(November 4, 2020)<\/p>\n
By: Emma Paling, Huffington Post<\/p>\n
TORONTO \u2014\u00a0An Ontario minister says her history of railing against Canada\u2019s health-care system with talking points used by right-wing Americans is old news. But critics say her ideology is outside the Canadian mainstream and raises questions about her handling of the\u00a0COVID-19\u00a0pandemic.<\/p>\n
For years, Ontario\u2019s Minister of Long-Term Care\u00a0Merrilee Fullerton, an Ottawa-area doctor, wrote\u00a0a popular blog\u00a0calling for increased health-care privatization. She said that \u201cgovernment monopoly health care\u201d is what Canada has\u00a0in common with North Korea\u00a0and argued that our governments here will soon start encouraging people to be put to death.<\/p>\n
\u201cI think this is about making sure people get the care they need when they need it. And that\u2019s definitely what we\u2019re doing in long-term care,\u201d the minister said.<\/p>\n
Ontario\u2019s long-term care ministry, which Fullerton took over in 2019, relies heavily on private operators. Now that\u00a0COVID-19\u00a0has devastated Ontario\u2019s long-term care facilities \u2014\u00a0killing 1,959 residents\u00a0and at least 8 staff \u2014 Fullerton is facing calls to make the entire system public.<\/p>\n
NDP Leader\u00a0Andrea Horwath\u00a0filed\u00a0a motion in the legislature\u00a0on Oct. 20, calling on the government to eliminate for-profit companies from the system.<\/p>\n
Fullerton called it \u201ca knee-jerk reaction.\u201d She and her Progressive Conservative colleagues voted it down.<\/p>\n
\u201cWe\u2019ve spent a great deal of time and effort to understand the issues … It needs to be better thought-out than what they\u2019re proposing,\u201d Fullerton said.<\/p>\n
The question over public versus private ownership is bubbling up because of how COVID-19 outbreaks have played out, Dr. Samir Sinha told HuffPost Canada. He\u2019s the director of geriatrics at Sinai Health and the health policy research director of Ryerson University\u2019s National Institute on Ageing.<\/p>\n
Research found that for-profit homes\u00a0had larger, more deadly outbreaks\u00a0than homes run by municipalities and non-profits, he said.<\/p>\n
About 60 per cent of Ontario\u2019s homes are owned by for-profit companies, but they all receive public funding, according to Dr. Sinha, including about $122 a day per resident for accommodation and care.<\/p>\n
\u201cHow did we get ourselves here in the first place? \u2026 We never included it in the\u00a0Canada Health Act\u00a0back in 1966,\u201d he said, referencing the federal law that lays out which health-care services the provinces must provide without cost to the patient.<\/p>\n
\u201cThat was our original sin. And as a result, because it\u2019s kind of this bastard orphan of the health-care system \u2026 we\u2019ve been underfunding our long-term care system.\u201d<\/p>\n
Dr. Sinha said that ownership isn\u2019t the most important conversation for Ontarians to have about long-term care.<\/p>\n
\u201cI think there\u2019s a deeper issue at play \u2026 our system is just grossly underfunded.\u201d<\/p>\n
He pointed to\u00a0research that suggested\u00a0Ontario needs to inject $1.8 billion more into its $4.3-billion long-term care system.<\/p>\n
He also said that homes run by municipalities or not-for-profits often invest their own money or fundraise to improve their care.<\/p>\n
If the government significantly increases funding, holds all homes to a higher standard and still finds that for-profits struggle to provide the same level of care, then it will be time to re-evaluate their role, he said.<\/p>\n
But the idea of nationalizing all for-profit homes may be a popular one.<\/p>\n
An\u00a0Angus Reid Institute poll\u00a0in May found that two-thirds of Ontarians said they support the idea of nationalizing long-term care homes. The poll was conducted shortly after the\u00a0military was called into Ontario and Quebec facilities, when images of bodies being removed from homes dominated the news.<\/p>\n
\u201cThis was a period of time where we were learning about what conditions were like in private for-profit care facilities in places like Ontario and Quebec,\u201d Shachi Kurl, Angus Reid Institute\u2019s president, told HuffPost.<\/p>\n
\u201c… I think the entire country convulsed and recoiled.\u201d<\/p>\n
The May poll only asked one question: do you agree that \u201clong-term care facilities should be nationalized\u201d or \u201clong-term care facilities should NOT be nationalized,\u201d Kurl noted. So it would be important to ask more questions and see what people think of allowing for-profits to keep operating under stricter rules.<\/p>\n
\u201cI think it\u2019s something that is worth taking a second look at,\u201d Kurl said. \u201cBut I would say that unequivocally, what you found with the main data, is that Canadians were really reacting very strongly to what they were seeing and hearing and were horrified by it.\u201d<\/p>\n
There is \u201can extremely broad and deep consensus\u201d in Canada that people should have equitable access to health care, longtime advocate Natalie Mehra, executive director of the Ontario Health Coalition, told HuffPost. The minister\u2019s views, prior to taking office, were \u201cvery far out,\u201d she said.<\/p>\n
\u201cThis was a physician who was lending her name and her weight to opposing public health-care reform in the United States and using Canada as a bad example,\u201d Mehra said.<\/p>\n
Before politics, Fullerton long called for a hybrid public-private health-care system, which she said would end the \u201crationing\u201d of patient care and doctors\u2019 incomes. The blog where the Kanata\u2014Carleton MPP shared her views has been deleted. But it\u2019s\u00a0still accessible through Internet Archive.<\/p>\n<\/div>\n
… I would caution anyone in the U.S. not to adopt the system we have here.Minister Merrilee Fullerton<\/span><\/p><\/blockquote>\n
\nIn 2013, Fullerton\u00a0went on a radio show\u00a0to warn Americans against adopting a universal single-payer system like Canada\u2019s.<\/p>\n
\u201cWe\u2019ve had socialized medicine here since the \u201960s,\u201d she said. \u201cPeople thought this would be a good thing.<\/p>\n
\u201c… I would caution anyone in the U.S. not to adopt the system we have here. We\u2019re trying to change the system we have here.\u201d<\/p>\n
\u2018No death panel per se\u2019<\/h4>\n
Fullerton said that Canadians feel an obligation to die for a health-care system that rations its services and treatments, borrowing\u00a0a phrase from former U.S. vice-presidential candidate Sarah Palin\u00a0to make her argument.<\/p>\n
\u201cThere\u2019s no death panel per se, but what we have is a system now that\u2019s being value based \u2026 It\u2019s almost to the point now where people are being given the idea they have a duty to die for the system,\u201d she said.<\/p>\n
\u201cSo we don\u2019t have death panels but we do have people that are in charge of evaluating what service should this person be able to get, because the evidence shows it will only give them another six months or only another three months and on the basis of that, the government decides that you will or will not be able to get that care or that treatment or that procedure.\u201d<\/p>\n
Palin\u00a0coined the expression\u00a0\u201cdeath panel\u201d in 2009. It was called the\u00a0\u201cLie of the Year\u201d\u00a0by fact checking website PolitiFact for falsely claiming that the Affordable Care Act would give bureaucrats the power to deny care to elderly people and people with disabilities. The act actually\u00a0provided insurance coverage\u00a0to about 32 million Americans by expanding Medicaid, requiring people to have insurance and requiring employers to cover their workers.<\/p>\n
Some Republicans took the lie even further,\u00a0claiming the bill\u00a0would take Americans \u201cdown a treacherous path toward government-encouraged euthanasia.\u201d<\/p>\n
In the following years, Fullerton made similar claims about Canada\u2019s system.<\/p>\n
During the Ebola epidemic in 2014, she\u00a0wrote that\u00a0there were other, more pressing threats to Canadians than the disease: jihadists and politicians.<\/p>\n
\u201cWe don\u2019t seem to be \u2018terrorized\u2019 by the thought of politicians encouraging euthanasia as a way to deal with rising numbers of frail elderly or people with diseases we can\u2019t fix. We don\u2019t seem to be \u2018terrorized\u2019 by jihadists mowing down soldiers in parking lots,\u201d she wrote. \u201cPerhaps we should be. Maybe then we would take our collective heads out of the sand and respond in a meaningful way to the real threats that are more insidious, less immediate, but even more harmful to society and to individuals.\u201d<\/p>\n
A year later, she wrote\u00a0a list of predictions\u00a0for Ontario health care on her blog. The ninth one read, \u201cAssisted suicide morphs into Duty to Die.\u201d<\/p>\n
\u2018Radical propaganda\u2019<\/h4>\n
If Fullerton really believes those things, \u201cthen the people in long-term care are really doomed,\u201d Mehra said.<\/p>\n
\u201cThose statements are ghastly \u2026 They are factually untrue,\u201d she said. \u201cThey feed into the most right-wing, radical propaganda against health-care reform in the United States \u2026 I think it raises serious questions about her judgment and her personal politics.\u201d<\/p>\n
Fullerton seems to be taking an \u201cideological approach\u201d to responding to the pandemic, Mehra charged.<\/p>\n
\u201cThere have not been improvements in regulation … They have not improved accountability at any level.\u201d<\/p>\n
She noted that the government is moving\u00a0to protect nursing home operators\u00a0\u2014 and all other businesses \u2014 from COVID-19-related lawsuits.<\/p>\n
\u201cIn the summer, there was an opportunity to regulate, to get measures in place to ensure when outbreaks started again, in a second wave, they would be nipped in the bud,\u201d Mehra said. \u201cNone of that happened. No home has lost a licence … including the very worst of them.\u201d<\/p>\n
The PCs didn\u2019t outline\u00a0their plan to protect residents\u00a0during a second wave of COVID-19 until Sept. 29, one day after Ford said\u00a0the second wave had started.<\/p>\n
While other provinces\u00a0trained thousands of new workers\u00a0over the summer,\u00a0Ontario wrote to homes\u00a0telling them staffing was their responsibility.<\/p>\n
Ontario did\u00a0release results\u00a0of a staffing study, which was launched in February, this summer. And on Monday,\u00a0the province said it would recruit\u00a0tens of thousands of new workers for the sector so that all residents get four hours of care per day by 2024\/2025.<\/p>\n
In response to questions about Fullerton\u2019s past writings and Mehra\u2019s view that it raises questions about her role, Fullerton\u2019s press secretary sent a short statement.<\/p>\n
\u201cOur government\u2019s priority and focus continues to be modernizing long-term care to improve quality of care and quality of life for our most vulnerable,\u201d it said. \u201cThe long-term care sector has faced significant challenges as a result of decades of neglect. That is why we have worked tirelessly towards building a 21st\u00a0century model that is resident-focused so that our seniors can get the care they deserve.\u201d<\/p>\n
NDP MPPs have been calling for Fullerton\u2019s resignation since May, when the Canadian Armed Forces\u2019 report on five hard-hit long-term care homes was made public.<\/p>\n