There’s nothing wrong with medicare… that a little democracy
often is said, exists because we live in a democratic society. If so,
it stands to reason that without democracy we wouldn’t have this great
social program that we all love. In fact, democracy, I would argue, is
the heart and mind of medicare, and of our ability to make it work the
way we want it to. When democracy is on shaky ground, so is medicare.
privatization happening across Canada, something that is riding roughshod over public values
and public opinion. Polls have consistently shown (for example a May
2000 Ekos poll) that the most acceptable--indeed the most
desirable--option chosen by Canadians is a publicly funded health care
system with services provided by not-for-profit institutions and
If democracy was
working in medicare, this is the kind of system we’d be building. But
democracy isn’t working in health care, and health care isn’t working
for an increasing number of people.
If democracy was
working, there would be an increase in the income taxes paid by the
wealthy to support the health care system. When asked, this is the
option Canadians have consistently chosen. But democracy isn’t working,
and middle and low-income Canadians are paying more than their fair
share to support the health system--including in the form of lower
wages for providing health services.
reject user fees as way to pay for hospital services--in one poll only
13 per cent supported that option. If democracy was at the heart of
medicare, surgical facilities that charge thousands of dollars in user
fees would be turned into not-for-profit publicly funded providers.
User fees for hospital services like physiotherapy or podiatry would be
a corporate fantasy instead of the cruel reality faced now by British
Columbians. But democracy isn’t working in BC and medicare isn’t
working for a lot of sick and injured people who are forking over scarce
dollars or are being deterred from obtaining needed care.
The Ekos poll
referred to above also asked Canadians for ideas about how to improve
the health system. In order of preference they chose more hospital
beds, new technology, more home and community care, more health
promotion and prevention, improving Pharmacare, more accountability.
Dead last on the list was more privatization and more queue-jumping by
people who pay. In fact, another survey found more Canadians (57 per
cent) chose “longer waiting times for some health care services” as a
way to relieve pressure on the system than chose privatization (23 per
cent) or user fees (22 per cent) in the Ekos poll.
If democracy was
working, privatization and user fees would be unheard of for medically
necessary health care. But democracy isn’t working, and as a
consequence beds in small and rural BC are closing, hospitals aren’t
getting new equipment, home care is being shut down and community care
strangled, health promotion and prevention is not adequately funded,
the system is less not more accountable, user fees and privatization
are rampant and Pharmacare is under attack.
Let’s look at
Pharmacare. According to Victoria’s
Monday Magazine, Big Pharma gave generously to the BC Liberal election
machine in 2001. For example, the Canadian Research Based
Pharmaceutical Companies, an umbrella group representing some 60+ drug
companies, gave the Liberal Party $11,800. Pfizer Canada Inc. gave the
governing provincial Liberals $5,400, while another $5,300 came from
AstraZaneca Canada Inc.; $4,304 from Merck Frost Canada & Co;
$3,650 from Glaxo-Wellcome and, last but not least, $2,500 from
Hoffman-La Roche Ltd. No higher taxes for these guys, and no expanded
Reference Drug Program to limit their revenues.
industry’s largesse compares to a mere petition from people throughout
the province to the BC government last Spring asking for an expanded
and strengthened Reference Drug Program (RDP) to better control drug
costs and greater cooperation with the federal government to establish
a national Pharmacare program.
the government ignored the penniless petition, not to mention the
outcry from tens of thousands of people, including seniors and disabled
citizens. There’s no democracy in Pharmacare, and there’s no Pharmacare
for a lot more British Columbians than before.
We’re right to
ask whether there’s any connection between the government’s failure to
expand one of BC’s key cost-savers, the Reference Drug Program (opting instead for a shift in drug expenditures
totalling $100 million to taxpayers);
and contributions from the drug industry to the Liberal Party.
for you--or rather that’s no democracy. And no democracy means no
entitlement, no right, and no access without the requisite cash.
is a health care researcher, author and public care advocate.