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Private Firms Thrive As NDP ‘Reinvents’ Medicare

By David South

Today’s Seniors (Canada), August 1993

Many of today’s seniors fought for Canada’s internationally-admired public health system. But more and more people are becoming worried that the combination of health care reform, funding cutbacks and free trade is fuelling the growth of a second tier of private medical services serving the well off. 

The provincial government sees things differently, arguing Ontarians no longer expect government to pay for everything and rather than eroding medicare, the NDP is reinventing it. 

Whichever way one looks at it, private insurance companies, homecare providers, labs and other services designed to make money are becoming more and more involved in the health care business. 

Operating in the territory outside the guidelines of the 1984 Canada Health Act – which sets out the principles of medicare for the federal government to enforce – the private sector has room to expand, at the same time as OHIP coverage is scaled back from more and more services. 

Janet Maher, whose Ontario Health Coaltion (OHC) represents doctors, nurses and other health care workers, worries for the future of medicare. 

“A number of things like accomodation services – laundry, food services – are in the grey area of the Canada Health Act,” says Maher. “So with all these fees that are being introduced, by the strict letter of the law, there is no way to stop them. But as far as we are concerned the spirit of the Act isn’t being observed.”

In its current reforms, the government of Ontario is emphasizing paramedical professions like midwives who fall outside the CHA and aren’t covered by OHIP. The turn to community-based services means that people have to rely more on services and providers that aren’t covered under the CHA. 

Maher says privatizing accomodation services is a recent phenomenon, the result of hospitals finding creative ways to trim their budgets. 

“It’s a new area that hospitals are taking bids on,” she says. “The other thing around the accomodation services is that because they are not categorized, strictly speaking, as health care services, none of this is exempted in the Free Trade Agreement from U.S. competition.”

A recent report by two British Columbia researchers tries to put together this complex puzzle. Jackie Henwood and Colleen Fuller of the 7,500-member Health Sciences Association of British Columbia recently charged that a combination of free trade and budget-slashing governments is eroding the universality of medicare and ushering in a two-tier system. 

Fuller and Henwood identify the Free Trade Agreement as the culprit. While the health care industry created more jobs than any other sector of the Canadian economy between 1984 and 1991, they point out the job growth has been concentrated in the private sector since free trade was implemented in 1989. And they expect worse under the proposed North American Free Trade Agreement (NAFTA). 

“NAFTA will accelerate trends towards a privatized, non-union and corporate-dominated system of health care in Canada.”

One provision of the Free Trade Agreement has also made it possible for U.S. companies to compete against Canadian firms in health care. Chapter 14, “health-care facilities management services”, allows wide-open competition. 

Under NAFTA, provisions will bind all levels of government to consider for-profit health care companies on both sides of the border on equal footing with public providers when bidding for services, and entitles them to compensation if they can prove to an arbitration board they’ve been wronged. 

“That represents a substantial encroachment on the democratic right of local, provincial and federal governments to make decisions,” says Cathleen Connors, who chairs the national wing of OHC, the Canadian Health Coalition. 

It’s this plus health care cutbacks – federal and provincial – that’s resulting in service and job cuts and bed closures in the public sector and an increase in privatization, say Henwood and Fuller. These opportunities have not gone unnoticed by private companies south of the border. 

One such company is American Medical Security Inc. (AMS) of Green Bay Wisconsin. After hiring Canadian pollsters Angus Reid to do a survey, AMS saw a profitable market in offering American hospital insurance to frustrated Canadians awaiting surgery. Sixteen per cent of those polled said they wanted this service; that was enough for AMS. 

“One thing that comes across loud and clear is that Canadians for the most part are happy,” says spokesperson Carrie Galbraith. “They know they are taken care of during an emergency. But they are willing to pay a little extra if they need care.”

So far, AMS offers its plan to Ontario, B.C. and Manitoba, with Toronto its best market. Galbraith says plans are in the works to expand to all of Canada except the territories. 

Unfortunately, like most private health plans, AMS cuts its losses by avoiding what Galbraith calls “adverse selection” – anybody with a known serious health problem need not apply. 

Here in Ontario, private for-profit home care services take in close to half of all OHIP billings. Many clients pay out of their own pockets for additional services. 

The Ontario health ministry doesn’t keep statistics on the extent of the private home health care sector, says spokesperson Layne Verbeek. But the Ontario Home Health Care Providers’ Association, a trade group, estimates private homecare companies now employ 20,000 and serve more than 100,000. 

“It’s a market situation,” says Henwood. “If the services aren’t available to people within the public sector, they will go outside of it. We’ve seen this in other countries like England, where they had a public system and now have a parallel private system. If you erode a system enough that people get angry, they are going to start to look for alternatives, and the people with the greatest liberty are those with money.”

But in a recent interview, health minister Ruth Grier was adament this scenario wouldn’t be allowed to take place in Ontario. She strongly disagreed that medicare is being weakened due to recent changes, and said the government has actually “reaffirmed its commitment to medicare.”  

More from Canada’s Today’s Seniors

Feds Call For AIDS, Blood System Inquiry: Some Seniors Infected

Government Urged To Limit Free Drugs For Seniors

Health Care On The Cutting Block: Ministry Hopes For Efficiency With Search And Destroy Tactics

New Seniors’ Group Boosts ‘Grey Power’: Grey Panthers Chapter Opens With A Canadian Touch

Seniors Falling Through The Health Care Cost Cracks

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Health Care On The Cutting Block: Ministry Hopes For Efficiency With Search And Destroy Tactics

By David South

Today’s Seniors (Canada), August 1993

It’s search and destroy time at Ontario’s ministry of health: search out savings and destroy inefficiency and waste. But many remain apprehensive that not all the cuts are going to be logical and fear the province’s health and well-being will be affected. 

As part of the social contract deal, the Ontario Medical Association must find $20 million in cuts from the list of services covered by OHIP. The OMA and the provincial government are currently haggling over which procedures and examinations will be cut. 

“We look at services that aren’t medically necessary,” says health ministry spokesperson Layne Verbeek. “Because we were wealthier in the past, we were able to cover some services. We aren’t in that position now. But I don’t see how eliminating medically unnecessary treatments will affect the population.”

The fallout of the Rae government’s attempts to reign in costs and recover lost revenues may take years to unfold, but it is already apparent that Ontarians will be paying more. 

“Access to necessary treatment should not depend on a person’s ability to pay,” says health policy critic Carol Kushner. “What disturbs me about any delisting program is that virtually every medical service could be termed medially necessary. There are very few services that are an out-and-out waste of time.

“We often point to the fact that Ontario spends $200 million a year treating the common cold. Well, most of that is a waste of time. But delisting even that kind of service would be a detriment to the public’s health, because a small group of patients really do need to see a doctor when they have a cold.”

OMA spokesperson Jean Chow says it’s too early to pin down the exact cuts that will be made. “It’s a little premature to try and speculate what the final list will be.”

The newly-created Non-Tax Revenue Group is hard at work finding fees, fines and penalities the government can add or hike to boost revenue from this source from $5 billion to $10 billion a year. 

The spring budget saw the first hit, with the addition of $240 million in non-tax revenue. 

A radical reshaping of medicare is taking place. Private sector services – for which consumers pay directly or through insurance companies – now make up 34 per cent of Ontario’s health care funding, compared to 42 per cent in the United States, according to a recent study by the Canadian Medical Association. 

Health minister Ruth Grier has also floated the idea of widespread hospital closures. Both the Toronto and Windsor district health councils (DHCs) are carrying out feasibility studies on “reconfiguration.” The ministry is remaining tight-lipped about which hospitals will get the chop. 

“One suspects there’s room for efficiency – there are a lot of empty beds in a number of different places,” says ministry spokesperson Verbeek. 

“All hospitals are being reviewed, with a view to closing one or two hospitals,” says health planner Lisa Paolatto, who is working on a feasibility study on “reconfiguration” for the Essex County District Health Council, along with Toronto’s DHC. 

Closing hospitals could present a serious political hot potato for the government. In Britain, the Conservative government is still recovering from the bad feelings surrounding proposals to close world-renowned hospitals in the London area. The public feels great loyalty to local hospitals, a feeling that has been further fostered by hospital charities that raise millions a year from the communities’ good will. 

“This is going to open up new discussions of money between doctors and patients,” says Kushner. “Seniors are a unique group in Canada because they remember what it was like before medicare – what it was like not to be able to pay for the doctor, to forgo treatment that they thought was necessary. They understand the financial hardship that could occur if they were unlucky enough to have a family member who needs expensive medical treatment.” 

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More from Canada’s Today’s Seniors

Feds Call For AIDS, Blood System Inquiry: Some Seniors Infected

Government Urged To Limit Free Drugs For Seniors

Health Care On The Cutting Block: Ministry Hopes For Efficiency With Search And Destroy Tactics

New Seniors’ Group Boosts ‘Grey Power’: Grey Panthers Chapter Opens With A Canadian Touch

Seniors Falling Through The Health Care Cost Cracks

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Do TV porn channels degrade and humiliate?

By David South

Financial Times New Media Markets (London, UK), October 26, 1995

Susan Sontag, the renowned American essayist, described pornography as a “crutch for the pyschologically deformed and brutalisation of the morally innocent.” The Campaign Against Pornography in the UK believes that pornography exploits women and children “in a degrading and humiliating way, often with the message that we enjoy this and want to be abused.”

The campaign encourages its supporters to take direct action against any distributor of pornographic material as part of its wider campaign to put the industry out of business.

The porn channels dismiss arguments that they degrade women and encourage male violence against women. Playboy managing director Rita Lewis argues that “women are happy to consume erotic imagery like pin-ups. Women are not hung-up by this anymore, they are not threatened by the fantasy women we show in our programming. We hope Playboy will lead to couples’ making love together.”

Andrew Wren, financial director of the Adult Channel, also dismisses the link between pornographic programming and sexual violence. “I don’t think there is anything in programmes that would encourage men to go and rape. Women are interested in sex as men are.”

Television X’s (Deric) Botham says that porn programmes are “a bit of titilation” in the fine, upstanding tradition of the British Carry On films. None the less, he admits that “I wouldn’t want my daughter to get involved in pornography.”

He says that the women involved in the programmes, some of them housewives, are willing participants and enjoy the opportunity. “I don’t produce anything that is against the law. We speak to the individuals concerned. If you have a reluctant model, it doesn’t work – I just won’t buy the video.”

The Campaign Against Pornography sees it all rather differently. Ann Mayne, a member of the campaign’s management committee, was particularly critical of two programmes on Television X – Shag Nasty and Mutley and Fly on the Wall.

She said that Shag Nasty and Mutley, in which a presenter approaches women in the street or in supermarkets and offers them £25 to look at their knickers, or £50 to be filmed having sex with him, gave the message that women were simply objects and that it was acceptable to harass them.

“It is complete prostitution of female sexuality,” she said. “Botham wants full-on, across-the-board prostitution of women. In his view, every woman must have a price.”

Mayne said that Fly on the Wall, in which real-life couples are shown having sex, was an open invitation for men to coerce their partners into being filmed, possibly to the point of abuse.


From Special Report: NMM (New Media Markets) Spotlight On The Emergence Of Satellite Porn Channels In The UK

Read more on the 1990s sex economy here: From Special Report: Sexual Dealing: Today’s Sex Toys Are Credit Cards & Cash: A Report On The Sex-For-Money Revolution

Update: It is over 20 years since this Special Report was published. The Internet now plays a significant role in the growth of sex content and the sex industry and vice versa. Here is an interesting overview of the situation in 2020. The Internet is for Porn – It always was, it always will be.

“One of the biggest and most interesting things happening in the consumer web right now is running almost completely under the radar. It has virtually zero Silicon Valley involvement. There are no boastful VCs getting rich. It is utterly absent from tech’s plethora of twitters, fora and media (at least, as they say, “on main”). Indeed, the true extent of its incredible success has gone almost completely unnoticed, even by its many, many, many customers.

I’m talking, of course, about OnlyFans.” 

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Redneck Renaissance: A Coterie Of Journalists Turn Cracker Culture Into A Leisure Lifestyle

By David South

Id Magazine (Canada), August 22 to September 4, 1996 

What happens when rednecks pick up a lesson or two from the world of identity politics? Mostly ridiculed by smug urbanites, or just plain ignored by the general population at large as cultural fads come and go, angry rednecks are standing tall in these conservative times. 

Part Mark Twain-like satire, reverence and condescension, a cottage industry promoting the southern American redneck lifestyle is starting to resemble past struggles for cultural pride. 

Just think of the gay rights movement in the 70s and 80s, which turned the derogatory word queer into a touchstone of homosexual pride. 

In the 90s, dismissing rednecks as a bunch of dumb crackers can not only ensure free dental work in many an American bar, it can also be seen as an affront to white American values. But while some want to stereotype this culture as the heart and soul of white working-class American ideals, it is hard not to be disturbed by this phenomenon. Can God, beer, the American Constitution and guns weave together a stable lifestyle? 

Author, radio personality and Redneck Olympics MC Bo Whaley was interviewed in a phone booth across from the bomb site at Atlanta’s Centennial Olympic park. During the interview Bo was kicked out of the phone booth by Atlanta police for talking too long. He picked up the interview from a truckstop near Dublin, Georgia. 

id: What is a redneck? 

Bo: A redneck to me is a lifestyle, that’s what it is. I relate rednecks to people who work hard, men of the soil. They look for the common things in life. They enjoy the outdoors, enjoy hunting and fishing. They aren’t too interested in status or setting the world on fire. They like to do their own thing. Real close to being what we call a good ole boy. They enjoy life – they work hard and they party hard. 

There is nothing put on by them. They are down to earth. I really enjoy them, they are on the level. If you ask them a question they will tell you the truth. They aren’t trying to impress anybody, just trying to be themselves. 

Go to the local bar and they are listening to the juke-box, smoking cigarettes and drinking beer. We can make fun of ourselves down here, we enjoy it. We laugh at ourselves. Poke a lot of fun. I’m having fun with people who live on farms, live in small towns. Like to hunt, like to fish. They drink beer. I have lived in the south for 24 years. I try to look at people and write what I see. I also wrote The Field Guide to Southern Women

id: I heard the Redneck Olympics didn’t go down so well with the city council. 

The chamber of commerce was concerned about the image. We attract a lot of industry to the town, they were afraid what was going out was a negative image of the lifestyle that is going on in Dublin. 

We didn’t know it was going to catch on like it did. At the opening ceremony we were expecting maybe 250 maybe 350 people – and we had 4,000! The national and international media has got into it. 

id: Are rednecks all right-wing? 

On the right of the political spectrum, yeah. Happy with Newt Gingrich. I don’t think we take politics as seriously as up north. (Former U.S. president) Jimmy Carter is not very popular with the rural people here in Georgia. Well, I think when he went to Washington his values changed. I can name many, many people including me, who don’t like him. Right now I’m five minutes from the Carter Centre in Atlanta. I’ve never been to it. Not really interested in what Carter is doing. 

He is trying to solve all the problems of the world. He looks at himself as more of a missionary than an ex-president. He goes to Haiti, he goes to South Africa, Bosnia. He calls these peace conferences and by-passes the established government in the United States to try to do his own thing. It’s a self-serving thing. 

id: What do you think about the militia movement? 

I do not agree with them. Right now I’m standing across from Olympic park where they had the bomb go off. People that I talked to have no sympathy for the militia, they say let the established investigators handle it and they don’t have any use for (the militia) at all. 

id: Do you think the militias are a symbol of the frustration a lot of rednecks are feeling? 

I agree. But they do a lot more talking than they do acting. 

id: Why do they distrust the federal government and imagine black helicopters are helping the U.N. to set up a totalitarian state? 

I think what they feel is that they know more about handling a situation than the government does and they want to do it on their own. I don’t agree with that. The government’s not perfect here nor in Canada. As long as it is the government I’m going to support it. I was not a Clinton fan but once he was elected he became my president. I have to support him until he gets out. But I don’t support everything he does. 

id: Is the redneck style locked in the 70s? 

The redneck symbol is more popular than it has ever been. A lot of people in offices in stuffed shirts and ties who would love to get out and live this way but they can’t do it on account of losing their jobs. They like to get in a jeep or ride on a motorcycle and say “whee” and to the heck with it. Everybody in the world needs some quiet time, time to yourself to do what you want to do. 

id: Do you think rednecks are in danger of extinction in the age of the Internet? 

They are on the increase. They don’t know about high-tech stuff. They haven’t even got into electric typewriter yet – they are still on manual typewriter. 

id: Do they have any heroes or heroines? 

They are beer people, and if they have any drug they smoke marijuana. 

id: I mean heroes. 

Many are country music fans, like Garth Brooks and Hank Williams Jr. They are big on country music. Female rednecks admire shows like Designing Women

Oh lord, they love T-shirts. The T-shirts say “Opry land,” “Dollywood,” “Get your heart in America or get your ass out.” They don’t like plain T-shirts. 

id: Can you give an estimate of the number of rednecks in the U.S.? 

I travel more in the South Eastern states. In my hometown, in my home county, there are 37,000 people. Most of the people there, I’d say 75 per cent are working people, they either farm or work in factories. Out of those people, I’d say 20 to 25 per cent fall in the category of what I call redneck – they work hard all day and they play hard all night. Nationwide, I have no idea. I can tell you towns that have a lot of rednecks. Chattanooga, Tennessee – lot of rednecks. Columbus, Georgia, it’s a military town. In Montgomery, Alabama they work real hard at being rednecks. 

id: Is there a problem with blurring rednecks with more negative elements like the Ku Klux Klan? 

No, I really don’t see that. Most of the people I know can’t stand the Klan. They give country people a bad name. 

id: Some guy at the Redneck Olympics had a Klan T-shirt on. 

I’m not surprised by that. The main thing you are going to see them wearing if they have anything to do with a symbol of patriotism is a Confederate flag saying “God bless America” and “God bless the South.” 

id: What about the rebel flag? 

They do not want to give it up. There is some legislator in Atlanta who is trying to ban it, and this has to do with trying to appease a faction for their votes. But you get out into rural Georgia, rural Alabama, they want to keep that flag. To be truthful it has a lot to do with the civil rights movement.

id: That it means it’s an affront to the civil rights movement? 

Yeah. 

id: Are there yuppie rednecks? 

I know a neuro-surgeon living in Birmingham, Alabama, I met him through his wife while I was signing books. She came up and said “I’ve got to have one of those Redneck Handbooks,” and I said “Why?” She said, “Because my husband is a neuro-surgeon and he’s from Arkansas and all day long on in his office he’s got his blue buttoned-down shirt, his navy blue suit and his spit shine shoes and driving his Mercedes. When he gets home in the afternoon he puts on his blue jeans, and denim shirt gets the pick-up truck, the dog gets in back and he starts riding in the woods.” He’s a Dr. Jekyll and Mr. Hyde type. I see a lot of that. They kind of let their hair down. It’s a release for them. 

id: Do you see the redneck lifestyle as a different kind of leisure lifestyle, a more working-class leisure lifestyle? 

I think so, David. They put on ragged jeans, say to the world “I am a redneck.” 

What they like to do is go fishing. They will go to the coast and go deep sea fishing. Especially they like to go to stock car races. Big stock car fans. The faster that car goes the better they like it, and the more wrecks they have the better they like it. 

© David South Consulting 2021