailings and waste rock from mining operations throughout the country.”4 Indicating the strength of Canada’s mining lobby, it has taken sixteen years since the National Pollutant Release Inventory was created for the sector to be held to the same reporting requirements as every other industrial sector.

When Anne Marie hears a question translated for her from an audience in Quito: “Mining companies say that their projects will be clean, that they won’t have serious enviromental impacts, what do you think?” she laughs at the coincidence. “We hear the same thing,” she remarks. “But the question isn’t whether a company will contaminate our water, it’s when.”

Given the industry’s track record in her home province, Anne Marie’s nation has not been swayed by company promises that environmental impacts will be mitigated. A recent press release from the Nak’azdli Nation states, “There are close to 2,000 abandoned or closed mines in BC and two third of them are still polluting the land and water.”5

So, when the Nak’azdli First Nation was approached by Terrane Metals to develop a gold and copper mine on their lands at the headwaters of the Peace River watershed, they did not jump at the opportunity for an agreement with the company. They did, however, take the chance to do some of their own investigations and accepted the company’s offer of $150,000 CDN without promising any further agreement.

Anne Marie was appointed to study the issue.

“Our elders advised us not to focus just on the economic aspect, but to also seriously consider the social and cultural implications,” she said.

With the company funds, they hired their own experts and examined the social, cultural, economic, environmental and legal ramifications of the project put together in what she calls an “Aboriginal Interest and Use Study.”

They concluded that they could not support the project. Even when they hit a period during which many of their members were without work, they determined that the kinds of jobs they could qualify for based upon their education and experience – cleaning, cooking and construction – did not outweigh the impacts.

Their disapproval has not stopped the company from seeking other nearby First Nation communities that would accept the project. Nor did it stop the provincial government from recently approving the company’s Environmental Assessment despite not having consulted the Nak’azdli Nation. However, it has been a key tool in their resistance.

It is a challenge because “time is not on the side of First Nations when it comes to a mining project. It’s always the timeline of the company.” But, she laughs, thinking about the time it took to read through the 6,000 page environmental assessment that the company provided and in which they found many weaknesses, “if I didn’t read [the study], I wouldn’t be able to tell you this story.” Education and communication, she says, “are key.”

ImageSorrow is Ours, the Cows are Not

The newly elected Prefect of Ecuador’s southernmost Amazonian province, Salvador Quishpe, welcomed the Canadian delegation to their final event in El Pangui. The Condor Mountain Range stretches along the eastern horizon of this steamy jungle town situated near some of the most contentious mining developments in the country.

Whereas Bob Lovelace contextualizes Canadian mining in terms of colonialism, Quishpe frames Ecuadorian mining around twenty five years of neoliberalism that he says continues despite Correa’s slogan “Our patrimony belongs to all.” He jokes for a moment: “the Canadians came along and said, “Belongs to all, eh?” “Hey, that’s good, then that includes us too!”

Quishpe reminded the 400-strong crowd that UNESCO has declared part of the Condor Mountains a World Bioreserve which has over 48 distinct ecosystems and is one of the highest priority areas for scientific research in the neotropics. He also reminded the audience that vast stretches have been claimed for mining exploration and that the principal concession holders are Vancouver-based Corriente Resources and Toronto’s Kinross Gold.

He observes that the industry’s principal proponents -  the Ecuadorian representatives of Canadian transnationals – are in large part former officials from the Ministry of Mines and Petroleum. So, he remarks, the same people who helped institute the neoliberal framework for mining in the 1990s are now sitting on top of some of the best deposits of gold and copper. “It is ultimately the companies, not the government, who makes mining policy in this country,” he concludes. “And while it’s a mortal sin to say it,” he continues, “mining should be nationalized.”

Having recently been called “an enemy of the government” and a “dumb leftist” by Correa, Quishpe adds, “We are not against development.” Rather, he emphasizes, his province needs proper planning with strong participation. He proposes at least one industry – tourism – that he plans to promote during his upcoming term in local office. “We want development for the well-being of our peoples, not so-called development by which a transnational company takes away our riches for itself.”

Sam has a similar comment. “Our community has always said, we’re not against development. But we need to have a say in what development happens in our area and where, and right now we’re not being given that opportunity.”

The Waterkeepers

As the event wraps up, Anne Marie hands Salvador a card. She explains that the image of a red and green frog was drawn by an artist from her community. The frog represents the waterkeepers, she says, and Salvador is a water defender just like she and the rest of her clan from the Nak’azdli First Nation.

“Coming here has opened my eyes to how connected we are,” says Sam reflecting on the visit shortly later, “and how similar the fight we have to protect the land and the connection [we have with the land] whether indigenous or not.” She thinks about El Pangui’s struggle at the headwaters of the Amazon, and recalls her own at the headwaters of the Arctic. “What we need,” she says, “is a stronger role for indigenous people that is not after the fact or after claims are made on the land.”

In British Colombia, she says they are using new technology that enables helicopters to identify and take images of what minerals are in the ground just by flying over their territories. “Instead of this information going direct to the internet so that people can begin staking claims,” she says, “the information should go to First Nations first. And then we can decide if we want to do small scale mining, or if we want to do something else because open pits are not a nice site to look at and a recreational lake in an open pit (which is what the Terrane Metals promises to leave behind in her territory) isn’t an ideal situation for us.”

Robert Lovelace also believes that a much more meaningful participation is necessary. He describes it as a spectrum that usually begins with information sessions or token consultations. “Consultation,” he explains, “is still a form of tokenism because to consult with someone does not mean that you’re going to agree with them or even take their advice into account especially when there’s a power differential, whether based on capital or politics.”

“But when the values of each of the parties are truly recognized,” he says “and we look at consensual partnerships where both parties are able to give consent, then if one party can’t give consent, a project or development doesn’t go ahead. But that’s honest partnership.”

“As long as the power of First Nations are recognized then they may assign their authority to a corporation or a level of government in order to facilitate something happening. But that’s their choice, they’re not being forced or imposed upon to do that. The last stage is true self-governance. That’s having full authority to choose to move forward with development or not, or to choose another future altogether.”

While it has yet to be seen what the Canadian Embassy’s upcoming delegation will share with Ecuadorian’s, it will most definitely get broader coverage from the Ecuadorian press. As well, one can be almost sure that free, prior, and informed consent; recognition of the inherent rights of indigenous peoples; and the possibility of different futures other than the Canadian-owned, open-pit and underground mines envisioned for El Pangui, Yantzaza, Intag, Victoria del Portete, Molleturo, Ponce Enriquez, and many other parts of Ecuador will not be up for discussion.

Notes:

1. For further detail see: Justin Podur, “Canada’s latest political prisoners” http://www.zcommunications.org/znet/viewArticle/17019
2. 2007 figures based upon the Toronto Stock Exchange’s Mining Presentation
3. For more information see http://www.ramirezversuscoppermesa.com/index.html
4. Press release “Court victory forces Canada to report pollution data for mines” available at http://www.commondreams.org/newswire/2009/04/24-0
5. Press release “Proposed BC mines cannot proceed without Nak’azdli First Nation” available at http://www.rightsaction.org/articles/Nakazdli_abuse_031909.html

N.B. Court of Appeal paves way for Morgentaler’s lawsuit May 21, 2009

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Source: CBC News

Posted: 05/21/09 6:25PM

The New Brunswick Court of Appeal paved the way Thursday for Dr. Henry Morgentaler to sue the province for refusing to pay for abortions at his private clinic in Fredericton.

“I accuse the government of New Brunswick of being sexist, male chauvinist, of victimizing and oppressing women,” Morgentaler said in 2002 when he announced his lawsuit.

Morgentaler wants medicare to pay for abortions at his clinic, while the province says it only has to pay for abortions approved by two physicians and performed in hospitals. Currently, women pay the $750 fee at Morgentaler’s clinic themselves.

The province argued Morgentaler couldn’t sue on the issue because it affects women, not him. In January, after a judge ruled in Morgentaler’s favour, the province appealed the decision. On Thursday, three appeal judges also ruled in Morgentaler’s favour.

The province had argued it would be better if the lawsuit was launched by a woman who had been forced to pay for a clinic abortion.

Chief Justice Ernest Drapeau said that argument doesn’t pass muster. None of the many women who have had abortions at Morgentaler’s Fredericton clinic in the past 15 years has come forward to file a lawsuit, he noted.

“That state of affairs is likely the product of two factors operating in tandem: the prohibitive cost of litigation and the intimate and private nature [of choosing to have an abortion],” wrote Drapeau.

“Dr. Morgentaler brings to the judicial arena financial resources and legal expertise which will undoubtedly help level the playing field and greatly improves the chances that any judicial decision on the merits is fully informed both factually and legally.”

Morgentaler’s long history of legal battles over abortion means his lawsuit is the only reasonable way to resolve the issue in court, he added.

The province could still appeal to the Supreme Court. If not, Thursday’s decision would pave the way for Morgentaler’s lawsuit to finally go ahead.