In many ways, the long-running battle to save medicare from privatization is a battle for the soul of Canada. And it's a battle that's about to heat up.
Public health care is much more cost-effective than private health care--as illustrated by the fact that the mostly private U.S. system is far more expensive than the mostly public systems in Canada and Europe.
On one side are a large number of Canadians, for whom medicare stands out like a sparkling jewel--a nationwide system dedicated to the proposition that access to health care be based on need, not money.
On the other side are some highly organized, right-wing groups that object in principle to collective, egalitarian solutions like medicare. Among these well-funded groups are the Fraser Institute and the Canadian Constitutional Foundation, a fiercely anti-government organization that raises funds for court challenges to medicare.
And now there's a new right-wing opponent of medicare--SecondStreet, which is closely affiliated with the ultra-conservative Canadian Taxpayers Federation and has recently financed polls that purport to show Canadians warming to private health care.
Allied with these right-wing ideologues are business interests that want to open up the potentially lucrative Canadian health-care market to private enterprise.
The anti-medicare crowd, which usually faces an uphill battle due to the popularity of medicare in Canada, is sniffing opportunity in the air these days--largely due to the pandemic.
After months of hospitals being overwhelmed with COVID patients, the backlog of delayed medical procedures is enormous--roughly a million surgeries and 20 million non-surgical procedures.
The obvious solution to this massive backlog would be a significant increase in government funding and better use of existing public facilities. That's because public health care is much more cost-effective than private health care--as illustrated by the fact that the mostly private U.S. system is far more expensive than the mostly public systems in Canada and Europe.
If Ontario turns to the private sector to help with the backlog, the procedures will still be paid for by government (that is, taxpayers); it will just cost us a lot more.
But Premier Doug Ford, who rarely believes a problem can't be solved through privatization, seems oblivious to this higher cost when the money is to be funnelled to private interests.
Ontario currently has about 1,000 private clinics, officially called "independent health facilities," which mostly carry out diagnostic procedures like ultrasounds and x-rays.
But, with the chaos created by COVID as a cover, the Ford government seems poised to allow a considerable expansion of private health care in the province.
In remarks at a press briefing in Ajax last month, with the premier standing directly behind her, Health Minister Christine Elliott mentioned "private hospitals" as among the facilities that will be dealing with the backlog.
"We're opening up pediatric surgeries, cancer screenings, making sure that we can let independent health facilities operate private hospitals, all of those things that are possible," said Elliott.
Her reference to "private hospitals" was brief but, for veterans of health care battles, it stood out like a bleeding appendage.
That's because private hospitals have been banned in the province since 1973, a year after OHIP was created. (Private hospitals that were operating at the time were grandfathered. A few, such as the Shouldice Hernia Hospital, still operate today, providing services paid for by the province.)
But prying open the long-sealed door to permit the creation of new private hospitals would be a dramatic development, allowing hospitals--the centrepieces of our health-care system--to be governed by corporate boards that prioritize profits, as in the U.S.
Elliott's statement attracted little media interest, but it certainly caught the attention of Natalie Mehra, executive director of the Ontario Health Coalition, who called it a "bombshell."
Mehra argues that private hospitals would undermine medicare by enabling well-to-do patients to gain faster access to treatment. And she points to the disastrous impact privatization has had on long-term care homes, now largely consolidated into corporate chains, where COVID death rates have been significantly higher than in non-profit homes.
The strong attachment of Canadians to medicare has survived over time, even in today's corporate-dominated society.
Indeed, in a world where the rich can buy their way to the front of just about every line, there's something inspiring about a health-care system where they can't.
