Health care must remain in the public domain

Universal health care across the country is under attack by Conservatives, like Ford and Kenney. They seem to be using the same playbook for underfunding, downsizing, and cutting health care services while accelerating the privatization of those same essential services.

In a recent interview, Ron Hikel, political scientist and management consultant, said, “It’s pretty clear that every provincial government across the country fears the demand for extra health care spending that they can’t meet.

Hikel added, “Not so long ago the federal government made a legal commitment to pay 50% of the cost of the province’s health care system. They reduced that to just a fraction of 50%. Some people say 25%, some people say 30%, but they’re all complaining and urging the federal government to start covering at least substantially more of the cost of the health care system than it does now.

The provinces that have the most difficulty providing effective public health care are those where the Prime Minister is extremely unpopular. And, according to Hikel, this common problem is one that has huge policy implications.

There are direct and physical political costs to the current inability of provincial governments to meet what the system itself is asking for in additional funding.

In 2001, Hikel was Deputy Minister of Health in Manitoba. At that time, there was a two-person committee that acted as coordinators for the Canadian health care system. The committee included one representative from the federal government and one from the provincial level.

“Fortunately for me, it was time for Manitoba to provide one of two people for this committee. So, David Dodge and I was the co-chairs of the Federal-Provincial Council of Deputy Ministers of Health. It was exciting work. »

Hikel described this experience as the most deeply satisfying experience of being a public servant he had ever had because, as he said, “you could see the benefits to the people of what you were doing” .

Hikel realized that the healthcare system is extremely complicated. He sees this as both a serious and persistent problem that has deeply complex clinical, organizational, managerial and political dimensions. According to Hikel, this makes it “one of the most complicated systems that exist in modern society.”

It’s extremely difficult for anyone, including people who work there full-time, to really understand what’s going on in the healthcare system at any given time.

Much of the health care discussion is about a problem that needs to be solved. However, finding both the parameters for this problem and the solutions that will work has become increasingly difficult and complicated.

According to Hikel, “there has been a persistent tenet in the health insurance system of this country that some people have tried to expand the reach of the private sector.”

Hikel went on to say, “There are likely specific and fairly narrowly defined aspects of health care delivery that could be effectively managed by the private sector to an extent beyond what they currently do. But the fundamental nature of the system must remain either primarily public or primarily private.

Hikel described the United States system as problematic because neither the private sector nor the public sector dominates the system. This ensures that the two diametrically opposed systems are constantly fighting each other. Although many fundamental problems of the American healthcare system were faced, they were ultimately not resolved.

Hikel believes that in Canada, “it is of enormous importance that the public sector continues to be the main rule-maker and the one who defines the fundamental characteristics of this system. Because the minute they lose that dominance, the system will start to break down.

If you listen to doctors and nurses, they will tell you that Canada’s public health care system is deteriorating as a direct result of provincial austerity measures that have resulted in waiting lists, backlogs and increased anxiety for patients.

On a trip to Wisconsin as Deputy Minister of Health, Hikel recalled, “Sitting in the reception room waiting for my meeting to start, I saw a health magazine in front of me and I picked it up. I looked at the headline on the cover of this magazine and the headline was, “Making the ER a Profit Center,” and my hands started shaking. I almost had a stomach ache. But there are people in this country today who are trying to do just that, and we all have to hope that they fail, and quickly.

Hikel acknowledges the continued attacks on the healthcare system. He knows firsthand the enormity and complexity of a system that requires substantial additional funding.

However, Canada’s universal health care system also requires clarity on authority, particularly who is responsible for managing the system and making decisions about it.

According to Hikel, “To the extent there is confusion about who is in charge, the system will suffer.”