Wasting Away: The Undermining of Canadian Health Care

Canada's health care, which comprises a myriad of institutions and practices, is often referred to as Canada's best-loved social programme. This support is not surprising, given that it has been one of the most accessible health care systems in the world and has played a significant role in prolonging the life of many Canadians. In recent years, however, it has come under attack from a variety of sources. Every jurisdiction in the country has initiated far-ranging reforms aimed at reducing costs and has introduced strategies developed for lean and mean production in the private sector. This book will examine how most of these reforms fail to address the fundamental problems in the system. Many of the provincial reports justified cutbacks by agreeing with critics of the system that the focus should be on health, rather than illness, and that health is determined not only by individual lifestyles but also by social conditions. With such an approach, it could be argued that part of the solution to rising costs is prevention and another part is to send care, in the words of one report, "closer to home". Although there is talk of "client-oriented" care, total quality improvement, employee empowerment and community support, reform has primarily meant less of the same within institutions and more unpaid work for women in the home. The basic problems with institutional care remain largely untouched or even exaggerated while fewer and fewer people have access to good care.