Key values at stake in health care

CPJ’s citizen movement character received several boosts at our Annual General Meeting on May 31.

First, the meeting took place in Halifax, for the first time in CPJ’s history. Local members Steve Martin, Elna Siebring, Jane Porter and Dale Poel have worked hard to build up our membership in the Maritimes, and their efforts are paying off. Forty people attended the event, which was covered by The Halifax Chronicle-Herald.

Secondly, keynote speaker Dr. Nuala Kenny praised CPJ’s work to promote citizen action during her address, which focussed on the Romanow Commission on health care, which involved thousands of Canadians.

Dr. Kenny, chair of Dalhousie University’s bioethics department, a pediatrician and Sister of Charity, held an audience of 40 people spellbound as she outlined the choices at stake for Canadians in light of the Romanow Report on health care.

"The fundamental question at stake is not about health care," she said. "It’s about responsible citizenship, about the nature of the good of health care." She zeroed in on the moral issues at stake: "What is health care, a public good or a market good? Is a health need my individual need, or is it ours?"

Good public policy serves as a statement of community identification. The United States, noted Dr. Kenny, is the only Western nation without some form of publicly-funded health care system. In contrast, Canada’s health system and the values behind it are much more like those in Europe. Yet we continue to compare our system to that of the U.S.

Dr. Kenny hammered on the critical importance of values in health care, noting how the Romanow Report stressed this feature as well. "If public policy is about values, changing our (health) system is not just a technical issue." Similarly, Romanow noted that "medicare is a moral enterprise, not a business venture." She agreed, however, that market mechanisms could help in some aspects of health care.

The Romanow Commission affirmed three core values held by Canadians: equity, fairness and solidarity. In our public system, we share risk, noted Dr. Kenny, by providing health care to rich and poor alike. "Solidarity is at stake. We’re in this together, or we’re not."

Yet current political trends are putting the system under pressure. "Canadians want American-style taxes and European-style services. It ain’t going to happen."

Meanwhile tremendous advances in medical technology pose other challenges in deciding what health care services are covered by the public purse and which ones are not. "Can we sustain medicare? We can make it as sustainable as we want it to be. The sustainability of medicare is about a serious discussion of what is covered and what is not."

A lively question period followed, in which Dr. Kenny touched on her experience as a deputy minister of health in Nova Scotia under both Liberal and Conservative governments. She praised the health ministers she worked with, but said they are constrained by the system in which they operate. "You have no idea how hard it is to be a morally good politician."

CPJ executive director Harry Kits reminded the audience of the importance of citizen action. He’d just flown in from the Canadian Council for Refugees consultation in Ottawa, where he’d heard of inhuman treatment of refugees both in Canada and the U.S.

"We have a security consciousness on overdrive and a fearful economics driving our responses to the border, to mad cow disease and to SARS. All this has increased Canadians’ sense of uncertainty and caused constant change in the state of politics today. The public mood – our mood – can swing hard to cynicism. We see power plays, personal posturing, evidence of poor management, and royal commission reports which only seem to gather dust. And we wonder if it is worth it all, when we want to see progress on the real issues of poverty, refugee policy, health care, Aboriginal rights policy and other concerns."

"But for those who support CPJ, our faith calls us beyond this truth to a greater one. It opens us to our common humanity, our calling to love our neighbour in our political life together. So we don the perspective of public justice to forge a way forward through the cynicism, the hopelessness and the overwhelming possibilities."

"Real people are suffering real hardships that concrete policies and prophetic vision can alleviate. And that must be our choice."

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