Canadian Health Care is not "Socialized"

Danielle Martin, a Toronto-based doctor, has recently been getting a lot of attention due to her participation in US Senate subcommittee debate about health care.  Brought in as an expert of the Canadian health care system, along with doctors from other first world countries that possess similarly accessible health care systems, she succeeded in making the Republican senator attacking her with half-truths and speculations about the Canadian medical system look ignorant.  More proverbial grist for the mill for the average Canadian nationalist looking for any reason to celebrate something "uniquely Canadian".  Both the National Post and the Toronto Star (the conservative and liberal papers, respectively) briefly bonded over this proud moment of Canadian punditry––they even had similar headlines about Martin "smacking down" US senator ignorance.

Obviously, there is something to be said about the assumptions and misapprehensions US conservatives have about medical systems other than their own, particular the Canadian system.  The dogma about people who die in the supposedly long line-ups (as if this argument from ignorance somehow outweighs the thousands of deaths produced by a denial of medical care), or the assumption that their medical system somehow possesses better doctors and medical technology, would be laughable if it wasn't so sad.  At the same time, the Canadian discourse surrounding our medical system, as well as the discourse of those social democrats who think of it in a utopian manner, is itself something that should be questioned.

The first problem is the assumption that we, and the European states who have similar (and sometimes better) systems, possess "socialized medicine".  This is not the case, and the article linked above is actually quite clear in its definition of our medical system: a single-payer medical system, meaning that it is paid for, existing according to market/commodity logic, by the government through a system of taxation.  And not the very best system of taxation at that!  The point here is that the logic of capitalism still applies to the Canadian medical system.  Simply because we do not have to worry about paying for every single service ourselves, or do not have to rely on parasitical insurance companies, does not mean that it is somehow outside the capitalist law of value.  The technologies and medicines are owned and sold by multi-national corporations, wage-labour and surplus value still determine price, and the state is paying for this "on our behalf" (haha), with tax money.  The tendency of the rate of profit to fall means that medical care is getting more expensive on a yearly basis; the tendency of the bourgeois government to submit to "austerity" measures––to a greater or lesser degree depending on the party in power––means that privatization has and will continue to creep into this "single-payer" system (services are continuously delisted); the fact that the Canadian government, regardless of what party is in charge, is disinterested in abolishing the capitalist law of value means that we continue to experience a creeping privatization in our system until, like so many welfare rights hard-won through struggle, it might evaporate altogether.

Moreover, due to the fact that access to medical care is experienced as free, it is easy to forget that welfare-healthcare, though partially originating from social struggle, is only possible, if we are not to abolish capitalism, in the context of global imperialism.  Super-exploitation permits the context in which the welfare state can exist.  Even if we limit the problematic of super-exploitation and the labour aristocracy, as some would like us to do, we cannot deny the imperialist logic of the medical system altogether: corporations that produce medical technologies and pharmaceuticals are often involved in some pretty brutal aspects of globalization.

Lest the hasty reader get the wrong impression, I am not arguing that we should reject our "single-payer" health system now out of misplaced sense of revolutionary purity.  I do think it is a good thing, despite its clear limitations, that those of us who live in a country with a certain level of welfare capitalism are capable of receiving medical attention without having to worry about the weight of terrible debt.  (And in this sense I think it is ludicrous when the National Post, after its patriotic crowing about how Martin "schooled" the US Senate, went on to advocate a two-tier medical system where we can get the "best" of both the Canadian and US medical systems, as if the latter has anything worthwhile in adopting.)  I am not interested in advocating some sort of "drop out of the system" politics that attempts to recreate, within the framework of capitalism, some sort of community healthcare program that is incapable of responding to the needs of people who require medical care.

The main point of this entry is simply to draw my readers' attention––particularly those readers who might be under the assumption that Canada has "socialized medicine"––to the underlying logic that allows us to have accessible medical care.  This is a logic is largely determined by the logic of capital and, due to the boundaries drawn by capitalism, will eventually reach its limits.  As noted above, we are already witnessing the cut-backs of so-called "austerity" measures that were happening even before the emergence of this austerity discourse.  Socialized medicine is only capable in the context of socialism, until then we only have a tenuous compromise that may not be permanent.