On 4/12/2016 3:45 PM, wrote:
> When our system came in 1968, they had done a huge study of the
> British system. The main fault they didn't want to repeat was a mix
> of private and public treatment.


That's why your provinces are PRIVATIZING now, you dizzy old shrew.

Wake up = smell reality!

https://www.solidarity-us.org/node/1679

Privatization by Stealth: Canadian Health Care in Crisis
— Milton Fisk

THE RECENT GROWTH of obstacles to getting health care here in the United
States has led to a renewed interest in Canada's system of universal
access, called Medicare. Premium inflation has accelerated after
stabilizing in the mid-1990s.

Employers, who had trusted Health Maintenance Organizations (HMOs) to
limit their expenses for employee health care, are either limiting
employee coverage or simply not contributing to it. The steady rise in
the number of uninsured in this country is a reminder that a robust
economy doesn't mean generalized affluence.

It is ironic though that, just when interest in the United States is
rising, the Canadian system itself has become more vulnerable. Emergency
room overcrowding has reached crisis proportions in Ontario and Quebec;
hospital closings have devastated rural communities in Saskatchewan and
Alberta; the provinces are begging for federal health care cuts to be
restored to prevent a collapse of the system.

For the past fifteen years, Canada has been ruled by neoliberal
governments that have cut back the overall social security system, and
Medicare with it. Still, in Canada, Medicare gets approval from 80% or
more, and 60% reject the idea of replacing it with a two-tier system in
which the government insures those who can't afford private insurance.

he Onset of Privatization

There has come to be more to the neoliberal program for Canadian health
care than federal cuts. There are other opportunities to be opened up
for capital by limiting government. The subtext of the cuts has become
getting a greater share of the $(C)75 billion health care industry into
the hands of profit-making outfits. The cuts have proven merely a
convenient indirect means toward such a privatization. It may, though,
be U.S. multinational health corporations, rather than Canadian capital,
that get to take advantage of privatization within Canadian health care.
Privatization takes many forms, and in Canada's health care system one
isn't faced now with privatization by sale to for-profit firms. Rather,
one is faced with a growth of competitors to Medicare. Thus one has a
growth in business for private health insurers, and as well a growth in
business for providers whose services aren't covered under Medicare.

These forms of competitor privatization are politically more expedient
than a sell-off of what Medicare “owns,” which is almost exclusively the
human bodies insured under provincial plans. Yet these privatizations
are promoted by the cuts and do threaten Medicare's ability to carry out
its mission of universality, accessibility, comprehensiveness,
portability, and public accountability, as defined in the 1984 Canada
Health Act.

Private insurance is getting a boost in several ways. As a result of
underfunding, some services have been taken off the provincial lists of
covered services. Thus in Manitoba and Quebec free dental services for
children were dropped. Other provinces have dropped coverage for eye
examinations. Moreover, in many provinces listed services have not been
updated to include non-physician services that can reasonably be
considered necessary for health, such as home and rehabilitative care.

Those who favor making private insurance available for coverage of as
many services as possible appeal to the fact that the Canada Health Act
itself requires coverage only of “medically necessary” hospital and
physician care. Such an appeal accompanies efforts, like those
spearheaded by Alberta premier Ralph Klein, to get around the legal
restriction that a service paid for by the provincial plan—“listed” by
it—cannot be billed to a patient and hence cannot be covered by private
insurance.

Can, for example, a service that a provincial plan pays for be covered
by a private insurer when it is performed in a clinic that announces it
has cut its ties with Medicare? Physicians sometimes leave hospitals,
complaining of low compensation, to offer services only to those willing
to pay for them without relying on their provincial health plan. If
their work is rehabilitation, they can argue that it is perhaps not
“medically necessary” and thus need not have been listed in the first place.

Recently this minimalist view of medical necessity has been pushed to an
absurd limit. Physicians have been successful in court against an
Ontario Ministry of Health challenge to their billing patients for
preoperative tests that under any reasonable interpretation are
constituent parts of procedures insured under the provincial plan. In
these various ways, private insurance is given the opportunity to fill
in a growing number of holes in provincial plans.

The provincial health ministries with which hospitals funded by
provincial plans have to negotiate their global budgets are to act as
the guardians of the principles of Medicare. This discourages the
handful of for-profit hospitals funded under those plans from having
ambitious goals for increasing market shares or attracting profit-hungry
investors. Thus far, then, for-profit privatization tends to work around
the edges rather than to increase the number of for-profit hospitals
working within provincial plans.

Here are some of the ways privatization is growing. With cuts in
hospital nursing staffs and with the employment of hospital therapists
not keeping up with demand, numerous for-profit extended care and
rehabilitation centers have sprung up. Often their services are not
covered by provincial plans—not because they are delivered in for-profit
centers but because the service is both non-physician and non-hospital care.

Cuts in hospital laboratory staffs cause long waits for test results
financed out of hospitals' budgets. For-profit laboratories provide
quicker service, at least for those who can afford to pay for it either
out of pocket or with private insurance. In some cases, hospitals form
joint ventures with for-profit laboratories, using the revenue to offset
inadequate global budgets. In New Brunswick, four for-profit
multinational firms have taken over the administration of the provincial
health plan, in violation of the public-administration condition of
Medicare.

Finally, hospital funding itself is being privatized. In Ontario,
continuing support for hospitals became incompatible with the desire of
its Tory premier Mike Harris to slash taxes. His government wants
Toronto's hospitals renovated through a hospital bond issue rather than
with funds from taxes.

This method of “renovation” begins to modify the goals of the hospitals
to conform to the interests of lenders rather than to the public
interest in having a healthy society. These and similar privatizations
lead toward a health care system with a public outer shell covering
for-profit functioning parts.