User fees: fair cost containment or a tax on the sick?

The federal government's reduction in transfer payments for health and education, in combination with a severe recession, has put provincial and territorial health ministries, health professionals and hospital administrators under immense financial pressure. In response, user fees are being discussed as one way to maintain medicare. Yet, charging levies for health services presents numerous ethical problems. User fees would end the universality of and accessibility to health care for many Canadians. Hence, they would constitute an unfair tax on the sick and the poor. The hardest hit would be the elderly, children, women, aboriginal people, the disabled and the chronically ill.