Fifth-Estate-Online
International Journal of Radical Mass Media CriticismThe Canadian Media's Relentless Push for Privatised Medicine by James Winter
So-called 'studies' by right-wing think tanks have long provided 'evidence' for the corporate media to bash big government and extol the virtues of the private corporations which, coincidentally, fund the think tanks. The mainstream media treat these studies like gospel, and why not? The findings are common sense. Take for example a recent study on health care by the Frontier Centre of Winnipeg. It introduces a few new twists on a tired and discredited theme: private is better than public.
The twists are necessary because a quandary has developed. It's become increasingly difficult for free market think tanks and corporate media in Canada to directly and openly espouse private medicine as practiced in the US. Word has gotten out, via Michael Moore's Sicko and the World Health Organisation data and others that the US system seriously sucks. So, how do you promote private medicine, when it costs the most and provides the least? Well, judging from a recent study and the reporting on it, you use a magician's slight-of-hand to substitute Europe for the US, and hope nobody notices the very public nature of European health care. Bit amateurish, perhaps, but desperate times call for deceitful measures. To begin with, the Frontier Centre report released in January admits (p.16) that while all of the European countries included in the study were given a chance to provide 'more recent data' and/or 'higher quality data' than what was in the public domain, Canadian provinces and the federal government were not. This means the comparisons are not equal, and may be misleading.
Additionally, according to World Health Organisation data, all of the European countries, like Canada (30%), spend mostly public money on health care. Only the US, amongst industrialised nations, spends more private money (55%) than it does public. The UK is only 14% privatised, while Sweden is 15%, France 22%, Germany 23% and Austria 24%. Almost all European countries' health systems are even less privatised than Canadian health care. This makes it illogical to argue, as did an editorial in the Windsor Ontario Star titled 'Health Care: How Our System Compares' (February 4th, 2008) that better European performance means 'innovative solutions' such as 'private clinics and care' will improve Canadian health care. If indeed Canadian health care falls short of European standards, it is precisely because of greater privatisation here, not less. The most meaningful comparison for those considering private health care is the US system.
But first, what happened to Canadian health care? The 'business liberals' of the Jean Chretien government and then-finance minister Paul Martin cut health and education transfer payments to the provinces from $17.3 billion in 1995, to $12.9 billion in 1996, and then $10.3 billion in 1997; a 40 per cent cut in two years. These deliberate and unnecessary actions manufactured a crisis in Canada's health care system, which was among the best health systems in the world. It's still a very good system, especially compared with its American counterpart, but problems related to MD shortages, and long waits for surgery and emergency room treatment have been greatly exacerbated; and why not? The 1996 cuts alone meant that Quebec, for example, lost $1.1 billion, equivalent to half of its payments for all MD's services (Read Murray Dobbin's, Paul Martin: CEO For Canada?)
The Canadian single-provider health care system is still demonstrably more cost effective than its American counterpart. On a per capita basis, the Canadian system costs 48 per cent less, with 100 per cent coverage. In the US, approximately 47 million people, perhaps one in six people are without health care insurance, although they pay 91 per cent more for their system. In Canada, health care spending comprised 10.3 per cent of Gross Domestic Product (GDP) in 2006 (The Canadian Institute for Health Information, 2007). In the US, this was about 55 per cent higher, at 16 per cent of GDP. US expenditures are higher, both per capita and as a percentage of GDP, than for any other major industrialised country. Despite this, sixteen per cent of Americans, or 47 million, lack health care coverage altogether (Plunkett Research, Ltd.). This is more than the aggregate population of 24 States, plus Washington D.C. One out of three Americans below age, 65 to 85 million people lacked private or public health insurance for all or part of 2003-2004. Millions more are underinsured, lacking adequate coverage for medical expenses (Read Holly Sklar, 'Time For Health Care For All On Medicare's 40th Anniversary', ZNet Daily Commentary, August 13th, 2005). As of 2003, Canadian per capita spending on health care was $2989, while it was 91 per cent higher for Americans, at $5711 per capita.
The US does not have guaranteed universal health care. Most Americans have health insurance which is paid for through their employment, or which they purchase directly from private insurers. There are some publicly funded health care programmes for the elderly, disabled, and the poor, and US federal law is supposed to guarantee public access to emergency services regardless of ability to pay. A number of free clinics also provide free or low-cost care for poor, uninsured patients, in non-emergency situations. However, according to Ron Pollack, founding executive director of Families USA, 'In 42 states a childless adult can be literally penniless but not fit a "deserving" category and therefore be ineligible for assistance' ('Universal health care advocate speaks,' The University of Pittsburgh, University Times, Vol. 39:5, Oct. 26th, 2006). In the words of Dr. Christopher Murray of the World Health Organisation (WHO), 'Basically, you die earlier and spend more time disabled if you're an American rather than a member of most other advanced countries.'
So, how well are we doing? What we see from the World Health Organisation's 2006 statistics is that although Canada had a smaller population and lower gross domestic product, per capita, it leads everywhere else. Life expectancy is three years longer; child mortality is 25 per cent lower, adult mortality is 66 per cent lower for men, and 70 per cent lower for women. Health expenditure per capita in Canada is only 52 per cent of what it is in the US, and as a percentage of GDP it is only 65 per cent of the US proportion in Canada. In short, using these admittedly broad measures, Canada's universal health care system compares quite favourably, despite serious cutbacks in the last ten years or so.
In spite of this, powerful forces in Canada consistently have been pushing hard in the direction of a private health care system similar to that in the US. This is ironic given that opinion polls show Americans are in favour of a single-payer, 'Canadian style' health care system. So, if the Canadian system is better, why is there this push for privatisation? The answer is profits. Although the system of multiple private providers is less efficient and more costly, it is very profitable for the insurers and other corporations involved. Canadian insurance companies want some of these profits, and their chums in government who make the laws want their friends in business to profit greatly, even if it means adopting an inferior system.
In writing this, I don't have the 'smoking gun', which might consist of an email from Paul Martin to his (and Chretien's, Bob Rae's, and Mulroney's) mentor at Power Corporation, Paul Desmarais Sr. But, as I pointed out in Democracy's Oxygen, the family ties are very close, and it doesn't take a huge stretch of the imagination to think of them sharing thoughts about policy initiatives over dinner. Chretien's daughter France is married to Paul Desmarais' son Andre; Paul Desmarais Sr. sold Canada Steamship Lines for $195 million to his then-employee Paul Martin, in 1981. Desmarais also hired Brian Mulroney as a lawyer to help settle a strike at his Montreal newspaper, La Presse, in 1972. Four years later, Desmarais was Mulroney's biggest backer in the latter's first bid for the leadership of the Progressive Conservative Party. It was Mulroney who started us down the path of the first Free Trade Agreement, and then Chretien with NAFTA, and in part these agreements have opened up Canada's public enterprise to privatisation (Read Jim Grieshaber-Otto and Scott Sinclair, Bad Medicine: Trade treaties, privatization and health care reform in Canada).
As Peter C. Newman noted, 'No businessman in Canadian history has ever had more intimate and more extended influence with Canadian prime ministers than Desmarais.' ('Epitaph for the two-party state,' Maclean's, November 1st, 1993, p.14). Multi- billionaire Desmarais' group of companies includes Great West Life Assurance Co., Canada Life Assurance Co., London Life Insurance Co., Great-West Lifeco Inc., Great-West Life & Annuity Assurance Co., London Reinsurance Group, and others. These companies, and Desmarais, stand to benefit enormously from privatisation of medical care and medical insurance in Canada. Indeed, the Power Financial subsidiary Great-West Life & Annuity Assurance Co. is already a provider of self-funded employee health plans for businesses in the US, with 2 million health plan members and 2005 revenues of $3.3 billion (US).
Through Gesca Ltee., and Power Communications, Desmarais has also been a significant news media owner over the decades. In the 1990s, he partnered with Conrad Black in controlling the Southam newspaper chain, the largest in the country. Today, Gesca controls seven daily newspapers in Quebec and Ontario. This media ownership did not harm Desmarais or Black when it came to promoting their shared belief in private enterprise. And it may go some of the way toward explaining the news media's steady criticism of public health care, and advocacy of private health care.
Parts of this commentary are excerpted from James Winter's most recent book, Lies the Media Tell Us.