SOCIAL: PROPOSED POLICY CHANGES/ HEALTH RIGHTS AND FREEDOMS

SUBJECT:  HEALTH RIGHTS AND FREEDOMS

PURPOSE:  This briefing note is a recommendation for changes in policy pertaining to guaranteed health rights and freedoms.

ISSUE:  There is not enough government action to guarantee health rights and freedoms.

Background:

The Canadian Constitution contains a what is referred to as, “The Charter of Rights and Freedoms.”  Such Charter is entrenched within the Constitution.  It guarantees certain political rights to Canadian citizens and civil rights of every person in Canada.  Royal ascent was given on April 17, 1982 resulting from Pierre Trudeau who initiated the process of Constitutional reform.  The Charter specifically has the following sections, “Guarantee of Rights and Freedoms,” “Fundamental Freedoms,” “Democratic Rights,” “Mobility Rights,” “Equality Rights,” “Official Languages of Canada,” “Minority Language Educational Rights,” “Enforcement,” “General,” “Application of Charter,” and “Citation.” Generally, the Charter protects all people within the confines of the state however, there are sections which pertain to Canadian citizens such as, section 3 (the right to vote), and section 6 (“to enter, remain in and leave Canada).  Generally, The Constitution of Canada is the most important law of the land and it is enforced through the political institutions of the state.  Before the Charter was included into the Constitution, other Canadian laws protected the rights and freedoms of Canadians such is the case with the “Canadian Bill of Rights” enacted in 1960.  The Charter is a method by which Canada’s values are essentially affirmed.  Today, the Canadian judiciary renders many of its decisions because of the Constitution.  Such rights guaranteed in the Charter are, equality, democracy, and mobility while freedoms include, “conscience, religion and peaceful assembly.”  Rights are contrasted from freedoms in that rights are legal entitlements protected by law and entitles freedom.  Freedoms are then the absence of constraint and protected/ granted by rights.  The question here is then, should health be a matter of rights or freedom?  Health rights include the right to have consent and the right to a second opinion.  Health freedoms would include the ability to choose a health care provider- choice and the ability to be informed.  These are the essential rights and freedoms in which could be amended into the Canadian Constitution.  It is these rights and freedoms that are currently standards in the public medical system of Canada.  Currently Health Care is under provincial jurisdiction per s92 which specifies, “The Establishment, Maintenance, and Management of Hospitals, Asylums, Charities, and Eleemosynary Institutions in and for the Province, other than Marine Hospitals.”  In the province of British Columbia, there are various legislation which govern healthcare of which include the “Health Professions Act” which stipulates professional conduct of medical personnel, “Public Health Act” which “supports dealing with current and emerging public health issues including communicable disease prevention and control, health promotion and health protection, chronic disease and injury prevention, poisonings and bioterrorism threats” (Government of British Columbia).  Federally there is the Canada Health Act which then funds the provincial health programs such as “Fraser Health, “Vancouver Coastal,” and “Providence Health.” Monies are dispersed to the aforementioned through various legislation through “Medicare Protection Act and Regulations,” and “Health Care Costs Recovery Act.” 

Considerations:

The United Nations has an initiative referred to as the “United Nations Development Plan” which they specify that there are community, economic, environmental, food, health, personal, and political security concerns.  As it pertains to health, it is a human need by which people require to be active members in civil society.  For the most part, Canadian society has established living standards for all Canadian citizens so that health risks are reduced through proper sanitation to remove illness and disease-causing organisms.  Most Canadian citizens live in shelters and homes which are clean thus promoting the individual health of the citizen.  What is of concern however, is the cost of health care.  According to Canadian Institute for Health Information Canada spent 10.8% of its GDP on health care.  For hospitals they spent, $2015 per person.  On medications $1114 per person and on physicians $1079 per person.  It becomes evident why health rights if included in the Canadian Constitution could be very expensive for the Canadian government.  Although Canada ranks high amongst G8 countries, health rights need to be considerate of cost to the government.  If however, such rights exceeds the cost, economic recession and or depression could damage the economy.  A country that has effectively implemented health rights into their Constitution is the Netherlands.  Their Constitution has provisions by which it protects the foundation by which health promotion occurs in article 22, it specifies, 1. The authorities shall take steps to promote the health of the population; 2. It shall be the concern of the authorities to provide sufficient living accommodation; 3. The authorities shall promote social and cultural development and leisure activities.  As specified earlier these base activities are very expensive and the Canadian government has to establish sources of revenue before including such rights into its Constitution.  The stakeholders for this matter are the government, the health care providers and the citizen. 

Options: 

Option 1:  Amend the Charter of Rights and Freedoms.

This option is not feasible.  Amendments to the Constitution would require a lot of bureaucratic cooperation however, it would promote equity.  By amending the Charter and giving people the rights mentioned above namely, consent and the right to a second opinion and health freedoms such as the ability to choose a health care provider- choice and the ability to be informed it serves to ensure that the government is acting in the interest of the citizens.  From a security perspective, this option ensures that citizens are being provided the care that they should be provided with regards to the economic standing of Canada.  This option is inclusive because it changes the paradigm of health care essentially giving citizens rights and freedoms.   

Option 2:  Status Quo.

This is the most feasible option however, if selected health care rights would continue to be provided via the above legislations.  This is also a sustainable option because such legislation is already providing health care in a satisfactory manner.  From a security perspective, this option continues what is essentially being enacted by the government as it pertains to health care. 

Recommendation:

Option one is recommended.