In 1999, under the leadership of Liberal Senator Michael Kirby (former Principal Secretary to Prime Minister Trudeau, Deputy Clerk of the Privy Council, Secretary to Cabinet for Federal–Provincial Relations, academic and corporate director), the Senate Standing Committee on Social Affairs, Science and Technology began to examine the challenges facing Canada’s medicare system. After hearing from 400 witnesses, Kirby and 10 other senators presented their report, The Health of Canadians — The Federal Role. In it they argued that “the federal government has a critical role to play in facilitating, encouraging and accommodating the provinces and territories in their efforts to restructuring [sic] and reconfiguring [sic] their health care system” (Senate Standing Committee on Social Affairs, Science and Technology, The Health of Canadians — The Federal Role, Volume 5, Principles and Recommendations for Reform, Part I, p. 12).
In presenting Volume 6 of the report, Kirby stated that “new federal funding must buy change,” that “these new revenues will be earmarked and dedicated” and that Canadians should receive “a Health Care Guarantee” to ensure that “if you cannot receive proper medical care within a clearly-specified, clinically-determined waiting time, government should pay for you to immediately receive the procedure or treatment in another province or even in the United States” (The Health of Canadians — The Federal Role, speaking notes for the release of Volume 6, Recommendations for Reform, October 25, 2002, pp. 1–2). Although the committee stressed its commitment to Canadian medicare, critics claimed that these proposals would increase the push for privatization.