‘ PLS a — a i ee ae he eS SMT Ril, POT ONG aa YEAS Ar Pea nrneed ledeianoneptaganennelnmundaeelitendabiiaas-sinhaiiane strait RMR Behn -Teady in place in Quebec where doctors are either “‘in’ > itimplemented the recommendations of the Emmett Hall on the future of medicare would go a lope way in engthening Canada’s health care system. But it has oe Come under some pretty heavy fire from both the _ Medical establishment and governments. It is obvious at pressure will have to be applied or the recommenda- N$ are in danger of remaining on paper. ee By KERRY McCUAIG ; Doctors who charge their patients above medicare Tates are undermining the existence of Canada’s health ‘ae system, a report released Sept. 3 on Canada’s medi- cae System finds. introduction of extra-billing, premium charges by ; me provinces and user fees erodes the concept which Overned the establishment of medicare and must be Hulshed, said the report’s. author Chief Justice Emmett Dy, a 101-page report entitled ‘“‘Canada’s National- ‘Ovincial Health Program for the 1980s — A commit- Ment for renewal’ was commissioned last September by ae n Conservative health minister David Crombie to aluate the state of Canada’s medicare System. While the country has a good system says Hall, pre- cat trends threaten to create a two-tier system, one for a Tich and one for the poor. A survey conducted for the ee found that it was the poor who were most likely to ve their access to health care limited ifa doctor bills his _ Patients directly or charges above what he already col- “cts from the health insurance plan. ° Miums charged by Ontario, British Columbia and 3 Alberta which range from $40 a month for family cover” age in Ontario to $8.50 for single coverage in British lumbia are also a deterent to medical care. Even ugh the provinces’ medical plans will pick up pre- Mum tabs for low income residents the survey found 5 t not all who were eligible were aware of or made use this service. Hall wants the premiums phased out over Next five years. User fees charged by hospitals in seven provinces Usually for long term convalescent care, attack the most vulnerable, the old and the very ill the report charges. To deal with doctors ‘‘opting out”’ of their province's Medical plans Hall suggests legislation such as that al- ’ Or “‘out”’ of the plan. An ‘‘in’’ doctor cannot collect any _ xtra fees from patients and an ‘gut’? doctor’s patients fe not reimbursed by the medical plan. Very few Quebec physicians are outside medicare. — This contrasts with provinces like Ontario where 16% Of the province’s 12,000 doctors bill their patients direct-: _ 1y. It has become impossible in cettain communities to ~ bi find an anesthetist, urologist or obstetrician without hav- ing to pay cash, the report found. Surrounded by complaints from medical associations that doctors salaries were not keeping far enough ahead of i Other wages and salaries, Hall concluded that doctors’ | Salaries, unlike most other professions were keeping abreast with inflation. Hall says doctors havearightto ‘be adequately compensated for their services: no.more no ‘Strikes under soci Marxism-Leninism in To The Sept. 3 issue of the Toronto Globe and Mail commented editorially on the Strikes in Poland under the head “A less”’. Ininstanceswhentheprovinceand medicalassocia- tion cannot reach anagreement on fees the issue should be sent to binding arbitration. The report proposes that an independent chairperson appointed by the province and a nominee each from the medical profession and from the government comprise — the arbitration board. Suggestions for user representa- tion on the board were excluded from the report. A major section of the report dealt with federal funding for health care. In 1977 the federal government shifted from matching grants to the provinces for medicare costs to block funding, where Ottawa hands lump sums of money to the provinces with no strings attached. Earlier charges by Ottawa tnat provinces were using lism day’s World medicare funds for other purposes such as road building were ‘‘not established’’ by the report. Block funding was originally established to encourage provinces to exercise ‘‘restraint’” in health care spend- ing. This was certainly accomplished as provinces de- creased their share of medicare costs from 50% in 1975 to 43.1% in 1979. The result of such restraint programs became obvious to Canadians during these past three years with hospital and clinic closures, staff reductions and cutbacks in basic health services. Hall dealt harshly with the effects of these cutbacks placing the blame solely on government underfunding and admonishes them to live up to their responsibilities. He urged the federal government to come up with more money and revert in some cases to dollar for dollar funding to encourage the establishment of drug plans, denticare and free orthopedic and prosthetic devices. Hall also incorporated a number of suggestions of- fered at public meetings into the report: e More extensive training and use of nurse practition- ers. e He urged the provinces to immediately undertake a feasability study on transporting health care coverage from one province to another to ensure adequate health care for those needing medical attention while outside their province. e Inresponse tobriefs submitted by several national and provincial Indian associations Hall recommended care- ful study. The briefs cited the worsening health of Cana- da’s Native peoples and called.on Ottawa to live up to treaty obligations for free medical care. The briefs all suggested an integration of Native culture and expertise in their health care system. e To combat what he describes as the growing ‘‘epidemic’’ of teenage pregnancies he recommends an extensive family life and sex education program integ- rated into the school system along with “‘store front” clinics. e One child in 10 or 1,000,000 Canadian children suffer from mental, physical and emotional handicaps. Shock- ingly, Hall maintains that at least one-half these cases could have been prevented with proper pre and perinatal care. 6 The report calls for placing greater emphasis on integ- * rated health care including counselling, and preventive care programs to be provided by community health centres. e Nursing home and supervised home care for con- valescing patients should replace extended and expen- sive hospital care. -~@»t*Placing. the. burden’ of injuries in. contact sports ‘‘where they belong’’, Hall suggests that injuries to pro- fessional athletes be covered under a workmen's compensation like program. Team owners would there- by be responsible for medical costs, not the taxpayer. Hall’s report isn’t the solution to the problems facing medicare nor do they ensure its future, however if implemented they would go a long way towards strengthening it. tire picture of class relations. By abolish- ing the exploitation of man by man, socialism does away forever with the class hierarchy, the system of subjugation _ Crack in thé facade’’. In doing so the Editorial quoted the words allegedly ut- tered by Jacek Kuron three years ago. The editorial introduces Kuron as the founder of the Polish Workers Defence Committee (KOR). Here are those Words as published by the Globe: “I think the possibilities for reforms are very promising. At the same time I think it is necessary to maintain a to- talitarian facade. Our (KOR we assume, A.D. ) program must be to create a Ppluralist society beneath the totalitarian facade without disturbing it, to create Unofficial social institutions representa- tive of the people’s aspirations.”’ * x OF There can be little doubt in anyone's mind why the Globe seized upon these words, for the notion they advance is that of capitalist restoration in Poland. The editorial notes with satisfaction that by 1980 it was no longer possible to leave the “totalitarian” facade uncracked, so the “totalitarian facade has been cracked’’. This the editorial views as progress. And this poses the question, progress for whom? There also can be little doubt that the Polish workers had serious grievances. And they took what they considered to be the steps necessary to correct them. They took strike action. Which action-by the way, gave the lie to those who trum- pet the myth that such action is not pos- sible in a socialist state. What is notable about the strikes in Poland, is the scale, unprecedented in a socialist country. The manner in which they were settled was exemplary. The government negotiated with the strikers in good faith, did not legislate them back to work, nor arrest and jail strike leaders, which often has been the case in Canada. * * * : It is important to note also that anti- socialist elements in Poland and in the capitalist countries strove to utilize the grievances of the workers, in order to steer the strikes along the path outlined -in the words Jacek uttered three years ago and considered by the Thomson owned Globe as a worthy goal to aim for. The reason the strikes in Poland were settled in a satisfactory manner was be- cause the socialist state of Poland is primarily a workers’ state based on the working class and supported by the great majority of the workers, peasants and intelligentsia led by the Polish United Workers Party. It was that Party and the Government of Poland that publicly admitted that they had made mistakes in implementing economic policies, and set about correcting those mistakes. * * ge ‘The socialist revolution brings the working people, led by the working class, to power. The exploiting classes — in the case of Poland the capitalists and landlords — are deprived of political power but as yet do not disappear from the scene of class struggle. What the re- volution does is to usher in the period of transition from capitalism to socialism. The length of this period of transition depends on the circumstances and condi- tions existing in the particular country. However, it should be stressed that the revolution deals-a vital blow against the basic interests of the former exploiting classes and those who serve those in- terests. Consequently, the coming to power of the working class and its policy of socialist construction meet with fierce resistance from this quarter. * * * Socialization of the means of produc- tion leads to a radical reconstruction of all social relations, of the political super- structure, ideology, culture, way of life, morals and customs. And, just as the displaced exploiting society with its own special institutions — classes, state and code of laws — grew up on the basis of private ownership of the means of pro- duction, so does the new, socialist sys- tem grow up on the basis of public own- ership, on the basis of the socialist mode of production. bd : The new class structure formed in- socialist society radically changes the en- of some classes by others which existed for thousands of years. * * * As events in Poland have shown, strikes can happen in a socialist country. However, for workers to take such ac- tion is the exception rather than the rule as distinct from a class-divided society like capitalism. This is so because socialism creates conditions under which it is possible to reach mutually satisfac- tory conclusions during the course ofcol- lective bargaining between management of state-owned (socialist) enterprises and the workers’ trade unions. It goes with- out saying that to maintain these favora- ble conditions requires constant atten- tionby:the socialist state and the work- ers’ party. The rate of economic growth and progress in the social, cultural and other spheres of the country’s life de- pends in turn on maintaining these favor- able conditions. Socialist society is not immune to mis- takes. But, it also has the strength to correct mistakes. For genuine political equality of the people is achieved under socialism. This is ensured by the fact that the people are truly equal in relation to the means of production and, therefore, have an equal right to participate as real masters, in taking decisions which affect not only their own immediate affairs but the whole society. - PACIFIC TRIBUNE—SEPT. 26, 1980—Page 9 bas 8 eee naeeenneneen on m0 a LL Prey i rT Ter irr iret