BLAMING THE VICTIMS: 'The poor and hungry are killing Medicare by getting
sick'
By Ed Finn

Shortly after she replaced Allan Rock as federal minister of health,
Alberta's Anne McLellan lectured Canadians for getting sick. If you people
stayed healthy, she told us, our health care system would be in great
shape. There would be no crisis.
Well, perhaps she didn't use exactly those words, but that was the import.
What she actually said, as reported in the newspapers, went like this:
"People have to take charge of their own health, by losing weight, watching
their diet, and not smoking. Otherwise, the demands on Medicare will become
so great that it will be very hard for us to sustain it. It will die of
overuse."

This is a convenient way of passing the buck. Medicare is in trouble,
according to this rationale, not because of federal government underfunding
and a failure to enforce the Canada Health Act, but because too many
Canadians don't make an effort to avoid disease. They don't look after
themselves properly.

Questioned by reporters on what her ministry was doing to promote a
healthier lifestyle among Canadians, McLellan pointed to the $238 million
being spent every year on such programs.

I haven't seen a breakdown on how this money is used, but I suspect most or
all of it is going into TV and newspaper ads advising people not to smoke.
It's probably only a fraction of the revenue Ottawa collects from tobacco
taxes.

What is most infuriating about McLellan's attitude (obviously shared by all
her cabinet colleagues) is its complete abdication of any government
responsibility for the state of Canadians' health. Wellness is up to each
of us to achieve and maintain, and if we get sick, we have only ourselves
to blame. The government's only role in terms of prevention seems to be to
warn us about the perils of smoking and overeating, and to berate us for
sometimes needing medical or hospital care.

Now, I don't entirely dismiss McLellan's self-righteous rant. It is true
that many of us fall short of maintaining an optimum lifestyle, and that
this sometimes results in avoidable illness and unnecessary demands on the
health care system. But it is equally true that many of those who require
medical treatment--probably a large majority of them--lack the social and
financial means to stay healthy.

I refer, of course, to the millions of Canadians who are poor, often
hungry, unemployed, on welfare, without adequate housing, many thousands of
them homeless. Of course they are going to fall seriously ill more often
than those in the middle and upper income brackets. To scold them for not
taking better care of themselves and their children and for becoming a
burden on the health care system is the ultimate in callousness.

Health Canada is well aware of how social and economic factors affect our
well-being. In fact, four years ago its Adult Health Division commissioned
CCPA research associate Monica Townson to do a study on the social
determinants of health. Her report, Health and Wealth--published as a CCPA
book and still available--was delivered to Health Canada in 1999.

"The quality of the social life of a society is one of the most powerful
determinants of health," Townson found. "And this, in turn, is very closely
related to the degree of income inequality...It is not the richest
countries which have the best health, but the most egalitarian. Public
policies that contribute to income inequality are also likely to result in
deteriorating population health.

"It is evident," she continued, "that Canada has not yet adopted strategies
for improving population health by addressing socioeconomic conditions.
About 1.5 million children, or about 21% of all Canada's children, now live
in low-income families. About 61% of lone-parent families headed by women
live below the poverty line. Unemployment is still high. Public commitment
to social housing has been abandoned... Perhaps most disturbing of all, the
gap between rich and poor continues to widen."

Officials at Health Canada praised Townson's report--as they did many other
previous studies with the same findings--and then promptly shelved it. The
Chretien government has since done even less than before to tackle the
serious social and economic causes of ill-health. It can easily find $5
billion to waste on airport and border security and many billions more to
lavish on profit-gorged corporations in the form of subsidies and
never-to-be-repaid "loans," but nothing to implement the MPs' unanimous
promise in 1989 to eliminate child poverty in Canada by the year 2000.

Instead, it has financially starved Medicare, allowed and even encouraged
its conversion to a two-tier system, and is now trying through the GATS
negotiations to throw health care (and other public services) wide open to
for-profit private companies.

Most of us are lucky enough not to be poor, hungry, ill-housed, or jobless.
We can afford--whether we do or not--to pursue a healthy lifestyle. We
don't need to take frequent advantage of our public health care system or
make excessive demands on it.

But millions of our fellow citizens are not so fortunate. They don't have
enough income to buy and eat nutritious food, or take vitamin supplements.
They are exposed to more pollutants and to extremes of heat and cold. Their
immune systems are too weak to fight off invasive viruses and bacteria.

These are the victims--all too many of them children--of our shockingly
unjust society. They are the ones who get sick most often, through no fault
of their own, the ones who are forced to seek medical help most often.

They live in a country whose government does nothing to help them stay
healthy--a government whose minister of health instead blames them for
getting sick.

They will still have a good chance of getting medical treatment when they
need it, if Medicare survives its government-engineered crisis. But will
they ever get the remedial social treatment they deserve from the
politicians?

Not from the current crop, that's for sure.

(Ed Finn can be reached at [log in to unmask])
Taken from The CCPA Monitor, May 2002
Canadian Centre for Policy Alternatives
http://www.policyalternatives.ca

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