Increased cuts push Canadian health care toward privatization

At Canada's Wonderland, you can buy your child a "Fast Lane Pass" so he or she can experience the thrill of pushing ahead of all the other children waiting to get on a ride.

It's excellent preparation for today's world of hyper-privilege -- where the rich get to buy their way to the front of just about every line.

We live in a society that's riddled with elitism and special privilege. One of the few holdouts is medicare, Canada's public health-care system, where a billionaire can't bypass a fast-food worker waiting for medical care. Access is determined by medical need, not wallet size.

We all pay for medicare through our taxes. And, if we're sick, we can spend weeks in a hospital, receiving top-level medical care, and walk out at the end -- without paying a penny.

It's not surprising that, in a national contest sponsored by CBC Television, Canadians voted Tommy Douglas, father of medicare, the greatest Canadian of all time.

It's easy to lose sight of the truly inspiring aspects of medicare in the midst of federal-provincial wrangling, like this week's negotiations, over health-care financing.

What's ultimately at stake is whether there will be sufficient public funding to prevent provinces from turning over more of our health-care system to the private sector.

The push for private, for-profit medicine really got going after the Chrétien Liberals deeply cut federal health-care funding in 1995. Ottawa had contributed 25 per cent of total health spending in 1977, but that contribution dropped down to just 9.8 per cent by the late 1990s, leaving the provinces reeling and sending hospital wait-times climbing.

Advocates of private health care eagerly moved in, and have been a loud part of the public debate ever since.

Since the late 1990s, Ottawa has been increasing the federal contribution, restoring it to about 23 per cent today. Now the Trudeau government, roughly following the course laid out by Stephen Harper, plans to slow the growth of the federal contribution. The provinces insist the Liberal offer would reduce the federal share back down to about 20 per cent, leaving them struggling with rising health costs.

All this creates conditions that embolden those pushing for privatization, including conservative think-tanks and private clinic operators. In B.C., orthopedic surgeon Dr. Brian Day is in court trying to strike down health-care laws that restrict his business opportunities. He operates two highly profitable private clinics and wants to ensure he and other medical entrepreneurs can collect fees from the public system while charging patients whatever extra amounts they wish. If he wins, the floodgates could open.

Privatization advocates want us to believe public health care is no longer affordable. But in fact, it's private, for-profit medicine that's unaffordable.

The publicly funded portion of our health-care spending -- doctors' fees and hospital stays -- has remained fairly stable as a percentage of GDP for more than 30 years. What is out of control is the part controlled by the private sector -- drugs, home care, physiotherapy, etc.

If we want to control health-care costs, we should extend the publicly funded portion, not open more services to the private sector. But that would require more public funding, which provincial and federal governments, after years of deep tax cutting, are reluctant to commit to.

High drug prices, for instance, are a major contributor to rising costs. The solution, as many studies have shown, would be a national universal pharmacare program, which would cost money to get started but ultimately save Canadians billions of dollars a year.

But while extending the public system would make sense, the political winds are blowing in the opposite direction, particularly with a Republican White House and Congress planning to move the U.S. even farther into the weeds of private medicine, with its special privileges for those with money.

Expect to hear privatization advocates try to destroy our faith in our public system, pointing out that a dog can get a hip replacement faster in Canada than a human. That may be true -- because veterinary care is private and, with enough money, you can get whatever you want as soon as you want it.

On the other hand, if an owner can't pay, the dog is put down.

In an age when the rich demand a fast lane to the front of every line, it will require resolve and determination to preserve our medicare system, a bastion of equality sharply at odds with the heartless corporate world we inhabit.

Linda McQuaig is a journalist and author. Her book Shooting the Hippo: Death by Deficit and Other Canadian Myths was among the books selected by the Literary Review of Canada as the "25 most influential Canadian books of the past 25 years." This column originally appeared in the Toronto Star.

Photo: David Prasad/flickr

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