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Discussion of Alternatives The Necessity for a Credible Public AuthorityThe pandemic has made it clear that a new direction is needed in the care of seniors and the health care sector generally. In order for that to happen, the most urgent need is for a credible public authority.
A public authority consisting of elected members from the seniors' care workforce, seniors themselves and those concerned with their well-being is required. Such an organization would be a victory resulting from the mobilization of the workforce and activation of the human factor/social consciousness. Workers directly involved in the health care sector and education sector for example, must have forms and mechanisms to discuss, exchange views and decide the direction of the sectors and the workings of the public enterprises they control and their relations with other enterprises, sectors and the society and economy as a whole. New mechanisms must be created on the basis that there are those who are charged with the social responsibility for the direction of the sector and its public enterprises and budgets. Those put in charge by the people would ascertain the amount of increased investment needed to raise the level of care, and engage in constant enforcement of regulations and compliance with them and the rules regarding care and working conditions. All discussions, decisions and reports of the public authority must be entirely open and transparent and available on television, the Internet and in written form. 2. Public seniors' care enterprises should be created that have uniform high level care for all seniors, including those in long-term care living facilities or receiving home care. No private profit should be allowed in any aspect of health care and seniors' care that receives any public money. This includes the creation of pharmaceutical and other health supply public enterprises or the transformation of for-profit enterprises to public enterprises, if they wish to continue to sell to the public sector. All added-value from the production in public enterprises in the health care and seniors' care sector should go back into improving health care generally. 3. Public colleges should train seniors' care workers in all aspects of care for seniors at the highest available level of knowledge and practical experience and expertise. All those wishing to work in the sector should be given free education and a living stipend to take courses to prepare them for the work of caring for seniors. The public colleges should be charged with the responsibility of collecting information from workers in the sector and from scientific studies on the highest level of care for those in need. This is particularly important in dealing with the issue of cognitive decline in seniors and how to combat it. 4. Pay for seniors' care workers and their working conditions should be at the highest level with no exceptions. The pay and working conditions should be set and monitored by the unions and collectives of health care workers, in discussion with the public authority, ensuring they never fall below what is considered a Canadian standard.
6. The value produced in the health care sector, including seniors' care, should be fully accountable and realized (paid for) in the broader economy and its enterprises. A price of production for seniors' care and health care generally should be determined through the use of a modern formula. The price of production for health care, including seniors' care, in producing a healthy working people and caring for them in retirement must be realized (paid for) on a prorated basis by the public and private enterprises in the economy over a certain size. The health care payment should go directly to the public health care enterprises established under the elected public authority of health care workers and others and not through a government budget. The budgets for the various public enterprises and sub-sectors within the health care sector should be set by the workers themselves and their collectives and verified through public discussion and the elected health care public authority of the health care workers and others. The money received should come to the public enterprises through the provincial health care authority and not through the provincial, federal or Quebec governments. 7. The regulations and rules governing the health care and seniors' care sector and the working conditions should be set through public discussion and agreed to by the elected public authority, collectives of health care workers and individuals. The public enterprises must be fully accountable for following the agreed upon regulations and rules regarding the care of seniors and working conditions and be transparent in reporting any violations and remedies required. All public enterprises in the health care and seniors' care sector must issue annual public reports that detail their operations, plans and needs for the coming year and foreseeable future, including increased investments.
Any funds needed for increased investment beyond what the sector and sub-sectors receive in realized added-value directly from other enterprises in payment should be borrowed from a public bank and not from private sources. The guarantee of return of the loan for the increased investment comes from the potential increased realized value arising from the expansion of the service. Any loans must come from a public bank such as the Bank of Canada or other newly formed public banks and not from private sources. The issue of public banking must also be on the agenda when discussing an alternative direction for the economy.
This article was published in Article Link:   Website: www.cpcml.ca Email: editor@cpcml.ca |
1. A credible public authority is necessary
in order for the people to participate in setting the direction
for the economy. For a public authority to be credible,
legitimate and accountable in the modern era it must have a
direct connection with the working class. Having a direct
connection with the actual producers relates to the important
issue of who decides the direction of the economy. In the
seniors' care, health care and education sectors generally, a new
form is needed to lead them and their public enterprises.
5. Family physicians refer seniors or even non-seniors, if the
need arises, for assessment for possible inclusion in long-term
and home care and the necessary level of that care. A collective
of professionals and other workers from the long-term care sector
should be responsible for the assessment and placement of
patients. The collective would aim to limit how long a patient must
wait for assessment and placement. This group could use its own
information and that of others in the sector on the needs of
the sector for additional beds and other resources, including
buildings and supplies.
8. The increased investments needed for social programs should
be determined by the workers themselves and their public
authority in all the various sectors including, importantly, care
for seniors. The workers in every sector, their elected public
authority and unions should be responsible for determining any
increased investment needed, which would be in addition to the
realized value from the sector.