If the definition of good governance includes the sound management of public monies and resources, then Canada has very bad governance.

The manufactured health care crisis is a case in point.  Solutions to challenges of cost, quality, and access are fairly straightforward but wilfully ignored, and current trajectories towards corporatization are leading us in the wrong direction.

If the challenges are responsibly addressed, every Canadian will have access to exemplary health care, based on need rather than ability to pay.  Additionally, Canadians will save money, and the economy will be positively impacted.

3 big ideas

Dr. Danielle Martin – family physician, V.P of Medical Affairs and Health Systems Solutions at Women’s College Hospital, and Assistant Professor in Medicine and Health Policy at the University of Toronto – is eminently qualified to offer solutions.

She argues that we could immediately implement “Three Big Ideas” within an expanded  medicare system. Martin describes these ideas as follows:

• “20 Drugs to Save a Nation”
• “Less is More”
• “Sick with Poverty”

The first idea, “20 drugs to save a nation” would save lives while improving the economy.

Currently, one in ten Canadians can not afford their prescription medications.

Consequently, their medical conditions often worsen, which invariably leads to more expensive care, including hospital admissions.  A study by the New England Journal Of Medicine, appropriately titled “Dead Man Walking” , shows that when heart attack patients fail to adhere to their prescriptions, they are more likely to be readmitted to hospital.

National public drug coverage also saves lives. As Alan Cassels explains in “Opinion: A prescription for cutting costs” , public drug plans screen drugs for value and safety better than their private drug plan counterparts. He explains:

[quote]… out of the top 50 most costly drugs covered by private drug plans, several of them wouldn’t merit coverage by public drug plans because of their poor value: they were branded drugs which had cheaper equivalent generics.[/quote]

The Vioxx tragedy

The tragedy of Vioxx resonates with this opinion: premature release of the brand drug Vioxx caused between 4,000 – 7,000 deaths in Canada.

Bulk buying through a public drug plan also means that one purchaser (versus many) can secure lower prices for medications. New Zealand, for example, pays 2.4 cents for one Lipitor pill, while Canada pays 32 cents for the same pill.

A national pharmacare program with first dollar coverage (a best case scenario) would save Canada as much as $10.7 billion per year.

Dr. Martin’s “Drugs to Save a Nation” plan would be a first step towards national pharmacare.  She argues convincingly that we could start bulk-buying 20 generic drugs, and that such a step would not only improve patient-adherence rates to medications – and their health – but it would save a substantial amount of money.

Less is More

The next idea, “Less Is More”, would also save money, and lives.  According to Martin, numerous medical tests, treatments, and procedures are administered more often than necessary. Consequently, health outcomes can be negatively impacted, and additional costs accrued.  A sobering study by Dr. Ray Sahelian reinforces the message.  He notes that “Radiation from CT scans done in 2007 will cause 29,000 cancers and kill nearly 15,000 Americans.”

The top five tests, treatments, and procedures that are done more often than necessary are:

• Electrocardiograms (ECG’s)
• Imaging tests for lower back pain
• CT scans and MRI’s for headaches
• Bone density tests (DEXA scans)
• Antibiotics for sinusitis

The excellent internet site www.choosingwiselycanada.org not only identifies the numerous problems, and dangers, associated with unnecessary testing, but it also explains  “When you need them – and when you don’t” .

Poverty as disease

The final big idea, “Sick with Poverty” explains that poverty is basically a disease. The corollary of this is that if poverty can be eliminated – and 1 in 7 Canadian children live in poverty – then we will be a much healthier (and productive) society.

A 2013 study by the Canadian Medical Association, “Health care in Canada: What makes us sick?” identifies four social determinants of health:

• income
• housing
• nutrition and food security
• early childhood development

Canada’s failure to understand this aggravates and perpetuates an unnecessary situation – poverty.  If all Canadians had adequate income, housing, nutrition/food security, as well as early childhood education, our population would be healthier, while societal costs for health care, policing, and other social services would be reduced, and we would collectively be more productive.

Evidence shows that Canada would save $7.6 billion per year on reduced health care costs alone if the lowest group of earners moved up by one “quintile” (to two) on a scale of earnings with the top quintile being five.

This could be financed by discarding Canada’s current welfare system

And replacing it with a Guaranteed Annual Income  system which would redistribute monies through taxes.

Clearly, we have the tools and the funds to make Canada a better and stronger nation, but it won’t happen until the current theology of predatory economics that is poisoning the economy, and our collective mindset, is rejected.

Instituting Dr. Martin’s “Three Big Ideas” would be a huge step in the right direction.

Canadians are forever being informed, explicitly or implicitly, that the solution to the crisis of the day, or decade, is a freedom-sounding word called “privatization”.  This, the free-marketeers tell us, will solve our problems.

The reality is invariably the opposite.  “Privatization” – also known as bailed-out, highly subsidized corporatism – is in fact the problem, not the solution.

Furthermore, the crises being addressed are often manufactured for the express purpose of rolling out a parasitical regime of corporatization that profits from calamity, even as its “host”, the public, is fleeced.

Exploiting the commons

Canadian author and social activist Naomi Klein identifies the process as the “shock doctrine” and/or “disaster capitalism”; author, environmental activist, and economist Winona LaDuke calls it “predator economics”; writers call it neoliberalism, and corporate media pretends it doesn’t exist.

A tattered thread is woven into a seemingly endless series of crises, and it is the public sector, the commons, that is invariably being exploited.

Neo-conservative strategists disguise  the real problem, and deflect attention from it, using a myriad of strategies, all of which serve to instil what insurance whistle-blower Wendel Potter calls FUD – Fear, Uncertainty, Doubt—in the collective mental landscape of the masses.

Instead of identifying the real problem – neoliberalism/predator capitalism/shock economy—neo-cons typically scapegoat other polities.

Canada’s emblematic instituions being undermined

According to neo-con politicians, union bosses and their minions, as well as public servants, and public institutions, are the causes of our economic woes, even as these are some of the few remaining polities that mitigate the damages caused by predator capitalism.

Two of Canada’s “emblematic” institutions, currently being undermined so that they can be replaced by inferior models, are “universal” health care, and Canada Post.

Canada’s public healthcare system is in distress.  Community hospitals are closing, wait-times are long, and the public is dissatisfied.  Corporate messaging proclaims that since the status quo of public universal healthcare is failing, then the answer must be privatization/corporatization.  Consequently, the 2004 Health Accord has not been renewed, and the federal government will be cutting $36 Billion over ten years from its Canadian Health Transfers (CHT’s) to the provinces.

Manufactured health care crisis

The manufactured crisis in health care is chronic under-funding, and the solution is more comprehensive public funding, not corporatization.  Since 1981 hospital funding has decreased significantly as a share of Canada’s  health care budget.

Corporate health care is less efficient, and more expensive, than public health care.  The more it is corporatized, the more expensive (and less accessible ) health care becomes.

A CUPE article entitled, “Public Health Care Costs Less, Delivers More”

clearly shows that the “private” components of health care far exceed its public counterparts in costs even as they deliver less. Listed below are some (of numerous) examples identified in the article:

• Ontario paid 75 per cent more to for-profit labs than it had to non-profit community labs over the    previous 30 years, for the same tests.¹⁰

• Public-private partnerships are 83 per cent costlier to finance than public projects.¹¹  * (Canadians) spend roughly half of what the private US system spends per person,¹⁶ and we get better coverage and outcomes.

• Studies comparing US and Canadian outcomes for heart attacks, cancer, surgical procedures and chronic conditions show that Canada does at least as well, often better.²¹

• A recent Canadian study found that expedited knee surgery in a for-profit clinic costs $3,222 compared to $959 in a public hospital (with worse return-to-work outcomes)²⁴

Clearly, the false “solution” is making a bad situation (under-funding) worse.

These two important examples are, nonetheless, the tip of the iceberg. The list is long, but the strategies are consistent: create a crisis to undemocratically impose inefficient, expensive corporate models in domains best suited to public funding.

Internationally, the same strategies are being used, and the descriptors are the same: predator economics, shock doctrine economics, neoliberalism.  But, when supranational polities such as the World Bank or the International Monetary Fund (IMF) impose these strategies on other countries, the process is called colonialism.

by Mark Taliano

Sometimes, the simplest solutions are the best ones. Unfortunately, though, Canada’s extreme concentration of corporate power often precludes the solutions from ever seeing the light of day.

The first step towards resolution of this problem is nomenclature. We need to free corporate-fashioned words from their false meanings.

Here are some examples:

Trade deals, including the so-called ‘free trade’ deals which have crippled North American manufacturing, are more accurately described as ‘corporate empowerment’ deals. Invariably, these deals empower transnational companies to relocate where wages are low (or in the case of prison labour, non-existent), where collective bargaining doesn’t exist, and where unions are impotent or non-existent.

Corporate empowerment deals, including the North American Free Trade Agreement (NAFTA) and the as yet unratified Foreign Investment Promotion and Protection Agreement (FIPPA), a bilateral agreement with China, empower corporations to the extent that government legislation becomes subordinated to corporate profits.

Corporate power deals are all shrouded in secrecy, but at least NAFTA arbitrations have pretensions of  transparency (and Canada has yet to win a case), but the FIPPA arbitrations will likely not even be made public. If Canada determines that its sovereignty, economic, or environmental needs are more important than Chinese state-owned corporate profits, the case will be heard outside Canadian law, and in private.

Free trade is not free

The ‘freedom’ being exercised by these deals is clearly corporate freedom from the shackles of democratically legislated rules, regulations and laws. The false notion that they are ‘free’, or that ‘liberalized’ trade agreements are ‘liberal’ for anyone but the corporations, should be put to rest. Trade agreements negotiated over the last 30 years or so have been neither free, nor liberal, for the people of Canada.

‘Globalization’ is another corporate-engineered word that is intentionally deceiving. The globalization being described is not ‘democratic’ globalization, nor is it the globalization of improved human rights, or a globalized respect for the environment. In fact, it is the opposite. Corporate globalization, a more accurate description, has led to top-down corporate rule, diminished respect for human rights as defined by the United Nations, and reckless destruction of the world environment.

The word ‘capitalism’ is also wearing new clothes, thanks to corporate messaging of the ‘free marketeers’, and those who profess a love for ‘free enterprise’. Now the term more often refers to state-subsidized ‘monopoly capitalism’ (think Walmart, Monsanto, etc.). The new ‘capitalists’ are the speculators who drive up world prices of food and fuel, as they trade in commodities, derivatives, and hedge funds. In the world of these boom/bust/starvation-creating ‘capitalists’, the term is divorced from production, and it is too often divorced from the notion of the ‘public good’ as well.

Hyper-privatization

The term ‘privatization’, a hallmark of neoliberalism/neoconservatism, has also been crafted to mislead the public. Now the term more accurately describes anti-public ‘hyper-privatization’.

In many instances, hyper-privatization means that para-private interests are making in-roads into the public sphere to the detriment of the public. One such instance would be Public Private Partnerships (P3 arrangements). Evidence clearly shows that P3 hospitals cost more and are, therefore, an unnecessary burden on the public. This, however, has not stopped them from gaining a foothold in Canada.

Another example of hyper-privatization would be healthcare. Once the insurance lobbies persuade the public of the false-logic that privatized healthcare is the way to ‘move forward’, we will be stuck with a multi-tiered, inefficient, and costly healthcare system, (similar to the U.S. system) that will be an unnecessary disservice to the public.

The deconstruction of the corporate nomenclature gives us a clearer view of what is happening, but there are still huge impediments, or firewalls, to achieving a better economy and a better world.

Self-Interest lobby groups

Some of these firewalls include self-interested lobby groups that have disproportionate influence over public discourse and legislative polities. A list of these powerful organizations, as described by award-winning investigative reporter Nick Fillmore, in  “It’s high time the Liberals or NDP challenged our ‘corporate elite’” includes:

• Canadian Council Of Chief Executives
• Canadian Bankers Association
• Canadian Association of Petroleum Producers
• Canadian Chamber of Commerce

Once past the nomenclature and the corporate-media supported ‘firewalls’, the list of better alternatives reveals itself.

The Bank of Canada advantage

One of many glaring examples, as described by George H. Crowell in his article,”An Urgently Needed Change in Monetary Policy: Borrowing from Bank of Canada would make governments debt-free” is brilliant in its simplicity.

Crowell argues that we should do what we did until about 1974 — instead of paying billions of dollars in interest on debts to private banks, the federal government should resume the practice of borrowing from the publicly-owned Bank of Canada, interest free. The benefits that would accrue, including the elimination of government debt, would empower the government to spend money on public institutions, improve the economy, and so on.

This change to monetary policy, endorsed by the Committee on Monetary and Economic Reform (COMER), is self-evident, but largely ignored by corporate media, since such a policy wouldn’t serve the immediate self-interests of their corporate owners.

Getting past the nomenclature and the lobby groups are the first steps to opening up the dialogue for a better Canada. Powerful special interest groups, such as the ones listed above, will not be our partners in the endeavour, but unearthing the seemingly simple solutions is a necessary step to rebuilding this country and the global community.

Mark Taliano is a writer, an activist and a retired teacher. 

Watch Robert F. Kennedy Jr.’s recent speech on the increased influence of corporations on the Canadian and US governments: