When it comes to gutting state capacity and services, the Right never misses the opportunity to exploit a crisis — or to engineer one. It’s a reliable strategy from an old playbook. First, ensure a disaster in state services by starving it of funds. Afterward, complain about the inefficiency of state provision and clamor for a system overhaul in the name of free-market orthodoxy. This play allows the Right to turn a public good into a source of private profit that will serve the few at the cost of the well-being of the many. So it was a note-perfect farce when, during Ontario premier Doug Ford’s recent outdoor press conference — while responding to a question about the health care crisis — he swallowed a bee. Luckily for him, he didn’t need medical attention. Of course, if he had, he could afford it. Most can’t.
In Ontario, Ford’s Progressive Conservative government is using the pandemic as a chance to further privatize health care in the province — and he’s pushing other premiers to do the same. The plan, which was scandalously underdiscussed in the recent provincial election, is cast as a response to an unsustainable and broken system. It is true that the Ontario health system was in trouble long before the pandemic — after suffering decades of neglect and insufficient funding, it was poorly primed to deal with COVID-19. It does not follow, however, that this means that it should receive more cuts. It takes a special sort of worldview to answer the problem of insufficient funding with a call for further retrenchment.
Ontario health minister Sylvia Jones is treating the issue as one would expect and attempting to frame the government plan in anodyne euphemism. “After decades of inaction, we can no longer stand by and support a status quo that cannot respond to the current challenges the sector is facing,” Jones announced at the conference for the Association of Municipalities in Ontario. Consequently, it’s time for “innovative solutions” and “all options are on the table.”
The immediate five-point plan in Ontario aims to increase private service delivery for surgeries and to open temporary long-term care facilities to which people could be sent without choice. Jones is careful to skirt the question of more private clinics, as CBC reports. Those LTC beds may even be outside the patient’s community. Jones is also careful to note, as Premier Ford has, that “Health care will continue to be provided to the people of Ontario through the use of your OHIP (Ontario Health Insurance Plan) card.” The statement is vague enough to drive a privatized system through. What kind of care? Will this care be accessible for everyone? Or will some get a pass to the front of the line because they can pay for it?
Writing in the National Observer, Max Fawcett recalls what it was like in Ontario under Ford’s predecessor, fellow Progressive Conservative Mike Harris. During his premiership, from 1995 to 2002, the province underwent painful retrenchment and privatization, the effects of which we are living with today. As Fawcett notes,
Conservative premier Mike Harris justified the privatization of Ontario’s home-care and long-term care system on the basis that it would be “better, faster [and] cheaper.” Instead, as the first wave of the COVID-19 pandemic revealed, those for-profit facilities made decisions that put the lives of their residents at far greater risk than those in public long-term care homes.
We’re now facing a similar risk: a shift in the system that will leave Ontarians vulnerable in the future. This is especially true if a hole is blown through the protections that stand between Ontarian patients and further privatization.
Ontario’s health care crisis is in part the effect of an avoidable nursing shortage. The province’s Bill 124 capped pay increases for nurses at 1 percent per year. There are few jobs tougher than being a nurse and even fewer jobs that are more important. Bill 124 is a slap in the face to workers who are essential to the system — and to our collective well-being.
Instead of repealing or amending the bill, the Ford government has been relying on a temp agency to staff nurses — a service whose use, in some parts of Ontario, has jumped 550 percent since the outset of the pandemic. The temp services cost the province a fortune but do nothing to address the structural problems — problems to which they themselves have contributed. As Colin D’Mello reports for Global News, for example, the Ford government has tried to convince constituents that they’ve hired 14,500 new nurses. The reality is the net growth in nurse staffing between 2018 and 2021 was just 8,300. Hence the need for the temp agency.
As Sara Mojtehedzadeh and Jennifer Yang report for the Toronto Star,
Since the pandemic began, hospitals across the country have increasingly turned toward agency nurses, nursing unions say. But critics say this stopgap solution is a dangerous symptom of deeper dysfunction in hospitals, where exhausted nurses are leaving permanent jobs for flexible gigs at privately owned temp agencies — where they can sometimes earn double their old hourly rate.
While the province ought to be doing everything it can do to keep nurses within the public system, they are, in fact, doing the opposite. The Ford government is forcing nurses out while growing and entrenching the private system — and then paying for it. As Dr Michael Warner points out, the province is “funnelling tax dollars to private companies” rather than increasing pay for nurses. Of course, the more they pursue this course of action, the more they can say the system is unsustainable and too expensive. Presto! We have the astroturfed need for a radical remake.
The myth of a better, more efficient private system in health care is nonsense. For instance, as Dr Andrew Baback Boozary, physician and executive director of Toronto’s University of Health Network notes, the United Kingdom has some experience in outsourcing surgeries with the Health and Social Care Act of 2012 and the results weren’t good. “[T]he evaluation over a seven-year period? Higher rates of treatable/preventable death.” The paper he cites concludes that
the privatisation of the NHS in England, through the outsourcing of services to for-profit companies, consistently increased in 2013–20. Private sector outsourcing corresponded with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of health-care services.
Now Ontario is headed down the same path.
The creeping privatization of health care in Ontario, and across Canada, can be slowed and stopped. Ontario, like Canada, doesn’t need a parallel system to cater to those with the resources to access it. It needs to fund and staff the public system. To stop this privatization campaign, the project of rehabilitating public health care throughout the country must become a priority. This is especially true for the Left, which must bring the fight to those who are exploiting this disaster. The Left must confront the canny operators who broke the system in the first place and who are eager to leverage the problems resulting from their handiwork in order to replace our public health care system with a new system that will work against the many and for the few.
Saving the public system and ensuring that no one is left behind through a two-tier system calls for a massive reinvestment in health care after decades of neglect. It will also require programming, such as dental care and prescription drug care, that entrenches a sense of public value in a shared institution. We are living through a health care crisis and without an immediate concerted effort to save public care, it won’t be long until we pass the point of no return on privatization.