Canada must be the only nation in the world whose citizens observe the sorry state of American health care, then turn around and elect provincial governments that gut the system, create health-care crises, and propose privatization as the only alternative.
Fully three-quarters of Canadians routinely indicate that our not-quite-universal health-care system is a source of immense pride. In an era of heightened divisions, health care is consistently one of the few things that truly unites us.
Unfortunately, for nearly as long as our society has endeavoured to provide this most basic of services, public health care has been opposed by a small minority who would much rather profit off your illnesses and injuries. These apostles of profit have had their voices amplified by think-tanks whose Randian talking heads would have you believe that even semi-socialized medicine “steals” freedom from consumers as much as it does money from the pockets of taxpayers.
Most of us don’t want to admit it, but they’re winning the war in Canada. In the last 40 years, the number of hospital beds per 1,000 people has dropped from nearly seven to less than two and a half. The number of physicians per 1,000 people has increased only from 1.9 to 2.4, on par with similar slow growth in the United States; the European Union average is 4.9 physicians per 1,000 people, nearly double what it was three decades ago.
To an extent, I agree with what Matt Gurney wrote in his recent column for TVO Today: the status quo is unacceptable, and Canadians must reject it. I also agree that the problems facing health care in Canada reach back much further than the pandemic and that the chronic underfunding of health care is not uniquely the fault of conservative governments.
To be fair, Ontario’s health-care system was brutalized by the Mike Harris government in the 1990s and never really recovered. It is worth remembering that health-care spending during his time in office did not increase in real terms, that 25,000 health-care workers were shown the door (at considerable public cost), that sustained cutbacks created a $4.1 billion health-care deficit, and that the privatization effort was well underway even while Harris was trying to convince Ontarians he was doing the opposite.
Don’t be fooled again — and don’t let anyone tell you not to panic either: the destruction of public health care in Canada is real. It has been happening for decades. And once it is gone, it is unlikely we’ll ever get it back.
We once had a publicly funded pharmaceutical company that ensured Canada had a constant supply of essential pharmaceuticals. It was privatized back in the 1980s. Today, it can be difficult to get baby aspirin.
If you think more privatization will provide better health care, I have a bridge to sell you.
There is an alternative that we haven’t explored, however, and I am convinced it would appeal to the very provincial premiers who advocate for lower taxes and smaller governments: nationalize it.
Gurney’s right: no province is leading the nation on health care, and it doesn’t really matter who’s in charge, either. The question is why we continue to allow provincial governments to hack away at services and budgets and incrementally privatize the system they themselves bear full responsibility for breaking.
Why bother with middlemen?
The solution is to eliminate provincial involvement in health care entirely.
A nationalized health-care system would provide a number of potential advantages.
No one proposing health-care cuts could ever dream of being elected prime minister. The elimination of provincial borders would allow for a better general distribution of health-care services and provide all Canadians with full health-care coverage anywhere in the country. The federal government would be far better positioned to address shortages of health-care professionals via immigration and the recognition of foreign credentials, redistributing the workforce, and/or creating a national medical university to address the current deficit of available spaces.
A nationalized system would necessitate the development of publicly owned plants to create essential pharmaceuticals and vaccines, not to mention PPE, allowing us to avoid disrupted international supply lines.
Most important, a national system would be integrated with national public-health policies and emergency-management services. All the lessons of the pandemic have so far demonstrated both the inadequacy of “private-sector solutions” and the inherent incompetence of the “province’s rights” approach to managing a national health crisis.
And as the provincial advocates of privatization also advocate for smaller budgets and lower provincial taxes, they should be very interested in and enthusiastic about just such a proposal.
If the prime minister were actually to advocate for a nationalized health-care system, Doug Ford and his ilk would likely object specifically because it would prevent privatization. His goal is seemingly not to make health care better, but to make it so unsustainably bad that privatization appears to be the only logical solution. Why else did he violate workers’ rights with Bill 124, underspend on health care throughout the pandemic, and refuse to use additional federal health-care funds?
What is supremely distressing about the privatization of health care is not that it will happen, but that it is already happening.
Gurney writes that it feels like “a whole hell of a lot of our health-care debates happen in some bizarre alternate reality or shared delusion where people were getting timely access to their family doctor so that [a] minor ailment could be checked out in the first place.”
If there is an alternate reality, it is one in which (a) there is any debate to speak of (the gutting of health care has been happening for decades and gone largely unchallenged by the political establishment), and (b) those arguing in favour of improved public health care believe the system is functioning well.
The advocates of public health care are all too familiar with how degraded it has become. They — and this is pretty much every professional health-care worker in the country, I might add — are not letting the perfect be the enemy of the good; they’re trying to sound the alarm that creeping privatization is making a bad situation worse.
Whether Ford is ideologically motivated or not makes no difference. The crisis in Ontario’s health-care system is at least in part his responsibility, and he needs to be held accountable. In a province rapidly running out of options, drastic measures may be necessary. That said, if Ontarians held a general strike to save public health care, we could reasonably expect Ford’s capitulation within a matter of days — his desire to be liked seemingly outweighs any specific commitment to any particular idea or ideology.
Achieving a truly universal, integrated, and comprehensive national public health-care system — one able to provide the full spectrum of medical, dental, pharmaceutical, psychological, and social services to the best possible quality and from cradle to grave — ought to be our national goal. We should accept nothing less. And as long as there are clearly no provincial leaders interested in leading by example, we — the people — may as well offer the job to federal leadership, if they think they could do better.
Maybe, just maybe, if we demand that the federal government take it out of the hands of the middlemen who’ve desecrated it, we might get the health-care system we deserve.
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