Plans for clinic raise fears of privatisation in Canada
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《英国医生杂志》
Quebec
Plans to offer magnetic resonance imaging to paying customers from Canada's indigenous communities have raised fears that their proposed clinic will undermine Canada's publicly funded healthcare system.
The plans come from a band, the recognised term for a group of indigenous people, who are living in a designated area in Saskatchewan. It comes at a time when there have been several challenges to the public healthcare system, particularly in Saskatchewan's western neighbour, Alberta. But this is the first time the threat has come from an aboriginal government—and in the province where Canada's Medicare system arose in the 1960s. Canada does not have a private health system, and there is ongoing debate in Canada over whether private services should be allowed and in what form.
The MRI clinic would be built on land owned in east Saskatoon by the Muskeg Lake Cree nation and would serve the aboriginal community, clients of the Workers Compensation Board, and patients referred by doctors.
Canada's aboriginal peoples are self governing, but their health care is provided under the medical services branch of the federal health department through the national healthcare system.
Saskatchewan has long waiting lists for magnetic resonance imaging. The band had hoped to be paid through the Saskatchewan government insurance plan, which operates under the Canada Health Act, for imaging services. But Saskatchewan health department officials said this would not be allowed.
The plans for the clinic raise questions about the relationship between health care and aboriginal self government. Saskatchewan's Health Facilities Licensing Act requires service operators to be licensed by the health minister, but Lester Lafond, a business adviser to the Cree nation, says the proposal is not for a private clinic.
"We are a government, and we will establish a crown corporation to own and operate this machine. We are trying to find an arrangement that is mutual and beneficial ."
But Norman Laberge, chief executive officer of the Canadian Association of Radiologists, said in an article in the Canadian Medical Association's journal that he feared that the project could open the door to private healthcare services on aboriginal land across the country ( CMAJ 2004;170: 1215).
Provincial laws governing health care have no jurisdiction on land controlled by aboriginal governments, meaning they can opt for fee for service procedures, foreign partnerships, and diagnoses made overseas. "It has the potential to become a monster here in Canada," Mr Laberge said in the CMAJ article.(David Spurgeon)
Plans to offer magnetic resonance imaging to paying customers from Canada's indigenous communities have raised fears that their proposed clinic will undermine Canada's publicly funded healthcare system.
The plans come from a band, the recognised term for a group of indigenous people, who are living in a designated area in Saskatchewan. It comes at a time when there have been several challenges to the public healthcare system, particularly in Saskatchewan's western neighbour, Alberta. But this is the first time the threat has come from an aboriginal government—and in the province where Canada's Medicare system arose in the 1960s. Canada does not have a private health system, and there is ongoing debate in Canada over whether private services should be allowed and in what form.
The MRI clinic would be built on land owned in east Saskatoon by the Muskeg Lake Cree nation and would serve the aboriginal community, clients of the Workers Compensation Board, and patients referred by doctors.
Canada's aboriginal peoples are self governing, but their health care is provided under the medical services branch of the federal health department through the national healthcare system.
Saskatchewan has long waiting lists for magnetic resonance imaging. The band had hoped to be paid through the Saskatchewan government insurance plan, which operates under the Canada Health Act, for imaging services. But Saskatchewan health department officials said this would not be allowed.
The plans for the clinic raise questions about the relationship between health care and aboriginal self government. Saskatchewan's Health Facilities Licensing Act requires service operators to be licensed by the health minister, but Lester Lafond, a business adviser to the Cree nation, says the proposal is not for a private clinic.
"We are a government, and we will establish a crown corporation to own and operate this machine. We are trying to find an arrangement that is mutual and beneficial ."
But Norman Laberge, chief executive officer of the Canadian Association of Radiologists, said in an article in the Canadian Medical Association's journal that he feared that the project could open the door to private healthcare services on aboriginal land across the country ( CMAJ 2004;170: 1215).
Provincial laws governing health care have no jurisdiction on land controlled by aboriginal governments, meaning they can opt for fee for service procedures, foreign partnerships, and diagnoses made overseas. "It has the potential to become a monster here in Canada," Mr Laberge said in the CMAJ article.(David Spurgeon)