Ken's response on Canadians' reaction to cuts and proposed privatizations of medicare, while I agree with what he said, leaves a lot more unsaid. Let me summarize as briefly as I can.
1. In the early 1990's the federal government cut a lot out of the transfers to the provinces to finance medicare. They also changed from dedicated transfers to the provinces for health care, education and welfare, and converted it all to a block funding that the provinces could do with as they like. At the same time, they transferred tax points to the provinces so that they could raise provincial taxes to offset the decline in federal contributions. 2. The response of the provinces was to cut health care expeditures -- "reform" it was called. This was also at the height of the 1990-1993 recession when government deficits were going through the roof so the cuts were justified on the basis of debt/deficit reduction. In Manitoba, approximately 10 per cent of medical personnel (mainly nurses) were given pink slips, nursing schools were closed and the intake of students into medical school was halved. (I have just completed a study of the labour market implications of this 'reform'. If anyone is interested, please write to the Economics Department, U of Manitoba, Wpg, Man, R3T 5V5 and ask for my paper to the Delta Marsh Seminar on Health Care Reform.) 3. Many of the provinces found that costs of their medicare program were rising though, almost without exception, those costs paid for by the public insurance program were actually **falling** as a percentage of GDP. Almost the sole reason for the rising cost was the cost of drugs, which many provinces insured under medicare for at least all of the people in hospital but control over the price of drugs was in the private market place. 4. Right wing governments used the rising cost of drugs as an excuse for arguing that public medicare was 'unsustainable' (sic) and that we had to turn to private medicine as a solution. This then led the corporate media to trumpet the **big lie** that medicare was unsustainable and that the only way to bring back decent health care was to privatize and let wealthy patients get privileged access to the health care system. As one Conservative polititian put it, "I was tired of having to wait in a roomful full of poor people before I could see a doctor." Besides which, in order to reduce corporate and income taxes on the rich, there had to be further cuts to public expenditure and since health care was (and is) the biggest single government expenditure, this required cuts to health care expenditure. 5. With regard to the public's reaction to the cuts -- why no public outcries? Well, I think there have been. Here in Manitoba, the main election program of the (sort of social democratic) NDP involved more expenditure on medicare. The result of the election which was largely fought around the issue, was a resounding defeat of the Conservatives. Since then, the main economic program of the New Democrats has been repairing medicare, with apparent strong support from the electorate. In Ontario, which was the source of the original post on this stream, the Conservatives are running a distant second in recent opinion poll, in part because of the debacle of medicare funding, but probably more because they deregulated and privatized electricity in the province with the result of massive increases in the prices of electricity that are screwing Ontarians accross the board. 6. The real culprit in this whole debacle is first and foremost the Conservative government of Alberta, a province originally populated by Americans and who have adopted the politics of (Bush's)Texas. The second culpable body in this is the corporate media which have spent millions of print inches arguing that public medical insurance is not sustainable and repeating all sorts of totally untrue 'facts' generated by the private health care industry. The fact is that in Manitoba, the Conservative government privatized the home care system -- and as soon as they were able to do so -- 'renationalized' it because the cost under private delivery skyrocketed. By the way, almost all these studies and reports are available on the net at Http.//www.policyalternatives.ca. Far more than enough for now. Paul
