Melvin J. Howard’s determination vs Canada’s ambivalence

In their evident ambivalence about a publicly funded, semi-privately delivered health care system, Canadians and their politicians have given an opening to a manic businessman. Arizona health care entrepreneur Melvin J. Howard, who has alerted the world to his bipolar disorder on his Web site, is portraying himself as an underdog in the effort to establish commercial clinics in Canada. He vows to continue his fight “no matter what obstacles get in [my] way.”

In May 2008, Howard wrote on his blog that he would file an investor’s complaint under the North American Free Trade Agreement (NAFTA) because “municipalities or city officials can and have put up numerous roadblocks such as zoning and by law requirements” that prevented his company from establishing a clinic in British Columbia. He cites recent developments in Canada, such as the Supreme Court’s Chaoulli decision and legislation in Alberta, as evidence that the time is ripe for private health care investment in Canada. Who can blame him? The government of BC has all but cheered on the establishment of commercial clinics and for-profit surgical centres

Howard, however, is not content with using the leverage granted investors by NAFTA. In his September 20th blog posting, he wrote, “I am calling on the WTO [World Trade Organization] to wade in on our trade dispute with Canada. In arguing to keep health care off the table Canada claims to have exemptions on their public health care system. At the same time they demand the right to export their own health care services and not allowing any imports; is that sending a message of double standard? I think so.”

Howard is referring to the fact that Canada has included commercial health insurance in its commitment under the General Agreement on Trade in Services (GATS). Canadian multinational insurance corporations have access to foreign health care markets, but foreign insurers are excluded from insuring medically necessary services in Canada. He also points to the existing privatized aspects of the Canadian system including home care and long-term care, laboratory services, and dental care.

As some commentators have pointed out, including Luke Eric Peterson, who broke the story in Embassy newsweekly, Melvin J. Howard’s Centurion is not a huge U.S. health care corporation like Aetna or Tenet. But he’s surely not the only investor who has watched the hypocrisy and complacency unfolding in Canada. The result is murky and confused policy, which may be the intended effect. The province and the country are in the grip of politicians who believe that markets provide solutions; public administrators and governments are impediments, or at best, conduits for the flow of tax payer money to private enterprise.

Nearly every Canadian who advocates for more commercialization of health care also proclaims opposition to a U.S.-style system. U.S. entrepreneurs and investors backed by NAFTA and GATS, however, have no aim other than making money; why should they change their business to accommodate "Canadian values"? Canadians may not be able to have it both ways, and Melvin J. Howard seems to have a personal mission to teach Canada a lesson.