It is a great pleasure to be able to take part in the discussions today on senior’s health care.

The labour movement has been successful in negotiating improvements in health care benefits for our members for many decades. It is not just our members that have benefited from our negotiations, but the general public and our employers as well.

The labour movement negotiated hospital coverage and then medical coverage, for its members. It then lobbied the provincial and federal governments to provide this coverage for all members of our community. It was volunteers from the labour movement along with others who spent their evenings and weekends at public places, such as shopping malls etc, in order to get petitions signed, supporting public health care. The labour movement was there again on issues like extra billing. And we will be there again to fight for our public health care, not just for our members but for all the members of our community.

If you ask a retired union activist what their greatest health care concern is the answer will always be the encroaching privatization of our public health care system.

The public run system that we have in Ontario, is also a benefit for employers. The costs for an employer in Ont. to provide medical coverage for employees is a fraction of what it would cost south of the border.

This lower cost helps make our manufactured good more competitive in the international market.

To give a comparison, a worker who recently lost his job at Bethlehem Steel in Gary Indiana was able to continue paying the cost of his company medical benefits for his family (himself, his wife and 3 kids). The cost was $760 per month (US funds) this compares to $227 Canadian for similar coverage in Ontario.

It is the profit motive that has driven these costs in the United States. In the last decade a massive transfer to private for-profit control of public and non-profit health care institutions: the biggest loss of public assets in history. It has been accompanied by an astounding increase in the cost of health care services. US health care is the most privatized of any industrial nation–a trillion-dollar industry dominated by an oligopoly of increasingly consolidated multinational corporations. Weighed down by unequalled administrative costs, white-collar fraud, duplication, an advertising-fed demand and profit taking, Americans now pay double our costs on average for health care. As a proportion of the country's economy, American expenditure has grown at double Canada’s rate since 1971 when we both spent 7% of GDP on healthcare. US health now consumes 14.9% of GDP, compared to our 10%. The US system is not only more expensive that the Canadian system, it leaves 45 million Americans without any health care coverage at all. The US average inflation rate for health insurance is 14% and is spawning labour unrest as access to health care benefits is cut for both workers and retirees.

To further this point let me quote Dr. Arnold S Relman, professor Emeritus of Medicine at Harvard Medical School and Emeritus Editor-in Chief of the New England Journal of Medicine, in his presentation to the standing senate committee on Social Affairs, Science and Technology "My conclusion from all of this study is that most of the current problems of the U.S. system — and they are numerous — result from the growing encroachment of private for-profit-ownership and competitive markets on a sector of our economy that properly belongs in the public domain. No health care system in the industrialized world is as heavily commercialized as ours, and none is as expensive, inefficient and inequitable–or as unpopular.

Indeed, just about the only parts of US society happy with our current market-driven health care system are the owners and investors in the for profit industries now living off the system."

It is the threat of loosing our publicly run health care system that is of greatest concern to our members and retirees.

Our retirees are concerned about the cost of prescription drugs, and the coverage provided by the Ontario Drug benefit program. There are presently 2600 drug products listed in the drug benefit formulary. Single seniors with an income of less than $16,018. or a couple with a combined income less than $24, 175. pay $2. per prescription for drugs on that list. If their income is greater than these amounts their prescription costs would be the first $100 per year each, and then up to $6.11 pre prescription after that. This is only for the drugs covered and that is not the majority of drugs that a senior may be prescribed.

These charges may not seem excessive but are all difficult for seniors who are also facing increasing property taxes, food and lodging costs etc. without any corresponding raise in pension income.

It is not just the cost of drugs but user fees for some medical services, the fees often charged by doctors to fill out forms, provide letters etc. and charges for certain medical tests are also a concern. For a senior the $20 to $30 charged for a PSA test for prostrate or a PAM test for eyes, or the cost of foot care, chiropractic care may be something that a senior chooses to ignore because of the cost. Some of these tests are important, and if not done because of the cost, may result in horrific results both for the senior and in costs for our medical system.

One of the many recommendations of the Romonow Commission Reports on health care states, that there is overwhelming evidence that direct charges such as user fees place the heaviest burden on the poor and impede their access to necessary health care.

Transportation to and from Doctor appointments, whether it be darts, taxi with or without the taxi scripts, bus fares etc. can all be a burden on our seniors, both financially and emotionally.

Dental Fees for seniors without coverage, additional hospital charges, and waiting lists for services such as cataract removal are all of grave concern to our seniors. Waiting an extended period of time to have cataracts removed may deny a senior the opportunity to read a book or newspaper, to watch their favorite TV show or even to go for a walk. This can be devastating for a senior and may result in other health problems because of the wait and reduced physical and mental activity.

A major concern, for our members and seniors in general is the ability to remain in their own homes. Accessing good supports, such as adequate home care.

In 1997 the conservatives privatized homecare, forcing the non-profits such VON and Red Cross to close in many parts of the province. They have been replaced by for-profit homecare corporations such as Paramed, Comcare, WeCare Allcare, etc. Once the non-profits were forced out, prices for the bids went up.

In the last year of the Conservative Government, 115,000 people were dropped from homecare rolls due to budget cuts. This amount to a quiet elimination of an entire section of the public Medicare system. Homemaking and personal support services for the frail, elderly, chronically ill and those with disabilities.

The lack of these supports will drive many seniors into long-term care facilities prematurely

The quality of Long Term Care facilities is also of great concern to our retired members. Long Term Care (nursing homes) in Ontario is now the most privatized of anywhere in the country. We pay among the highest out-of-pocket fees for long term care beds and we receive the least number of hours of care of any jurisdiction in Canada or the US according to a government commissioned study. The for-profits mounted a lobby campaign to eliminate minimum hours of care and succeeded in 1995and 1996 when the Conservatives eliminated regulations that forced them to provide an RN at all times and a minimum of 2.25 hour of care per day per resident. As seniors we want these regulations not only re-instated but also the hours of care increased.

A retired CUPE member that I know personally is presently paying over $1700 per month to live in an assisted living apartment. He is entitled to only one bath a week and if he wants a second one the charge is an additional $25. Is this what is meant by living your senior years in dignity?

Speaking on behalf of union Retirees I can clearly state that it is the encroachment of privatization in our health care system that is the biggest threat to our wellbeing. The consequences in long term care will stalk us until at least 2020 when the current licenses conclude, so too the transfer of public hospital assets to for-profit control will haunt our health system for at least the next half century if it is not stopped.

Our provinces’ move toward P3 hospitals (public private partnerships) will have disastrous results. The plans are the same model as the British PFI (private finance initiative) hospitals where the government has signed generation long leases. The most rigorous studies of these projects are reported in the prestigious British Medical Association Journal whose editors have called them "PFI Perfidious financial idiocy". The BMAJ reports that higher costs of these hospitals has strained scarce resources leading to 30% of beds and 26% of staff cut on average. The results? A growth in two tier access and service charges as the corporations seek sources of revenue in their endless search for profits.

If we need new hospital or other health care facilities, the province should build, borrow the money at today’s low interest rates and pay for them over the next 20 years. At the end of the 20 years, we the people of Ontario will own them, not some profit driven corporation responsible only to their shareholders.