THE MEDICAL-INDUSTRIAL COMPLEX

(The following article is from the November 16-30, 2007 issue of People's Voice, Canada's leading communist newspaper. Articles can be reprinted free if the source is credited. Subscription rates in Canada: $25/year, or $12 low income rate; for U.S. readers - $25 US per year; other overseas readers - $25 US or $35 CDN per year. Send to: People's Voice, c/o PV Business Manager, 133 Herkimer St. Unit 502, Hamilton, ON, L8P 2H3.

Letter to the Editor
Re. "Time for a fact check on Brian Day, M.D." in the October 16-31 edition of People's Voice.

     Although I endorse the basic content of the article by Michael McBane of the Canadian Health Coalition/CALM, and I don't wish to quibble over minor points, I do have some concerns about the analysis of health care financing. The suggestion that one must not look at health care budgeting as a percentage of overall government budgets as opposed to GDP is questionable. Since there have been all sorts of cutbacks in health care, including layoffs, contracting out using lower paid workers, service reductions, hospital closures and delisting, it follows that health care costs should at least stay stable as a percentage of government budgets as other departmental budgets are cut.

     The fact is that it is rising. The government blames "rising workers wages" and "misuse of health services." But workers' wages have scarcely risen in two decades and many services have been cut.  There is another factor at play.

     Health care has become a milk cow for big business with government support. The obvious example is the skyrocketting cost of drugs perpetrated by the drug cartels. But that is just the tip of the iceberg. There are private contractors doing renovations in health facilities. In the hospital sites where I worked for over 30 years, I have seen constant renovations, sometimes three and four times in one area. I have witnessed in-house maintenance workers fixing what these private contractors did wrong.

     One day in the mid '90s, I noticed a small bag of hard plastic items in the sterile processing department. I have no idea what they were, but they had a price tag on them, which was unusual, as most people don't see the price of hospital supplies. It was $98. I can't forget the scandal in the U.S. military during the Reagan era whereby toilet seats cost $600.

     All sorts of supplies go into health care, the cost of which inevitably go northward. Medical, housekeeping, food service, laboratory, office, rehabilitation and other supplies are required for the running the system. But many times things are not needed. At the end of the fiscal year, if a departmental budget is not spent, it will not get it the following year. So there is a spending spree, while workers' wages are being held down and there is less staff. This is a handout to all sorts of business.

     The health care hierarchy, especially in hospitals, are linked in all sorts of ways with business interests, ways in which I can only guess. Most local managers and directors all the way up to the CEOs, the boards of directors, health authorities or whatever structure there happens to be, province to province, have business training. One former CEO of the hospital where I worked before I retired bragged that only M.B.A.'s like herself were worth anything.

     Public hospital corridors are littered with temporary and permanent commercial outlets, from Second Cup and Starbucks to Tupperware and bookstores. They are beginning to look like shopping malls. Some of these outlets are linked with charities, like the hospital foundations, which are also controlled by various corporations.

     In addition, all sorts of consultants are hired to screw public health care and the base level workers. In the 1980s when I worked in the old Shaughnessy Hospital in Vancouver, I discovered an ad by an anti-union outfit promoting a meeting on "Zero based budgeting".

     A lot of the hospital closures are due to the pressure from developers who want to get hold of land on which the buildings sit to build condos or townhouses. The people who are fighting to preserve and enhance the public health care system should never forget that we live in a capitalist system, and that not only are the capitalists trying to  retake control of all aspects of the system, but also they feed off it right now. Even though it is a partly public system, under capitalism, health care in Canada is part of the Medical Industrial Complex.

     - Peter Marcus, Vancouver