Tag Archives: Privatization

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