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.