Rising costs could force governments and Canadians to adjust their expectations of public health care, including the role of private medical clinics, the head of the IHA said Thursday.

Norman Embree, the Liberal-appointed chairman of the IHA board of directors, told The Daily News he is not philosophically opposed to the idea those with money can get health care services from private clinics.

“I have no problem with it. We’ve had two tiers for years, but nobody wants to admit it,” Embree said.

“I can go to Seattle and get something done tomorrow if I really want to. I’m from Ontario. Buffalo (New York) has been advertising for years in Toronto — go down and get your MRI.”

He agreed not all Canadians have the financial ability to travel to the U.S. for medical procedures or diagnostic tests.

“That’s the nature of two tier — if you can, you do it. If you can’t you hang in there,” he said. “I’ve got nothing philosophically against it. As long as we maintain universal access and portability, I’ve got no problems with it.”

Embree’s comments come just a few weeks after B.C. Health Minister Kevin Falcon expressed to the Vancouver Sun similar philosophical approval for some kinds of private medical care.

Falcon said he sees nothing wrong with people accessing private clinics for non-medically necessary procedures such as plastic surgery. He noted provincial and federal statutes prohibit extra billing for medically necessary procedures.

Adrian Dix, the NDP’s health critic in B.C., said he finds the combination of statements from two senior health officials “very disturbing.”

Dix said Embree is the IHA’s most senior health official, reporting directly to the health minister.

“It’s significant we have people who seem to believe queue jumping is a good thing in charge of the system,” said Dix. “It’s very disturbing. They give political direction . . . and they are speaking out publicly.

“Until now the government has at least said they do not believe in two-tier health care. Now we have two senior government officials expressing views contrary to the stated position. So what is it?”

Embree said his beliefs reflect a reality — health care is become more expensive and something needs to be done.

“I don’t know where it’s going to go, but everybody is thinking about it. I believe they are talking about this now,” he said.

“In 40 to 50 years, insurance companies will come in. Sooner or later, we are going to have start talking to the population about what to expect out of the health care system.”