Health-care privatization is no cure

Opinion

Health care remains in crisis in Manitoba. Wait times are high, surgical backlogs continue to leave patients in pain, and staffing deficits are straining the capacity of the system to a breaking point.

Patients and providers of health care are rightly frustrated and worried for themselves and their loved ones, unsure if public health care will be there for them when and where they need it. Some have grown so disillusioned with the public system that they are pushing for private alternatives to improve ER wait times and overall performance. Increasingly, there are prominent voices in Manitoba and beyond who are determined to abandon the public system, although they are at times subtler than calling for outright privatization and Americanization. Instead, they advance a route toward stealth privatization and a two-tier health-care system.

Take, for example, a series of recent opinion pieces published last month in the Winnipeg Sun. In these pieces, the authors repeat familiar arguments about the need to modernize health care in Canada. Yet, in practice, such calls for modernization always seem to mean more privatization. Mixed public and private systems like those in Switzerland, France, or Germany are often held up as examples of a better, still equitable, way forward. Access for all and more autonomy is promised.

It sounds like a great idea, on paper.

In practice, what proponents of such privatization and two-tier health services typically fail to mention is the inequalities in society that privatization exacerbates. They tend to downplay the out-of-pocket costs to individuals and the increased cost to the public system that remains.

There are only so many people willing to work in health care, as many Manitobans know all too well, especially those living in remote and rural communities. The public health-care system in Manitoba already faces steep competition from other provinces. Bringing in further competition from private health-care providers will only weaken the capacity of the public system that the majority of us would continue to rely on even if more private alternatives were available for the few who could reliably afford them.

Health care is a public good, and accessing it should not be determined by income or identity. When we allow health care to be commodified and subject to the motives of profit, costs go up and the conditions of work and care suffer, impacting both the social and economic health of society.

It will take political will and a long-term vision to reverse years of privatization and expand the coverage of the public system to include much-needed health services like enhanced mental health supports, expanded pharmacare and dental care, coverage for eye care, and fully public home and long-term care.

Yet, instead of moving forward with urgency to root out privatization and rebuild the public system, the government is making modest public investments while expanding privatization.

Reliance on private staffing agencies continues under the NDP, even though data show that these agencies are expensive, and that much of the public money going to private agencies is spent on travel and administrative costs, not patient care.

A new, five-year deal was recently struck by the NDP with Dynacare, entrenching the for-profit, private delivery of lab services in Manitoba, despite their criticism of this practice while in opposition. The government claims this will improve access, but Dynacare has a record of closing locations where Manitobans need them most. Alberta recently went in the opposite direction, bringing community lab services back under direct public operation and oversight, while B.C. just experienced 10 weeks of labour disruption with a private, American-owned outpatient lab service provider. It is unclear why the NDP chose to take such a practical and political risk.

All Manitobans deserve access to high quality public health care in their own communities. Publicly delivered care provides the best bang for our health-care buck, ensuring that care is integrated, accountable, and not beholden to the whims of shareholders or private owners seeking to line their own pockets. Evidence from other provinces in Canada shows that privatization of health care does not lower wait times or reduce costs for delivering that care.

To rebuild and strengthen publicly delivered health care, the NDP must prioritize health-care spending, especially in this time of growing economic uncertainty and increasingly frequent environmental crises like the wildfires that have ravaged Manitoba this year. They must show leadership in shifting the culture of health care so that patients receive the care they deserve regardless of income or identity, and providers can leave work knowing they served their patients well and were given the resources they needed to provide that care.

And finally, the government must rethink and reverse Manitoba’s growing reliance on private interests to deliver public health care.

Noah Schulz is the provincial director for the Manitoba Health Coalition.