by Ish Theilheimer
Published on www.straightgoods.ca

The oldest play in the conservative playbook is to ruin public services and then rally public opinion against them because they no longer work very well.

Canada's once-proud, single-payer public health system is a case in point. Despite study after study showing Canada's public health care system (or "medicare") is more efficient than US-style private care, medicare has been cut repeatedly since the 1990s. Now it doesn't work very well, and its private competitors are saying they could do better.

Every wave of hospital cuts has been accompanied by turning more and more of the nursing home industry over to for-profit companies.

I had vivid personal experience of these changes this week. My daughter's two-year-old daughter took a two-hour ambulance ride to the Children's Hospital of Eastern Ontario for emergency lung surgery necessitated by severe pneumonia. Ten hours after the time she arrived at the hospital, she was finally put in a hospital room.

The delay was not the fault of the caring and hard-working hospital staff. It was because their waiting room is crammed with miserable families trying desperately to find health care. Governments and voters have repeatedly chosen tax cuts rather than expanded services. The inevitable result is that there were fifty people in the ER waiting room at the kids' hospital.

A toxic pattern of cuts, privatization and deregulation in the health care system is emerging. Last week in Toronto, I interviewed Mary Susan Yankovich of Service Employees International Union (SEIU) — Local 1 Canada. She was on her way to file a complaint with the Ontario Labour Relations Board "on behalf of Red Cross homecare workers, who don't get paid for the time they spend traveling," she told me. "In effect, they work sometimes twelves hours a day and get paid for eight hours. They’re getting paid less than the minimum wage."

She isn't impressed by government claims that it is doing everything possible to allow people "to keep their dignity in their own homes. A lot of these women, and it’s mostly women, are subsidizing their own jobs."

Workers have been staging rotating one-day strikes across the province since March 23, when their contract expired. The labour board complaint makes the point, says Yankovich, that unpaid wages are a major issue, "with many people out of pocket between $1,100 and $5,000 for the six-month period."

Later in the day I spoke to Natalie Mehra, coordinator of the Ontario Health Coalition, who told me the home care workers' story is consistent with a general trend across the province, driving down standards of patient care.

The Coalition is campaigning against attempts by the for-profit nursing home industry to block new regulations that would improve patient care in nursing homes. Ontario, she says, has "the most privatized nursing homes of anywhere in the country.

"Every wave of hospital cuts has been accompanied by turning more and more of the nursing home industry over to for-profit companies. And there are several very large multinational companies that own a significant proportion of Ontario's nursing home beds."

These companies, she said, conduct a "sophisticated and aggressive lobby" against regulations that would improve care levels. "One of the major problems for them is that the more staff you have to hire, the less profits you can take out of the homes. So they oppose at every step of the way improving the staffing levels, improving the care levels in the homes."

The impact of deregulation is apparent to old age home residents and their families, she says. "We hear from residents left in diapers… and the staff is not allowed to change them until the diaper is 75 percent full," she says. "We hear from people who can't get help getting to the bathroom and they become incontinent. We hear from families having to hire in extra caregivers if they can afford it, because there just isn’t enough care to turn [patients] over so they don’t get bedsores, to feed them slowly enough they can eat their food, to take care of them, to give them their baths..."

Despite the misery of Ontario families and the outrage they express locally, the industry has more sway when the rules are made, she says. The problem, she says, isn't so much privatization on its own as it is "private industry winning deregulation from the government. They [government] hand over the homes for the aged industry and then you’ve got this big, powerful lobby group. They [lobbyists] push very hard inside the doors of Queens Park every day. Residents and family members don’t get that kind of access to politicians. They fund political parties and they get their way, even when it’s counter to the public interest."

The Coalition's work helped promote an investigation into long-term care by the Provincial Ombudsman, who is expected to issue a report soon.

The Coalition is also campaigning against widespread hospital funding cuts, which helped contribute to the crowding in my granddaughter's ER. "The provincial government has set global budgets for hospitals at less than the rate of inflation," says Mehra, and this has required wholesale cuts. Fifty percent of the province's hospitals were in deficit last year and 80 percent are expected to be this year.

"So they have to cut services," says Mehra. "Even if it means eliminiating medically-necessary services — beds, the pain clinic in a certain town, the fertility clinic in another town, shutting down emergency depeartments. That has thrown all these hospitals into a major, major round of cuts. What that looks like is wholesale closures of small rural hospitals all across Ontario, closing down of emergency depertments, closing of hospital beds, layoffs in the thousands of nurses and other support staff and health professionals, cuts to services and clinics, and privatization."

Patients are forced to get medical help privately. Patients have to "pay out of pocket for what once was provided as a public service. And that kind of thing is happening all over the place."

The provincial Liberals have, so far, managed to avoid political heat over the changes, in part because of the system of regional health bodies (Local Integrated Health Networks or LIHNs) "that they are hiding behind," says Mehra. "They're all appointees of the provincial government, but they are hiding behind these appointees to escape the political blame for this."

Mehra urges concerned citizens to get in touch with the Premier himself to urge a change in course. For more information, please go to the Ontario Health Coalition website.

In the snack bar in the hospital on Sunday, the cashier was talking to a medical staffer wearing hospital greens. He explained how the budget changes at hospital mean that he now works 48 hours and gets paid for 40.

With over-crowded Ers, seniors in disgusting diapers, homecare workers subsidizing their already-low-paying jobs, it doesn't seem that difficult to recomment some easy ways to stimulate the economy. Research tells us that social infrastructure creates three times more jobs than tax cuts. With the shocking expansion of human need in amidst economic crisis, it is astonishing we would not solidify the front lines of support in hard times — human services.

Ish Theilheimer has been Publisher of the leading, and oldest, independent Canadian online newsmagazine, StraightGoods.ca, since founding it in September 1999. He is also Managing Editor of PublicValues.ca. He lives wth his wife Kathy in Golden Lake, ON, in the Ottawa Valley.