All Canadians have revered universal health care. Right-wing administrations are using the COVID-19 epidemic to question this traditional understanding and increase private sector engagement in health systems.
Last month’s royal assent of Ontario’s Bill 60, euphemistically dubbed Your Health Act, is the most aggressive attempt to construct a two-tiered health care system in Canada.
The Ford government could not rely on popular support for its measures since universal health care is vital to Canadian civic identity. Instead of compromising on Bill 60’s content, the province aggressively rammed it through the legislature and gave the provincial executive the power to implement its provisions before public opposition could coalesce.
In reaction to neoliberalism’s diminishing credibility, the Ford government curtailed legislative examination and democratic discourse, adopting authoritarian techniques seen abroad.
Bill 60?
Bill 60 authorizes the government to license private contractors for CT scans, colonoscopies, diagnostics, and orthopedics, among other health services.
Bill 60 opponents believe that expanding commercial health care would create a two-tiered system that drains public system employees and experience. “Manipulative upselling” for regular OHIP-covered treatments is also probable.
Public opinion survey shows that Ontarians oppose health care privatization, despite the Ford government’s attempt to depict market growth as the only way to reduce hospital wait times.
According to an Environics online study, 80% of Ontarians prefer public health spending to private access. In February 2023, an Angus Reid cross-country poll found that roughly 40% of Canadians are “public health care purists” who want no private sector participation in health care.
Thus, the Ford government had the challenge of implementing a program that few wanted but that it was committed to. How does a government pass laws that benefit the elite but are opposed by the majority?
Bypassing Congress
The Ford government used “neoliberal parliamentarism” to renovate legislative institutions to overcome institutional resistance to contentious neoliberal reforms. Two methods accomplished this.
First, it handed broad authority to the administration to implement Bill 60’s provisions, including cabinet powers. The minister can designate a “director” or board of directors to categorize and create new private sector clinics, monitor growth of existing clinics, and manage licensure.
The director reports exclusively to the cabinet, replacing the Ministry of Health’s monitoring of private clinics. The director is exempt from public service freedom of information and financial accountability disclosures.
The measure also allows the director to license various health services to private sector clinics by calling them “integrated community health services centres.”
The Standing Committee on Procedure and House Affairs can review the director’s actions, but it cannot influence or control them.
Second, the Ford government used legislative norms to rush Bill 60 through parliamentary procedure before a popular backlash could form.
Your Health Act, introduced on the first day of the fall legislative session, amends 34 provincial statutes and hundreds of regulations. The measure had four days of committee hearings with only a few presenters.
The administration also invoked closure on both the house’s second and third readings to speed up Bill 60’s passage. Closure was employed to preempt discussion, not to break a parliamentary deadlock.
Bill 60 passed in 73 days, barely enough time for a significant discussion.
Conclusion
Thus, Bill 60 goes beyond health care privatization. The elite-driven quest for a two-tiered paradigm and democratic norms are interdependent.
Given the absence of real popular support for privatized care, the administration had to speed Bill 60 through the house, employ closure, and enshrine it as law before serious popular resistance could form.
The government gave the executive czar-like authority to direct the bill’s execution, removing it from the civil service and public sector accountability.
The Ford government’s attitude to the legislature is consistent with a global democratic backsliding as governments have insulated neoliberalism’s reforms in an authoritarian political shell to counter its falling popularity.
With senior public officials around the country openly discussing health care privatization, Ontario’s Ford government has provided a legislative blueprint for other provinces considering universal health care reforms against popular resistance.
