The North American Free Trade Act (NAFTA) currently contains exemptions that protect Medicare from encroachment from American health care insurers and for-profit hospitals.  NAFTA is up for renegotiation, and it is very likely that the United States will exert intense pressure on Canada to eliminate these exemptions.

American corporations see Canadian health care as an opportunity waiting to be exploited, and they rightly see Medicare's NAFTA exemptions as a barrier to corporate penetration of the Canadian market. If Medicare loses its exemptions under NAFTA, it will be easy for these corporations to dismantle it entirely through actions undertaken with the NAFTA tribunal.  Opening Canada's health care system up to privatization would inevitably lead to higher health care costs per capita for Canadians and deepening poverty among people ill-equipped to pay for private insurance, such as the unemployed and underemployed and those people on a fixed income. It would lead to a high number of bankruptcies as both poor and middle class people found themselves burdened by overwhelming medical debts. Such a move would also lead to far worse health outcomes for Canadians. 

In order to protect Canadians from these evils, Medicare must retain its exemptions under NAFTA or under any bilateral trade deal replacing NAFTA. Prime Minister Trudeau, Medicare is a defining feature of Canadian society and its protection must be an overriding priority in any trade agreement.