Free Health Care?

Occasionally in some of the classes that I taught we discussed the social determinants of health (I never called it that - it would have driven too many of them away). I started off my conversation by asking each of  the classes if health care was free for individuals in Canada. All students thought the answer was yes. Occasionally a few students would add to the conversation by reminding me that free health care was what made us different to those to the south of us.  I would then ask "how long have Canadians had free health care". While the answers to this question were much slower in coming than for the first question, the consensus was "forever" or at least nearly that long.

The students were surprised to find out that universal health care in Canada is, relatively speaking, a fairly new thing. I suspect some if not most were surprised and perhaps disbelieving when I informed them that my mother, while my birth in a hospital had not cost my parents money, visiting the doctor had. Perhaps surprised is the wrong word. My students by that point in the school year had decided that not only was I of a different generation to them, I had in all likelihood been born on an entirely different planet.  Most of them flat out thought I was wrong when I said that some Canadians had to pay a monthly premium to get "free" health care.

In Ontario, Alberta and British Columbia, health insurance premiums are funded in one of three ways. If your income is below a certain level - the province pays, if you are employed by a company,  the company pays, and if you are self-employed or retired but make above a certain amount - you pay directly. In B.C the monthly premiums are $75.00 or $900.00 a year.

I have just filled out the forms to get BC coverage. Because the government use Revenue Canada data from the previous tax return, I have to use my net income from 2014 - the last year I worked. The fact that I have been retired for 14 months and that my income is one third of what it was in 2014 is not relevant. Next year I may be eligible for assistance, but for the next 10 months I will have to pay the full amount. If I had migrated in May or June, I would have been able to use 2015 data and my cost would have been substantially reduced.

I am not complaining (or at least not too much) about having to pay a bit of money for my health care. I, and my extended family have used more than our share of hospitals and doctors in the past 30 years. But my sense of fairness is disturbed by the fact that if I had moved to anyone of the other seven provinces or the territories,  or if I had migrated a few months later and thereby been able to use 2015 data, my costs would have been different. It seems to me that universal health care should mean that everyone not only has access to good health care, provided in a reasonable time frame, but also that we all share the burden equally.

I have always taken some pride that at least on paper the richest person in Canada and I have the same opportunity to access medical care. The only difference is - if that rich person lives in one of the seven other provinces - they don't have to pay for it and I do!

Another Invasion of Privacy?

According to the CBC,  Manulife Life Insurance Company is planning on offering a discount to those who wear a fitness device/armband. Individuals who wear such a device can accumulate points every time they exercise, get a flu shot or get an annual medical check-up. These point can be used " to earn other rewards and discounts from leading retailers"(CBC).

Is this the thin edge of yet one more wedge? Is this the first step of insurance companies (among others) requiring us to share more and more personal information? Will they start to increase premiums of those who refuse to wear such tracking devices? Is it in fact just a continuation of the corporate world demanding more and more access to all of our lives? One can already have reduced car insurance premiums if one installs a monitoring device in your car (and follow their standards of what good diving is).

When people argue that the police and the state need to have ever increasing access to our private world, those in favour of such intrusion suggest that "if you are not doing anything wrong - why do you care that the police have access to your e-mail, or the statistics on your internet usage?" I can hear people making the same argument about wearing a bracelet that monitors my exercise regime, whether or not I smoke, how much I drink or whether I chose to go to the western educated doctor. I am a law abiding citizens and I work hard at staying healthy but I don't think the state or a private company (sometimes it is difficult to differentiate the two) needs to access such personal information. I don't think that a private company which has the sole function of making money for its shareholders has the right to expect to know everything about me. I, quite frankly, don't trust them. Whether it is intentional or not, the risk of such information being shared is just too high. At the very least I will be on someone else's email list and subject to unwanted ads, at the worst the information will used to control me or limit my options.

Of course the logic requiring people to electronically report in when they exercise is obvious to all who have (1) access to such devices and the capacity to use them properly and (2) the opportunity to engage in preventative health activities. Those who take delight at wearing such bracelets (which can cost anywhere from $25.00 to $140.00 and I suspect are some sort of status symbol among a certain "crowd")  will argue that people will be free to choose to wear the device and not.  Not true.

There is, unfortunately, a large segment of the Canadian population for which either buying a bracelet or engaging in all of the "right activities" is not really an option.  As noted in numerous studies (see for example Barriers to addressing the societal determinants of health: public health units and poverty in Ontario, Canada) , people living in poverty are less able to engage in the type of healthy life styles that ensure a long life. There are numerous reasons as to why but quite simply it is hard to find the energy, the time or the resources to exercise when one has just worked at two different, minimum pay, on your feet all day jobs.

Then there are all of the cynics like me out there who will refuse out of principle. I perhaps could even save a few cents a day in insurance costs...... but I will be damn if I am going to give anyone any more information about who and what I am.

The Demise of Newspapers

Neil Macdonald, a CBC Senior Correspondent is a writer who I have long admired. His articles are always thoughtful, well written and more often than not, their tone or conclusions surprise me. His piece this morning however, on the demise of newspapers (CBC's web page) was pretty much what you would expect from a writer who got his start in the news business by being a print journalist.  Macdonald, like many other main stream journalist, bemoaned the reduction of staffing or the outright closure of some of Canada's newspapers. He is deeply concerned about the fact that mainstream media today is far more concerned about their bottom line; more concerned about pleasing their corporate masters than at any other time. Macdonald argued that writers and their editors are become more and more fearful of displeasing their masters and their public. In doing so, they are afraid to take on some of the larger issues of the day in case the newspaper's position proves unpopular and therefore their customer base is reduced further.

Macdonald is no doubt right that the media is under constant pressure to perform better with fewer resources. I am sure that the mega corporations who own the large chains of newspapers are primarily concerned, as Macdonald suggests, about how much profit they can take out of the newspaper rather than bringing to the light the multitude of injustices that permeate our world. Without question, the media in general caters to the lowest common denominator, Consequently we are fed an endless progression of mindless pap where self-declared celebrities are allowed to pretend that what they do is important. For those of us who want news, more and more of us are looking to other sources. If newspapers cannot provide comprehensive news or commentary that is both well written and demonstrates some critical thought, there is no point reading it. If one is obliged to wade through pages of non-news for the occasional nugget of real reporting then it is not worth the effort.

There is of course a consequence to those of us who enjoy good writing, critical news reporting and thoughtful analysis leaving the fold. It means that by the very act of leaving, we are weakening the position of the paper. That is,  as fewer and fewer people read the morning edition, the pressure is to titillate the remaining masses even more, which in turn drives away more discerning readers.

There is however an additional problem. For those who use the internet for their news, it is very easy to accuse mainstream media as only being shills for corporate America/Canada.  Amongst many groups whether they be  anti-GMO, anti vaccine, anarchist, anti-capitalist, pro Republican or armchair bound eco warriors, the assumed position is that the media is biased and therefore cannot be believed. The media in turn, because they are under increased pressure not to confront the very multi-nationals that either feed them (through advertising) or own them outright are at increased risks of sounding like the very shills they are accused of being. And so it goes around and around in ever diminishing circles where cause and effect lose all meaning.

I suspect that there is not a solution. Within a generation, perhaps sooner, large newspapers will not exist. And that is a pity if no other reason that those who praise the increased access to news via the internet have forgotten that all news reporting is biased. As every good sociologist or anthropologist who has ever done field research acknowledges, the very act of choosing the subject indicates a bias.

When we live in a world where news can be slanted to every possible bias, that does not mean that we have better access to the news -  in fact it could mean the exact opposite.