The vast majority of Canadians support the guarantee of universal access to medically necessary health services irrespective of ability to pay. And their support would be given knowing they could not likely afford to pay either out-of-pocket or through private insurance premiums for the type of catastrophic medical care that could devastate them or their loved ones. And their support would be given in the belief that access to health services shouldn't be determined by employment status; pre-existing health conditions; wealth or and any other individual factor, but health need.

The vast majority of Canadians continue to support collaborative initiatives and essential reform within the existing health system to enhance access and quality; whether through public re-investment to create additional capacity to eliminate wait lists; ensuring greater integration and coordination of care; or enhancing 'upstream' preventative health measures or health promotion. The vast majority of Canadians have no vested interest in allowing "credit card" medicine; where personal wealth determines the speed or quality of access to medically necessary services.

The vast majority of Canadians have in fact consistently rejected any regressive user fees; patient co-payments or "flat rate" health premiums that impede access to essential primary care or medical treatment. And this after decades of campaigning by the likes of the Fraser Institute or Canadian Taxpayers Federation to restore our fiscal well-being at the expense of our social health; of a determined and relentless assault on public deficits or debt, while only providing meager re-investment in public programs. The loudly trumpeted deep fundamental cuts to corporate and personal tax rates only created greater poverty and social inequality in the midst of record profits and obscene corporate salaries.

The vast majority of Canadians realize we can both afford to ensure universal access and remain capable of inspiring and sustaining collective action and common purpose across this land to ensure quality care is provided those requiring health services. The vast majority of Canadians, I suspect, find the shrill attack on Medicare to be over-wrought; a campaign that simply rings hollow and contrived when compared to their own personal experiences and interactions with health providers or the actual care their family or friends received in Canada.

They realize that through our progressive income tax system, they have already bought and paid for universal access to health services. All that is required is to hold both government and health providers accountable for the services provided.

But there is a small, vocal minority of Canadians for whom two-tiered private health or queue jumping has appeal. Private payment would, in fact, allow them to purchase something quite radically 'new' and different. They would purchase 'first class' rather than 'economy' health services; or 'front of the line' queue jumping priority in public health queues. What they want to purchase would trump the medical needs of others; what they want precludes or excludes others by restricting resources or lowering priority for other Canadians potentially in greater need.

The vast majority of Canadians would find it illogical to argue that private payment or insurance, rather than increased public resources would be the balm to sooth our maligned health system; rather than imperil it. There is simply no evidence to suggest to these Canadians that a single-payer model means less access or lower quality and more expense than dual, competing for-profit insurance models.

The vast majority of Canadians would appreciate, on the other hand, that the pursuit of profit inevitably entails monopoly rather than competition; that individuals cannot and do not stand as market equals with multi-national insurance corporations. The vast majority of Canadian would appreciate that the negotiation, writing, adjudication and enforcement (let alone rescinding) of insurance policies does not favour them; that marketing; advertising; administering; profit and regulating ensures only adds costs without tangible health benefits.

The vast majority of Canadians are willing to consider international comparisons for lessons in search of necessary reform to enhance our health system. We could certainly learn from the Australian example of permitting private financing for in-patient hospital services. The claimed reduction in wait times or costs did not occur as promised. The experiment was clearly rejected by the Australians in their recent national elections.

A small minority of Canadians remain prepared to abandon any notion of egalitarianism in favour of elitism; consenting to private markets and personal income as arbiters of access rather than citizenship and health needs. The benefits of opting out for this small group may lie in tax avoidance of the costs of universality. The impact is to deny others public access to care as much as enhance their own privileged or private access.

The struggle to build our universal, publicly funded single payer health system through Medicare was waged in connection with a fundamental debate around the nature and character of Canadians and the vision of a future for our country as more just and equitable. There were concessions along the way to the medical fraternity but the enterprise was never directed at solely making the scheme palatable to wealthy Canadians. It was also never about simply scoring ideological points; about defiling the mythical beauty or theoretical sophistication of perfectly functioning 'markets'.

Canadians know from direct personal experiences what "market failure" represents in terms of pain, suffering and untimely death. We don't need to see "Sicko" to be reminded of the inequity and inefficiencies of private markets delivering essential health services. The vast majority of Canadians long ago recognized health care services as "public goods" providing significant social benefits and essential to the exercise of citizenship.

The vast majority of Canadians will realize that the Charter challenges making their way through the courts in various provinces seek not just the ability to pay privately out-of-pocket for health services. Rather, these individuals want public tax dollars to finance their private choices and preferences in terms of the scope, timing and/or location in which they receive health services.

The real and important challenge of improving our public system; of reducing wait times for all, should not come at the expense of Canadians of low income or ill health; those likely to be hurt most by parallel private insurance. That is not the health care that the overwhelming majority of Canadians support.