Public Health Funding: Who are they trying to kid?

By  Armine Yalnizyan, Catholic Register Special
  • May 4, 2007
I started my career as an economist 20 years ago trying to improve reintegration and vocational training for workers who had been injured on the job. Our work was mostly shelved.
In the mid-1980s, with free trade agreements looming, we fought to improve training opportunities to facilitate “labour adjustment” of the unemployed, and lost.

In the early 1990s, we fought to prevent massive erosion of income supports — first unemployment insurance benefits, then welfare — and lost.

In the mid-1990s we fought to preserve social housing programs, and lost.

In the late 1990s, we fought for sufficient investment in core infrastructure to assure clean water and electricity, and lost.

We lost every time because the counter-argument was “the cupboard is bare.”

To my dismay, the fight has now turned to securing the future of public health care, the social program considered most fundamental to, and most treasured by, Canadians. And the reason that we are struggling to assure everyone’s access to this quintessential human right — timely, high-quality health care — is again because “the cupboard is bare.”

But that line is not as credible as it once was. Not when the federal budget surplus hits $13 billion. Not when the inflation-adjusted size of the economy is almost twice what it was in the early 1980s, when Canada’s first food banks opened as “a temporary measure.”

So the fiscal basics are there. But after two decades of downloading and offloading of public services, increased individual independence (couched as individual responsibility, but really permitting us to not need one another) has begun to impair the clarity of our vision. We are less able to find politicians who will champion these programs because, reflecting the electorate, they are convinced that too much support may feed an unhealthy “dependence.” It takes no philosopher to understand, however, that our survival makes us critically dependent on one another.

What stories and metaphors can help us clarify our vision? Most of our faith traditions are replete with stories about our relatedness to one another, to creation, to the Creator.

One of the most helpful metaphors to describe how we are connected to one another comes from the Bible in 1 Corinthians 12, where the body is deconstructed. It is not, we are told, in and of itself one part, but many. For the body to function fully, we require all our different capacities: our eyes, ears, internal organs, limbs and systems (immune, circulatory, nervous). When one part of the body (society) suffers, every part suffers. When one part rejoices, so do all.

The message is: we are genuinely different. But to think that means we share nothing in common, and are unaffected by one another, is a mistake. “Unity in diversity” is the theme. We need one another to function properly, to be our best.

It is disheartening to see how easily interconnectedness is dismissed, how the growing number of voices calling for help, even in the midst of unprecedented prosperity, are left out and ignored.

They are ignored because they are not “on message” for politicians, whose political currency resides in their ability to point to success. Canada’s and Ontario’s exceptional economic performance in the G-7 countries has got most incumbent politicians crowing loudly. They conveniently put aside the fact that despite this growth:

  • the intensity of poverty, and the number of homeless is rising;

  • the growth in deregulated and rapidly increasing rents leads to more undernourished households;

  • a growing number of communities are not assured of potable water;

  • rising tuition fees are making post-secondary education an increasingly risky finan
    cial investment, especially for those with low incomes;

  • the gap between rich and poor is greater than ever, and half of Canadians feel insecure about their own financial circumstances; and

  • emergency rooms and waiting lists for diagnostics and surgical procedures are increasingly backed up.

They leave out these details and the community voices that expose these details because these voices and messages don’t count. At least they don’t contribute to the counting that counts. The message is about a growing economy, not about the growing health and well-being of society.

As those who get left out become more ill, it is not just as individuals that they find themselves deteriorating. This disease contributes to the disease of the whole body politic, with a growing part of it becoming stressed, disabled, potentially malfunctioning and ineffective.

What makes the body politic healthy? What are the determinants of health? They are the basics listed above: adequate shelter, adequate food, clean water, health care and education. Access to these basics is deteriorating for a growing number of citizens.

Community voices have been asking for practical, specific changes for decades, backed up by research and passion. Yet elected officials, for the most part, offer only supportive nods and maddening delays while they preside over continued deterioration. In 2004, a vigil was held only a couple of kilometres from the provincial legislature to commemorate the burial of the 300th homeless person in Toronto. Late in 2006, a vigil marked the death of the city’s 500th homeless resident. Why is this happening?

(Yalnizyan is an economist working for the Community Social Planning Council of Toronto. This excerpt is taken from Lives Still in the Balance, Ontario’s Social Audit, a publication of the Interfaith Social Assistance Reform Coalition.)

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