First Ministers' Meeting on Health Care

Forms of Deception in the Name of Fixing Health Care System

 – Enver Villamizar –

Demonstration in defence of right to health care outside First Ministers' meeting, February 7, 2023.

The meeting of First Ministers in Ottawa on February 7, ostensibly to deal with health care funding, was a first category historical fraud. The communiqués and statements from the federal government, responses from premiers, media spin and counter spin was unprecedented for the amount of nonsense they contained and the new low they reached by marketing their announcements of billions for this and billions for that in the name of high ideals.

Prior to the meeting an effort was made to suggest there was a consensus that privatization is a problem but it can be resolved because the state will pay for private services and individuals don't have to; transfer payments can be tweaked to better meet policy objectives as defined by private consultants, a concession here by government merits a concession there by those involved in negotiations, and so on.

The fraud includes the claim that governments at all levels and the opposition parties are intent on adopting good policies to provide Canadians with the health care services they need. A plethora of proposals say what Canadians want most: dental care is pitted against pharmacare, mental health care, child care and so on.

Nothing they say or do, which the media faithfully repeat, is based on concrete reality. What polls and marketing and consulting firms declare is taken as the proof of what Canadians want. This gave rise to nonsense that cataract surgeries and knee and hip replacements are the most urgent problem and to hell with the all out destruction of the public health care system, the principle of universality, the abandonment of remote areas and old facilities, to hell with the failure of a system which no longer provides enough family doctors, emergency services, ambulance first responders, hospital beds and, most important of all, never mind about trashing the human factor/social consciousness.

The February 7 meeting was preceded by a meeting of the federal, provincial and territorial finance ministers. There the Minister of Finance/Deputy Prime Minister lectured that every province should up the ante on giving tax credits and incentives to financiers who will pony up to pay for infrastructure required as a result of the massive advances made by the technical and scientific revolution. The mantra was that the aim of Canada's economy must be to make sure it is competitive with the U.S. and the rest of the world. Nothing to do with making sure it meets the needs of Canadians or explaining a plan of action which puts everything on the table and meets the approval of the people of this country. They are left out of the equation altogether.

The announced agenda of said health meeting was to "sort out the funding arrangements between the federal and provincial authorities." In that regard it met expectations. It sorted out nothing and became the nasty squabble predicted over which level of government has what jurisdiction to do whatever it wishes with what are called transfer payments. In the increasingly distant past, transfer payments had to do with making sure there was universality of standards and everyone, no matter where they lived, could access health care services which they needed. Far from giving this principle new meaning, which is understood clearly as providing all Canadians with what they need in terms of health care, a major focus for the announcements from the First Ministers Meeting is an emphasis on "harmonizing health indicators." 

Even this need is taken as a fait accompli and its aim is not defined in a manner which benefits the people. One issue is for Canadians to have access to their own health records in a timely fashion; another is the talk which confounds the principle of universality with the thrust to adopt "common standards and policies related to data" in a manner which denies the human factor/social consciousness. 

The meeting purported to address the crisis in health care but excluded the people from any consideration in the deliberations and dismissed out of hand all the solutions and demands put forward by doctors, nurses, health care unions and others.This is unacceptable. The "solutions" take their cue from what investments and contracts tech companies providing health services say they require. In this regard,  federal funding was announced for two agencies, Canadian Institute for Health Information (CIHI) and Canada Health Infoway (CHI), to manage and harmonize the health data of Canadians across different levels of government, with the stated aim to address the "fragmented" health care system.

The competition between  private interests to capture the health information market is fierce. It has nothing to do with meeting the health care needs of the people and everything to do with defining health care as a commodity in the market system. In this system the workers who provide care are considered a cost which is to be disposed of wherever possible, to be replaced with instruments which use Artificial Intelligence (AI) to carry out analyses, diagnoses and treatments. 

The fraud is the claim that  provincial and federal governments will solve the health care crisis by ignoring the solutions clearly enunciated from coast to coast to coast by health care workers. Fulfilling their just claims on matters related to wages and working conditions will ensure a health care system worthy of the name which can then also be equipped with modern equipment and programs. But to base funding of the health care system on modern digital equipment and programs and eliminate the human health care providers qualified in all the aspects required by a modern health care system is not only ridiculous but shameless.

Looking after the health care of Canadians is not satisfied by looking at it as a cost that is not in any way a benefit to society. The level of discussion has been lowered to such an extent that the rulers and their media do not even hear how ridiculous their assertions sound, such as the claim that because the services will be paid for by the public purse Canadians do not have to worry about paying for it themselves. No matter how much they try to detach the individual members of society from their collectives and the individuals and their collectives from the general interest of society, it will not succeed. The relations are a material reality which will prevail in the end, no matter how much governments try to tear them asunder to maintain their control over the material and human resources. The fraud is to deliberately ignore the concrete needs of society and the people and, most importantly, leave the people out of the equation and deliberation altogether. Presenting their pretense to govern as representatives of the will of the people is a real block to sorting out any problems facing the people and their society.

The security of Canadians and health care workers at all levels lies in their fight for the right to timely health care services at the highest standards for all, in a system delivered and paid for in a manner which puts the human factor/social consciousness at the centre of its concerns. The working conditions of all those who work in the health care system -- referred to as an industry -- have a direct bearing on the health of Canadians. Everybody knows this. The market-driven deception of federal and provincial authorities is treachery of the first order. The revolving door of government ministers and private enterprise and the monies doled out to consulting firms and modern methods to collect data are not synonymous with providing human beings with the conditions they need to flourish and, unless they flourish, society will continue to stagnate and descend into anarchy and violence as we see escalating every day with disastrous results.

All out to join the health care workers in fighting for their just claims for wages and working conditions with belong to them by right! Without putting the activation of the human factor/social consciousness as the aim of the billions handed out here and there to further fragment the health care system, schemes are scams, fraud is fraud, and governments must be held to account by demanding they meet the demands of workers who provide their services in all aspects of the health care system, including long-term care and senior's homes.

For Your Information
Canadian Institute for Health Information

The Canadian Institute for Health Information (CIHI) is a publicly-funded body that has a mandate to speed up the improvement of health care delivery. Its Board is made up of heads of certain public hospitals and deputy ministers from the provinces and two members at large. One is Dr. Alexandra T. Greenhill "one of Canada's leading physicians in digital health innovation." She is the co-founder, CEO and Chief Medical Officer of Careteam Technologies, a digital health platform that "aims to use artificial intelligence to solve health care fragmentation and enable optimal health." She is also a Global Ambassador for Blackbox Connect powered by Google for Entrepreneurs, and Entrepreneur in Residence at Innovation Boulevard.

Clearly, publicly funded in no way provides a public health care system!

Careteam is a "health care-grade team collaboration platform" which claims to bring together health care professionals, the patient and personal support team with an integrated care plan, instant communications, and population analytics to enable transitions, complex chronic care, and innovation in a fragmented health care environment.

Why we have "a fragmented health care environment" in the first place and what is meant by that seems to be not worthy of an answer. The deliberate destruction of the public system by depriving it of an aim which provides health care to all Canadians is not to be discussed. Instead we are treated to market jargon and conclusions. According to CIHI's website: "We are concerned that the fragmentation of health care is getting worse, as there are more and more co-morbidities, options, apps and devices. Patients, families, clinicians and health organizations are overwhelmed by the noise. We need to make the health 'system' act as a system, starting for some complex and chronic health issues and also for multi-morbidity patients and integrated care systems. [...]

"Careteam's platform extends existing investment in technologies such as Electronic Medical Records (EMRs) and digital front doors with personalized actionable care plans enabling collaboration within and across multiple organizations."

We are to believe that providing investment technologies and digital front doors will replace the human factor/social consciousness. CIHI says:

"Everyone can work together on the same page, easing the burden of care on families and improving the health and lives of children. Deployable same day, configurable without coding and easy to adopt, we have helped many health teams succeed on their objectives."

Blackbox Connect, partnered by Google for Entrepreneurs is a mechanism through which Google trains a handful of "startup entrepreneurs from around the world," while they stay together in a mansion, and gives them access to "mentorship, intense training, and investors." Blackbox Connect was founded by Silicon Valley veteran Fadi Bishara, "in order to, 'inject global start-ups into the ecosystem, mindset and "magic" of Silicon Valley'; enabling entrepreneurs to access the expertise needed to expand their ideas, and develop a global marketplace strategy."

Canada Health Infoway

Canada Health Infoway was established in October 2000 with an initial investment by the Government of Canada of $500 million. It calls itself an independent, not-for-profit corporation. On January 22, 2001, Infoway was incorporated. Since inception, Infoway has received some $2.5 billion in public funds. According to their website "by integrating digital health into the health care experience, we unlock more efficient and accessible models of care. We facilitate faster, more seamless and secure information sharing. And we can help enable better health outcomes for all Canadians."

What a scam!

Its Directors are made up of deputy ministers who are involved in data and analytics in health, and former Ministers as well as entrepreneurs and business consultants in the field of health care. The Chair, Dr. Peter Vaughan Canadian Forces Colonel Commandant, is a former deputy minister. Also on the board is former Ontario Health Minister Dr. Eric Hoskins. He is now a partner at Maverix Private Equity which is made up of various Ontario-based venture capitalists such as Jim Balsillie (RIM), Arlene Dickinson (District Ventures) and John Bitove (Obylysk).

Canada Health Infoway has a number of projects:

e-Prescribing with PrescribeIT -- which they describe as Canada's not-for-profit e-prescribing service, (which) enables prescribers to electronically transmit prescriptions as data directly from their electronic medical record into a pharmacy's management system, removing the need for faxed and paper prescriptions.

Interoperability -- Infoway claims it is facilitating "a national collaborative effort to advance what is called interoperability in health care." It says: "While there are many interoperability-related challenges, the sharing of patient summaries across different solutions has been identified as a priority based on extensive consultations."

Patient summaries are "portions of health records comprised of a standardized collection of information. They enable a concise package of patient information to be accessed and updated by patients and clinicians, making it easier to share necessary information between care providers and settings (e.g., acute, primary and specialty care)."

Canada Health Infoway's website indicates that "a collaborative development process is underway, with the aim of publishing a pan-Canadian Patient Summary specification (PS-CA) for trial implementation by early 2022."

In November 2022 in Ontario, for example, the patient summary was begun and "its first iteration" includes:

- Medication Summary
- Allergies and Intolerances
- Problem List
- Immunizations
- History of Procedures
- Past History of Illness

Investments -- Infoway supports provincial, territorial and pan-Canadian efforts to implement effective virtual care initiatives,

Change Management -- the Virtual Care Change Management Program is aimed at ensuring that clinicians have the tools and training they need to help transform care and at improving digital health equity and literacy of the Canadian population.

Procurement -- Infoway is supporting interested jurisdictions to pre-qualify solution vendors through a cross-jurisdictional request for pre-qualification (RFPQ). These RFPQs are first stage procurement activities and will result in a list of pre-qualified solution providers.

Partners -- in "projects like the Mustimuhw Citizen Access Health Portal and Crisis Text Line powered by Kids Help Phone, Infoway works together with stakeholders to drive digital health adoption."

This article was published in
Volume 53 Number 2 - February 2023

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