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HEALTH CARE PRIVATIZERS EYE BC FACILITY
By Hanne Gidora
(This article is from the June 16-30/2000 issue of People's Voice, Canada's leading communist newspaper. Articles can be reprinted free if the source is credited. Subscription rates in Canada: $25/year, or $12 low income rate; for U.S. readers - $25 US per year; other overseas readers - $25 US or $35 CDN per year. Send to: People's Voice, 706 Clark Drive, Vancouver, Canada, V5L 3J1.)
WHILE ALL EYES have been on Alberta's Bill 11, other provinces are not safe from the drive to privatize health care. The Simon Fraser Regional Health Board (SFRHB) in British Columbia is hatching plans to close Cascade Residence, the extended care unit of Burnaby Hospital. The idea is to replace it with a smaller facility that may be run by a for-profit provider. The region is accepting "expressions of interest."
Long term care in BC and elsewhere has been a two-tiered system for many years. To put it simply, if you need round-the-clock nursing care, and if you are wealthy, you can move into a private facility. If your "net worth" is like that of most of us, i.e. zero until we die, you move onto a waiting list.
In Burnaby, this waiting list now has about 700 names; in five years, it is projected to climb to 2,000. Not a good time to close facilities, or replace them with smaller ones, as the SFRHB was told at its regular June meeting by a crowd of nearly 100 activists, residents and employees of the region, unions and senior citizens' groups, and family members of residents currently living at Cascade.
The fact is, long term care facilities are not like acute care hospitals. People don't go to extended care to get better and go home again; the facility becomes their home. Threats of closure or "replacement" are like threats of eviction. Few of us actually enjoy moving, but for elderly people, any kind of move carries the risk of deteriorating health or even death. This has been proven over and over. Why, then, this sudden taste for change?
The RHB argues the Cascade facility doesn't meet standards. That is open to interpretation. The Hospital Employees Union says the part of the building that is to be demolished is structurally sound and usable, while another unit, which is twenty years older and should be replaced, will remain open.
Since the SFRHB is calling for "expressions of interest" from non-profit as well as private providers, there seems to be another agenda at play. The corporate sector is pushing relentlessly for privatization of all public services. Often this is sold to the public in the form of "public-private partnerships," also known as PPPs or P3s.
"Partnership" suggests a relationship of mutual consent and benefit. PPP is an attractive notion for cash-starved provinces, municipalities and health boards. The cuts in federal transfer funds, combined with health care restructuring in B.C., have left many public providers scrambling for money.
PPPs claim to be more cost efficient and therefore a savings for the public purse. But since governments and private companies borrow money under different rules and at different rates, PPPs end up costing the taxpayer more. Corporations involved in PPPs also get additional tax breaks, leaving individuals to make up for the loss of government revenue. They do, however, enable government bodies to give the appearance of lower debt loads.
Other concerns with PPPs are deterioration of services, loss of public accountability, loss of jobs, and falling tax revenue as the numbers of wage earners are reduced. This is only common sense; how else can corporations make a profit? If they had to pay the same overhead as government operations there would be no profit margin; so they cut back on services, supplies or wages. Yet health care workers are suffering from huge increases in workloads, leading to higher stress and an increase in occupational illnesses and injuries. Health care is now the most dangerous working environment in B.C.
Privatization of health care does not improve services to the public by creating healthy competition. The corporations most suited to get into health care are huge transnationals with the explicit goal of building a monopoly for themselves. Imagine a pharmaceutical corporation as owner of a long term care facility. Elderly people often take multiple medications for a variety of ailments. Guess whose products would be pushed in such a circumstance?
The way to improve long term care and health care in general is not privatization. Regional Health Boards and Community Health Councils must be held accountable as stewards of public service, not its dismantlers. These bodies must be given the necessary funds, and held accountable for their appropriate use. There must be full consultation and disclosure of cost-benefit studies that include all costs, including user fees and other charges that let the government bodies off the hook but are detrimental to the public.
Canadians overwhelmingly say that health care is one of the most important issues of the day. We must translate that view into action, by supporting campaigns like the June 14 National Day of Warning against privatised health care, organized by the four largest health care unions.
(The author is a nurse at a long-term care facility, and a union activist.)
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