That adage, “If the only tool you have is a hammer, everything looks like a nail,” was demonstrated once again at the recent premiers’ discussion on health care in Halifax; where they decided to elevate the fixes to, in the words of PEI Premier Robert Ghiz, “the premier level.”
Thus, instead of unleashing the innovation potential of those working in the system, the smothering command and control structure is to be moved up yet another level. The conference press release gives the impression that one might soon see a premier wearing medical whites at your local hospital, working on: “reducing complications from foot ulcers, improving clinical guidelines for treating heart disease and diabetes, establishing more team-based models, sharing continuous improvement principles, reviewing the appropriateness of certain tests and procedures and improving communication about health human resources and labour markets.”
If all of this bureaucratese sounds familiar, you’re right. This is the 19th major examination of the Canadian health care system in the past 15 years. Once again, the “nail” each study has continued to hammer is stuck in the paradigm that Canada’s health-care system must remain a government-run monopoly. That paradigm was starkly enunciated by Health Council of Canada member and former Vancouver General Hospital President Charles Wright, who stated: “Administrators maintain waiting lists the way airlines overbook. As for urgent cases, the public system will decide when their pain requires care. The individual cannot decide rationally.”
Just days before the premiers gathered, in Halifax, the B.C. Medical Services Commission moved to stamp out the green shoots of patient care choice by ordering two private Vancouver clinics to stop collecting fees for providing treatment facilities to patients on waiting lists. In response, Dr. Brian Day, the clinics’ founder, served notice of a lawsuit against the Commission, the B.C. Attorney General and the provincial health minister.
Supporting Dr. Day’s lawsuit are four patients who received treatment at his clinics after suffering long waits in the public system. One of those patients is 36-year-old Mandy Martens, who was told she would have to wait nine months for a colonoscopy after blood was detected in her stool and an ultrasound detected three masses in her liver. After an expedited colonoscopy at Dr. Day’s clinic confirmed metastasizing colon cancer, she was finally able to access lifesaving treatment.
Dr. Day’s lawsuit is expected to go all the way to the Supreme Court of Canada. The facts are essentially the same as Quebec’s 2005 landmark case in which the Court held that patient Jacques Chaoulli’s rights were violated when he was prevented from seeking timely treatment. In their decision, the judges wrote: “The evidence shows that delays in the public health-care system are widespread and patients die as a result of waiting lists for public health care.”
It as politicians of a neo-con stripe that put the country in this hospital bed.
By cutting funds for operating rooms, and by closing thousands of hospital beds, by limiting the number of seats in medical schools and, in co-dependence with the Medical Colleges, restricting the admission of foreign-trained doctors to the "Canadian profession," the neo-con politicians, like Mike Harris, have to share a tractor-trailer load of both responsibility and guilt (of course they have no shame!) for the crisis that is Canadian Health Care.
There is a myopic, bureaucratic and parsimonious, even miserly, quality to the neo-con non-leadership that is plaguing this country, and others, that applies to many social issues such housing for the poor, access to enough food, opportunities for both education and work with dignity, and, yes, access to affordable and high quality health care.
It is as if the human beings, including all of those whose histories cripple their spirits and/or their bodies and, as a consequence, also their minds, are not part of the body politic and therefore are excluded from the national equations that constitute provincial and federal budgets. Oh, there is a box somewhat on the balance sheet for their numbers, but their individual identities and their individual limps, or stutters, or hiccups, or Salvation Army threads, or their diets of KD and beer, or their broken families, or their truncated educations or employments are nothing more than their own "failures".
The public has no responsibility for their "spinelessness" when, in fact, without those very spines, many of them probably would not even be alive.
No, this is not a plea for a 'nanny state'...far from it!
And this is not, either, an endorsement for the corporate-run state.
It was Eugene Robinson, Pulitzer columnist of the Washington Post who wrote recently, in depicting the U.S. presidential election as a struggle between two forces:
- "We're all in this together" versus
- "I've got mine."
In Canada, Harper is clearly on the side of number 2, and we're not sure if anyone really represents number 1. More and more provincial leaders, following the public opinion polls, are veering toward number 1, whereas the health care system in Canada would not exist without leaders who were committed to number 1. It is almost as if there has been an "ethnic cleansing" of those political actors who carried the convictions of Tommy Douglas and number 1. Nevertheless, there is a chorus of leading thinkers, some of them even economists, like Stiglitz, Sachs, Krugman, and Canadians like John Ralston Saul who are singing from the song-sheet dedicated to number 1. It may take a few months, or even a couple of years for the pendulum to swing back to the middle, or even a little to the other side, in the self-interest of both the rich and the poor, because the income disparity harms the long-term fortunes of both groups.
We, collectively, have to stop pandering to the rich and the policies and the vacuity of their social consciences. And that "we" includes both our politicians and the voters, the CEO's and the consumers, the scientists and the poets/philosophers, the pilots and the air crew, the teachers and the executives, the professors and the administrators, the clergy and the indigent.
We have to say, "NO!" to the Murdoch media machine, including Sun Media, which propagates this brain-washing subtly, seductively and insidiously, on behalf of the worship of corporate profits, of tax exemptions for the rich, of tax havens for the uber-wealthy, of tax-dodging by the international corporations, of eliminating benefits and pensions and environmental protections for workers in all countries, in order to chase the fast buck.
And one of the ways to fight back is to vote for moderate candidates, from whatever parties they call themselves.
It is not macho or 'manly' to lean to the right; in fact, it may well be self-destructive. How is it that many preach the virtues of caring, of giving to others and of compassion while voting to bear arms, to reduce taxes for the rich and to privatize health care, to pander to the insurance companies?
Who is it that stampedes for 'big' government when the Second Amendment is under scrutiny while remaining silent when a woman's right to choose is under attack, but the NRA?
Who stampedes to attack Iraq, Iran, Afghanistan and even Lybia or Syria yet remains silent when the DNA proves unequivocally the innocence of a 25-year prisoner facing the death penalty? The neo-cons.
Who is it who stampedes through the House of Commons a bill increasing sentences and reducing judicial discretion, when all the evidence points to a falling crime rate, and the demonstrable success of rehabilitation programs for convicted felons? The Harper gang.
Let's put real people back into the health care debate. And those people, many of them, have no political voice, no social status, often very limited educations and prospects for secure employment, because we are really "all in this together".