Commentary
Money for War and Handouts to Capitalists, but not for Health Care
In the wake of September 11th the federal government was quick to promise billions of dollars for increased "security" and to send Canadian troops to Afghanistan. It has also found billions of dollars to bail out the airlines and to provide handouts to countless other corporations whose profits have been affected by the recession. Nevertheless, it is adamant that there is no more money to adequately fund health care.
Since the Liberals took office in 1993, billions of dollars have been cut from federal transfer payments to the provinces to fund health care. In 1977-78 the federal share of health care expenditures was 24.9 percent, and in 1979-80 it rose to 26.1 percent. Since then, it has been declining steadily to a low of 10.0 percent in 1998-99. The infusion of federal money in September, 2000 increased the federal share to the 14 to 16 percent range, but did not even come close to restoring the money cut from the system during the previous seven years.
The withdrawal of federal funding, more than any other single factor, is what has created the funding crisis afflicting the Medicare system. Provincial governments, on average, have maintained their levels of expenditures relative to revenues, so the funds cut by the federal government have not been replaced. This, in turn, has resulted in downward pressure on the wages and working conditions of health care workers, leading to an unprecedented exodus of health care workers to the United States and from poorer to wealthier provinces. This, in turn, has created growing waiting lists for surgery and medical tests, the proliferation of hallway medicine and restricted access to medical care.
In Manitoba, thousands of nursing jobs remain vacant, while the remaining nurses are overworked. There is a severe shortage of family doctors in urban areas and some rural hospitals have been forced to close because doctors are simply not available. The crisis is even more severe in remote northern communities.
Instead of insisting that Ottawa restore funding to previous levels, some provincial governments are using the health care crisis to fuel the privatization of the health care system. Alberta has now approved overnight stays in private hospitals in contravention of the Canada Health Act. The Gordon Campbell government in British Columbia is also going ahead with plans for a Public Private Partnership (PPP) hospital in Abbottsford and Ontario has announced PPP hospitals for Brampton and Ottawa. In Manitoba, a private clinic is attempting to force the provincial government to allow overnight stays.
Those who have embraced privatization as the cure for the funding crisis in Canada's health care system have never explained how it will reduce the cost of medical care. The experience of the United States, which spends one-third more per capita than Canada on a health care system which excludes millions of people living in poverty, disproves the neo-liberal mantra that private enterprise is more efficient. Since private hospitals charge extra user fees, the total cost of health care for Canadians will actually rise with privatization.
The public debate on Medicare funding being organized in the wake of the Romanow Report is taking place in an atmosphere in which public opinion can be easily manipulated. An artificial funding crisis has been created, not because of a lack of funds, but because of the desire of the federal and various provincial governments to undermine the public health system in Canada. Faced with the apparent "failure" of the public system and presented with false alternatives, people will be more inclined to opt for privatization, user fees and other means of offloading the costs onto private citizens. A meaningful public debate can take place only after Ottawa restores its previous levels of expenditures on health care. Then the problems can be examined in a calm and rational manner. The money is there; the massive expenditures on war, "security" and bailouts to the capitalists proves that much. What needs to be debated is how the priorities of the Canadian people can be achieved.