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Obama crashes CMA annual meeting

Well, not really. But with the CMA’s annual meeting set to begin this weekend, the long shadow of the US president is definitely looming over the coming debate on the future of Canada’s healthcare system.

It’s become a tradition in recent years for the CMA to release a discussion document prior to their annual shindig, laying out the leadership’s thoughts on weighty matters of health policy. And it’s also become traditional that this document should be a thinly-veiled call for more privatization, hidden under a few unconvincing nostrums about patient welfare.

But not this year. This year’s document actually calls for the principles of the Canada Health Act to be extended to prescription drugs and long-term care. Nor is there any of the nagging for private insurance and for-profit delivery that we’ve come to associate with these releases.

Is it coincidence that the CMA is changing its tune right after the US acted to curb the worst excesses of private healthcare? Unlikely. Obama’s reforms have changed the landscape.

In recent years, while Canadian patients looked at the US system and wanted to run away from it as fast as possible, CMA leaders looked at America and saw something quite different. They saw the doctors’ fat incomes, and they made it their task to keep up with the Joneses.

But now, we’re treated to the spectacle of the Americans themselves running away from their private system, albeit not very far away. No-one, least of all reform’s opponents, believes that the US will go back on these reforms, even if Republicans gain power. A slew of polls have just shown Obama’s health reforms steadily gaining in popularity south of the border. You can’t stop history. Privatization is in retreat.

The advocates of privatization within the CMA are also on the back foot. The CMA can’t credibly bemoan the “unsustainability” of Canadian healthcare expenditure– a theme they repeat this year – when their proposed role model is a system that was threatening to consume the world’s largest economy. They can’t credibly claim to be speaking for patients when they are the main source of schemes to squeeze more dollars out of the patient’s pocket.

Previous CMA leaders have nevertheless sought, like Obama’s health reform opponents, to portray themselves as the patient’s defenders against a heartless government. But the shoe fit poorly – poll after poll has shown that Canadians overwhelmingly favour government-run, publicly financed healthcare. It’s the CMA leadership that has been the odd man out, and its motives have been all too transparent.

The organization has done itself considerable harm with self-serving and intellectually dishonest arguments unworthy of a scientific body. For example, CMA leaders have argued that Canada needs reform because international monitors rank it poorly in quality of health delivery among developed nations. They make the same point this year, in fact. But they’ve routinely failed to mention that the same rankings score the US – towards which they’ve advocated moving – far below all publicly-funded systems including Canada.

The apparent shift in CMA policy is a step in the right direction. Canada's health system has many problems, but underpaid doctors really isn't one of them. One of the leadership’s new recommendations is a Charter for Patient-centred Care. Because, the CMA now says, the discussion in recent years has drifted too far from what should be the central issue: the needs of the patient. That is certainly true. Physician, heal thyself.
Owen Dyer