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Introduction

The two articles re-published in this pamphlet were written to address the 50^th anniversary of North America’s first public healthcare system for all citizens initiated in Saskatchewan on July 1, 1962.

We were researching the prolific resources and books available on the subject in preparation for a forthcoming book on the fight for medicare in Saskatchewan and wanted to raise the profile of the anniversary as the actual anniversary approached.

This pamphlet is intended as a short and quick resource for labour and health care activists as we celebrate 50 years of medicare.

272 billion reasons to fear privatization

Defending Public Healthcare
Notes from Leftwords for the Ontario Council of Hospital Unions

August 22, 2012

Below is a list of the 11 US health corporations on the Fortune 500 list. They had a combined revenue of approximately $272 billion in 2010. They make about $15 billion in profits.

Trying to reform America's largely for-profit health care system is bound to come up against these interests. With such large revenue streams they have incredible power and resources to divert health care reform to match their own interests. They have (literally) billions of reasons to do so.

Their influence has not led to good results. The privatized American system is far and away the most expensive health care system in the world. Despite this, tens of millions of Americans have no health care insurance and tens of millions more have inadequate health care insurance.

If Canada let's more and more corporations into our health care system, we will more and more face the same corporate interests able and willing to push health care in the same direction that corporate health care pushes the American system.

			Revenues		Profits
Rank	Company	Fortune 500 rank	$ millions	% change from 2010	$ millions	% change from 2010
1	UnitedHealth Group	22	101,862.0	8.2	5,142.0	11.0
2	WellPoint	45	60,710.7	3.2	2,646.7	-8.3
3	Humana	79	36,832.0	8.8	1,419.0	29.1
4	Aetna	89	33,779.8	-1.4	1,985.7	12.4
5	Cigna	130	21,998.0	3.5	1,327.0	-1.3
6	Coventry Health Care	219	12,186.7	5.2	543.1	23.8
7	Health Net	221	11,901.0	-12.6	72.1	-64.7
8	Amerigroup	385	6,318.4	8.8	195.6	-28.4
9	WellCare Health Plans	401	6,106.9	12.3	264.2	N.A.
10	Centene	453	5,340.6	19.5	111.2	17.3
11	Molina Healthcare	500	4,769.9	16.7	20.8	-62.1

Issue date: May 21, 2012

Opinion: Time to fight for universal Pharmacare

A universal program would save Canadians up to $10 billion a year, some estimate

By Steve Morgan

The Vancouver Sun

August 20, 2012

When Prime Minister Stephen Harper, along with the health and immigration ministers, tried to justify cutting refugee health coverage in Canada they argued it was about fairness. Providing prescription drug coverage to refugees was unfair, they claimed, because other Canadians do not have such coverage. They were at least partly right.

As a country, we provide universal access to medically necessary hospital care, diagnostic tests and physician services based solely on need. It’s a point of national pride. But Canadian “medicare” — as it is affectionately known — ends as soon as a patient is given a prescription to fill.

Provincial drug plans cover only limited populations, such as seniors or social assistance recipients, or limited costs (such as costs exceeding “catastrophic” deductibles). Private drug insurance is a perk not easily obtained by Canadians who are retired, self-employed or employees of small companies.

The patchwork of drug coverage in Canada has consequences that cost us all.

As medicare turns 50, let’s see the full vision implemented

Association of Ontario Health Centres

For AOHC, “medicare” is not just the inner workings of our health system. For us, medicare is an inspiring aspiration enshrined in Canada’s Health Act:

… to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial barriers and other barriers.

Financial barriers were addressed in medicare’s first stage – a publicly funded health insurance system designed to cover costs for doctors and hospitals. The second stage that Tommy Douglas and medicare’s other founders envisioned was intended to address the other barriers standing in the way of improved health and well-being – the root causes of poor health and out-of-date delivery of care.

Potential for billions of dollars in increased health cost if Canada-EU trade deal goes through

With Europe in a financial crisis the question remains how far is Canada willing to go to achieve a deal?

NUPGE News

16 Aug. 2012

While negotiators for the proposed Canada-European Union trade deal say that negotiations are in the final stages, serious concerns continue to be raised about some of the provisions expected to be in the agreement. It is reported that negotiators have reached agreement on 3/4s of the text but that there are some serious issues remaining to be addressed.

In particular, Canadian officials say there is a large gap in the negotiations over such issues as investment rules, financial services, and taxation. With Europe in a financial crisis the question remains how far is Canada willing to go to achieve a deal?

A number of commentators suggest the intellectual property chapter of the deal as being particularly difficult.

According to Michael Geist, the University of Ottawa's Canada Research Chair in Internet and E-Commerce Law, the revelation that "provisions from the Anti-Counterfeiting Trade Agreement may sneak their way into CETA generated widespread headlines throughout Europe last month with politicians and activists expressing exasperation at the clumsy attempt to secretly revive an agreement that was roundly rejected by the European Parliament."

"The Canadian opposition to the chapter will come from European demands for patent reforms that could result in billions in additional health care costs due to higher pharmaceutical prices. The pharmaceutical demands are one of Europe's top priorities, but Canada has thus far refused to counter the EU proposals, creating a stalemate that has dragged on for years."

Canada's lead negotiator, Steve Verheul, says that the pharmaceutical industries demands won't be on the table during negotiations in September and October.

While big pharma insists that these reforms are needed to increase research and development investment in Canada, past experience suggests otherwise.

In the 1980s, the industry lobbied for patent reforms while promising to increase spending on research and development in Canada to 10 per cent of total sales by 1996. In reality, investment in drug research and development has declined and is as its lowest level since the 1987 reforms.

According to Geist, "given 25 years of mostly failed targets, the rational approach is to put a freeze on any further reforms at least until the industry lives up to its commitments. But with the agreement shrouded in secrecy - the government has steadfastly rejected calls to release the draft text - it appears that the major health care decision will be made behind closed doors with no public discussion, debate, or access to the official text."

Physicians take healthier approach

BY GREG FINGAS

SPECIAL TO THE LEADER POST

AUGUST 16, 2012 

Physicians must become stronger advocates for health equity, says incoming CMA President Dr. Anna Reid, an emergency room physician in Yellowknife, Northwest Territories.

Just a few short years ago, the Canadian Medical Association's leadership launched a series of direct challenges to Canada's universal public health-care system. Two CMA presidents known for their involvement in private service delivery used the national profile associated with the organization to pitch their business model. And CMA members came within an eyelash of voting for health care to be at least in part patient-funded.

But the effort of one faction within the CMA to shift our health-care system toward a profit-based model didn't do much to sway public opinion or reshape the delivery of health care. (Yes, we've continued to see privatization by stealth - but not at any greater pace than was already under way.) Instead, it was met by the founding of Canadian Doctors for Medicare, who made it abundantly clear that the CMA couldn't claim a professional consensus to dismantle our prized national health-care system.

Now, the CMA looks to have changed direction entirely. And there's reason for optimism that Canada's medical profession is headed down a much more viable path.

To address health inequalities, look beyond the role of individual responsibility

By Iglika Ivanova 
Progressive Economics Forum
August 14th, 2012

A new report by the Canadian Medical Association provides a timely reminder that money buys better health, even in a country with a universal public healthcare system. A poll commissioned by the CMA found a large and increasing gap between the health status of  Canadians in lower income groups (household income less than $30,000) and their wealthier counterparts (household income over $60,000).

The fact that income affects health is hardly a surprise. A large body of research has shown that both globally and in Canada, income (and socioeconomic status more broadly) is closely related to virtually all health outcomes that one can think of, from life expectancy to mental health. Health experts have coined the term “social determinants of health” to draw attention to the factors outside the healthcare system that affect health, and income is identified as one of the key social determinants of health.

The next 50 years: What does the future hold for Medicare in Saskatchewan?

By Christeen Jesse
L-P Specialty Products

July 23, 2012

The induction of Medicare into Saskatchewan law 50 years ago has done more than just provide affordable health care - it has also placed importance on the values of equality and democracy.

"We have seen a real establishment of an ethic and understanding that people should be treated if they're sick - regardless of how much money they make and of where they are in society," said Ryan Meili, a family physician in Saskatoon and the head of the Division of Social Accountability at the College of Medicine at the University of Saskatchewan. "I think that's a really positive thing to have been developed here and it effects the way we see lots of areas of social investment."

Meili, who wrote the recently-published book A Healthy Society: How a Focus on Health Can Revive Canadian Democracy, recognizes the province's past accolades in health care, but says as society evolves, Medicare needs to change with it.

Stronger measures needed to crack down on for-profit clinics, say doctors

Canadian Doctors for Medicare

July 19, 2012

BC’s Medical Services Commission called for an end to extra billing at afor-profit surgical clinic infamous for its illegal billing practices yesterday, in a movedoctors say has been a long time coming.

“We’re thrilled that the illegal billing practiced by the Cambie Clinic is finally being calledto account by the Medical Services Commission,” said Dr. Danielle Martin, chair ofCanadian Doctors for Medicare. “But there must be real consequences to chargingCanadians for their publicly-insured services.”

After a lengthy audit, the Medical Services Commission concluded that CambieSurgeries Corporation and the Specialist Referral Clinic (Vancouver) Inc. owned by Dr.Brian Day charged illegally in more than 200 cases, charging the BC Ministry of Healthnearly half a million dollars in extra billing. This violates BC’s Medical Protection Act.

Although the Cambie clinic’s actions are illegal, the BC government is only seeking toensure the clinic stops these practices in the future. Canadian Doctors for Medicare iscalling for stronger punitive action to create a real deterrent to extra billing by for-profitclinics, and for accountability to BC citizens for their tax dollars.

The Canada Health Act stipulates that the federal government may withhold one dollarof cash transfer for every dollar collected through direct patient charges – a penalty thatshould be imposed in a case such as Cambie, where illegal extra billing has been continuously rampant.

“This is a prime example of what happens when the federal government doesn’t enforcethe Canada Health Act,” said Dr. Vanessa Brcic, executive member of Canadian Doctorsfor Medicare. “On behalf of Canadians who are emptying their savings accounts into thecoffers of for-profit clinics like Cambie, the federal government should be taking a muchtougher stance on working with the provinces to stop illegal billing practices, andinvesting in care that all Canadians can access in our public system.”

Harper Hacks Down Our Medicare

By Danielle Martin
Board Chair of Canadian Doctors for Medicare

Huff Post
July18, 2012

Canadians can feel it -- something's not right in our country when it comes to health care. We know our public system is fundamentally sound, but we also know that there is much work to be done to improve it and ensure it's as sustainable as we want it to be for generations to come. We see our health care providers and provincial governments struggling to improve services in the context of tight public budgets and an aging population. Almost everyone is trying to make medicare better.

But one critical player is missing from the effort -- where is our federal government when it comes to health care?

A Healthy Society: Interview with Ryan Mieli

By Am Johal

Rabble.ca

Ryan Mieli

July 18, 2012

Q. In your book, A Healthy Society, you argue that a focus on health can revive Canadian democracy. How so?

The book starts with a discussion of the disordered state of Canadian political discourse , from media coverage to the way in which parties present ideas. There is a general lack of focus, a lack of a common project for society. The WHO defines health as not just the absence of disease, but full social, mental and physical wellbeing. In A Healthy Society I propose that health is a useful shorthand for our goals as a society, and one which we can measure our success in reaching.

Such a focus on health must move beyond healthcare to the upstream elements that impact health outcomes: the social determinants of health. Income, education, employment, social supports, housing, nutrition, these are the elements that make a greater difference in health and wellbeing. While these are disparate areas, the common thread of health allows us to address them in an evidence-based fashion.

Get back to the table!

Health care activists send Premiers and Harper a message on National Day of Action on 2014 Health Accord

NUPGE News

July 17, 2012

 The federal government is turning its back on health care at a time when we need elected leaders to help build a caring future for Canada, say advocates of publicly-funded health care who are organizing a National Day of Action on the 2014 Health Accord set for July 18. Many are concerned that the federal government has already walked away from the negotiating table before negotiations have even started with the provinces. The current Health Accord expires in 2014.

At a meeting of Finance Ministers from across the country in December 2011, Flaherty announced that the federal government would extend the six per cent escalator clause, part of the 2004 Health Accord, for the Canada Health Transfer (CHT) only until the 2016-17 fiscal year. After that, until at least 2024, annual increases in the CHT will be tied to nominal gross domestic product (GDP) growth.

James Clancy, National President of the National Union of Public and General Employees (NUPGE), criticized the Harper government for acting unilaterally rather than working in partnership with the provinces to improve health care.

"Canadians want the federal government to work in partnership with the provinces. not dictate terms and conditions," says Clancy. "Where was the consultation or negotiations? How are the provinces health care needs and priorities reflected in this announcement?"

Now, in the lead up to a premiers meeting on health care in Halifax on July 25 - July 27, Clancy is urging the provinces to work with Canadians to pressure the government to go back to the table and negotiate fairly.

"There is still much more to be accomplished at the negotiating table," Clancy noted. "The provinces will find common ground with Canadians on this issue. In addition to more investment, Canadians want the federal government to work with the provinces to fill in the gaps in the continuum of care. They want to see new programs and services in the areas of home care, long term care, prescription drug coverage (pharmacare) and mental health."

Some provinces have already come forward in opposition to the federal government’s actions. If the provinces work together to get the federal government back to the negotiating table, they can get down to the work of creating a new accord and building a caring future for health care in Canada.

More information:

NUPGE's Negotiating Federal Transfers to the Provinces report: Here they go again: Less sharing, more inequality

Sick People or Sick Societies?

By Jill Eisen 

Canadian Dimension

July/August 2012

The words “health care” and “crisis” have become inseparable in any discussion about health policy in Canada. Stories about long waiting lists for surgery, interminable delays to see specialists, spiralling costs and the spectre of a two-tier system flood our media. With baby boomers reaching their senior years, things are only going to get worse. As numerous studies and Royal Commissions have pointed out, there’s much that can be done to make the system more efficient and responsive. But unless we do more in the way of prevention, the system threatens to collapse under its own weight.

Our healthcare system is more aptly named our sickness care system. It does a pretty good job of treating illness, but when it comes to prevention, it’s mostly up to us: don’t smoke, eat lots of fruits and vegetables, keep physically active, take time to relax. It’s hard to avoid the messages that bombard us from the media and our doctors that our health is our responsibility. Healthy lifestyles are no doubt good for us, but it turns out that the social conditions in which we live and work are more important in determining our health than either the health care system or our personal habits.

Canada's Health Care "Crisis": Accumulation by possession and the neoliberal fix

By Heather Whiteside 
Studies in Political Economy
Autumn 2009

Public health care in Canada (“medicare”) is based on five principles, and its realization balances precariously on the method by which this public service is provided. At one end of the delivery spectrum, medicare could be a fully decommodified public service similar to the public education system; at the other end, public health care insurance could exist alongside the private, for-profit delivery of services and infrastructure. However, these varied delivery options are not interchangeable equivalents, since the increased commodification of health care serves to erode the five principles, a process that has been steadily underway since the 1980s. Thus, while medicare may remain formally tied to its core commitments, the Canadian landscape is now dotted with public-private partnerships, privatized support services, and newly sprouting private clinics, and it has been subject to chronic underfunding.

Addressing the various stages through which medicare has passed — the struggle over its formation, its eventual implementation and brief stabilization, and its current internal erosion — is a complex issue that may be approached in a variety of ways, ranging from the synchronic to the diachronic.3 While much can be gained from a slice-in-time approach, a policy that aims to provide free and universal public health care to all citizens is not one that operates in a vacuum, as it is intimately bound up with the prevailing social relations of power and thus with developments occurring within capitalism itself. In this regard, the growing exposure of medicare to the logic of capitalist profitability underscores the need to explore the relationship between crises, fixes, and the framing of public policy bound- Studies in Political Economy 84 AUTUMN 2009 79 aries. This leads to the conclusion that commodification has less to do with the often-lamented efficiency problems of medicare than it does with a crisis of accumulation. Furthermore, it is a reminder that Canada is not alone in its reforms, given that crises are global in their reach, and thus restructuring is a national phenomenon only in a limited sense.

Read more HERE. (pdf)

Medicare’s 50th Anniversary Sets Important Context for N.S. Legislative Review

By Ian Johnson  
Behind the Numbers, CCPA
July 11th, 2012

July 1 of this year marks the 50th anniversary of Medicare in Canada. On June 29, Nova Scotia’s Minister of Health and Wellness released for public input proposed new legislation to replace the outdated Health Services and Insurance Act. Are these two events related? Probably not, but I think they should be.

For it was on July 1, 1962 that insured medical services started in Saskatchewan. This did not happen overnight. A number of important preparatory steps took place over almost 20 years. This included creating the first health region in the province, and setting up insured hospital services in 1947.

Nor did it happen without major struggle. There was a bitter provincial election campaign in 1960, and there was a lengthy and controversial debate on the Saskatchewan Medical Care Insurance Act before it was passed in 1961. And when Medicare began, so also did a three-week doctors’ strike. And throughout that period, there was strong opposition by the established medical profession, the insurance industry, the mainstream media, and the provincial Liberal Party of that time. There was intense pressure applied to the government to back away and withdraw the Act.

July 18: National Day of Action for a 2014 health accord

Rabble.ca

In December 2011, the federal government announced that it would cut $31 billion from public health care by 2024 effectively downloading much of the responsibility for health care onto the provinces and territories. After that announcement, the federal government walked away from the 2014 Health Accord negotiating table.

Without a 2014 Health Accord, it is unlikely that we will be able to protect, strengthen, and extend public health care. Canadians need to act now to protect public health care by demanding that Harper return to the negotiating table. Otherwise, it will be every province for itself and many of us simply can’t afford it.

Come participate in the National Day of Action!

Please participate by joining us to partake in a human formation – we will be forming a giant red umbrella for Medicare (we’re covered).

This event will happen one week before the premiers of every province and territory will meet in Victoria to discuss what their next step will be for the 2014 Health Accord. We need to send the premiers to this meeting with a strong mandate from their constituents to protect public health care by standing up against cuts.

The Ontario Health Coalition, The Council of Canadians and Canadian Doctors for Medicare are joining forces with other provincial coalitions across Canada to encourage the premiers to call Harper back to the 2014 negotiating table.

In Toronto:

Join us on July 18 for a National Day of Action for a 2014 Health Accord! We will be forming a giant red umbrella to symbolize Medicare (we're covered)

Meet across from the Holy Eucharist Ukrainian Catholic Church on Bain and Broadview Ave (just south of the Danforth) in Riverdale Park East at 11:40 am to participate in this exciting human formation! The more the merrier.

In British Columbia:


Link HERE.

Beyond Acute Care: Covering Seniors and the Disabled with the Medicare Umbrella

Beyond Acute Care

 

Canadian Health Care Under Neoliberal Assault

By Milton Fisk

Solidarity

THE RECENT GROWTH of obstacles to getting health care here in the United States has led to a renewed interest in Canada's system of universal access, called Medicare. (See note 1)  Premium inflation has accelerated after stabilizing in the mid-1990s.

Employers, who had trusted Health Maintenance Organizations (HMOs) to limit their expenses for employee health care, are either limiting employee coverage or simply not contributing to it. The steady rise in the number of uninsured in this country is a reminder that a robust economy doesn't mean generalized affluence.

It is ironic though that, just when interest in the United States is rising, the Canadian system itself has become more vulnerable.  Emergency room overcrowding has reached crisis proportions in Ontario and Quebec; hospital closings have devastated rural communities in Saskatchewan and Alberta; the provinces are begging for federal health care cuts to be restored to prevent a collapse of the system.

Debt Panels By Stephen Colbert

The Colbert Report

Start at 9:30 minutes in video HERE.

Event: Remembering the Future – Can Medicare and Pensions Survive?

Remembering the Future – Can Medicare and Pensions Survive?

Saskatchewan Seniors’ Mechanism Annual Conference

Guest speaker: Louise Simard – The History of Medicare (May 16 – 10:30 a.m.)

When: Wednesday & Thursday, May 16 -17
Where: Hotel Saskatchewan, Regina

Full conference registration is $50 (age 55+) or $60. Register early as interest is high. For further information contact Sask Seniors’ Mechanism – 306-359-9956, ssm@skseniorsmechanism.ca, website: www.skseniorsmechanism.ca.

Conference brochure PDF HERE.