On November 22 and 23, Canada's premiers are holding an economic summit in Halifax. Stephen Harper was invited, but he's not coming. Harper's quiet absence at the first ministers' meeting in Halifax speaks volumes about his commitment to universal health care. Harper is well aware that his refusal to negotiate a 2014 Health Accord and the downloading of almost $40 billion will encourage provinces to charge patients out-of-pocket and bring in more for-profit services. This is the most expensive and least efficient method of delivering health care -- if you need proof, just look to our southern neighbours.