WHY ARE THESE MEN TALKING ABOUT GIVING PROFIT A PLACE IN OUR HEALTHCARE SYSTEM?
Kathleen Wynne
Doug Ford is a wealthy man. Justin Trudeau is a wealthy man. So maybe they just don’t ever worry about being able to buy the things that they need. Maybe they actually feel they have more control over their lives when they pay for those things.
When I was a little kid, and I concede that was a long time ago, there was no universal healthcare system in Canada. Both my grandfather, Charlie Wynne and my dad, John Wynne were general practitioners in a time when people paid for their medical services out of pocket or through a private insurance plan. What that meant was that there were lots of diagnoses missed, lots of families who decided not to make an appointment simply because they couldn’t afford to pay. Charlie told stories about people paying their bills with gifts of food and for sure, both of them accepted non-payment of bills as a fact of their practices. Both he and my dad were frustrated by patients who waited too long to come to see them delaying diagnosis and treatment.
That was the reality in Ontario and in Canada through until the end of the 1960’s. Healthcare delivery was very local and unevenly accessible.
And then as a country we embraced a different reality. We decided that everyone deserved to have access to the best healthcare that we, as a society, could provide.
We built a system that has grown and evolved into one of the institutions that defines us as Canadians. We all know it is far from perfect. We all know that COVID has only made things worse and that change is necessary. Frontline workers are burnt out. Surgeries that should have taken place have not. People are waiting too long for anything that is not an immediate emergency.
Some of these problems are self-inflicted by governments who, during COVID, did not make the investments needed or in the case of the Ontario government actually antagonized the very people they needed most, the nurses and frontline staff, by capping salary increases and ignoring their working conditions.
But while these decisions were egregious, there is no doubt that the pandemic has seriously disrupted the system. The many good changes that were in the works in communities and hospitals across the country were interrupted by the virus. And the things that were already a problem have gotten worse.
There are too many stories about people not getting the services they need—even in emergency situations. Too many stories about short-staffed units. Too many stories about low morale in the rooms where we need confident, well-supported professionals. There is no one government or one leader to blame. We literally are in this mess together and we need solutions.
One of the longstanding issues in healthcare in Canada has been the interjurisdictional responsibility to fund and administer it. In my time as Premier of Ontario, I, like all of my colleagues across the country were pressing first Stephen Harper and then Justin Trudeau when he became Prime Minister, to increase the federal share of funding the provincially administered health system. We argued, as have current Premiers, that the original deal of a 50/50 funding split between the two levels of government had long been abandoned leaving the provinces holding the bag. Far from 50/50, we argued, the current reality is more like 25% federal funding, 75% provincial. Not fair, not the deal and not sustainable. It’s one of the things that has to change and one part of the solution.
Let’s hope that there is soon a new agreement on healthcare funding that recognizes the need for more federal dollars and it’s fair to argue that for those dollars, provinces should be held accountable for their investment and the outcomes those investments achieve.
But there is something else happening in the frenzy to find solutions to the myriad issues we are confronting.
In some provinces, and I am particularly focused on Ontario, we are seeing businesses whose sole purpose is to generate profit, putting themselves forward as the solution to all that ails us.
A man like Doug Ford is very susceptible to the siren song of the profit motive whether in land speculation and development or in delivery of healthcare. And after all, in Ontario, we have always had private delivery of public healthcare services. For decades general practitioners have essentially been private deliverers of healthcare and since the advent of Medicare, they have delivered public services.
But here’s the difference. While it is true that we have had private delivery of many services. And while it is true that we have a history of governments, including the one that I led, increasing the number of private community clinics that could deliver publicly funded services, those were not for profit.
What Doug Ford, apparently supported by Justin Trudeau, has decided is that we should now turn our backs on what we have built. What they have decided is that it is ‘innovative’ to let the notion of profit into the healthcare system that we have built for 60 years.
Why are we doing this? Why can we not increase the decentralization of services and even surgeries out into the community to not for profit delivery? Why would we risk private companies establishing a two-tiered system in which your income will determine the speed and the level of care that you will receive?
Why are we calling these changes innovation when in fact, some Canadians being included and others being excluded actually takes us backwards to the days before we made that decision to provide universal healthcare?
Are we doing it because the people in charge know that they will always be able to pay?
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ABOUT THE AUTHOR:
Kathleen Wynne - Kathleen Wynne was first elected to the Ontario legislature in 2003 as the MPP for Don Valley West. She was Ontario’s 25th Premier and leader of the Ontario Liberal Party from January 2013 to June 2018. Kathleen has dedicated her professional life to building a better province for the people of Ontario. She is guided by the values and principles that knit the province of Ontario together: fairness, diversity, collaboration and creativity.
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