Tag Archives: Privatization

Today’s big demonstration at Queen’s Park

Picture of an OPSEU flag at a rally.

Wouldn’t it be great to tell your grandchildren you played a role in protecting Canada’s Medicare system? Come to today’s rally at Noon and stand up for public health care.

Today will likely be the biggest Ontario Health Coalition demonstration at Queen’s Park since 2008.

Across Ontario seniors groups, union activists and family members frustrated with their own access to care will be boarding more than 40 buses, some in the pre-dawn darkness on an abnormally cold November morning.

The coalition has spent weeks organizing the day’s event to convince the Wynne government that privatizing more hospital services is not the road to good quality care or sustainable long term costs.

When: Friday, November 21 / 12 Noon
Where: Queen’s Park and University Avenue

Last spring the government was set to begin competitions for hospital services. Theoretically these competitions were to be between not-for-profit private clinics and the public hospitals, although the reality is there are very few not-for-profit clinics in the province. You might say most people were thinking of the not-for-profit edict with a wink.

Hospitals complained that it made it difficult for them to plan when their services would be left up to the caprice of the market.

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Toilets without seats — warnings from England

Too big to fail.

For most that expression applies to big banks, but what about our health care?

As Ontario prepares the way for further transfer (read: privatization) of hospital services to mostly for-profit independent health facilities, it’s a good question to ask.

When the government recently decided earlier this year to end its relationship with 90 private OHIP designated physiotherapy clinics , it was revealed that these clinics were almost all owned by just four companies.

The same narrowing of interests also occurred in Ontario’s home care, where the former competitive bidding system ushered out many of the smaller players.

That’s far from healthy.

We’ve previously said that if you want to see the future of Ontario’s health care system, look to England.

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Poking the beast – “P” word missing from reform talk

The problem with discussing health care sustainability is there is no definition of what that means. Data would suggest that our health care spending is not out of control – the so-called cost curve has already been bent. Past increases appear to have occurred in sync with economic growth, the exception being the economic crash of 2008. Clearly those who are worried about sustainability are not equating it with affordability.

Across Canada the average increase in provincial health care spending this year is 2 per cent – hardly a matter of excess especially when one considers aging and population growth.

While Canada has done better than just about every other country in the OECD in controlling health costs, it has often come at a difference kind of price given quality issues that persist.

This week the Conference Board of Canada is hosting a two-day conference in Toronto on health care sustainability. Next week the discussions will be sure to spill over into the Ontario Hospital Association’s annual get-together at HealthAchieve. We’ll be at both.

Earlier this year health policy analyst Steven Lewis and former Cancer Care Ontario CEO Dr. Terrence Sullivan issued a paper on how to keep the cost curve bent.

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Privatization: The “big bad mistake” Ontario is intent on repeating

“The stealth privatization of Ontario’s gas plants over the past decade set the stage for the inevitable payouts that we now face for decades to come.” – Martin Regg Cohn, Toronto Star columnist, October 9, 2013

Has Kathleen Wynne really learned her lesson? With last week’s report raising the cost of the cancelled gas plants to $1.1 billion, you’d think it would give the government pause over similar privatization deals. That, after all, is the essence of why the cancelled gas plants cost so much. Ground had not even been broken on the Oakville site, the contracted company unable to secure construction permits from the municipality.

Ontario’s Premier called the cancellation a “big, bad mistake,” but much of the cost of these cancelled deals lies in the privatized structure the government chose to develop public infrastructure.

Only a week earlier the same government, supposedly humbled by this deal, announced that a different private consortium had been chosen the winner to build a new 30-year public-private partnership hospital in Kingston.

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Chemo drug scandal: Why would Peterborough contract out in the first place?

Craig Woudsma is the reluctant hero of the so-called “chemo drug scandal.” He is the OPSEU pharmacy assistant at the Peterborough Regional Health Centre who stopped to question the differences between oncology medication prepared by the hospital’s old contract supplier and the new – Marchese Hospital Solutions.

He was the first to do so. 1200 cancer patients received less than their prescribed dose due to an error that has four Ontario hospitals, their purchasing agent, and Marchese all pointing fingers at each other.

Yesterday Woudsma may have not felt the hero, appearing before the Ontario’s legislature’s social policy committee heavily coached by senior hospital officials and their contract lawyer, who sat directly behind him and his senior colleague Judy Turner.

As it turns out, maybe it was the hospital officials themselves who should have been back on the hot seat.

Why would Peterborough Regional Health Centre want to contract out the preparation of oncology drugs 200 kilometers away in Hamilton when it had the resources to do so on site?

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Who should you trust? Former PC advisor shills in the Star for private health care

Francesca Grosso says she is an established expert in health care policy. A former PC health care policy director, her day job these days is a principal at Grosso McCarthy, a public affairs company for hire.

So when she writes in the opinion pages of the Toronto Star, as she did on Sunday (What’s Behind The Attack On Clinics?), who is she really shilling for? Who paid for this?

The piece itself is full of misinformation about private delivery of health care, a situation that might be embarrassing to her professionally given her claims to expertise.

She argues that private clinics are getting a bad rap as a result of a Toronto Star series that reveals nine private clinics failed a quality inspection by the College of Physicians and Surgeons.

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Will the new health accord include a privatization clause?

Will the federal government insist the provinces “experiment” with for-profit delivery of health care as part of the next Canada Health Accord?

Colleen Flood says there is “some talk” that this may be a new condition. Flood, Canada Research Chair in Health and Law Policy at the University of Toronto, told Canadian Business magazine that it “may be a condition that the feds actually put on the transfer, the condition of experimenting with private for-profit delivery within the context of a public system.”

The idea wouldn’t be entirely new – the Harper government set a similar proviso to new infrastructure projects requiring federal funding. The Conservatives set a condition requiring the provinces to examine the “viability” of public-private partnerships on any infrastructure projects seeking at least $50 million in federal funding.

The idea of embedding the new health accord with a privatization clause may be disturbing to Canadians. Canadian values have long rejected the idea that health care is a business venture rather than a “moral enterprise.” Will that belief apply to private for-profit delivery of publicly funded health services?

The problem is the feds appear ready to dash into this without any evidence to support it.

The Romanow Commission found no advantage to the delivery of public health care services by private for-profit entities. In the US, an influential 2002 meta-analysis by P.J. Devereaux concluded that for-profit ownership of hospitals and kidney dialysis clinics led to poorer outcomes and higher mortality rates. A BC study of for-profit versus not-for-profit long term care homes came to similar conclusions.

At a recent conference held by Students for Medicare, Dr. Michael Rachlis said Canada’s health care costs rose faster in the private sector. Governments were far more successful in restraining rising health costs in the public sector. Hospital and physician costs have been amongst the slowest to rise.

Once that pandora’s box is opened, can it be closed again?

Critics suggest that private delivery is not the edge of the wedge towards full privatization. They suggest that Canadians would never accept an Americanized system. However, we have already seen delisting of services, something anticipated to increase. Delisting is the ultimate privatization. When the McGuinty government first came to power in 2004, physiotherapy and eye examinations were among health services to be delisted.

Following public uproar a compromise was reached where hospitals were left performing publicly-funded outpatient physio. That didn’t last long — over the last eight years these services have slowly dried up as individual hospitals have stopped offering outpatient rehab services.

Now we are seeing less subtle forms of privatization, such as the recent news that the Scarborough Centenary Hospital – part of Rouge Valley Health System – is charging “alumni” in its cardiac rehab program $500 a year to continue on with the program.

The attack on our public Medicare system will likely not be a full frontal approach. That would be too toxic for any politician. It is more likely we will see the system eroded by increments, making way for greater opportunities by the private sector.

How the federal government proceeds will be watched closely by all who value our Medicare system.

Statistical recovery, human recession — McNally

We are in a statistical recovery but a human recession, says author and academic David McNally, speaking May 28 at the Students for Medicare conference in Toronto.

While the statistics show economic growth, jobs, personal income and public services are failing to recover.

“Medicare and public health care are one of the key social justice issues of our age,” says McNally. “We are in an entirely new historical moment.”

He says there is a more subtle set of strategies to undermine public health care, including privatization. It comes at a time when we need health care the most.

According to the Ontario Medical Association, Canadians are spending less on food, exercise and pharmaceuticals – three areas that will impact on the delivery of public health care.

McNally said that public services are now under one of the most unrelenting attacks in several generations, leading to what some are labelling “the age of austerity.”

These attacks on public services are having an impact on countries such as the UK where they are about to fall back into recession.

Whereas government had previously told us that programs such as universal child care or national pharmacare were not possible, it suddenly became possible to use enormous sums of money to bail out banks and other corporations, he says.

McNally estimates that the worldwide cost of the bailouts and stimulus – largely to construction firms – is $21 trillion, or about a year and a half of the entire economic output of the United States.

“When it comes to bailing out capitalist institutions, the cupboards are not bare,” he said.

“It tells us a lot about global elites and their governments.”

The age of austerity effectively found its beginnings at the Toronto G20 summit, where governments decided to direct belt tightening at public and social services. That belt tightening does not apply to police, military and prison building, tools governments will use to stifle unrest from these policies.

McNally says the process has already begun, pointing out that Latvia has fired 30 per cent of its teachers, Ireland has cut public sector wages by 15 per cent. Greece has cut public pensions. In the U.S. the State of Michigan has closed half of its schools, taking the average class size up to 60 students. California has cut health insurance for 900,000 children. Arizona scrapped all public health insurance for children.

Ontario is not exempt, noting the province has already cut the special diet program for individuals on social assistance.

While this is taking place, corporate taxes are being cut internationally.

McNally points to Mervyn King, Bank of England Governor, who has expressed surprise that there is not greater anger over the price of the economic crisis being paid for by the very people who did not cause it.

Instead governments are creating myths about out of control costs, blaming public employees.

This statistical recovery overlooks an unemployment and underemployment rate in the US that is more than 17 per cent. Among black and Latinos, it is between 24-25 per cent.

“Half of U.S. school –age children will be reliant on food aid at some point in their childhood, and among African-American children it will be closer to 90 per cent.”

The “Great Recession” has driven 64 million more people into poverty world-wide, many affected by spiking food prices created by speculators. 47 million will be driven into conditions of absolute hunger.

McNally says we are only in the first phase of this new age. Quoting Naomi Klein, he says governments are using the shock doctrine to push through this roll back of social programs.

The goal, he says, is a lower wage economy, low tax, and a low cost investment climate.

McNally compares the present era to the 1930s. People forget that while there were great changes in the 1930s, these didn’t happen until the latter half. Under Canadian Prime Minister “iron-heel Bennett” life was miserable for many Canadians until a coherent social movement forced changes.

He says there is hope in social movements, but this is a process that will take time.

“We need to think about a longer horizon that next week or next month,” he says, certain that the “last laugh will not belong to the Stephen Harpers and Rob Fords of this world.”

David McNally is author of Global Slump: The Economic and Politics of Crisis and Resistence. He teaches at York University in Toronto.

David McNally speaking at the Students for Medicare conference May 28.

How to lose a public health care system – Leys speaks to activists in Toronto

UK professor Colin Leys spoke to health care activists May 16th in Toronto. The event was organized by the Ontario Health Coalition.

It’s not a simple matter for a western democracy to lose a public health system. Citizens strongly support tax-funded public systems. In Canada, we believe it to be one of our defining features.

Yet in England the National Health Service (NHS) is being gradually eroded and taken over by giant U.S. health maintenance organizations (HMOs) and run increasingly on market principles.

What is more frightening, is the gradual approach in England has strong parallels to Canada.

UK professor Colin Leys has documented this transition from a public health care system to a market-based one in his new book, “The Plot Against the NHS.”

Meeting with a group of health care activists May 16 in Toronto, Leys pointed out the irony of the U.S. having the most inefficient health system in the world and exporting it now to other countries.

Leys said that current initiatives of UK Prime Minister David Cameron’s government were made possible by a decade of gradual market initiatives under the Labour government of Tony Blair and Gordon Brown. While Scotland and Wales have turned back towards a more public system, England continues the march towards a more Americanized system.

Cameron’s new health care bill would leave it up to consortia of doctors to determine how public health care funding is spent. Many of these consortia are in fact owned by private for-profit companies such as the U.S. health care giant UnitedHealth and Virgin, better known for operating record stores. Given doctors have little or no experience in buying or “commissioning” health care services, private firms are moving in to take up this role.

The ability of these general practitioner commissioning bodies includes discretion over what services they will buy and which should be publicly available.

That includes buying public health services from “any willing provider” approved and registered by the system monitor.

“The bill also removes the duty of the Secretary of State for Health to provide a National Health Service,” says Leys.

What has angered many in England is the fact that Prime Minister Cameron has done this without any discussion of the bill in the UK’s last election.

In fact, “Cameron promised no more top-down reorganizations of the NHS,” says Leys.

Leys says the new bill will mean the loss of comprehensiveness through delisting – something the professor says is already taking place.

It is also likely the bill will pave the way for more user co-payments as cash-strapped health foundations respond to cost pressures.

Leys says that while Cameron “pretends” to exempt the NHS from cuts, the reality is more of the system funding is being siphoned off into “social care,” creating a net real cut.

The new bill also takes a cap off of the number of private patients English hospitals are allowed to take on, shifting the hospital model to focus on raising money through more private patient income.

Many doctors assumed that because their trusts are no longer answerable to the Department of Health that there would be more freedom from bureaucratic control, says Leys. Instead they are now even less free under the new private model.

While many of these shifts to market-based health care were taking place under the labour government, the UK government dramatically increased public funding to more closely resemble their peers in the rest of Europe. The results were improvements in wait times that were mistakenly attributed to increased privatization.

Leys says there are many holes in the new act, including no provision for failing hospitals.

Nor is there any approval process when a private company sells their assets to another.

The debate rages on in Britain. The Royal College of Nurses has passed a no-confidence motion in the plan, which has in turn stiffened the resistance of many of the country’s doctors, says Leys.

Given the complicity of the Labour Party in setting up these reforms, the official opposition has been noticeably muted in its criticism.

Cameron has recently told the media he would not allow private companies to cherry pick the NHS, that there would be no privatization, and that patients would experience no up front costs.

Within days of promising this, news reported that the Labour Party leader would have to pay for surgery on his nose because it was considered to be a low priority for his local health care trust.

The Ontario government has closely followed the path of health care changes in the English NHS. At present Jim Easton is touring the province speaking to groups such as the Ontario Hospital Association and the Ontario Association of Community Care Access Centres.

Easton is the NHS National Director for Improvement and Efficiency. It has been his job to cut billions of pounds out of the NHS.

The timing of Easton’s tour suggests the McGuinty government is seriously considering rolling back health care costs on this side of the Atlantic too.

Given years of Ontario’s own changes to a market-oriented health system, we may be paving the way for similar reforms should Tim Hudak’s Tories come to power.

Second Opinion debuts

The Ontario Health Coalition has launched a new quarterly magazine – Second Opinion. 

The Spring 2011 edition debuted last week, featuring stories on legal challenges to private clinics, privatization, debunking spending myths and building a social movement around health care.  20,000 copies of the magazine are being distributed across Ontario.

Copies of the magazine are being sent out to OPSEU’s 22 regional offices next week.  While quantities are limited, any locals wishing bulk copies should e-mail Rick Janson at rjanson@opseu.org