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Preserving Public Health: Ontario’s Battle – Privatization vs. Public Care

By Amandeep Anu

In the ongoing debate surrounding the future of healthcare in Ontario, the pivotal choice between privatization and public care assumes a central role in shaping the well-being of the province’s residents. While compelling arguments emerge from both sides, the necessity of advancing public healthcare is the definitive path forward for Ontario. This assertion is grounded in exploring the principles underpinning the Canadian health system, examining the current state of Ontario’s public healthcare infrastructure, and critically evaluating the pros and cons associated with privatization.

The Foundation of Public Healthcare

The Canadian health system stands on principles designed to prioritize the welfare of its citizens. Universality, comprehensiveness, portability, accessibility, and public administration form the bedrock, ensuring that healthcare is not merely a privilege but a right accessible to all Canadians. These principles resonate with the foundational values of a just and compassionate society.

Challenges Facing Healthcare in Ontario

A comprehensive 2022 survey highlighted significant concerns within Canada’s healthcare system. Foremost among them were inadequacies in staffing, issues related to access to treatment, and prolonged waiting times, spotlighting systemic challenges that demand targeted attention. The imperative to address these underlying issues takes precedence over contemplating a shift toward privatization.

The 2022 survey highlighting concerns within Canada’s healthcare system depicted various significant issues reported by respondents. Notably, 63% of individuals identified insufficient staff as a primary challenge, while 47% expressed concerns regarding access to treatment and long waiting times. Additionally, the aging population was recognized as a significant factor by 29% of respondents. Bureaucracy, lack of investment in preventive health, and general lack of investment followed, with percentages of 20%, 18%, and 16%, respectively, pointing to systemic issues requiring attention.

Further concerns included the cost of treatment accessibility, poor safety, and inadequate treatment quality, each noted by 12%, 7%, and 7% of respondents, respectively. Less frequently cited issues encompassed the lack of choice, low standards of cleanliness, and other unspecified concerns, ranging from 4% to 3% of those surveyed.

Ontario’s Current Public Healthcare System

An intricate network, centered around the Ontario Health Insurance Plan (OHIP), defines Ontario’s healthcare system. Oversight by the Ministry of Health and Long-Term Care (MOHLTC) and coordination by Ontario Health set the framework within which healthcare providers operate. Accountability to the MOHLTC and/or Ontario Health ensures adherence to standards (Ontario’s Healthcare System). The regional intricacies managed through Local Health Integration Networks (LHINs) further customize healthcare delivery to address local needs.

Privatization Argument

Proponents of privatization advocate for shorter wait times, increased choices, and more autonomy over treatment decisions. However, the associated flaws, including inequalities in access, prioritization of profits over patient care, potential cost escalation, and the strain on public healthcare due to resource diversion, pose severe threats to the fundamental principles of the Canadian health system.

Public vs. Private Healthcare

The advantages of public healthcare in Ontario, anchored by the Ontario Health Insurance Plan (OHIP) and coordinated efforts through agencies like Ontario Health, include publicly funded insurance ensuring access for all, progress in reducing wait times, a focus on public health outcomes, and the elimination of a profit motive, facilitating efficient resource allocation. However, challenges such as a shortage of healthcare providers and a fragmented system persist.

On the other hand, private healthcare, while potentially offering enhanced efficiency, increased patient choice, and treatment control, raises concerns about limited accessibility and a focus on profit over care. The choice between public and private healthcare hinges on aligning with the core principles of the Canadian health system and ensuring that the selected model prioritizes equitable access, quality care, and the well-being of the entire population.

How to Improve Public Healthcare

Acknowledging challenges within the public healthcare system, the Ontario Medical Association (OMA), representing 43,000 physicians, has proposed comprehensive recommendations to address existing gaps. These encompass reducing service backlogs, expanding mental health programs, enhancing home and community care, fortifying public health, and fostering digital connectivity between healthcare providers and patients.

The trajectory for Ontario’s healthcare system necessitates a commitment to strengthening its public care infrastructure. Addressing challenges inherent in the existing system and implementing recommendations from authoritative bodies, such as the OMA, will foster a healthcare system that authentically reflects the values of its citizens. Public healthcare, anchored in principles of accessibility, equity, and the pursuit of public health outcomes, remains the unwavering guardian of the well-being of Ontarians. As the province perseveres to preserve public health, collective advocacy for a system aligned with the principles that define the Canadian ethos becomes imperative.

Is Punishing Canadians for Personal Illegal Drug Use Still the Answer?

By Beth Fleming

The harm to citizens caused by substance use across Canada is substantial: drug overdoses, gun violence, addiction, school dropouts, mental health problems and negative financial repercussions.

Alarmingly, 21% of Canadians will experience a substance use disorder during their lifetime and the pandemic has only worsened Canada’s overdose crisis, yet the government Canadians elected has failed to properly acknowledge this devastating situation.

Sadly, substance use and addiction is rapidly rising, and Canada’s Federal Government must swiftly implement a new drug-related system in order to get ahead of the crisis.

Fortunately, there is another option.

Canada’s Current Policies

Punishment is Canada’s current policy strategy to prevent illegal drug use, through the criminalization of drugs. Public Safety Canada works with various partners to combat the import, production and distribution of illegal substances. The Controlled Drugs and Substances Act (CDSA) defines offences and punishments pertaining to the possession, acquisition and trafficking of drugs and substances.

But this act is outdated. 

Canada’s Present Problem

In Ontario, every 10 hours, an opioid related death occurs, and approximately 21 opioid related deaths occur per day across Canada. And yet, surprisingly, Canada’s current drug policies remain the same. Current drug policies have several problems, including a lack of citizens seeking treatment due to the stigmatization of drug use or being labelled as criminals, and an overloading of the Criminal Justice System (CJS) with a focus on punishment rather than treatment.

The CDSA is dismally failing citizens; individuals are not receiving necessary therapy or treatments, resulting in the hopeless cycle of indefinite drug use. 

Alternative to Criminal Penalties 

Canada must develop policies to fight crime, not illness, but what can be done?

The decriminalization of personal illegal drug use and possession occurs when criminal penalties for specific drug law violations are removed. This change excludes the illegal production and distribution of drugs. The decriminalization of personal drug use has already been successfully implemented in over two dozen countries with encouraging results. Clearly, Canada is falling behind. 

Through implementation, Canadians would be steered away from the CJS and directed towards treatment. As a result, Canadians would experience a number of constructive benefits. Drug use would finally be addressed as a health problem, drug tax revenue would be distributed towards necessary education and treatment, and prisoner overflow within the CJS would be considerably reduced.

Successful Models to Follow

Portugal

In 2001, Portugal implemented a decriminalization policy for personal drug possession and, as a result, deaths related to drug use decreased drastically, sitting persistently below the European Union average, and prisoners sentenced in relation to illegal drugs decreased from 40% to 15%.

Portugal’s model has been successful; the country focuses their resources on prevention, education and treatment. By pairing decriminalization with rehabilitation, drug use and the associated harms are greatly reduced.

Switzerland

In 1994, Switzerland passed drug policies focused on decriminalizing personal drug use and creating access to new supports and treatment options. As a result, drug overdose deaths decreased significantly, overall crime rates dropped and infection rates of HIV and Hepatitis C steadily declined.

Switzerland sensibly focused on these four pillars: harm reduction, treatment, prevention and repression. Their policies shifted to a focus on public health, which successfully decreased barriers to obtaining treatment.

Things to Keep in Mind

The decriminalization of personal drug use has potential consequences that need to be taken into consideration, which the government can counteract. 

Potential Consequences of Decriminalization

Decriminalization can make illegal drugs less expensive, more accessible, and more widely accepted by society. In addition, the resources and services currently in place as drug treatments are not extensive enough to handle a large influx of new addicts and more experimentation may occur if individuals do not fear legal sanctions.

What can the Government do?

While an increase in the supply of drugs and decrease in the price of drugs may occur on the illegal drug market, the government can utilize the freed up CJS resources to target those producing and distributing illegal drugs. The government must implement a policy that expands existing treatment programs to account for an influx of new patients. Finally, by decriminalizing personal drug use the government will ensure that the drugs Canadians are experimenting with are not contaminated through government inspection and monitoring. 

Drugs are not going to disappear so the government needs to focus on what it can do to reduce their harm on individuals and society.

How Old Is Old Enough? The case for younger Canadian voters

By Zuhair Ahmad

Canada should lower the federal voting age to 16 because many of the key issues we are facing today — climate change, environmental degradation, the COVID-19 pandemic, and social and racial justice — will have serious consequences for young Canadians in the future.

In the past, voting was seen as a privilege, which meant that certain groups in the population were not allowed to vote. Now almost all Canadian citizens over the age of 18 have the right to vote. 21 was the “age of majority” for most of Canada’s history because that’s when a person was considered mature enough to participate in the democratic process. The federal voting age continued to be 21 well into the late 1960s. A series of bills proposing legislation were eventually introduced in 1969, and the voting age was eventually lowered to 18 in 1970.

The right to vote is supported by constitutional law. The Supreme Court’s January 2019 decision in Frank v. Canada reaffirmed voting as a fundamental political right, which cannot be limited without a compelling justification. The court found that the limit placed on voting violated Section 3 of the Charter of Rights and Freedoms — which says “every citizen” has the right to vote. The Supreme Court wrote “since voting is a fundamental political right, and the right to vote is a core tenet of Canadian democracy, any limit on the right to vote must be scrutinized and cannot be tolerated without a compelling justification.

More and more young Canadians are appealing the federal age to vote by deeming it unconstitutional. In Canada, the federal NDP and Green Party publicly support a younger voting age. The federal Conservative, NDP and Liberal parties already allow members as young as 14 to vote in leadership contests.

Several countries, such as Belgium, Brazil, and Austria, have already lowered their voting ages to 16. Research shows that jurisdictions that have introduced under-18 voting have had a positive impact in terms of political engagement and civic attitudes amongst young adult voters. The current voting age does not align with the minimum age of many other activities that require maturity and judgment, such as driving, joining the military and getting a job.

From March to April 2020, Children First Canada led a national consultation to better understand how young Canadians felt about lowering the voting age. A total of 180 children and youth from across Canada provided their feedback on a range of issues related to the right to vote. 58% of youth agreed that the federal voting age should be lowered to 16 in Canada.

The current voting age aligns with the time that adolescence naturally ends. This is usually when teenagers are graduating high school and leaving home for the first time. Before then, many feel that teenagers should be focusing on education, friends, and after school activities – not getting involved with politics. Teenagers at 16 are unsure about their personal values, political or otherwise. Teenagers are also more likely to be pressured or influenced by those around them.

Some might argue that people under the age of 18 lack knowledge about policies and democracy to make informed decisions. However, adult voters are not necessarily more informed about policy issues than young people when making political choices. Anyway, lowering the federal voting age would probably not change election outcomes. Demographics show that young people below the age of 17 are a much smaller population compared to those in the over 25 age group.

If the federal voting age were be lowered to 16 in Canada, we could combat concerns by first lowering the municipal age to vote in order to gauge the interest and turnout. Or we could require students to pass their civics education course to be eligible to vote. But imagine the potential depletion of the voting lists if all citizens were required to pass a similar course.

Voting rights in Canada have changed over time to become more inclusive. Challenging the federal age to vote could be the next step in expanding and strengthening our democracy.