Over the years I have regularly found myself pleasantly bemused by finding that most high-profile politicians do what you predict they will do. I don’t think this is a startling revelation as these people’s public proclamations are well scripted by their communications consultants and are usually designed to alert us to the party’s future political policies. One of these supposedly predictable individuals, however, has been just the opposite, and his reluctance to do the expected has been a frustration for many of Canada’s keen observers of the medical/political scene.
For the past decade Alberta Premier Ralph Klein has had a host of Canada’s medical writers predicting that he would spearhead a challenge to the Canada Health Act as the first step in partially privatizing the delivery of health care in Canada. There have been a number of opportunities for him to initiate a challenge, but whenever one arose we always saw Mr Chrétien on the evening news with his brotherly arm around Mr Klein’s shoulder. I suppose there were some incentives (or nasty disincentives) for those two seemingly polarized individuals to be mugging for the camera and making statements about the sanctity of medicare. However, it seems that the richest province in Canada has now come to the conclusion that it can no longer afford to fully fund medicare and is planning a challenge to the Canada Health Act.
Mr Klein made this announcement at a press conference recently, and medical writers across Canada breathed a sigh of relief knowing that they could now go to their keyboards and sagely relate back to many of their editorials of the past 10 years in which they predicted this action. My question as one of these self-professed oracles is, why did it take him so long? At the same time, what has happened to the mind-set of the country’s politicians that makes it suddenly politically okay to make these statements? We have recently heard Mr Chrétien state that the federal government is considering the possibility of user fees and is prepared to look at anything that will ensure the sustainability of medicare. Mr Campbell here in BC is making similar statements, and, wonder of wonders, Mr Romanow has recently made similar statements—and all this long before his royal commission’s report is released.
Another interesting element in the equation is the current BC health ministry’s moratorium on spending on all new health care technology. In other words, if any of us want to make use of any new investigational equipment or interventions utilizing new technology we have to go elsewhere for it, because none of it will be funded in the foreseeable future. To my simple mind this means that the only way these technologies will be available to our population will be through privately funded and administered centres.
It seems obvious, I think, that all of the recent political posturing is a well-orchestrated announcement that the Canada Health Act will be successfully challenged and health co-insurers will be not only allowed, but in fact welcomed, by our politicians. I get the sense that we are sitting at the edge of a private health care tsunami, and if you don’t have a surfboard I hope you can hold your breath for a really long time.
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org