The Sixth Estate

Predictably, the Fraser Institute has joined the C.D. Howe Institute‘s recent call for the elimination of the Canada Health Act. The new offensive takes the form (for now) of a column published at Troy Media by economist Mark Rovere. He argues, on behalf of the Institute, that Canada should adopt Dutch-style compulsory private health insurance (the same thing the Obama administration was gunning for in the U.S., though Rovere doesn’t mention this). Various vague promises about cost savings are mentioned. He forgets to mention that the Fraser Institute’s backers include private medical companies. According to Allan Gotlieb, a former diplomat who now chairs two of the country’s largest conservative foundations, .

First of all, I would be very hesitant to take healthcare advice from any organization which believes that cigarette smoke does not cause lung cancer. (By the way, one of those disreputable studies can still be downloaded from the Fraser Institute website. Its distribution was paid for by tobacco companies.) I personally believe that the Fraser Institute’s current work on healthcare is also being funded by corporations in the medical sector who have a very definite interest in killing off universal non-profit healthcare so that they can sell us expensive insurance products and private healthcare.

Second of all, as usual, Rovere’s argument simply does not stand up to scrutiny. He vaguely suggests that Holland has cheaper healthcare than us now because it has its new private insurance scheme. Interestingly enough, the Dutch also paid less for healthcare before they put in that system. European countries in general pay less than either Canada or the U.S. And the United States spends twice as much per person as Canada does. So there is no healthcare crisis, and even if there was, a Dutch solution wouldn’t necessarily be a Canadian solution. Especially a Dutch solution that’s only five years old. The Fraser Institute spent years, arguing until they were blue in the face, that there wasn’t yet enough evidence to regulate tobacco or to do anything about climate change. Now they want us to totally remake our healthcare system on the basis of a five-year-old experiment in a tiny European country? Something doesn’t pass the smell test here.

Plus, the bottom line is that the only way to seriously reduce costs in the healthcare sector (where most of the money goes either to highly qualified professionals or highly advanced technology and medication) is to reduce how many people get serviced. Introducing a private insurance scheme that fixes a required level of benefits at a fixed cost with some government top-up subsidies, which is what Rovere suggests in his op-ed, wouldn’t actually do anything more than what the public healthcare system already does. In fact, that’s literally how BC (for instance) operates its Medical Services Plan. The only difference is that now you would also have private for-profit insurance companies clamouring for their piece of the same pie. Our society is complex enough, and we are affluent enough, that we should be willing to do some things collectively so that we can get on with enjoying our lives rather than individually fighting over health insurance policies like Americans do.

The real clues about Rovere’s intentions lie elsewhere, in a report he published last fall called Value for Money from Health Insurance Systems. Unlike the op-ed, Value for Money is not the slightest bit modest in its suggestion for reforms. There, he suggests that the current universal healthcare system be replaced by one with private insurance, payment by people seeking medical care (he calls it “cost sharing”), and allowing private for-profit hospitals to bill the government. Hence his suggestion for eliminating the Canada Health Act. Under the Act, these ideas are illegal.

But they’re also highly profitable for some of the Fraser Institute’s backers. The Institute’s Board of Trustees, among other things a monitoring service for the institute’s largest donors, counts among its members representatives from two Canadian private “executive” clinics (Medcan’s Shaun Francis and Medisys’s Stuart Elman), one from pharmaceutical giant Pfizer (Catherine Windels), and a private surgery company that bills itself as “Canada’s private healthcare consolidator” (Surgical Spaces’s Anna Stylianides). Brett Skinner, who is Rovere’s director at the Fraser Institute, is also funded by Abbott Laboratories. These would all stand to benefit from privatization of healthcare — especially the private clinics, who would love to bill the government for more services but right now have to content themselves with wealthy clients willing to pay in cash.

How exactly does the Fraser Institute avoid letting its ties to private healthcare providers and big pharmaceutical companies influence its pro-private healthcare agenda? It says it’s independent, but as Allan Gotlieb reminded us in 2009, a think tank that is heavily dependent on one particular sector of society is “not well placed” to criticize the activities of that sector. Gotlieb is a former high-level diplomat from the Trudeau and Mulroney era who now chairs two of Canada’s largest right-wing foundations, Peter Munk’s Aurea Foundation and the Donner Canadian Foundation. Both of his foundations fund the Fraser Institute.

The typical response from the Fraser Institute is that it is independent of its donors and does not let trustees influence research. Because of the documents emerged from the tobacco suits of the 1990s, we know that is at best half-true. Here’s how the Fraser Institute’s modus operandi works. First, they come up with a research centre (or a project, or both) that will be of interest to a particular economic sector. Next, they send out fundraising letters to large companies in that sector asking for help setting up a research centre to carry on the proposed research. Finally, they produce the research itself, which usually (though not always) neglects to identify where its financial support came from. That’s how they did their pro-tobacco research, and the fundraising director who handled that work, Sherry Stein, is still listed as the institute’s “Chief Development Officer.”

The Fraser Institute, like all think tanks, should automatically be considered an unreliable and disreputable source unless and until it discloses its funding relationships with its sponsors. This is especially so because we’ve caught them with their hand in the till before.