By Mark Taliano
Hybrid cars and privatized health care share one commonality: they’re both too expensive. 
Apart from that, they’re worlds apart. Hybrid cars represent a wonderful, forward-looking technology. Privatized health care, on the other hand, is regressive and exploitative.
An article by Thomas Walkom, published this past January 24 in in the Toronto Star and titled “Why Ontario’s bid to cut health care costs could backfire” highlighted a key difference: He cites Dr. S. Woolhandler, a professor at Harvard Medical School, who says, All (studies) showed that for-profit hospitals cost the government treasury more – by about 18%. The evidence of higher cost is irrefutable.”
For-profit health care systems ( which include P3 hospitals) are also exploitative because increased costs are passed on to the 99, some of whom can not afford them. It fosters a “I can afford to live healthier and longer than you” mentality.
Dr. R. Evans, a leading health care economist, noted that “from 1975 to 2009, medicare represented from four to five percent of Canada’s G.D.P, while health care costs not covered by medicare (prescription drugs, dental, home care etc.) are currently twelve percent of G.D.P” Private costs are soaring, not public costs. Pharmaceutical companies, in particular, enjoy exorbitant profits, to the detriment of the 99.
If we had a single-purchaser (Pharmacare) system, with medications purchased by the government, prescription medicine prices would fall precipitously, to the advantage of the 99, but to the detriment of transnational pharmaceutical profits. The health of human beings should be more important than company profits, but clearly that isn’t always the case.
The extreme of health care commercialization would be the U.S system. Dr. Arnold Relman, professor emeritus at Harvard Medical School notes, “ No health care system in the industrialized world is as heavily commercialized as ours, and none is as expensive, inefficient, and inequitable.” Further, he argues, “taken as a whole, the American Health Care system is failing badly.” The current state of American health care reflects the excessive influence of corporate lobbies over politics, to the detriment of the 99.
This insinuation of profit into health care necessarily detracts from what should be of fundamental importance, and that is people. As Maude Barlow points out in her book, Profit Is Not The Cure, A Citizen’s Guide To Saving Medicare, registered nurses see patients as a whole person, and the fractured “unbundling” of nursing care into tasks administered by unlicensed “service-providers” is both dangerous and unproductive. Consider the statistics: in March, 2002, the Canadian Journal of Nursing Research documented the tracking of thirty day death rates for nearly 47,000 hospitalized patients discharged from acute care in Ontario. When the proportion of registered nurses in hospitals was increased by 10%, there were five fewer deaths for every 1,000 discharged patients. It gets worse. The Canadian Health Coalition notes that in Canada, 2,200 preventable deaths will occur each year if Canada adopts a privatized health care system similar to the U.S model.
Unfortunately, our current government is in thrall of an ideology of out-sourcing and privatization, despite the human costs. If hybrid vehicles cost less, the 99 could afford to buy them and the environment would be healthier. If health care cost less, both the 99, and the government treasuries would be healthier.
It’s time to say “Hello” to alternate energy and goodbye privatized health care.
Mark Taliano is a Niagara, Ontario resident and frequent contributor to Niagara At Large.
(Niagara At Large invites you to share your views on this post in the comment boxes below. Please remember that NAL does not post anonymous comments or comments by people using pseudonyms. Only comments attached to real names are posted on this site.)
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Why only compare our healthcare with the U.S. who is even lower on the World Health Organization list than Canada. Why not compare our healthcare with those at the top of the list such as: France, Italy, Germany and all of Europe? Why should Ontario’s abysmal 30th place WHO listing slog around the bottom of the barrel with the equally abysmal U.S. 39th place?
Comments from Harvard Professors may very well be accurate assessments for U.S. 39th place healthcare and MAY even be appropriate as a comparison of Canadian 30th place healthcare with that of the world’s leading countries in healthcare.
What’s wrong with examining just what the leading countries are doing right instead of continually comparing our 30th place healthcare with OTHER losers?
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Because France, Italy and Germany have way better social safety nets than Canada does. In Canada, people that do not get paid sick time can still lose their home to an illness. What limited safety nets we have are either insufficient or take too long to qualify for in order for them to be useful for those of us without these kinds of benefits. But in especially the western European nations, there are universal benefits for people, even the self employed and lower waged workers. I know people who still continue to work at two jobs despite undergoing chemotherapy here, because their workplace does not have paid benefits and many times, they cannot get EI,.
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I think we should be looking at the top systems and moving in that direction. France, as an example, has universal health care, more so than Canada. So I agree with you.
Unfortunately, we’re moving in the opposite direction, despite evidence that it will be more expensive etc.
I’d like to the know the projected costs of the P3 hospital in west St. Catharines, and compare those projections with what it will actually cost.
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It’s nice to agree with you Mr. Taliano. We certainly should follow the lead of the best healthcare providing countries.
Perhaps you missed my article: A Hybrid Of Public And Private Health Care May Be Best For Ontario And For Canada At Large
In my article I provided info from The World Health Organization, which as you say, lists France as number one in health care for its citizens with 65 per cent of hospital beds in France are provided by public hospitals, 15 per cent by private non-profit organizations, and 20 per cent by for-profit companies.
What gets my attention is any myopic view that only government can effectively and efficiently operate a healthcare system. Obviously a 30th place rating belies this opinion.
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I have enormous respect for your intelligent views, but I also have serious concerns with the constantly escalating union demands, which plays a big part in the rising costs of everything, including health care.
I can assure you I am not part of the 1%, but am obviously also not part of the 99% as I have never worked for union wages. What do people like me do to survive.
For instance teachers, who get paid over $90,000 annually and get 20 sick days leave, which they can bank and cash in when they retire is unconscienable. This is just one example. Why are policeman on the sane pay scale in Niagara as they are in Toronto, where the cost of living is much higher?
I strongly support labour unions, but how do we get them to be more balanced and less greedy so that we can bring the cost of living down?
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Pat, maybe this isn’t the solution but I think it’s a start. We need to stop accepting the status quo belief that public unions can and should function the same as private sector unions. The automobile industry for instance would never allow it’s employees to make $90,000 a year – the money simply isn’t there. Governments however can raise taxes and lower service to the community. Aside from this, the only other option is asking the unions to cooperate voluntarily, It might work, but I’ve never heard a public sector union say they wanted their wages lowered before.
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This is an issue where I agree with all the posters thus far. The benchmark in Ontario for a private facility is the Shouldice Clinic for hernia repairs. It is fully covered by OHIP and has a stellar history for patient outcomes. If a facility can perform specialized treatments such as cataract surgery, hip replacements etc. be fully covered by OHIP, meet all care standards and make money doing so, I’m okay with that. That’s not a betrayal of the universality of our healthcare,it’s complimentary.
As far as the new St. Catharines Hospital projected cost overruns, I’m not certain that can be blamed solely on the P3 process. Many of those costs will be attributed to incompetence from the NHS team. As far as labour costs in healthcare, there has been a carefully orchestrated story line through the unions and the Ontario Health coalition to distort the narrative.
A good example was during the C-difficile outbreak whereby the spread was attributed to the lack of hygiene and that was due to the fact the NHS outsourced cleaning staff. That is managements prerogative to do so, but it is equally their responsibility to make certain the tasks were performed to standard. I don’t care who cleans the hospitals as long as I have the confidence in the hospital system and the staff to do a proper job.
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A few almost random points for consideration (and I don’t pretend to have all the answers):
1. The government can secure bank loans at a lower interest rate than the private sector, so … they should be able to build buildings at a reduced cost.
2. As a country, we should be emulating health care systems that are highly rated.
3. If highly rated health care systems have control over outrageous pharmaceutical prices, and if they can offer Universal coverage, and STILL cost much less than other systems, then why aren’t we headed in that direction?
4. This is a bit of a stretch, but I personally think that our current government is setting up the public health system for failure so that they can institute a model that is closer to the American model and further from the French model.
5. Finally, if we had a single buyer for meds, such as Pharmacare, drug prices would plummet. Shouldn’t this be on the health care agenda?
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Point #4 is the major factor for the decreased current standing of our health care system. That is not a stretch at all. It’s like planned obsolescence. It’s planned failure, then when it fails, replace it.
Also 30th place is still better than 39th and everyone is insured in Canada.
How about copying France?
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CUPE Research Report, April, 2011:
“In 2008 the Auditor General found that the building of the William Osler P3 hospital in Brampton cost $194 million more (in 2003 dollars) than it would have as a public hospital.”
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Here’s an excellent article on the Brampton P3:
http://www.theglobeandmail.com/life/health/article655944.ece
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According to the Globe and Mail (Feb 2009) article, tax payers paid $394 million too much for a $614 million hospital.
* The Private Consortium cost $194 million more than if it was built and run publicly.
* Financing adds a further $200 million, because a government can finance at a lower rate.
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The UI unemployment insurance system is not what it’s supposed to be, I once worked in the insurance business for a brief spell,this government run system has been used as a slush fund by the ruling party of the day, billions were stolen to decrease the national debt by Prime Minister Jean Chretien and the Liberal Party, used to give more to Newfoundland and the Maritimes in off season fishery seasons, also the rules change across the country,Ontario residents were the ones that paid the most in and got the least out, I was laid off from GM because of a strike in the US,I was off over two months and never got one dollar from the insurance fund, to me it’s a fraud and a government run scam. some Provinces had shorter waiting times and paid the least in.and got the most benefits.
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Mr. Taliano, it would appear that this is just another example of government mismanagement and possibly even collusion in corruption.
Why is it that great overruns happen when government is involved? The government let out the contract and the contract was their responsibility.
If it were just a matter of private verses public for the cost overruns, then there would be a serious problem with every building that has ever been built.
Can you imagine what would happen, if outrageous cost overruns of up to 100% were to happen in private enterprise?
It’s not an audit by Auditor General Jim McCarter that is needed. It’s a criminal investigation that is needed and/or the firing of those responsible for the contracts.
If the Government COULD have saved ‘$200-million in interest charges because government can borrow money at a lower rate than private business’, then why did the government NOT borrow the money to finance the Hospital?
Protecting government by blaming everything on private enterprise guarantees our 30th place WHO standing! The leader in healthcare is France. France has 65% public hospitals and looks after its contracts with builders.
This Brampton debacle and our health care under NHS is just another searing example of government ineptitude.
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The government has done a great job at saving money and time building the new Hydro Tunnel.
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The initial cost of the St. Catharines hospital was around $ 325 million in the mid 2000’s. A few years later it became a P3 hospital at a cost of $ 750 million and then it jumped to $ 1.2 billion. We are paying a higher price due to the higher interest rate. The land bought was much larger acreage han what was required – I guess this is to accommodate building medical service building next to the hospital. This does not include the furnishings and equipment.
Upper management ‘ s compensation packages are excellent- much better than anything the unions could negotiate. Given the serious front line understaffing at the NHS, they could reduce their management by 4-5 positions and hire 15-25 front line workers.
The largest percentage of the health care budget in Ontario is taken up by the cost of drugs. Pharmacare would help reduce that expense. The second largest expense is doctors salaries. Hospital take up less than 30% and its percentage has been decreasing steadily over the past 20 years.
We have seen in the past few years instances where more than $ 2 billion dollars were wasted in ehealth and air orange.
Workers are not responsible for the droughts which have led to an increase in the price of flour and other cereals, they have nothing to do with the rising cost of fossil fuels and the greed of large corporations. Are Union workers greedy when they look for pay increases which mirror the cost of living? Are seniors greedy because they want CPP to be tied to the cost of living? They all pay their fair share of taxes – and help support our economy. There are way more seniors than union workers in Canada. This is not the time to scapegoat a group or another .
The reality is that our provincial government needs to increase the business tax so that we have more money in our coffers to
support our social services, health care and education. Businesses have not used their tax savings to create more jobs and or upgrade their facilities. The upcoming provincial budget and the changes in regulations and legislation will I fear lead to a greater deterioration of health services and care in the Niagara region.
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Common sense would dictate that Mr. Harris’ infatuation with P3 funding formulas was misguided.
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Wow Sue Hotte, you have nailed it. Well mostly. Cost increases from $325 Million to $1.2 Billion for the same hospital! Could that be the work of our inept government? Could it suggest corruption? Should it demand an investigation or a forensic audit?
What higher price due to the higher interest rate? Interest rates have been at record lows since before our hospital got off the ground!
We are losing our businesses or at least diminution of our businesses at an alarming rate. Lost businesses pay no taxes and no wages. Lost wages means lost spending power. Lost spending power means lost property taxes, school taxes, user fees, etc., etc.
There is a finite level of business tax that can be levied before business collapses. If our business community collapses, we will we have even LESS money in our coffers to support our social services, health care and education.
We must understand that cost and foreign competition has taken a toll on business. Our business must try to provide goods to consumers who prefer to buy cheaper imports. Perhaps ‘businesses that have not used their ‘tax savings’ to create more jobs and or upgrade their facilities’ are a clear indication of business in crises.
How does hiking business tax (cost) assist in the retention of Business? Why try to make business a scapegoat?
Scapegoating denotes failure. Yet, our problem has been created by government, and only government, and it appears that our governments have not the ability nor the inclination to fix our problem.
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Susan, Is right about corruption I just heard the horrendous tales about the Montreal Olympic Stadium that was finally paid off, the roof never did get a workable dome cover, and huge pieces of concrete are falling off the stadium.the mob scammed the builders of the Stadium and security on building supplies was none exiistant, triple billing and inferior concrete escalated the final cost. that whole Olympic fiasco was a license to steal. Mayor Drapeau had to have a gun in his desk, he famously said it would not cost the Quebec people more , than if he had a baby. Quote.
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According to a Globe And Mail article by Andre Picard,( “In this PPP taxpayers are the ones who paid”) the financing of the William Osler P3 hospital cost a further $200 million more than a government financing plan would cost because governments can finance projects at lower interest rates. If we add up the numbers, taxpayers are paying $394 million too much on a $614 million hospital.
On paper, P3’s look good: private industry builds the hospital and provides services, and the government leases the hospital, much as a homeowner would use a mortgage. In practice though, it’s like over-paying on the house and on the mortgage (or, in the case of the hospital, a twenty or thirty year lease, after which the government still doesn’t own the hospital). It works for the private consortium, but, as Picard noted, “the taxpayers (get) screwed.”
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Mr. Taliano, are you saying that when a ‘citizen’ borrows money to have a private contractor build his house he would then allow the builder to charge more than double the contracted quote?
You might very well be correct in your opinion that ‘Mr. Harris’ infatuation with P3 funding formulas was misguided’ but common sense would also dictate that the McGuinty gang cannot manage a straight forward contract much less the Province of Ontario. No wonder the taxpayer gets screwed!
With all due respect Mr. Taliano, cherry picking questionable opinions of others just to make flimsy points are robbing you of your credibility.
Thanks NAL for this great forum…
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Here’s a link to Infrastructure Ontario http://www.infrastructureontario.ca/What-We-Do/Projects/Project-Profiles/Niagara-Health-System/
The pdf Economic Benefits provides an interesting read.
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Click to access kc-ppp.pdf
2,200 additional deaths per year
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Mr. Taliano, are you saying that when a ‘citizen’ borrows money to have a private contractor build his house he would then allow the builder to charge more than double the contracted quote?
You might very well be correct in your opinion that ‘Mr. Harris’ infatuation with P3 funding formulas was misguided’ but common sense would also dictate that the McGuinty gang cannot manage a straight forward contract much less the Province of Ontario. No wonder the taxpayer gets screwed!
With all due respect Mr. Taliano, cherry picking questionable opinions of others just to make flimsy points are robbing you of your credibility.
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Re- my earlier comment on the Economic Benefit of the NHS P3. What will be interesting is the differences between the projections and the reality in costs. I predict the numbers will be staggering.I believe Preston is right , the current government has yet to be able to manage a project without runaway costs. Whether a P3 or a publicly funded model, the new St. Catharines Hospital would be a financial disaster. The other cost aspect that isn’t so easily quantifiable is the total economic impact of closing services in other hospitals throughout the region.
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My understanding of Picard’s article is that P3 hospitals are a mistake, certainly it was a mistake in Brampton. Governments are using P3’s because it frees up short term cash, but the Brampton case (and many others) shows that , long term, they’re a financial mess, according to the evidence. If Sue Hotte’s statistics are correct, and I’m assuming they are, then the P3 in St. Catharines may well turn into another “Brampton scenario”. You’ll notice, upon careful consideration, that all of my points are supported by evidence. I will also add that the people on this blog with a medical background (nurses etc.), such as Sue (I believe), and Linda, also have expert insights since they have worked in the system.
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http://www.operationmaple.com/big-business/the-p3-hospital-a-public-health-hazard
P3 hospitals
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http://www.operationmaple.com/big-business/the-p3-hospital-a-public-health-hazard
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What an outrage to have someone point to a video with Natalie Mehra ranting that the failure of the Ontario Liberal Government is totally the fault of private enterprise.
Is this not the same Natalie Mehra that railed against the NHS public hospital, owned and operated by the Liberal Government of Ontario?
Is Natalie Mehra saying that the very productive private hospitals in France, which is the #1 country in health care, are also the first step toward American style health care? This is total nonsense!
It is quite apparent that there is an agenda to protect lethargy and inefficiencies, which is exactly what Natalie Mehra was in Niagara complaining about. Lethargy and inefficiencies more than offsets what would have been either profit of cost saving. Bureaucratic government mismanagement is precisely what is at the heart of our health care problem.
If anyone wants to see what health care looks like under socialism the only need to view what happened to health care in the socialist countries? http://www.persnicketiness.net/nwc/nwc1107full/index.html pages 6/7
During the nineties TV showed hospitals with no food, no medicine, no doctors, and no nurses. What we saw on TV was a few volunteer ladies doing their best to care for crying children in cribs.
Now we are treated to misinformation for the selfish benefit of more self-serving, admitted socialists, spouting biased theology from an irrational psyche.
It is far more understandable if these socialists are acting out of self interest than it is to wonder if they are just obtuse.
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I’m outraged that you’re outraged. According to the 2000 WHO Report, most of the French system is either public or non-profit. Privatized health care is the epitome of bureaucracy by the way. Insurance companies feed at the public trough, and there’s plenty of paperwork. Socialism is far removed from communism and/or tyranny by the way. And socialism is closer to democracy than either communism or any number of other governing systems. I suppose you can wonder if people are obtuse, but of course that doesn’t mean they are. The P3 in Brampton was/is a financial mess. The one in North/West St.Catharines … time will tell. I believe we’re at one of those “impasses” which others on the site find boring, so I’ll restrict my comments.
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2005 P3 hospital article:
http://thetyee.ca/Views/2005/10/27/HospitalBoondoggles/
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http://rabble.ca/blogs/bloggers/djclimenhaga/2012/04/wildrose-leader-openly-lays-out-plan-privatizing-health-care
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More on P3 hospitals:
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