Health care under attack from within
Neo-conservative economists have stressed “living within our means,” being “economically responsible,” and generally just lowering public expectations of what governments can or should do.
(I stress the word “general” here, because the hundreds of corporate lobbyists that visit government offices consistently deliver sitting MPs advice on what government can and should do for them. Usually these requests have little or nothing to do with general welfare but plenty to do with greasing the wheels of corporate activities.)
Given the high profile nature of health care among Canadians, as well as the lucrative market in delivering health care goods and services, it’s little wonder that corporations of all kinds from manufacturers of medical technology to drug companies and insurance providers are drooling to get a greater slice of the pie.
When universal public medical insurance was instituted through the Canada Health Act, some of these markets became strictly regulated. Most user fees for physicians’ services are prohibited under the act. Insurance is provided by a single government agency in each of the provinces and, until now, was guaranteed to a national standard. This government single-payer plan creates tremendous cost efficiencies.
Compared to the bewildering system of health insurance in the US, Canadians receive on average far better care at less cost.
Harper’s Conservatives, however, prefer a “free-market” solution to all problems, and although they don’t wish to alienate Canadian voters too dreadfully by attacking the Canada Health Act directly, they have taken strategies from US Republicans.
A most effective Republican strategy to make a government program dysfunctional is to starve it for revenue. This strategy exists in all the Republican-governed US states, in their Congress, in Canadian provinces that have conservative-leaning governments (such as BC), and in our federal government itself. The ongoing tax cuts, especially corporate tax cuts, that have characterized Canadian legislation under the Conservatives have effectively removed hundreds of billions of dollars in revenue from government programs over the past decade and a half.
Corporate media trumpet, as if it were holy writ, the “news” of government mismanagement and of the “inefficiency” of public services. This public sector bashing and corporate self-flattery condition Canadian citizens simply to expect less from government, precisely what Harper plans to do.
Recently Harper’s finance minister delivered an ultimatum about capping health spending. As always, the sotto voce muttering in the background from the Fraser Institute promotes “experimenting” with other health delivery systems, a euphemism for various privatization schemes.
There is another view, however, one quite eloquently argued by a group called the Canadian Health Coalition (www.healthcoalition.ca). Their Nov. 2011 report soundly debunks the air of crisis frequently to be found in mainstream media coverage.
Harvard economist Robert G. Evans states unequivocally that the argument that public health care is “fiscally unsustainable” is “a lie.” Population growth and inflation, not the aging population, cause most of the growth in health spending. Further, “medicare spending takes up roughly the same share of tax revenues as it did 20 years ago.”
The highest rises in total health care spending are in precisely the areas not covered by our single-payer plan (e.g. prescription drugs, dental care, home care). If these were covered by a single-payer system health care spending would be much more efficient.
The editor-in-chief of the New England Journal of Medicine argues cogently that in contrast to our system, for-profit health care is expensive, inefficient and inequitable, precisely the problems that the Canada Health Act skillfully, if imperfectly, manages.
CIBC Scholar-in-Residence André Picard states, “A universal health system is essential if you want a country that’s healthy and productive on many levels; it’s an economic driver and it’s a tool for social justice.”
To Harper, “living within our means” means shrinking corporate taxes, creating artificial deficits, generating artificial panic, and, if we let him, gradually replacing Canada’s fair public health insurance system with an increasingly unequal private one.
Al Lehmann is a teacher living in Terrace, BC.