The Parkland Institute

Healthcare

Profit before people

Manufactured health-care "crisis" designed to justify privatization

The problem with public health care functioning in a free-market society is that it is perceived as being socialistic. After all, the basis of a capitalist society is the unfettered pursuit of self-interest. Public health care makes no allowances for investment for profit. It is viewed as an obstacle to the maximization of profits by the capitalist super rich.

The super rich tolerate public police protection, fire protection, and the military, because these services reduce the possibility of harm to themselves and are too costly to maintain on a private basis. They tolerate a public primary education system even though they seldom use it, because they recognize the advantage of having an educated work force that is capable of enhancing their profits. But when it comes to public health care, they view funding it with tax dollars as a drain on their profits and a missed opportunity for a lucrative investment.

The super rich, particularly those connected with the private health-care insurance or pharmaceutical corporations, hire international public relations firms to persistently lobby government officials and decision-makers, with a view to having health care in Canada privatized. They regard Canada’s health-care system as a fat cow ready for milking.

Right-wing government officials are aware that the vast majority of Canadians view public health care as a sacred cow that is not to be messed with. However, this doesn’t prevent them from making every effort to gradually whittle away public health-care benefits. Their only impediment is the Canada Health Act (CHA), which requires every province to provide publicly administered, medically necessary health care that is universal, comprehensive, portable, and accessible. Since each province decides which procedures are “medically necessary,” there is considerable discrepancy in the extent of coverage between provinces. Some provinces take advantage of this ambiguity to delist benefits.

Another clever strategy used by politicians (and no doubt encouraged by corporations that stand to benefit) is the chaos theory of market restructuring. Simply put, it involves deliberately creating chaos so people will be dissatisfied, then capturing the market by providing alternatives. The move, in the mid-1990s, to close hospitals, cut the availability of active treatment beds, withdraw certain insurance benefits, and compel patients to wait longer for treatment, were all part and parcel of the game plan to create chaos. As soon as dissatisfaction reaches a critical level, the private sector is ready to step in and provide solutions.

Even though they contravene the CHA, private for-profit clinics are allowed to operate in several provinces, with the excuse that they reduce wait times. The irony is that by bleeding health professionals from the public system, the private clinics actually increase wait times in the public sector.

Delisting services that they don’t consider to be “medically necessary” is another measure taken by governments that are unsympathetic to the public system. This despite the reality that delisting these services can often result in patients eventually ending up in hospitals which are already short of staff and beds, and where care is much more costly. Of course, whenever a service is delisted, it becomes a plum for the private health-care insurers, who are eager to step in and fill the void.

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The super rich... hire international public relations firms to persistently lobby government officials and decision-makers, with a view to having health care in Canada privatized. They regard Canada’s health-care system as a fat cow ready for milking.

Moving to private health clinics increases the overall cost of health insurance because shareholder profits have to be factored in. According to 2008 figures released by the Organization for Economic Cooperation and Development, the U.S. spent 17 per cent of its gross domestic product on health care as compared to 9.7 per cent in Canada, 10.7 per cent inGermany, and 9.5 per cent in France (see http://www.nchc.org). The latter three countries have public health care, while private health maintenance organizations (HMOs) provide the bulk of health services in the U.S. A switch to a private system in Canada can only result in fewer benefits for those who cannot afford high private insurance premiums. Health professionals will “following the money” and shift to the private sector, leaving the public system with the crumbs.

Given these realities, why then, do some provincial politicians pursue the privatization route? There can be no doubt that they are reacting to immense lobbying pressures by health-care corporations. Sustainability is often  used as an excuse, but health-care costs in Canada, as a percentage of gross national product, have remained relatively flat over the past several decades. There can be no dispute that there are some gross inefficiencies in the public health-care system. A national drug plan would reduce drug costs through single desk bulk buying. An expanded long-term care system with adequate facilities and staffing would take the pressure off acute care beds. Setting up public community clinics manned by teams of health professionals would reduce the crisis onto hospital emergency rooms, and a properly staffed home-care program would serve to reduce the need for costly hospital and long term care facilities.

Lack of funds is often offered as an excuse for cutting health benefits. This claim is especially absurd in the province of Alberta, where Premier Stelmach refused to accept the recommendations of his own Royalty Review Committee to increase petroleum royalties to a more realistic level. Across the country, super rich Canadians are avoiding the payment of their fair share of taxes with impunity by using tax havens, yet nothing is done about it.

One has to wonder who it is that is in charge of governments? Is it the ordinary people who elect MPs and MLAs, or is it the super rich who fund right-wing political parties?

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