It’s now or never for Ontario public healthcare

As Ford imposes “innovative” healthcare “options”, Ontarians need the truth and we need to get loud about what we want. It’s now or never.

Published in The Seeker, August 22, 2022

Despite downplaying their ongoing efforts to privatize our healthcare system in the lead-up to the recent 2022 provincial elections, Doug Ford’s conservatives are in the process of doing just that by allowing “independent health facilities to operate private hospitals”.

“Options” and “innovation” are ambiguous buzzwords designed to cloak the reality of for-profit healthcare which is “associated with worse care, higher costs and more deaths”. I don’t see innovation in privatizing what has been a successful social program. What is innovative about forcing citizens to pay for health care or private insurance?

Why is this our only “option”?

Who gains in this shift from public to private healthcare? I don’t think it’s the majority of Ontarians.

For-profit healthcare means that big corporations must make a profit; they are legally bound to maximize investor returns on their investments overriding any other considerations. And with all businesses, the way to make a profit is by raising prices for the consumer and doing things cheaply. Cheaply means cutting costs by lowering staff levels, faster patient turnarounds, prioritizing the more profitable procedures and using fewer supplies etc. The CEOs and stockholders of big corporations always, always come first. NOT the patient.

Up until now, universal healthcare was an important social benefit that we took completely for granted. But imagine if it didn’t exist.

Americans have had it rough in the healthcare arena. Based on their experiences, here are a few questions you need to answer before allowing any provincial or federal government to gut your public health.

• What if you only got free healthcare if you were poor?
• What if you did not meet the province’s definition of “poor enough” and you had to pay for health insurance?
• If your employer offers health insurance what portion do you pay? Does it affect your salary?
• If you quit or lose your job do you lose your insurance?
• What about deductibles – how much you do have to pay before insurance kicks in?
• What about the % that insurance pays and the % you pay based on the premiums you can afford?
• Have you thought about the co-pays (flat rate payments for services that you pay even with insurance)?
• What things are not covered – like pre-existing conditions?
• What about those pesky lifestyle choices that can affect your premiums or ability to get coverage like smoking, drinking, drug use or risky sports?
• What about getting older? Can you even get private health insurance? Are your premiums higher? Does your insurance cover less?
• What happens if the insurance company changes what is and is not covered in a couple of years?
• If you are paying for a health claim, have you considered that you are on the hook to pay these bills until the balance is zero and if you can’t, the only option may be bankruptcy?
• How do you feel about for-profit corporations delivering your healthcare options?

An example from a quick online peek at health insurance costs under the Affordable Care Act (ACA) in the US tells me that average health insurance under the plan costs about $456/month++ for individuals and $1152/ month++ for a family. So roughly: $5,472/yearly individual & $13,824/yearly for a family. That is just for the insurance, not the out-of-pocket expenses. I included a screen grab of how premiums and their costs could work. (*note: the rates vary between states).

Out of 197 countries in the world, all but 43 have universal health care systems. The US is the ONLY country in the developed world that does not have universal health care. Now Ontario wants to join them. Did you know that medical bills are the leading cause of bankruptcy in the United States?

In the US, health insurance is complicated and expensive for the average individual. You must shop around for the best deal. You must read the small print. You must know what is and is not covered. You must do the paperwork. And you must keep up to date because things change from year to year.

In Ontario Canada, when you hand in your health card most things are simply covered.. Or they were.

You didn’t have to think about it.

But now you do.

Why? Because Ford and the Conservatives are giving you the freedom to pay for private healthcare to fix a system they have deliberately destroyed through chronic underfunding.

According to the Ontario Health Coalition “per capita, Ontario now has the lowest health care and hospital funding, and the fewest hospital beds and nurses, of any province” (something like $2,000 less per person per year). “Yet provincial revenues are $19.5 billion higher than estimated a year ago (@March 2020), providing plenty to spend on public services, if the will were there.”?

Why isn’t the “will” there? Is it a lack of money in the province? Or is it the promise of great wealth to be made by corporations and those who promote them?

Recently Health Minister Sylvia Jones assured us that access to health care through OHIP is “never going to change“. Forgive me if I don’t believe her – it is already in the process of changing. Real access to health care for all, should mean that you get the health care you need when you need it. Failing this, access to healthcare is like access to the outdoors by “free range” chickens who see the open door but rarely go out.

There are all kinds of costs to privatized healthcare. The money either comes out of our pockets or out of our taxes. The patient’s cost in private care is insurance and other out-of-pocket expenses. The public side costs now include things like certain lab tests provided by for-profit labs that are no longer covered by OHIP. Up until recently, a Covid PCR test cost taxpayers around $40 on the public side. The private out-of-pocket cost for the same test is $200-$250.

Privately run services like Telemedicine will charge OHIP more than a regular doctor would for the same service. Why? The private side needs to make a profit while the public side does not.

But there is another cost in Doug Ford’s scheme that few are talking about, and that is the one billed to the government and paid for by our taxes called “public-private-partnerships” or P3.

P3 means that for-profit corporations build and own public infrastructures like roads, schools and hospitals. The “public’ services they charge the government for are more expensive in order to cover their profit. They become the middlemen endlessly extracting money from the system that we pay for through our taxes.

The short-term benefit to this is that they invest the money to build. The long-term downside is that we pay way more for P3 public services and we don’t own the infrastructures, which puts us at the mercy of corporations.

With all the other issues we are facing today (climate, unstable politics, pandemic etc) do we really want to add in another variable to worry about so that a select few can make money from our misery? I sure don’t.

Corporations are not the answer. They do not add any value. They do not provide jobs that would not be provided in the public system. They do not provide services that cannot be provided as well or better and for less money in the public system. They do not pay their employees as well as the public system. As far as I can tell, corporations do not add anything into this mix. They insert themselves into an existing system and extract money. Study after study shows that they cost more, they have poorer health outcomes and they produce more deaths than public systems.

The solution does not lie in the slippery slope of more privatization, but in funding health care properly. We need to open the doors to education for more doctors and nurses. We need to fast-track and support immigrant doctors and nurses to get licensed.  We should be offering subsidies and incentives for professionals wanting to go into family practice to cover clinic overhead. We need to incentivize and encourage the practice of preventative medicine which will translate into huge cost savings down the line.

Also, if we support a proper network of public home care practitioners we will take the pressure off of our emergency rooms. The latter would also reduce the need for more expensive and un-affordable private senior residences.

Photo by Karolina Grabowska; Pexels

Additional information and links:

Info on Public-Private Partnerships. Ontario Health Coalition article

Risks for equal access to healthcare. Press Progress article

The crisis of privatized care in Ontario (Long Term Care) article

Ford ramping up privatization. Rabble article

Here Are All the Corporations Lobbying Doug Ford To Privatize-. Press Progress article

COVID-19 test results reveal two-tier health care in Ontario. Toronto Star article

Ford Government’s Plan to Defund & Privatize Our Public Health Care System. video

Private vs Public Healthcare. Brittlestar video