Credit to Michael Butler, health care campaigner at the Council of Canadians.
Last week the Council of Canadians and CUPE Saskatchewan went on a five city tour to raise awareness about the increasing privatization of public health care in the province. Sadly, in the heartland of medicare we are seeing, “increased creeping privatization across the province in all health care sectors. What’s happening is Brad Wall knows that people value universal health care in its heartland of Saskatchewan. There’s been backdoor cuts and policy and legislative changes. The founding principle of medicare – need and equity – trumping ability to pay is being eroded.”
We heard from people across Saskatchewan explain why public health care matters so much to them. In Prince Albert we heard from CUPE Saskatchewan president Tom Graham who highlighted that medicare is, “something we should be preserving – not selling off… It started in this province and it needs to carry on. We can’t be having private surgeries, private MRIs, private laundry, private food services; who knows what’s next?” In Yorkton, we heard about how hospital laundry services, and the important jobs in the community they provide, have been contracted out to Alberta. Audience members went on to share stories of how they are already hearing that laundry is coming back unfolded, moldy, and in some cases with blood stains still on them. In North Battleford, the audience told us the process for the P3 prison/hospital has been a boondoggle so far and local trades people questioned the competence of those in charge of the project (before the 2011 election, the provincial government priced the new building at $100 million but now –unsurprisingly- estimates have already ballooned to $175 - 250 million). In Weyburn, the epicenter of medicare in Canada, we heard a disturbing story from an audience member about how her grandmother (before medicare) had to sell her cow to get enough money for cancer treatment. If it wasn’t for her neighbours who kindly proposed that they would share their cow’s milk with her children, she would not have sold the cow and got treatment. While times have changed, the audience member highlighted no one should ever be put in the position where ability to pay comes before need. Lastly, in Regina we heard how the provincial government refused to vote for legislation to make P3 deals more transparent and accountable (similar to legislation in Manitoba), and they do not want the public looking into these crooked back room deals.
People were concerned that provinces are facing a difficult situation as the federal government decides to walk away from its responsibility to provide quality health care to Canadians. Nationally, without a renegotiated Health Accord, we will see -$43.5 billion in health funding in only eight years. In Saskatchewan, the cumulative projected loss $1.37 billion and already (from March 2014-2015) the province has seen a loss of $33.2 million due to changes in the equalization formula for the Canadian Health Transfer. While this situation creates challenges, instead of showing leadership the Saskatchewan government is following in the footsteps of the Harper government and putting ideology ahead of fairness. Across the province, we heard from people who questioned how after ‘8 year of prosperity’ in Saskatchewan there was so little to show for it except for excuses and creeping privatization of the services the people of Saskatchewan need.
In every city we visited, people were fed up with the rhetoric and fictions the Brad Wall government uses instead of looking at evidence based studies and putting people before profit. The resent changes to legislation to bring in private pay for service MRI scans isn’t about better care, or decreasing wait times, but smuggling in 2-tiered US style private health care into the heart of medicare. What is being proposed is queue jumping for the rich, and goes against the very founding principle of medicare which is based on need, not the ability to pay. This inequitable system is being proposed by the same Premier Wall who said in 2009 that, “his government’s health reforms would not allow anyone ‘to use a bulging wallet to jump the queue’.
While wait times are an important issue to address, this government has learned nothing from the failed experiments in other provinces that brought in private MRIs and saw their wait times increase. This pay-per-use model of care for the rich has been shown in study after study to increase wait times for the majority of patients (the ordinary people in Saskatchewan). There are a limited number of technicians to work the machines, and when private clinics enter into the equation they poach workers from the public system leading to increased wait times in local public hospitals. For example, when Alberta introduced their private MRIs, one Calgary hospital lost three of five diagnostic technologists to a new MRI clinic that offered large signing bonuses. According to the Canadian Institute for Health Information, Saskatchewan posted typical waiting times for MRIs are around 28 days. Whereas in Alberta, even with pay-for-service private clinics, typical wait times for a MRI scan was around 80 days. These waiting lists exist despite Alberta having the second highest number of scanners per capita in the country. After introducing pay-per-use imaging to address wait times, the Government of Alberta moved away from the policy at great cost.
Along with resource drift from the public system and lengthening wait times, there is also no financial savings, and no increase in accessibility - there is actually no real evidence for provinces to promote patient-pay imaging centres. What it does is it takes government off the hook as they pretend to be doing something. It doesn’t have to invest in the public system, but in health care privateers. This is simply a step backwards that defies common sense, and frankly the people of Saskatchewan deserve better. Everywhere we spoke, people were outraged that the Saskatchewan government is putting ideology and rhetoric ahead of evidence and fairness.
Another place quality public health care is being eroded in Saskatchewan is in the use of public private partnerships (P3s). These ‘deals’ are a waste of citizen’s money that should be invested in our public services. There is no health policy or business case for P3s; study after study demonstrate that P3 hospitals/health services cost more, are less transparent and not accountable. Moreover, in addition to expensive financing and construction costs, these P3 hospitals deals often include hidden privatized services such as maintenance, security, cleaning and laundry, adding tens of millions more to the final price tag and reducing health outcomes for patients. Yet, the Saskatchewan government is aggressively privatizing health services through P3 deals and building P3 hospitals.
Recently in Saskatchewan the auditor general report on P3 shows that rather than learning from the mistakes of other jurisdictions, the government is actually repeating them. Most striking, the report finds that the risk assessments which are the primary means used to justify the cost effectiveness of the P3 model were made with no recourse to any empirical or historical evidence of similar projects of the past. SaskBuilds, who is in charge of these P3 deals, has already spent $5.6 million on advice from Partnerships BC who are providing advice on virtually all P3s in the province. Yet, this company generates all of its income through consulting services which promotes P3s and provides biased advice which can make them more profits (they will never say the public option is better). As we heard on the tour, this is like going to buy a truck and paying a salesman to tell you that his trucks are the best.
Saskatchewan is the home of universal public health care, the heartland of Canada’s most cherished social programs. When Tommy Douglas first campaigned to introduce universal public health care in the 1960 Saskatchewan provincial election, he had long term aspirations and integrity, with no fear in polls or appearing electable. His dream was truly visionary in scope and revolutionary in its effects. The people of Saskatchewan have not forgot what this means and are sending a clear message to the government that our health care must be based on need and not the ability to pay.