As I write this column, the COVID-19 death toll in Canada stands at 6873. Plus one potential death, that no one talks about.
COVID-19 may finally have shaken the blind belief that private enterprise can do any job more efficiently than public.
When death rates in long-term care facilities soared, the governments of Ontario and Quebec called in the military to help out.
Some military members of those Augmented Civilian Care tears wrote a report on the care deficiencies they observed. Which they passed to their superior officers. Who passed it to the provincial governments. Who made them public.
The Ontario report hit the headlines first. Ontario Premier Doug Ford didn’t mince words. He called it shocking, disgusting, and disgraceful.
The Quebec report was, perhaps, less inflammatory, but just as damning. So far, no one has speculated how universal the deficiencies may be:
· Re-using hypodermic syringes
· Re-using catheters without proper sterilization
· Using outdated medications
· Limiting access to personal protective equipment
· Failing to change protective equipment when moving from COVID-infected patients to non-infected.
· Having inadequate staff -- too few, overworked, poorly trained.
Thank God my wife chose to die at home.
Actions have consequences
But before you simply recoil in shock, notice please -- every one of those defects results directly from the facility’s operators trying to pinch pennies. To reduce costs. And thus to improve profits.
With the staff shortage go other horrors documented in the Ontario report:
· Unattended patients crying for help for two hours.
· Diapers not changed.
· Pressure sores untreated for two weeks.
· No baths for up to two months.
· Rooms infested with cockroaches, flies, and ants.
· Infected patients mingled with non-infected patients.
If you doubt those details, you can read the full report for yourself: https://www.macleans.ca/wp-content/uploads/2020/05/JTFC-Observations-in-LTCF-in-ON.pdf
Once again, I need to state that this report deals with only five of Ontario’s long-term care facilities. There is no suggestion that all privately operated facilities are equally guilty. One of those five, a charity operated home, had far fewer faults noted.
A Toronto Star analysis of public data found that for-profit nursing homes had four times as many COVID-19 deaths, proportionately, as non-profit and municipal homes -- a figure later confirmed on TV by Ontario’s Chief Medical Officer of Health, Dr. David Williams.
The National Union of Public and General Employees came up with an even higher figure -- for-profit homes had “double the death rate in non-profit homes, and more than eight times the death rate in publicly owned homes.”
How could it be otherwise? Provincial health plans define how much they will pay for patient care, regardless of who owns the facility. If for-profit facilities want to make a profit, they have only two options. They can increase charges -- which means opting out of the provincial health system. Or they can cut costs -- of staff, of buildings, and of services.
All other things being equal, a public institution doesn’t have to make a profit; a private one does. Do the math for yourself.
Years of cutbacks
In Ontario, 57% of long-term care homes privately owned, 24% owned by non-profit/charitable, and 17% municipal.
Premier Ford sounded genuinely distressed by the military’s whistleblower report. He shouldn’t be. Before the current pandemic, Ford bragged about cutting social services -- including the number of inspectors checking long-term care facilities.
Just as former Conservative premier Mike Harris slashed environmental inspections shortly before the Walkerton contaminated-water tragedy.
Harris instituted deficit-cutting slashes to health and education in 1995. Liberal governments under Kathleen Wynne and Dalton McGuinty didn’t reverse the trend.
The policies are commonly attributed to economist Milton Friedman of the Chicago School of Economics. Friedman advocated a free market economic system with minimal government intervention.
In essence, he argued that private enterprise could do anything more efficiently than government. Taken to an extreme by disciples such as Ronald Reagan and Margaret Thatcher, his principles translated into a conviction that the less government, the better.
It also translated into countless “P3 projects” -- public-private partnerships -- meaning that if a project is successful, the private part takes the profit; if it fails, the public part pays the tab.
Interestingly, the only thing that what’s called “neoliberal economics” or “monetarism” didn’t urge government to get out of was funding for the military.
Which is, ironically, the institution that has now rung the bell on the innate falsity of Friedman’s premise.
Perhaps the COVID-19 pandemic will force us to recognize that there are some things that governments should do, and there are some things that should not be left to the tender mercies of for-profit corporations.
Copyright © 2020 by Jim Taylor. Non-profit use in congregations and study groups encouraged; links from other blogs welcomed; all other rights reserved.
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The old joke about seeing the light at the end of the tunnel, and then realizing it’s an onrushing freight train, seems appropriate for last week’s column about change. Here are your responses, in the order in which I received them.
Tom Watson: “You say you can't think of Canada without the Hudson Bay Company. That thought manifested itself 14 years ago when HBC was sold to an American owner, NRDC Equity Partners (parent of Lord & Taylor chain) in 2006. The HBC store in Guelph closed a good ten years ago.
“As for churches, I agree that many will close. Given the age demographic, churches won't sustain themselves for very long on viewing services via YouTube or Zoom, and without person-to-person connection there's no incentive for younger people to hook in.”
Janet Hicks King suggested, “Where you use ‘COVID-19’ I would say ‘the COVID-19 LOCKDOWN,’ because it is the LOCKDOWN closures – rather than the coronavirus itself! – that has caused most of the damage. Many doctors, scientists and knowledgeable individuals have acknowledged that social isolation and wearing a mask are both very unhealthy responses for generally-healthy people.”
Cliff Boldt: “As an amateur historian, I am fascinated by watching things change in front of me. I am looking at what is happening knowing that our grandchildren’s children will read about it in a history text some day.
“I still miss Eaton’s [in Vancouver] clock and lunch counter.”
Laurna Tallman connected my column on closures and change with grieving: “We grieve each death differently. C.S. Lewis captures that uniqueness in this passage from The Magician’s Nephew.
[Digory] thought of his Mother, and he thought of the great hopes he had had, and how they were all dying away, and a lump came into his throat and tears in his eyes, and he blurted out: “But please, please—won’t you—can’t you give me something that will cure Mother?” Up till then he had been looking at the Lion’s great feet and the huge claws on them; now, in his despair, he looked up at its face. What he saw surprised him as much as anything in his whole life. For the tawny face was bent down near his own and (wonder of wonders) great shining tears stood in the Lion’s eyes. They were such big, bright tears compared with Digory’s own that for a moment he felt as if the Lion must really be sorrier about his Mother than he was himself.
“My son, my son,” said Aslan. “I know. Grief is great. Only you and I in this land know that yet. Let us be good to one another.”
Jessie Carlson’s response might have been written for today’s column: “I am a retired nurse who worked in Long Term Care for 43 years, until I was 74 years old. I worked 6 years in a private home and 37 years in a publicly run home. In the public we were better staffed and I feel gave very good care. By today’s standards the physical plant was lacking, but the care and the food were excellent.
“The second thing that Covid-19 has taught us is the importance of staff not coming to work when we are ill. That is a challenge for all care facilities as it is hard to have enough replacement staff. We were often asked come in if you are not too ill -- just wear a mask. Covid-19 is very contagious so this would not be recommended.”
Ruth Buzzard: “But you didn’t speculate on what the future will be. Costco and Walmart soaring, but corner grocery stores closing. Amazon taking over the known world and Netflix changing the face of entertainment. You’re right, the pandemic has accelerated changes to warp speed..
“I look to the stock market to see the big trends. The obvious ones are Clorox and Kimberley Clark (toilet paper) soaring, and the cruise line and airline shares near record lows. But these are to be expected and have already moved on the market. But what about the more subtle trends? The motorhome and travel trailer manufacturers rising due to people preferring to holiday in their own little cocoon, with their own bedroom, bathroom, and kitchen.
“Maybe shares in educational courses will thrive, as unemployed people decide to better their education.
“But what are the personal consequences of the pandemic? I think people are kinder and more considerate overall. And I think we older folks are infinitely more careful to not spread germs. I hope that we will seriously reform the operation of nursing homes, now that we are aware of the almost medieval state of the worst of them.
“The world has changed forever. I hope the kindness will last and the politicising of medical safeguards will not. As Dr. Bonnie Henry says, ‘Be calm, be kind, and stay safe’.”
Isabel Gibson commented on the pace of change: “In the mid-1980s my business teachers gave us readings on the predicted impending death of department stores. They were too high-cost to compete on price like the big box stores (which were just coming in then), and they had too few staff to compete on service with specialty stores. I've watching for 35 years as one after another shut down but it's been a slow demise for sure. This could be the coup de grace, all right.
“As for other institutions, like schools and doctors' offices, I think we'll see some changes there too. Now if only I could get my teeth scraped and my hair cut online, I'd never need to go downtown again.”
Bob Rollwagen did some imagining: “Covid-19 has brought home the fragility of life. We evolved over millions of years starting when oxygen reached a level that allowed sea life to exist out of water. The human we are today over the last 40,000 years has populated the globe, killed all other human species, and caused the extinction of thousands animal species. We have existed through an ice age. The only reason is that we adapt faster than any other species.
“Oh, one other trait, most animals kill to eat and survive. Humans kill for power.
“Covid-19 is a first-world-controlled disease. It is forcing developed countries ahead at a faster rate than ever before. Those wanting to keep existing economic- and resource-based products to maintain their style of life will have a harder time than those demanding better and moving towards it. Value will be redefined. City-centre expensive real estate will have to be repurposed, maybe to low-rental housing for those than can’t afford expensive transportation. Churches have gone virtual. Those with resources are doing faith-based activities all weak, reaching those that have technology and are not mobile. You can worship at any time you want during the week and revisit the service if you wish.
“Change is happening faster than our elderly want to accept. We will need more government, we will need appropriate care for all ages. Wealth will need to be taxed. The first world has accumulated so much personal wealth at the expense of the third world, that they could substantially reduce poverty and narrow the gap.
“If we wait or try to maintain the status quo, who knows what else could be needed as viruses occur more frequently. Why should we expect the third world to stand and watch the “haves” have and the “have nots” not. Covid is to the total population what AIDS was to the more sexually active population decades ago.
I think your point is clear -- change is occurring and we have not seen much [of it] yet.”
Ruthanne Ward compared my column with “Don Pittis's piece on CBC ‘Covid-19 may be the catalyst -- not the cause -- of a painful but useful economic transformation.’ https://www.cbc.ca/news/business/coronavirus-economic-change-1.5581084
“You say similar things -- not surprisingly, because many of us are thinking that way. I have been a big proponent of certain changes in church culture over the years, and feel grateful for the ways this crisis is speeding up what has been a long and painful time coming. I am not grateful for Covid-19 (I've already had it myself), nor for what it is doing to many people's lives -- physically, financially, emotionally and spiritually. However, I have a ‘resurrection’ viewpoint and I do see the promise and possibility in the midst of this suffering.
“Death is hard (I love HBC and can't imagine my life without it!), but as people who try to follow Jesus, we know death is often necessary for new life to unfold.”
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