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Next Year Country Books

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

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)

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.

Labour activists fight against privatization and contracting out of healthcare workers

NUPGE News
May 31, 2012

"These workers should not be tossed aside in a drive to reduce costs and increase profits.” - Darryl Walker, BCGEU President.


Over 100 activists from all sectors of the labour movement rallied in Kelowna on May 25 in support of the 130 workers from Spring Valley Care Centre who have all been given lay off notices.

The rally, which took place outside the office of Kelowna-Mission Member of the Legislative Assembly (MLA) Steve Thomson, also raised awareness.

“The passage of Bill 29 in 2002, allowed care facilities to contract out care and support services to reduce wages. This is one more example of how B.C. Liberal policies have failed seniors and their families,” says Darryl Walker, B.C. Government and Service Employees' Union (BCGEU/NUPGE) President. “At the same time it continues to drive down the wages of health care workers, most of whom are women. These workers should not be tossed aside in a drive to reduce costs and increase profits.”

BC Federation of Labour President Jim Sinclair called on Premier Christy Clark to intervene and protect the jobs of the Spring Valley care home workers and the quality of care for seniors throughout the province.

"Our seniors and their families deserve better from this government," said Sinclair. "Bill 29 has done nothing but line the pockets of facility owners at the expense of seniors and the people who serve them."

Is the Charter changing Canada for the worse?

By Haroon Siddiqui
TheStar.com
April 17, 2012

The Charter of Rights and Freedoms, the 30th anniversary of which falls today, is changing Canada for the worse — its emphasis on individual rights may trump the broader public good and even open the door to Americanization of medicare, says one of its architects, Roy Romanow, the former NDP premier of Saskatchewan.

A new generation of “Charter kids” and “Charter judges” is advancing individual rights and diluting the “communitarian impulses” of Canadians, he said in a telephone interview from Saskatoon, where he teaches at the University of Saskatchewan.

Delivery Matters: The high costs of for-profit health services in Alberta

By Diana Gibson, Jill Clements
Parkland Institute
April 11, 2012

Executive summary

In Alberta and across Canada, the private for-profit healthcare sector is being positioned as a solution to wait times and the financial challenges facing the health care system. Consequently, for-profit delivery of healthcare is increasing. The provincial and federal governments are also increasingly referring to public healthcare as a publicly funded health system, under the premise that it does not matter who delivers the services. This report explores the implications of this trend with regards to costs, wait-times and other issues associated with healthcare delivery.

The Alberta government promised to provide a cost-benefit analysis to demonstrate to Albertans the value of utilizing for-profit service providers in the delivery of publicly funded health care.1 To date this has not been completed or published. This report provides some of the information necessary to do that cost-benefit analysis on the basis of information and data garnered through the Freedom of Information and Privacy (FOIP) request process.

UK: 'Healthy competition’ in the NHS is a sick joke

Real health choice under the NHS reform Bill doesn't exist, and the so-called market is a mockery.

By Max Pemberton 
The Telegraph
April 9, 2012

Richard Branson and his daughter Holly Photo: REX

On March 27 the NHS reform Bill – or to give it its official name, the Health and Social Care Bill – received Royal Assent and became law. With the ink barely dry on Her Majesty’s signature, the carving up of the NHS has begun. Virgin Care has won a £500 million contract to provide community services across Surrey and began running these services, as well as the county’s prison healthcare, on April 1.

This was no April Fool’s joke, though I had to smile at the thought of Virgin managing sexual health clinics. In reality, the joke may be on all of us, as Richard Branson’s company becomes one of the first of many vultures to start picking over the rich, tender flesh of the NHS now that it has been splayed open by the Bill.

His daughter, Holly Branson, was a few years below me at medical school. I remember thinking how good it was that someone steeped in privilege had seemingly decided to dedicate her life to serving other people. I had a vision – somewhat idealised, I know – of her working in the East End, providing care to the deprived and poverty-stricken. But no. After a brief stint as a junior doctor at a London hospital, she quit the NHS to work for her father. It saddens me to see someone who underwent the same training I did stand by as their family business profits from the sick and undermines the very institution that provided them with their education.

Richard Branson likes to be thought of as an affable, benign maverick, on his way to becoming a national treasure. He’s the cuddly face of corporate Britain. But just because he has a beard and looks like Noel Edmonds does not mean his multinational business is any less aggressive and expansionist than the next.

What the Virgin Care takeover in Surrey really exposes are the two fundamental lies that have been peddled by the Government over the past year in attempts to manage the PR disaster that was the NHS Reform Bill.

The first is the flat denial that the Bill represented any sort of privatisation of the NHS, despite it being obvious to anyone who read it that this is precisely what it was.

Wildrose Party Disguises Health Care Myths as Facts

By Adrienne Silnicki
Council of Canadians
April 8th, 2012

Danielle Smith of the Wildrose party has been quoted extensively talking about health care in the Edmonton Journal and Globe and Mail, among others. The Wildrose is running on a platform of creating a two-tiered system of health care in Canada. They claim that offering private health care creates: more options, reduces wait times, and protects and strengthens public health care. Each one of these points is false and not backed by evidence from the science and health research community. I’m going to attempt to separate myth from fact in the paragraphs below. I hope you’ll read more.

Myth: Private Care Reduces Wait Times

Fact: Health professionals are in short supply in Canada. We need more nurses, doctors, technicians (MRI, CT, X-ray), anesthesiologists, and others. When we create a parallel public-private health care system we split these much needed health professionals into two different systems, creating more demand while the supply remains static. This creates a backlog in health care and lengthens wait times for everyone. Studies completed on parallel private systems have not shown a reduction in wait times for public health care. In the UK, a parallel private health system has only extended wait times.

Medicare's 50th Anniversary Calendar

This post is connected to Medicare's 50th Anniversary Google Calendar and will display events as they are entered. You can bookmark this page or simply click on the left sidebar calendar to visit this events post.

If you have a relevant event you would like too see added, email me at redougie@gmail.com.

"Medicare's 50th Anniversary" now a blog book

NYC
March 22, 2012

Don't want to spend time scrolling down this blog or searching for something? Check out the blog book below to see if assists you.

You can also download the book or embed it.

Open publication - Free publishing - More ccf

Mending Medicare

Mending Medicare: Special 24-Page Supplement on how to improve Medicare from the Canadian Health Coalition and Canadian Centre for Policy Alternatives, 2006

Open publication - Free publishing - More canada

Drumming Up a Healthcare Crisis: The Drummond Report’s Implications for Health Policy

By Justin Panos
Socialist Project Bullet
February 21, 2012

In a Maclean's interview in November 2008, former TD Bank Chief Economist (2000-2010) and head of the eponymously titled ‘Drummond Report’ spoke truer than he might have then known. Don Drummond, who spent 23 years in the Federal Ministry of Finance, was asked if he missed “being in the middle of the action,” to which he replied:

“There's definitely a buzz from being there when the economy is turbulent, and I would be surprised if there weren't people in the government who didn't take some perverse...pleasure's the wrong word, but interest in what's going on. You don't wish for anybody to lose their jobs or investments, but it is fascinating and there is an adrenalin rush; it taxes your analytical skills and your knowledge of history, looking back to see if there are parallels. It's great when everything's going smoothly, but more exciting when it's not” (author's emphasis).

Where to start? Drummond makes it clear that whether on Parliament Hill or Queen's Park, reputations are made or broken in a crisis. His name became equivalent with fiscal pragmatism after he helped Prime Minister Paul Martin return the federal government to an operating surplus in the late 1990s. Able to enjoy the feral experience of the Ministry of Finance during a crisis, Drummond's composure made him one of the most decorated public servants, the type for whom privatization is his most public utterance.

Drummond: More Mike Harris than Mike Harris

LeftWords
February 15, 2012

As expected, the Drummond Commission has proposed the province shrink and privatize hospital services.

Drummond has recommended that health care funding be limited to 2.5% until 2017-18. This is considerably less than the 3.6% increase proposed by the Liberals not long before the election. That proposal caused the Auditor General to observe in his pre-election review of Ontario's finances that $1 billion in hospital savings would have to be made.

The main target for Drummond cuts in health care spending are hospitals.

Canadian Health Care: Privatization and Gendered Labour

Pat Armstrong/Priscillia Lefebvre
Socialist Project
February 6, 2012

Priscillia Lefebvre is a collaborative Ph.D. student at the Department of Sociology and Anthropology, Institute of Political Economy, Carleton University (Ottawa, Canada).


Pat Armstrong is Professor of Sociology and Women's Studies at York University (Toronto, Canada). She held a CHSRF/CIHR Chair in Health Services and Nursing Research, focused on gender and chaired the group Women and Health Care Reform for more than a decade. She has published on a wide range of issues related to gender, health care and work. Pat was interviewed by Priscillia Lefebvre over August 2011.

Priscillia Lefebvre (PL): A large focus of your research seems to be the ways in which gender and labour intersect from the vantage point of health care delivery. What have been the main influences that have affected the trajectory of your research in terms of a feminist rooted political economy approach? Why is this approach so important in understanding the contradictions that exist regarding the role of women within health care?

Pat Armstrong (PA): It is difficult to identify the main influences on my thinking and research. Growing up in a family where community involvement was not only encouraged but required meant seeking engagement at university. Also, the red Tory approach in our household did not fit so comfortably with the Marx I read as a student in the 1960s or with the growing feminist movement I participated in. As Juliet Mitchell[1] explained, Marx was not good about women and did not provide a detailed blueprint for analysis, but he did offer a way to make systems transparent and to think about progressive change.

Harper’s health care agenda driven by ‘theory and politics

By Brent Patterson
Council of Canadians
January 20th, 2012

Globe and Mail columnist Jeffrey Simpson writes, “Prime Minister Stephen Harper is going to give money to the provinces without any strings, conditions or demands. It’ll be the first time since medicare began that a federal government has handed money over carte blanche. Broadly speaking, two reasons explain his decision – one theoretical, one political.” Simpson argues, “The politics of his decision have been almost completely ignored, but they’re important for those who think about political angles all the time.”

Theoretical - his view of federalism

“Mr. Harper believes, when it suits his purposes, in a kind of classical federalism wherein the two levels of government more or less stay out of each other’s jurisdiction. He thinks Liberal governments abused Ottawa’s constitutional ’spending power’ to intrude into provincial jurisdiction, especially in social policy such as health care and daycare. Conservatives would rather use the federal tax system, or unconditional grants to the provinces, thereby respecting classical federalism.”

Private delivery of public health a serious threat

By Rachel Tutte
The Daily News
January 20, 2012

The new Health Care Innovation Working Group announced at this week's Council of the Federation meeting in Victoria is a chance for the provinces to build on the many positive public solutions available to strengthen Medicare.

But patients should be concerned by working group co-chair and Saskatchewan premier Brad Wall's comment that suffering patients choose surgery over ideology when receiving the services of a private for-profit surgical facility.

Given the choice between ideology and evidence, responsible policy makers choose evidence. The evidence from across the country is clear: for-profit clinics cost more than public facilities, increase wait times by draining health care workers from public hospitals, and compromise patient safety

Private delivery of publicly funded surgical services is not innovative. It's a serious and increasing threat to our health and our wallets and leads to unequal, two-tier care that most of us can't afford.

Fortunately, evidence-based public solutions are available right now to policy makers who are serious about addressing our health care challenges. The best examples are some of the innovations in home and community care that take pressure off hospital and emergency services right here in B.C.

Rachel Tutte, Co-chair BC Health Coalition

Harper’s plan would kill medicare in Canada

The Harper government has set in motion a strategy that will lead to the unravelling of Canada’s national health system. All Harper has to do is nothing. By abdicating the essential federal responsibilities in health care, the system will fragment on its own into 14 separate pieces.

By MICHAEL MCBANE
The Hill Times
Jan. 16, 2012

There is a deficit of political leadership in health care, especially at the federal level. Prime Minister Stephen Harper stated in a year-end interview recently that he had no idea how to secure the future of health care in Canada. Instead, he said it is up to the provinces to find “solutions.”

Harper’s recent unilateral, non-negotiable decision on the future of federal health financing stunned provinces. It seems the federal government intends to limit its role to signing blank cheques with no strings attached and no accountability. If rumours on the Hill are true, once the current arrangement expires Harper may replace cash transfers entirely with tax credits.

Why medicare needs Ottawa

ROMANOW, SILAS and LEWIS
From Monday's Globe and Mail

The federal government has signalled its intention to reduce its role in shaping medicare to writing cheques. This would complete a 35-year journey that began in 1977, when Ottawa first capped its financial contributions to the provinces. At its peak, Ottawa’s share of publicly financed health-care spending reached 41 per cent. Today, its cash contribution is just over 20 per cent.

The provinces run health care and have traditionally welcomed federal cash transfers with few strings attached. So what’s wrong with Ottawa’s self-imposed exile – is it not merely recognition that it has no legitimate role in shaping how the system develops?