PHILADELPHIA – Doug Allan, an authority on the Canadian health care system and a longtime health researcher for one of Canada’s largest public employee unions, spoke to appreciative audiences in Philadelphia, Baltimore, and Cambridge, Mass., this week in a tour sponsored by the People’s Weekly World/Nuestro Mundo.
Allan’s talk, “Lessons From Canada’s Public Health Care System,” explained how the Canadian people have organized to fight back attempts by the right-wing conservatives and greedy corporations to privatize many of their health services.
“Canadians see universal health care as one of the defining accomplishments of the country, a great achievement of the Canadian working people,” Allan said. “Canadians have removed the area of health care from the control of monopoly capital.”
Before 1964 Canada’s health care system was pretty much like that of the United States. In the early 1960s, after much public discussion and debate about their health care, Judge Emmet Hall appointed the Royal Commission on Health Services, which established what Canadians call Public Medicare. Public health care in Canada provides hospital and medical coverage for all necessary services for all of its people. User fees are outlawed.
The 1984 Canadian Health Act defined and reaffirmed the five principles of the public health care system: comprehensiveness, universality, portability (national standard rates), accessibility, and public administration. Forty years ago the national government split the costs of health care 50-50 with the provincial governments. Now the provincial governments pay 80 percent and the national government pays 20 percent.
“Despite Canada’s universal coverage, costs are much less in Canada than the privatized system in the U.S.” said Allan. One reason for this is the lower costs for health administration in Canada: $307 per person in Canada versus $1,059 per person in the U.S. Administrative costs account for 31 percent of health care expenditures in the U.S., nearly double the 16.7 percent figure in Canada.
In spite of the billions spent for health care in the U.S., at least 43 million people have no health care coverage and millions more have only partial coverage. Because Canadians have heard about the downsides of the U.S. system, conservatives are careful not to use the U.S. as an example when demanding health care “reforms.” But Canadian corporations are relentless in trying to privatize the system and make big profits like their U.S. counterparts.
During the 1990s Canadians voted in conservative governments at the national level and in the provinces of British Columbia and Ontario. Conservatives opened the door to privatization, eroded worker rights, and contracted out many health care support services. In Ontario in 1995, a far-right government introduced for-profit homecare services and abolished local agencies set up to coordinate homecare. The result was cutbacks in services and waiting lists. MRI and CT diagnostic services were also privatized. An attempt to privatize ambulance services, however, was blocked by unions and community groups.
Ontario’s conservative government introduced “public-private partnerships” for hospitals (P3’s) – a scheme where a for-profit corporation would own the facility and provide support services, while the public hospital would provide clinical services. A private corporation would be allowed to build a hospital facility and lease it back to the hospital for 25-60 years. Clinical services would remain (for now) under the control of the public hospital.
Angered by what was going on, Canadians in Ontario organized the Ontario Health Care Coalition, composed of 300 union and community groups. In 2002 teams began to canvass door-to-door, asking people to display signs on their lawn and red ribbons on their porch to show support for public health care.
“Tens of thousands of signs and red ribbons were displayed,” Allan said. “Seventy coalitions have formed across Ontario and continue today as the struggle continues.”
As a result of the pressure, the New Democratic Party (social democrats) and the Liberal Party (a middle-of-the-road, pro-business party) both came out strongly against privatization and supported the people’s outcry to keep and expand their public health care system. On Oct. 2, the Conservative Party was voted out, including the minister of health who had led the hospital privatization campaign.
“It would be instructive for those in the United States to study the struggles of the Canadians around health care. Privatization has been set back and strong popular support for public health care continues. But corporate campaigns continue and so does the fight back!” said Allan.
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