Canada’s 40-year old system of socialised medicine is under threat. Powerful private corporations have lobbied heavily for entry into what they see as an untapped, lucrative market. Ontario’s conservative government has been hungrily looking for ways to dismantle the system, in spite of polls showing overwhelming opposition to "American style" health care.
Ontario’s government falsely claims that health care costs are "out of control." In fact, compared to 1992, the provinces spend 0.4% less of their GDP on health care. Contrary to right-wing myths, the fastest growing part of health care budgets is not the public system, but private elements of the system such as drug costs.
Ontario’s Harris government recklessly cut almost $1 billion from the health care system supposedly to make it more "efficient," but in fact to help pay for their $4 billion tax cut to the wealthy. This blow to funding, exacerbated by the federal Liberal government’s cuts, was used by the Tories as an excuse to "restructure" the system by closing dozens of hospitals and laying off thousands of nurses. The results were line-ups for treatment, hospital bed shortages, and overflowing emergency departments. And what did the Tories propose as their solution to the crisis they created?
The government has privatised home care, introduced private clinics for cancer care, and is now planning to build a new hospital as a ’Public Private Partnership’.
Privatisation has been disastrous whenever its been tried. Privatised cancer-care treatment at Toronto’s Sunnybrook Hospital costs over $500 more per treatment than public care, with no reduction in waiting lists.
Laboratory privatisation has not reduced costs and has resulted in new user fees. In Britain, privately built hospitals have suffered a 30% reduction in hospital beds and a 25% reduction in clinical staff budgets as management cut costs in order to maximise profits.
The for-profit health care system in the US is a monument to capitalism’s inefficiency. The US system costs more than double Canada’s system per person and consumes more than 13% of GDP to Canada’s 9%, despite serving only a fraction of the population.
As the Ontario Health Coalition argues: "43 million Americans have no health coverage whatsoever and another 100 million are considered under-insured. So where does all that money go? The US system has the highest level of private health care administration of any industrialized country. Vast sums of public money go to duplication, administration, advertising, lobbying, and profit. The bottom line? The US for-profit health system costs more, serves fewer people and delivers worse health outcomes in virtually every category of measure."
Most damning of all, a research study led by Dr. Gordon Guyatt of McMaster University found that mortality rates in for-profit hospitals in the US were 2% higher than in non-profit hospitals. In Canada, that could mean up to 2,200 more deaths per year.
Despite enormous pressure from capitalists to privatise health care around the world – the World Bank estimates internationally privatised health care would be a $5 trillion per year industry – a growing global movement is mobilising people to stop privatisation in its tracks and in some places reverse it.
A year ago, the Romanow Commission on the Future of Health Care in Canada appeared ready to recommend some form of private health care delivery.
However, pressure from thousands of workers, students and the elderly rallying outside of commission hearings has worked. The Romanow Report issued in November recommended the expansion of the public health system, an increase in federal funding of health care to $15 billion a year to reverse years of cutbacks and rejected any forms of privatisation including "Public Private Partnerships" (also known as PFIs or Private Finance Initiatives).
Grassroots action, particularly widespread protests by workers and their community groups and unions, were key in building a public consensus that pushed Romanow as far as he went. If privatisation is to be defeated and the public system expanded, the mass movement must continue and spread.
- Money for health care, not for war! Use budget surpluses to restore and expand public heath care, not for tax cuts for the rich or weapons for the war-mongers.
- No for-profit health care delivery!
- End all experiments in private health care delivery!
- Nationalize labs, home care, and clinics!
- For a national pharmaceuticals program!
- Repeal patent protection for private pharmaceuticals!
- Nationalise drug manufacturers!
- For rotating job actions leading to a general strike to demand the preservation and expansion of public health care!
A version of this article first appeared in the November/December 2002 issue of Justice, paper of the US CWI section, Socialist Alternative