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As predicted, medicare is dominating the public agenda across the country and CUPE is speaking out loud and clear in defence of our public system.

On November 22, we announced a legal challenge, to compel the federal government to live up to its obligations under the Canada Health Act. We are pursuing this legal challenge with the Council of Canadians, Communications, Energy and Paperworkers, the Canadian Federation of Nurses Union and the Canadian Health Coalition. The challenge was announced in Ottawa and centers across the country, and drew national media attention.

Since the Board met in September, two long awaited reports have been released.

The Kirby report, as expected, left the door wide open for for-profit health care.

Roy Romanows report has good news and bad news in it for CUPE members.

The good news is Romanow drew a line in the sand and stood up for the values and principles of public medicare. His report rejects the arguments in favour of for-profit health care and calls for a much needed cash infusion of $8.5 billion over the next two years to expand public health care. His plan to reform primary care, expand home care, shorten wait times, help fund provincial drug plans and improve access in rural and remote areas is a good start. Were going to do everything we can to pressure the federal and provincial governments to act on these important reforms without delay. This is one Royal Commission Report that must not be allowed to gather dust.

But theres also bad news in the Romanow report. First of all, theres no enforcement mechanism in the report. If we dont pressure governments to commit to concrete policy initiatives to implement the good reforms recommended by Romanow, the federal government seems unlikely to impose accountability mechanisms on the provinces.

Even more troubling is the clear line that Romanow draws between what he calls direct health services such as hospital and medical care and ancillary services such as food preparation and maintenance services. While he says the former should be delivered primarily through our public, not-for-profit system, the latter could be in the domain of private providers, according to Romanow. Theres no doubt that this part of Romanows report will embolden employers and provincial governments like Gordon Campbells Liberals to target dietary, laundry and cleaning services for contracting out.

On the issue of P3s, there is also good news and bad news. The Romanow report states that there is no evidence that P3 hospitals are a good deal for taxpayers or good for quality health care, and that there is experience and evidence that they cost more and result in fewer beds. Yet, even after acknowledging their many problems, and saying they are not a panacea, he concludes by saying this is not to say that P3s are without a place, for example in the case of health information systems.

Coming up next are a First Ministers Conference in January and the federal budget, expected in February.

We must focus our energy on making the case to provincial and federal governments for public delivery of all parts of the health care system with our allies in the fight for medicare.

Last week, CUPEs national Health Care Issues Committee met to update our medicare campaign to reflect the new challenges in the post-Romanow period. While our goal has been to make this an issue for CUPE members in every sector, Romanows report makes it clear that we need to put a spotlight on the specific threats to healthcare workers who are facing privatization of their work.

So far, provincial planning sessions have taken place in Saskatchewan and Nova Scotia and plans are underway for planning sessions in the remaining regions. Campaign materials are in production. CUPE members are attending CLC-sponsored training sessions on the workplace canvass, slated to take place this spring.

Locals in every sector are being encouraged to attend the Peoples Summit on Health Care, taking place in Ottawa February 7 to 9, 2003. CUPE health care locals will gather the day before for a national health care conference.

The peoples Summit will be a key opportunity for us to get our allies on side in defence of CUPE health care workers and to develop an action plan around our demands for implementation of the good reforms in the Romanow Report.