The late Saskatchewan premier is considered the founder of medicare in Canada.

In a letter to Ontario Premier Mike Harris, released May 4, the institute said a decline in the quality of patient care and greater incident of fraud have occurred in the U.S.

"The United States has extensive experience with for-profit hospitals that must inform the debate under way in Ontario," wrote institute chairman David Barrett, a former NDP premier in British Columbia.

"Ontario will face enormous enforcement policing costs related to for-profit hospitals (and) witness a diversion of public dollars from health-care services to fighting health-care fraud."

Barrett cited a Harvard University study published in March that found U.S. patients had more difficulty obtaining services and interacting with private health-providers than they did when dealing with non-profit services.

"Medicare patients rate for-profit and nationally affiliated health-care plans much lower than not-for-profit or local plans," says the study, which polled more than 82,000 patients from 182 different plans in late 1997.

"Hopefully, Mr. Harris is paying close attention to the rising cost of policing the for-profit hospital sector in the United States," Barrett said.

"You can't introduce for-profit hospitals without ramping up your capacity to investigate and prosecute health care fraud." (6 May 2001)