History of the Medical Reform Group: 1979 - 1996
1990 and After
The Pharmaceutical Industry
Led by Joel Lexchin, the MRG continued to be very active in fighting
the interests of multinational drug companies. Joel sat on a committee of
the Royal College of Physicians and Surgeons charged with developing guidelines
for interaction between physicians and the industry to which Rosana Pellizzari
and Gordon Guyatt made a submission on behalf of the MRG. Joel led the
MRG in joining with Canadian Health Coalition to submit a brief to the government
opposing Bill C-91, which would further extend the patent life of products
produced by the multinational companies. Gordon Guyatt, on behalf of the
MRG, published a major editorial on the "Commentary" page of the Globe and
Mail in January, 1993. The editorial pointed out inaccuracies and spurious
arguments raised by a McGill Emeritus Professor who, in a previously featured
editorial in the Globe and Mail, had suggested that science supports C-91.
Gordon Guyatt, in his role as Residency Director of the Internal Medicine
Program at McMaster introduced Guidelines to eliminate both receipt of
industry largesse (including drug lunches) by residents and attendance by
industry representatives at resident educational events. The Guidelines
were inspired by his work and contacts with the MRG.
Working with Other Groups
The MRG continued to play an active role with the Canadian Health Coalition
and played a particularly important part in the revival of the Ontario
Health Coalition. Haresh Kirpalani was very influential in helping set the
direction of the new OHC. Particularly important were the well-formulated
policies coming out of the documents produced by the Resource Allocation
Working Group. The OHC was aware of the importance of stressing the need
for alternative services, and thus new resource commitments, if resources
to hospital and other high technology services were to be cut.
The Public Face of MRG
The MRG was active in radio, television, and the newspapers on a number
of issues. These included the threat to universal health care by reduction
of transfer payments from the federal government, the great benefits of
Canadian versus American health care, and the threat of reintroduction
of user fees. Venues included radio interviews, letters and op-ed pieces
in the Globe and Mail, the Toronto Star, and the Hamilton Spectator, and
magazine articles. MRG spokespeople representing the group included Mimi
Divinsky, Haresh Kirpalani, Gordon Guyatt, Rosanna Pellizzari, Don Woodside,
and Bob James. In February of 1992 McMaster University notified all faculty
that they should bill patients without health cards directly. A group of
MRG McMaster faculty took on the administration over this issue, and ended
up having them rescind the initial directive.
Re-Invigorating the MRG
The period from 1992 to 1994 was a relatively low-energy phase for the
group. Late in 1994, the Steering Committee decided we needed to be much
more active. We set a goal of having a press release at least once each
month. Our media profile rose immediately, but our major impact was facilitated
by two important events.
One, an internal matter, was Ulli Diemer's decision to move on and
the Steering Committee's choice of Janet Maher as the new Executive Director.
Janet had a long history of social activism and effective leadership, with
a major focus on health care. When she took the position in the autumn of
1995 she brought new energy, enthusiasm, political understanding, and contacts
in the progressive community. The MRG benefitted enormously from her organization
and facilitation.
Associated with Janet's assuming the ED role was the Steering Committee's
streamlining of our internal and media communication. Most Steering Committee
members joined electronic mail and the committee developed a "rapid response"
media strategy. Early morning newspapers would inform the Committee of
the latest health-care news and a press release would be prepared before
0900, emailed to Janet and committee for revision. The press release would
be faxed to initially 40, and subsequently more, media outlets either the
same or the next day. Thus, our statements to the media became very timely.
Second, and somewhat ironically in terms of MRG success, was the election
of the Harris government. The government's attacks on the poor, their focus
on cost-cutting, and their autocratic approach provided high-profile policies
for MRG attack.
Bill 26, the government's omnibus legislation, provided the first
major focus. The MRG was one of the few groups allowed to present to hearings
conducted to allow public reaction to the legislation. The MRG brief, prepared
largely by Ian Scott and presented to the committee by Gordon Guyatt, Ian,
and Murray Enkin, highlighted negative aspects of the legislation. The
MRG brief pointed out how modification of the Independent Facilities Act
could facilitate a move to two-tiered medicine, the adverse consequences
of user fees for drug prescription on the health of the poor and elderly,
and the inappropriateness of plans to restrict practice opportunities for
newly-graduated physicians. The brief received much positive feedback from
Harris opponents, including former Health Minister Elinor Caplan.
Organized medicine's response to health-care cuts allowed the MRG
to place its alternative views in bold relief. Strong elements within
organized medicine aggressively advocated a privatized two-tier system,
and groups of doctors responded to government caps on physician incomes
with threats to withdraw services.
Over a year of MRG activism, the improved communication, and the carefully
developed MRG positions lead, in the summer of 1996, to an MRG media profile
higher than any since the 1986 strike. The media looked to the MRG to respond
to physician and government actions, and MRG spokespeople (including Rosana
Pellizzari, Gordon Guyatt, Mimi Divinsky, Murray Enkin, and Bob James)
played prominent parts in reports on television, radio, and newspapers,
and on radio talk-shows. MRG spokespeople highlighted the dangers of two-tiered
medicine, and called on physicians to recognize that they were only one
(and the most privileged) among many groups being hit with the consequences
of government cut-backs.
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