THE CANADA HEALTH Act needs to be ripped open and subjected to the most extensive and unconditional review imaginable. Now!

Of course, supporters of the legislation, whose 25th birthday passed almost silently last April, will decry how anyone could imagine treating the cornerstone of our social safety net like that. The simple retort: How can we not?

Before we examine the act’s increasingly glaring shortcomings, let’s look for comparison’s sake at two other pieces of legislation.

The British North America (BNA) Act is a rock upon which this country is based. Guess how much time elapsed before that iconic 1867 document was reviewed? Ten, 15, 20 years?

Nope. Four. In fact, by 1982, when it was replaced by the Constitution Act, the BNA was reviewed 20 times, once about every six years, with the last being in 1975. True, the BNA is a wide-ranging document, but many Canadians will say the Canada Health Act is, too. Meanwhile, three bills have been passed over the past two years alone to update Ontario’s Regulated Health Professions Act of 1991.

Ten years ago in June, the Canada Health Act was ostensibly put on trial when the Ontario Medical Association (OMA) convened a day-long blue-chip summit focusing on the act. Interestingly, almost 60% of participants in an OMA-sponsored poll had never heard of it. When told of its contents, though, 71% felt it needed to be changed.Sadly, that session is as close as anyone has ever got to re-examining the act since.

Today, the OMA’s West Coast counterpart seems to be girding for such a review.

Last September, the British Columbia Medical Association issued a policy statement calling for strengthening of the act’s principles of accessibility, an expansion of its concept of comprehensiveness and the addition of a new principle of sustainability.

In another position statement, the organization said it is “adamant” that the act needs to be “restructured to remain meaningful in today’s health-care environment.”

Opening the Canada Health Act, then, needn’t be the doomsday scenario as opined by most of the act’s supporters.

Most Canadians would probably faint if someone showed them the Canada Health Act. It is far from being a massive legalese monster that defines everything in the huge health sector down to the letter.

The act is just 13 pages. It could be easily folded into quarters and slipped into your back pocket. Its framers made it vague intentionally so as to include as many health services as possible. It was meant to set the floor of the health-care sector, not the ceiling.

When asked by the Medical Post about his thoughts on reopening it, former Canadian Medical Association secretary-general Bill Tholl, a member of the team that helped draft the act, he replied: “Is there a need?” before adding, “The Canada Health Act doesn’t preclude building on it. All it does is prevent a backslide, so why would you want to open it?”

Tholl continued by saying a compelling case could be made that the agenda of the act’s founding father, Tommy Douglas, has yet to be completed. “(Douglas) would say we also need home and community care and pharmacare—but why can’t that be done with new legislation, then after five or 10 years, we could look at (developing) one overarching piece of legislation.”

Have we critics over-reacted? Maybe. But it’s clear the stalemate continues, and it will be much longer still before anything substantial gets done. So maybe over-reaction is better than no action at all?

Matt Borsellino is national editor of the Medical Post.