During a trip to Washington D.C. in April, I was thrust into the American health-care system’s troubled waters. When my hotel’s concierge discovered I am a nurse, he told me of his car accident. He ended up in an ER, and developed an adverse reaction to medications. That meant a four-day hospitalization with a $14,000 price tag. Now, without insurance, he owes three years of monthly payments. If he can’t pay, a credit agency will come calling.

Then a taxi driver shared his story.  He went to an ER with a knee ailment. The solution: ibuprofen and a sleeping pill; no diagnostic or lab test needed. He was uninsured and left with a $1,000 bill. Both men shared their hopes about President Obama’s changes that promise insurance for more Americans. These were important and timely conversations. I was in the American capital to share RNAO’s work with the Health Resources and Services Administration (HRSA), an agency that improves access to care for groups such as the uninsured or isolated. It’s headed by Mary Wakefield, RN, PhD, appointed to this top position by the President.

Hearing these experiences brings shivers and me reminds of Michael Moore's documentary, Sicko. These stories alert Canadians to stand up to those who promote “competition” and for-profit services. We need to support governments that commit to public health care. And we need to enhance Medicare by including national programs such as home health care, pharmacare, and dental care.

Unfortunately, our federal government isn’t rising to the task. The government’s most recent report to Parliament on the Canada Health Act acknowledges violations of the law, but takes little action to remedy them. The government is not standing up to actual or potential provincial violations, including in Quebec where health-care user fees have been proposed.

Following the 2003/4 Health Accord and Action Plan, Prime Ministers Chretien and Martin committed $41 billion in new federal funding over 10 years to advance, among other goals, home care, primary care, and a national pharmaceuticals strategy. Sadly, Prime Minister Harper’s government has demonstrated little political will to achieve these goals. Moreover, politicians remain mum about the agreement’s renewal as it comes to a close.   

Meanwhile, the Canadian Medical Association (CMA) continues to call for increased competition and privatization. At the last CMA annual meeting, members passed a resolution calling on governments to examine market mechanisms, including their role in health-care delivery. Anne Doig, CMA president, speaks about the need to decide which health-care services should be necessary and universally accessible. But instead of calling for new public programs, she defends her predecessors who thought to privatize the system. Thankfully, not all physicians agree. Canadian Doctors for Medicare and the Medical Reform Group are vocal about strengthening Medicare.

Even the strongest free-market defenders, such as Britain’s new prime minister, David Cameron, can discover the benefits of publicly funded and delivered health care. In 2003, Cameron’s eldest son was born with severe cerebral palsy and epilepsy. Both Cameron and his wife are wealthy, but they still couldn’t afford the care their child needed before he sadly passed away at age six. Cameron relied on the National Health Service (NHS), the British version of Medicare, and he saw it worked. During this year’s election campaign, he pledged that government spending cutbacks won’t harm the NHS.

Many leaders know publicly funded, not-for-profit and universally accessible health care works. It costs less, we get more, and we can trust it is there for us. Not so with for-profit care, as Albertans are realizing. Recently, the Health Resource Centre, a private Calgary hospital that has been performing hip, knee, foot and ankle operations for four years, announced its bankruptcy. Now, taxpayers have to pick up the tab.

Nurses must continue to remind Canadian politicians of these facts. We must speak out loudly and clearly with the strength of our values, the authority of the evidence, and the courage of our convictions. Medicare must be expanded through publicly funded home health care so that everyone, old and young, lives long in the community. Canada needs a dental care program so those who cannot afford costly procedures can shake off the stigma of poor oral health. And our politicians must move ahead with creating national pharmacare. We ask that you speak with your families, neighbours, co-workers, the public and the media. We must pressure politicians to get on with the task of strengthening public Medicare. Stories like those of my concierge and taxi driver in Washington will continue to remind us of that.

Doris Grinspun, RN, MSN, PhD (cand) is executive director of RNAO.