If, however, there is no political appetite or public support for increasing public revenues for health on the basis of universality and risk pooling then we will be faced with options for raising funds from private sources. These could include co-payments for publicly insured services, private insurance or out-of-pocket payment for uninsured/deinsured services, and deductibles linked to utilization.
In other words, the CMA is acknowledging what we all already know: our public infrastructure is failing sufficiently badly that we may be forced to privatize it in order to provide a reasonable and decent level of service. And this is largely because, as they put it, of a lack of “political appetite” and “public support” for a level of taxation necessary to keep these public services running.This applies to the university sector as well, for example. In Ontario, our beloved Finance Minister, in his infinite wisdom, has decided he wants to make his budget numbers work by introducing a real-dollar wage cut to everyone who works in the public service. (He calls it a “wage freeze”, but given that prices and inflation continue to increase, it’s a real-dollar wage cut. If he were honest, he’d admit that. And probably not a McGuinty cabinet minister. Still, onward.) For some reason, this includes people who work for universities, even though the province, when convenient, claims that universities are autonomous institutions. (Such as when the University of Toronto imposes a user fee on anyone who wants to access their library. This was later reduced to a user fee for anyone who wants to take anything out.) This therefore includes graduate students who are providing their services in the form of teaching assistance and marking and contract lecturers, such as myself, who are working on a per-course basis. This is not sustainable. It is normal, in US universities, to provide graduate students with full tuition stipends and living stipends — that is, in effect, graduate students pay no tuition and are paid enough to live on. If Canadian provincial governments continue to nickel and dime graduate students, then the best graduate students will head south, and our own graduate students will be unprepared to compete for university places. Furthermore, if Canadian provincial governments continue to throttle spending on the university sector, then we will be unable to attract top-level faculty and we will be forced to rely more and more on part-time, short-term, tenuous contract workers. That is, the jobs that used to be stepping-stone or emergency positions are soon becoming the norm for academic employment.Privatization is a solution, though. The private sector is a source of money to increase full-time academic positions — tenure (the only real “full-time” academic position that exists) in the US is fast becoming a benefit that only exists in private universities, as well as some of the largest public ones. The private sector is a source of money to increase stiends for graduate students. It is also a source of money to fund undergraduate tuition and fees, as well as to improve university infrastructure.I accept this sort of reasoning, when it’s applied to healthcare, education (university or otherwise), roads, utilities, what have you. All places where this argument could be repeated easily, by the way. I agree with it and see the logic of it. But I’m infuriated at the unwillingness and inability of our political leaders, and of the general public, to see that it only makes sense because of a blatant false dichotomy. The choice is not limited public money vs. unlimited private money. Public money exists because it comes from private money. Private money is unlimited — at least in comparison to public money — because we have chosen to let it be so. The obvious way to pull some of that money into funding public services is to increase taxes. But, as the CMA imply, there doesn’t seem to be either political appetite or public support for this.I wonder if there’s political appetite or public support for doing anything bold any more. Or if we’re just supposed to accept that every service we currently receive from and control through our government will ultimately be owned by someone and doled out to us as the new serfs.I don’t have any solutions or real arguments about this — obviously. But it still seems to me that we’re heading towards a new feudalism. And no one’s really interested in stopping it.
