I thought a lot about public health care on election night, and how the impacts of the federal election would impact health care in Ontario – including provincial cuts by Premier Doug Ford. The outcome of a Liberal minority offers an opportunity to negotiate in favour of better health care, including a much-needed pharmacare program. Given the major cuts to Ontario health care services that the Doug Ford and the Ontario PCs are pushing through, the broader Canadian political landscape puts us in a Good News, Bad News, and more Good news situation.
The Good News:
Three major parties made commitments to pharmacare. The Liberals, NDP and Greens all have stated their support for a pharmacare program – now they can work together to implement it. In June 2019, the Liberal government’s Advisory Council on the Implementation of National Pharmacare released their suggestions for a national program. The framework is a good start for negotiating a national pharmacare program with the provinces and should be acted on.
We know the need for pharmacare well. Drug costs are growing, in part because we can’t negotiate prices down as a collective. Instead, those of us who have coverage get it from some combination of 19 public and 24 private different insurance policies, either public or private, often from our employers. That means many people with precarious work don’t have coverage and are more likely to not have the income needed to pay for prescriptions out of pocket. These individuals also face hard choices of paying for necessary prescription drugs and other basic necessities like groceries and rent. Because of this system, Canada is one of the top three spenders on prescription drugs amongst OECD countries, just behind the U.S. and Switzerland at $1,043/person.
At the Council of Canadians we will continue to push the federal government for a fully public and universal Pharmacare program. The strength of these three parties working together could get us there if we continue to mobilize in support of it.
The Bad News:
The Ontario PCs still have the most sway over health care in the province, and their cuts to health care are staggering. The targets for cuts include nursing positions and hospital staff, services for lower-income families, mental health services, ambulance services, coverage for residents travelling abroad, public health units, research, autism programs, overdose prevention sites, and more. These individual cuts are damaging enough, but they also come with new Ministerial powers to close, merge or privatize services without public notice.
These cuts intentionally position the public health care system for corporate capture, allowing private for-profit interests to make decisions about and profit from health care services. The simplest examples are those of outright privatization. Lab services, for example, are already being turned over to private management. A less obvious example is the revolving door of employees between private and public health care management, normalizing a policy environment where corporate relationships have more access and influence over public processes.
Health care needs to be maintained out a concern for healthy lives for everyone and these cuts and changes weaken that long-held pillar of health care in Canada. Private companies don’t have to stick around when profits dip, and they don’t have to manage for the public good. The legislation governing these cuts, Bill 74, places no accountability on these processes because there are no mandates for public notice periods or feedback should the Minister decide to close, merge or privatize more services. Corporations aren’t in it for the long run, so we have to mobilize to ensure health care stays public.
More Good News:
People are organizing for the health care we need! Starting this weekend, the Ontario Health Care Coalition is putting on four stadium-filling rallies to pressure the Ontario PCs to reverse or stop cuts. Local municipalities are asking the Provincial government to reverse the cuts, and people across the province are pushing back as we also pressure for a comprehensive Pharmacare program.
Across the country, we need to let every decision-maker know that health care must stay public, and grow publicly. It is how we’ll sustain the care we have and ensure that more people are able to access what they need.
