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Liberal MP writes user-pay prescription for health care

A Liberal MP wants political leaders to finally show some courage and consider a health-care system that would allow Canadians to pay out of their own pockets for some services.

Keith Martin, a B.C. veteran of 17 years in the Commons, warns the existing system is "busting at the seams" and needs private-sector help. "We don't need more studies we need action," he said in an interview Monday. "We need the courage for politicians at all levels to start talking about the facts and to bury the ideology."

The Liberal MP, who is also a medical doctor, practiced emergency room medicine when he returned to his riding from Ottawa until three years ago.

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Elected first for the Reform Party in 1993, Dr. Martin left the new Conservative Party in 2004 and sat as an independent before winning the seat as a Liberal under Paul Martin. Since his early Reform days, however, he has been pushing for a private/public system similar to that used in many European countries. His views have never aligned with his party's health-care policies.

Indeed, as Reform health critic in 1999, Dr. Martin presented his bold plan for a private system running alongside the public one to then-leader Preston Manning and the shadow cabinet. It didn't fly; more than a decade later, he is still fighting for his reforms and his vision.

But Mr. Martin's views may be finally catching on. He is not alone now in voicing his concerns about the dire need for health-care reforms.

Last week in a speech to the Canadian Council of Chief Executives in Montreal, former Conservative prime minister Brian Mulroney called for a " serious, adult discussion" on health care. "The OECD, not exactly known for radical analyses, recently concluded that, because our health-care system is not sustainable in its current form, some form of user fees and greater scope for competition within the system will be necessary," he said.

Mr. Mulroney called for a blue-ribbon panel of medical and financial experts to provide "a sensible framework for the debate" as the federal-provincial funding formula ends in 2014.

For so long, politicians have been afraid to speak up about reforms that might lead to some form of privatization. Mr. Martin, who recently wrote an op-ed piece calling for Canadians to pay for some services " out of their own pocket," says political parties "generally are afraid to move into this territory."

"Whenever, somebody raises the false claim that ... we want to pursue an American-style health system they are afraid of that because none of us want that to occur," he told The Globe. "So that simple statement destroys the debate and terminates the debate and in doing that we actually harm our patients and contribute to the erosion of our public health care system."

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The MP has not informed his leader about his bold position. Rather, he jokes: "It's better to ask for forgiveness than permission."

Mr. Martin said the health-care system in Canada works for the acutely ill but not for the "millions of people in Canada who have chronic problems." He noted they "wait a period of time that is almost inhumane" for care.

To fix this, he suggests patients be given a choice. Everyone would be paying into the public system but "for a small number of people who don't want to wait they could pay privately for private services that were only paid for private money."

He said this would reduce demand on the public system without removing resources from it. "Those people are not jumping a queue. They have moved temporarily into a separate line. They are removing demand out of the public system so people in the public system would move up the line."

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About the Author
Ontario politics reporter

Jane Taber is a reporter at Queen’s Park. After spending three years reporting from the Atlantic, she has returned to Ontario and back to writing about her passion, politics. She spent 25 years covering Parliament Hill for the Ottawa Citizen, the National Post and the Globe and Mail. More

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