It has been a very busy time for us as we get ready to go on our 7-month journey to the Philippines to demonstrate our solidarity and lend our hands-on support.
There are a myriad of tasks, some minor, such as passports, plane tickets, vaccinations… some massive, like packing up our apartment and planning our various organizational strategies for the year at the Organizing Centre. But as the time grows increasingly closer, we also need to do our research and prepare our sharing’s on our local work and the situation in Canada!
History of the Canadian health care system
When I think about how I will present the Canadian health care system to my Filipino comrades, I am torn. Compare a delivery room in the Philippines to one in Canada:
Of course, there can be no comparison between our insured and medically advanced maternity care and the situation of extremely limited access, appalling underfunding, and ramped privatization in the Philippines.
The labour export program of the Philippines government has put so much pressure on families to send members to work overseas that Filipino doctors are retraining as nurses to work abroad! The ‘brain drain’ (AKA the plunder of Third World intellectual resources) has left countries, such as the Philippines, that carry huge debt loads and US-backed neo-colonial regimes, bereft of skilled health care professionals. Meanwhile WTO/WB/IMF imposed conditions leave the public health care system stripped of any potential for quality care while privatized hospitals and clinics grow at a steady rate. Medical tourism, anyone?
Comparisons aside, a critical examination of the Canadian health care system from a working class perspective is in order. Many believe that in Canada we are privileged with ‘socialized health care’!
Medicare was first introduced in Saskatchewan in 1962, and by 1971 was incorporated into the social safety net of all provinces. This health care plan, rather than a socialized health care system of public ownership of health care infrastructure, publicly salaried health care workers, and public provision of services, ended up (after a bitter struggle) as a public health insurance plan which covers a component of the health care costs of First Nations communities, Canadian citizens, landed immigrants, and refuges.
Private insurance companies and physicians with their powerful and persuasive profit-oriented lobbying undermined the creation of a social health care system by opposing socialized medicine, and imposing a system with clear paths to corporate ownership and profit making. In 1962, the pro-profit, free enterprise agenda of the medical professionals and insurance companies pressured the Canadian Commonwealth Federation (CCF) to accept fee-for-service billing and actively undermined the burgeoning collective model of community health centers which were rapidly springing up in response to workers demands for ‘health for all!’
What we have today is a public (for now…) health insurance system which covers the basic costs of ‘listed’ services for those who are eligible under each provinces health plan.
Creeping privatization
Privatization is nothing new to the Canadian health care system. De-listing of insured services, rising health care insurance premiums, the lack of a national pharmaceutical or dental program, physician/midwife fee-for-service remuneration, public-private partnerships (P3s), extra-billing, and a variety of other schemes and programs leave the Canadian health care system teetering on the edge of complete privatization.
As the profit motive increasingly impedes upon our ability as working class communities to access affordable, timely, and quality care, we are hit with a double edged sword.
We know that health requires much more than the provision of health care services. Health Canada identifies primary determinants of health as: income, social support, education, employment and working conditions, social environment such as housing and nutrition, and physical environment including particulate and noise pollution, while personal habits (smoking, drinking), exercise, and genetics appear as the last on the list.
Social class and annual income is the greatest indicator of health in the world today!
This leads us to ask “What about the working class?”
The global shift to neo-liberalism results in the slashing of the economic re-distributive measures, such as health care, which are highly regarded as a Canadian value, at the very same time the need for such economic re-distribution is on the rise.
Take a look at these statistics
In Canada:
The poorest 50% of the population own 6% of Canada’s wealth while the richest 10% own 53%
While the top 30% has ownership of 83% of the countries wealth, the remaining 70% have 17%
1 in 5 families have no net worth whatsoever
The lowest income Canadians has annual debts greater then their earnings
In British Columbia:
20% has an average net debt of $2,759, while the richest 20% has an average worth $1 million
Women are earning on average 20% less than men; Aboriginal women are earning even less still
The average annual income of a First Nations woman in BC is $13,000, far below the poverty level
Women comprise 60% of those living below the poverty level
25 % of First Nations people report having no source of income
The life expectancy of an Aboriginal person living in BC is 30 years less than a non-native counterpart!!!
More than one in five children in BC lives in poverty
The forever widening gap…
In clinic a few weeks ago, during a postpartum visit, a father of a family I helped care for broke down and started to cry because he was worried his wife would not be able to sustain breastfeeding their baby because her nutrient intake was so low. In short, they were starving.
Can you imagine how this man must feel? It is beyond comprehension to me that we live in a society with such gross displays of wealth, and a man is worried that his wife and children are starving; in BC, 2008.
This has a massive and almost unimaginable impact on the health of our communities.
Poor neighborhoods in urban Canada experience a much higher infant mortality rate (6.5/1000 as compared to an upper income rate of 4/1000). Poor Canadians are more likely to die from cancer, diabetes, infectious disease, and respiratory disease than their wealthy counterparts; these are examples of diseases of poverty, as extreme stress, poor housing, close quarters, inadequate nutrition, environmental hazards play a role in the contraction of these diseases.
In fact, low-income women and their families are more likely to fall ill or die of illness or injury at any stage in their life-cycle.
Infectious diseases such as AIDS and tuberculosis are epidemic in some working class neighborhoods in Canada, such as the Downtown Eastside of Vancouver. In fact, TB cases in Vancouver were 4 times more prevalent in low income neighborhoods. Immigrants to Ontario were at higher risk for contracting TB after immigrating to Ontario than prior to departure from a country where the disease was endemic; this example highlights the socio-economic roots of TB contraction.
So what can we do about it?
Borrowing a line from the Organizing Centre for Social and Economic Justice strategy document, “the word on the street is, “there is no alternative””.
As grassroots organizers, as leaders in the struggle for social transformation, we know there is an alternative! That alternative lies in our collective struggle for a new society.
That is what this trip to the Philippines is all about – taking part in that powerful transformation, the birth of a new world – and bringing the lessons back to Vancouver, to the Organizing Centre for Social and Economic Justice, to the Alliance for People’s Health, to the Bus Riders Union, and to all of our collective endeavors!
Makibaka! Huwag matakot!
