17.10.2006Market Justice Healthcare; A Contradiction in Terms
Market Justice Healthcare (MJH) is the academic and intellectual expression of the corporate agenda in Canada. The proponents of Market Justice Systems argue that Canadian social services such as publicly funded healthcare violate the North American Free Trade Agreement (NAFTA) between Canada, the United States and Mexico, because they create “unlawful barriers to trade.” “Free trade” agreements, such as NAFTA, are designed to protect multinational corporations from protectionist government subsidies and regulation that may favour domestic providers. The domestic provider of health care services in Canada is the provincial government. Proponents of the corporate agenda, including the corporate media, commonly argue that the 1984 Canada Health Act is unlawful and the Canadian health care system should therefore be privatized.
International trade agreements aside, health care corporations and their advocates, including the Federal Liberal and Conservative Parties, argue that only the free market, and not the government, can allocate society’s finite health care resources in a sustainable way. Corporate faith in the “free market” is both disingenuous and avaricious. Privatization of social services liberalizes massively profitable markets, previously unexploited, to the private sector with predictable results. Privatization inevitably leads to the initiation or proliferation of user-fees, a decrease in the quality and quantity of service provided, a decrease or stagnation of real wages and a subsequent decline in labour relations often culminating in work stoppages and a general perversion of the original mandate of the service, away from serving the public, and toward the single-minded drive for profit. The privatization of massive and bloated social programs generates unprecedented profits for those corporations ready to step in and fill the void.
The “free market” is a theoretical construct in which the price of a commodity is determined by the supply and demand of that commodity. Corporate academics argue that the mythological “free market” will bring “justice” to the health care industry because prices will reflect the real cost of providing the service. This argument reflects an obvious contradiction in terms. Corporations have nothing but contempt for “free markets,” as evidenced by their consistent behaviour. Corporations systematically sabotage free markets by demanding billions of dollars in government subsidies (corporate welfare) and artificially manipulate prices to maximize profit. Inevitably, markets are dominated by mega-corporations that create powerful monopolies. The corporate drive to privatize health care in Canada is motivated by greed, not altruism, needless to say. Market Justice Healthcare is the academic and intellectual rationalization for that greed.
The aforementioned 1984 Canada Health Act is the democratic expression of the people of Canada. It states that the government of Canada must at all times ensure its five core principles: (1) public administration, (2) universality, (3) comprehensiveness, (4) portability, and (5) accessibility. The Canada Health Act enjoys overwhelming and unwavering support from the vast majority of Canadian citizens who feel that universal health care is a fundamental human right. The Canadian government is elected by the people of Canada, the Prime Minister can be held accountable for his actions. The CEO of a corporation is not elected and not accountable to the people. If health care is privatized it will naturally fall into the hands of mega-health care corporations. Corporations are not subject to democracy, do not pursue the public interest, and thanks to modern free trade agreements enforced by the World Trade Organization (WTO), are not subject to government regulations either. The (US dominated) WTO works within its mandate to undermine democracy and promote corporate hegemony by marginalizing domestic governments. A health care corporation, such as a Health Maintenance Organization (HMO), like any other corporation, has a responsibility to its shareholders to maximize profit at any cost.
The profit motive creates an inherent conflict of interest for the private health care provider. HMOs and other health care corporation administrators are legally required to put the interests of their shareholders above the interests of their patients, the two naturally at odds. In a private (MJH) model the patient as the consumer will demand value for their money in the form of more time with their doctor and so on. On the other hand the HMO will want to maximize profit by decreasing the quality and quantity of treatment provided. Notably absent is any consideration for the actual health of the patient. This is a fair reflection of the “justice” of the “free market.” In the United States of America, where MJH is the pervasive (but not universal) model, over 40 million citizens are without health care. So long as the free market dominates society, there can be no social justice.
It is not surprising that civilized societies tend to hold certain values such as universal human rights. Social services that reflect these values, such as health care and education, tend to be held too sacred to be allowed to leave the public sphere. Access to these fundamental services, as a reflection of social values, is constitutionally guaranteed. By definition, the more democratic a society is, the more services it will maintain in the public sphere. In this way, capitalism and democracy become mutually exclusive phenomena. As Canada privatizes its social services and natural resources, ordinary Canadians lose their ability to exercise democratic control over their own society.
The proponents of Market Justice Healthcare often argue that despite legitimate concerns, privatization and subsequent deregulation of healthcare is inevitable in Canada because the public model is unsustainable. This argument is ubiquitous in the corporate media, despite castigation. In the United States, the federal government assumes responsibility for 32% of the financial burden of providing health care for the nation ($541 Billion annually). The Canadian federal government assumes 25% ($28 B). Ironically, the Canadian public health care system is less costly than the American MJH dominated system. These facts are uncontroversial, but ironic because proponents of privatized health care consistently and stubbornly make the erroneous claim that the public model is unsustainable, despite widespread evidence to the contrary. The American government subsidizes American HMOs with billions of dollars in corporate welfare every year. In the MJH model, government investment in healthcare is reflected not by increased public service, but by increased private sector profits. The efficiency of a social program should be measured by its ability to meet the needs of society at the lowest possible cost to the taxpayer. The private health care system is innately inefficient because corporations manipulate supply and demand to maximize profit, and in a massively subsidized industry, the taxpayer and the consumer inevitably pay more, and get less. Those unable to pay, get nothing.
“Market Justice” is a contradiction in terms. Corporations and their governments conspire against the ineffectual “free market” ensuring neither markets nor justice, only “corporate justice,” as articulated by NAFTA and the WTO. Corporations set prices and refuse to compete with one another. As a third-party payer, the government subsidizes profits, creating a massive “corporate welfare state”. Free market ideology is cynically used by corporate intellectuals to justify an unsustainable system of privately operated (yet publicly funded) healthcare in which corporations profit from user fees that simultaneously exclude millions of disadvantaged Canadians from the care they need. In a democratic society fundamental human rights such as health care are safeguarded by government regulation and a vigilant population. Canada needs to enforce its sovereignty by rejecting NAFTA and other international corporate globalization policies that seek to limit our democracy and our ability to pursue real social justice.
By: Max Pollack
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