On private interests

A few weeks back, I noted how odd it was that Brad Wall looked to be raring for a fight to privatize health care even when the issue wouldn't seem to be a winner for the Sask Party. But in retrospect, the move was likely aimed far less at the public than at a corporate media audience. And sure enough, the province's major newspapers have served up a giant steaming pile of Canwest love for Wall's effort to push public services into the private sector.

So let's take a few minutes to deal with the most ridiculous of the Sask Party claims which are being repeated unquestioned by the province's two main print media outlets.

First, nobody is arguing against providing better health services or dealing with waitlists. This has been the favourite strawman of the press in mischaracterizing the NDP's position - but the next argument that the province shouldn't address the need for improved surgical capacity or CT scan availability will be the first.

But that leads into the second point: there's a choice to be made as to how to deal with health care improvements. And it's on this point that the media has bought the Sask Party's spin hook, line and sinker - bashing the NDP for having a preference which it actually defends with some reasoning, even as it's the Wall government which has stated without justification that it's looking for any "opportunity" to push private-sector delivery.

In fact, there's absolutely no reason why improvements can't be made within the publicly-operated system - and the Sask Party's defenders haven't even tried to provide one. At most, there's been some tangential observation that some of the usual efficiencies associated with single-location health care delivery (e.g. CT scans on hospital sites) won't apply. But even if it's taken as a given that a CT scanner can't fit into one of Regina's current hospitals, that doesn't answer the question of whether we should prefer public or private operation of a new scanner to be set up on another site.

But what about the cost of setting up a publicly-run scanner? Welcome to point three, which has been negligently omitted by the media at every turn: privatization is not a free lunch. Even on the Sask Party's own account, privatized service delivery may well cost as much as the current public model. And that's ignoring both the real possibility that a privatized system will in fact make the public system less efficient, and the reality that once a private interest is relied on to provide vital public services, it'll have plenty of leverage to raise the price later on.

And that in turn leads to point four: privatization has real structural consequences, as more decisions about public health are put in the hands of actors whose primary interest is to increase their own market share and profit margin rather than to achieve the best possible health outcomes. Murray Mandryk's column manages to unwittingly make this point in using past examples of privatized services to suggest that we shouldn't worry about just one more (or two more, or however many more the Wall government can jam into the next year and a half). But if past governments didn't sufficiently take into account the reality that corporate actors may create warped incentives within the health care system (and yes, the NDP can take some blame here), that's hardly an argument to continue to ignore the dangers now.

In sum, the Sask Party's case has been based entirely on lowballed costs, dishonest assessments of our options and straw men. But while that deception has unfortunately been parroted by observers who should know better, it's still an open question whether Saskatchewan's voters will be so easily fooled.

(Edit: fixed wording.)