Thursday, September 14, 2023

Using People Power To Save Public Healthcare In Ontario

 


So last time I wrote about the need to spend the majority of our time articulating a positive vision for humanity and a coherent road map for how to get there.  I also said that while we were doing this we should carry out smaller campaigns, such as the saving of public healthcare in Canada, both because they're necessary in the short-term and because they can serve to rally and empower ordinary people.

The big picture is democracy and human rights.  In a democracy the majority of people most likely believe that the children of the poor should have the same access to healthcare as the children of the wealthy.  People in Canada look at the sufferings of people in the USA in being denied access to healthcare or being bankrupted by medical expenses and they come to the obvious conclusion that our system is better. 

But, at the same time, frustration with our publicly funded healthcare system grows, because our politicians (Conservative, Liberal, and NDP) continue to deliberately under-fund it.  The NDP does this because, at the provincial level, in BC, Saskatchewan and Manitoba, where they often form the government, they could easily be mistaken for garden variety Liberals.  The Liberal Party does this because they are a "big tent" party.  And if there's a bunch of nobodies in the tent along with some millionaires and billionaires, guess who gets more attention?  And the Conservatives do this in the most brazen and crude ways because they're "Liberals in a hurry."

Why do they do this?  Why do these politicians seek to destroy an efficient, politically popular program like public health insurance and public hospitals?  Because this is a capitalist society.  Some capitalists go into the insurance industry or private medical care.  (Some skilled medical professionals seeking to maximize their income and bridle at restrictions to this.  Some US-American doctors earn annual salaries of $750,000 a year.  Many highly paid doctors also own clinics that make millions of dollars annually.)  These mercenary medical providers are organized and they know what they want.  And they approach compliant politicians to get what they want.

As I understand it, employer provided health insurance became a thing in the USA in World War II, when employers were barred from offering higher pay to attract workers as this contributed to inflationary pressures.  Instead they offered health insurance.  During the 1990's employer provided health insurance began to decline and the process has continued from small employers in low wage industries to larger, higher-paying firms.  In short, US-American employers responded to rising health insurance premiums by getting out of providing health insurance.

That is what will happen in Canada.  As medical expenses and, therefore, medical insurance costs rise, Canadian employers who provide insurance plans to their employees will find themselves facing rising costs and they will abandon them.  They will not organize to lobby governments to control the greed of privatizers.  They will eventually shrug their shoulders and move on.  Leaving ordinary Canadians to shoulder the burden on their own and to suffer as regular USians do.


Politicians across the G7 countries continue to embrace austerity, as part of the process of cannibalizing their societies to maintain their oligarchs in the face of declining economic growth rates.  In healthcare, this involves under-funding of services, lowering the quality of the public sector and thereby providing an excuse to allow private service providers as an alternative.  One way to do this, that Doug Ford has been enthusiastically pursuing is allowing completely private clinics to provide services that the province has made difficult for its public sector to provide through the deliberate starvation of resources to the public sector.

A more established practice has been "Public-Private-Partnerships" (PPP's) wherein the public sector "teams-up" with private sector professionals to apply market-forged efficiencies and sound business sense to the bloated, inefficient public sector.  Or that's how it's sold to the public.  Capitalists exploit the depressingly common tendency of working people to hate each other through capitalist media's giving the impression that public healthcare workers are overpaid and lazy.  In the USA, where hospitals are privately owned, this criticism can't be used.  So they focus laser-like on the fact that many hospital workers are unionized to explain the perception of bad service.  In Canada, capitalists can claim that it is the double-whammy of unionized workers in a publicly-funded, publicly-managed enterprise that contributes to rising costs and declining services.  [This argument rests on the stupid notion that if only hospital orderlies could be brought down to the minimum wage that those running the hospitals wouldn't keep the difference all to themselves and that the lower-paid workers would provide better service.]  PPP's are based on asinine, fabricated justifications, and the facts (which don't care about capitalist propagandists' feelings) expose the lie.  PPP's are more expensive to fund from the start (more money for Bay Street "investors" though) and these higher costs continue on to front-line service provision.

Front-line healthcare workers have to deal with the fall-out from these cynical policies.  But when they attempt to use their only power they possess to fight-back against it, those same cynical politicians accuse them of hurting patients for their own selfish greed.  (The same way that asshole politicians attack strikes in education for not "putting kids first.")  As well, the right to strike only comes around when a contract expires.  And it's never a given that the membership of a union will want to, or be able to endure the expense of a strike at such a time.

Clearly, something else needs to be done.  The general public, the vast majority of whom will suffer from the continued privatization of public health insurance and public hospitals, needs to be moblized to defend its own self-interest.  Because the healthcare unions have not been able to do it on their own.  And rotating amongst the various neo-liberal political parties hasn't done it.  And petitions, afternoon rallies, and bitching and grumbling online and amongst like-minded friends hasn't done it.

The first thing we have to do is have a final goal in mind.  What is it that we want?  That's easy enough to articulate.  We want both the federal and provincial levels of government to return to the status-quo as it prevailed in the 1980s.  With the federal government providing the same proportion of healthcare spending vis-a-vis the provinces as it did then.  And the provinces providing the per capital spending on public health that it did then.  And with this federal contribution will come the Five Principles of the Canada Health Act (Publicly Administered, Accessible, Universal, Comprehensive and Portable).

To save time, the Left will do what the corporate oligarchs do. We should have our own economic and political experts write the healthcare legislation that we want, outlining the federal-provincial sharing of costs, the money amounts, the whole kit and kaboodle, and simply hand it to "our representatives" and tell them to pass it.  I wouldn't be surprised if the corporate media were to decry this intrusion of a "special interest group" into the legislative process and trying to act however they imagine "grim, wise, guardians of democracy" act like, but fuck them.  Writing the legislation and giving it to compliant politicians is what our oligarchs do all the time.  The most brazen example of this being the American Legislative Exchange Council (ALEC) in the USA.  Things operate pretty much the same way here in Canada as corporate lobbyists lord their influence, utilize their access, threaten and bribe, to get what they want.


Where is this money supposed to come from?  The same place that it came from before: Through taxation of the wealthy.  And make no mistake about it!  There is plenty of money around.  But also realize this: There is such a concept as "Modern Monetary Theory" (MMT) which posits that governments don't need to "find" the money (through taxation) in order to do what they want.  They spend the money on what they want and they tax afterwards.  And the taxation isn't so much for revenue purposes as it is to limit the supply of money in circulation.

At first I wasn't all that impressed with MMT.  I thought that taxation is taxation.  Whether you're saying you have to find the money to be able to afford to do what you want or you have to remove money from circulation to avoid inflation, it amounts to the same thing.  But as I read about it now and then over the years I came to see that this was a much more efficient way to think about things.  Obviously the government of Canada can't just give every man, woman and child a cheque for one-million Canadian dollars and tell us that we're all rich.  There are limits to Canada's fiscal capacity.  But within those limits we can do many things.  And, whereas the shit-heads and oligarchs (often the same people) can throw $10 billion down a rat-hole in Afghanistan, and hundreds of millions of dollars to nazis in Ukraine, and $1 billion to cover "security" at the G-20/G-7 in Toronto and Trudeau can pull billions of dollars out of his ass to bail-out his Bay Street masters from their tar-pipeline debacle (and then tens of billions more due to "unexpected" expenses) and the way Doug Ford is withholding tens of billions of Ontarian's money while starving public services, and all the other historic waste I mentioned here; ... THIS INITIATIVE of ours is for something useful and beneficial to the citizenry. [US.]

Essentially, the governments (federal and provincial) WILL spend the money necessary to restore our public healthcare system to pre-neoliberal revolution levels and afterwards it will tax the bejeezizz out of the stupid oligarchs who are essentially hoarding it overseas or using some of it to drive up the cost of housing and other non-productive things.

This is getting kind of long.  Next post will be about the people's campaign to achieve this.

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