Canada's Vast Rightwing Conspiracy

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Appeared in the Saint John Telegraph-Journal and the New Brunswick Telegraph-Journal

In comparison, conspiracy theories about the assassination of President Kennedy are small beer. The only folks involved in JFK`s assassination were the FBI, the mob, the Teamsters Union, the CIA, Fidel Castro, Lyndon Johnson, global communism, the Freemasons, Elvis Presley (apparently jealous about JFK`s fling with Marylyn Monroe), Jack Ruby and a few other folks, possibly including Lee Harvey Oswald.

Canada`s anti-medicare conspiracy seems to involve all Canadians, except the authors of the report – University of Toronto professor Michael Rachlis, University of British Columbia professors Robert Evans and Morris Barer, and policy consultant Patrick Lewis. Apparently, the rest of us fabricate scare stories about medicare in order to destroy publicly-provided medicare in Canada.

According to the report, we have plenty of doctors and nurses nationally. Emergency wards aren`t overcrowded except for the very rare event. No problem with waiting lists either. And, if anything, we`ve had too many hospital beds, not too few.

A strong case can be made that inpatient care had been over-provided in Canadian hospitals and that a dramatic reduction in inpatient beds … was long overdue. But, we just don`t get it. The underlying realities of bed utilization have, however, had little influence on media reports, on the public perception of the success of Medicare, or on hospital workers.

Hospital unions are also rightwing dupes, despite all those noisy demonstrations the unions organize and finance to halt any reform of medicare. Hospital workers` representatives have, in many cases, the authors write, claimed that the health care system is in a state of imminent collapse, inadvertently supporting Medicare`s traditional allies.

So when hospital workers – or for that matter, nurses and doctors – talk about the evidence in front of their eyes about overcrowded hospitals, waiting lists, deteriorating facilities, etc. they are suffering from rightwing hypnosis. So, you`re a rightwing dupe the next time you tell someone how long you waited for treatment, or listen to people from a rural community who can`t find a doctor, or get irritated about an overcrowded hospital.

The authors of the report ignore evidence they don`t like, for example on waiting lists. The extent and seriousness of the problem overall remains largely unknown, because reliable information on waiting lists is not routinely available in Canada. What data are available suggest the problem is not nearly as severe as claimed by Medicare`s enemies.

Data on waiting lists is available from several sources. My colleague Martin Zelder, a University of Chicago Ph.D. who has held economics appointments at prestigious universities in the United States and Australia, prepares a well-respected annual report on waiting lists. If you don`t trust Martin, you can find the similar results in studies in the Journal of the American Medical Association and the Ontario Medical Review.

The studies show that waiting lists are growing longer and more dangerous. For instance, on average four months elapse between a patient`s visit to a GP and treatment by a specialist.

The Douglas report claims only small problems plague medicare, easily solved by tightening government control and, in effect, by making doctors salaried civil servants. We also need to launch an attack on the drug companies combined with a government ordered reduction in prescriptions. This flies in the face of literally a world of evidence that appropriate use of today`s advanced pharmaceuticals is not only cheaper than traditional treatments, it is more effective.

The media routinely quoted the authors of this bizarre report as impartial health experts. That does raise questions about the Canadian media, but hardly suggests a rightwing conspiracy.

Sadly, this report launches the Tommy Douglas Institute. Douglas was a great Canadian, the first social democratic head of government in North America. As Premier of Saskatchewan, he launched medicare in Canada. He was an open-minded, practical man. The medicare system he devised had nothing like the huge apparatus of government control that has been layered on it in the intervening years.

Douglas designed a structure like systems now operating in socialist Sweden and other leftwing nations in Europe. They are far more open and successful than Canada`s inflexible government-dominated system. Tommy Douglas would have shuddered at any report that dogmatically rejected reform and dogmatically dismissed evidence of medicare`s problems that are visible to all Canadians.

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