Published in This Magazine Special Issue: 25 Stories You Missed in 2012 | January 16, 2013 | Circulation: 5,000 subscribers

After a year of high-stakes campaigning – from blocking private hospital expansion to preserving rural services – members of the Ontario Health Coalition gathered for their annual assembly Nov. 17-18, entitled ‘Protecting Health Care in the Face of Austerity.’

Emboldened by increasingly aggressive cutbacks, the province-wide network of public health care activists vowed to ratchet up their fight for a more progressive system. This Magazine spoke with the coalition’s director, Natalie Mehra, about the implications of what she called today’s ‘austerity agenda’ – and some lessons for the whole country.

THIS: You mention the ‘austerity agenda.’ What is that?

MEHRA: Austerity means a particularly harsh approach to budget cuts, public service cuts, and labour force restructuring. That’s what’s happening in Ontario. So instead of dealing with the deficit in a balanced way, the Ontario government has gone for a really one-sided approach: very severe public service cuts, the most severe we’ve seen since the Harris government cuts of the 1990s – and in some ways more severe than those cuts – as well as very aggressive labour force restructuring in the public sector, and cuts to funding resulting in service cuts.

In concrete terms, what that means in a local community is unprecedented cuts to clinical services in hospitals, the closure of out-patient services all across Ontario, privatization of clinical hospital services… Across the whole health care system, the government is trying to curtail spending by more than $3 billion. We’re seeing wholesale axing of programs. Hospital CEOs are warning that they’re under pressure to ‘jettison’ whole services. Pain clinics are being closed. Cancer care is being centralized. Diabetes care is being cut. For rural communities, services are being centralized out of their local towns into fewer sites. These are the consequences of moving a giant step closer to an American-style private health care system.

THIS: Authors like Naomi Klein and others talk about ‘shock capitalism’ – where taxes are cut and austerity is imposed in order to actually create a system in which privatization is the answer. Do you think that’s what’s happening in Ontario?

MEHRA: I absolutely do. And I realize that, for a lot of the public, it sounds a bit conspiratorial. But, in truth, if you look at the pattern of budgeting for Ontario, at this point there’s no reason whatsoever that the provincial government would decide, arbitrarily, with no public consultation, to refuse to look at any revenue measures – ie. taxes, tax loopholes, etc. – and only consider service cuts and budget cuts. There’s no reason for that. We have the lowest corporate taxes of virtually any jurisdiction in North America, and it has not resulted in business investment in Ontario… And the consequences are being paid for by us Ontarians in hundreds of ways.

THIS: You mentioned inequality, and you recently authored a report for Ontario Common Front on inequality. Could you talk about that? What were your chief conclusions?

MEHRA: The private marketplace is dishing out more inequality… That is compounded because governments, at the same time have moved away from equalizing [it] through public services and income transfers. That has happened all across Canada to some extent, but Ontario really is an exceptional case: it is the most radical province in terms of embracing, or just allowing, this greater inequality. There’s an astonishing rate of child poverty. One in seven children in Ontario live in poverty; that poverty is racialized.

THIS: Across Canada, people are consistently shown to care about health care in the polls. And yet, it seems that people are not really mobilizing. Do you think Ontario presents a lesson for the rest of Canada?

MEHRA: For those of us who believe in building a society in which everyone has a chance to live to their human potential, we are a living example now of the wrong way to go. Across the country, we have had a hard time making health care, in particular, a clear issue in elections. Part of what’s happened is that no political party will openly campaign on privatizing health care… They do it by stealth: through rationing services, through offloading, through no longer following proper public policy processes, so there’s no legislation, no public debate, no hearings.

But so far in Ontario, the truth is that we have managed to stop health care privatization in a way that has not happened across the country… Where we’ve done that, it’s because we’ve launched a massive fight-back. Our call now is that we have to build that again. And when we fight, we win: When we expose privatization, if we can create public debate about it, we win it.

THIS: What strategies do you think are most essential to take, going forward from here? Not only, around health care, but around the austerity agenda in general.

MEHRA: We have to pull all the cuts together and get them out: … to expose the austerity agenda and the increasing inequality. The second thing is to organize and provide the tools for people to resist it. That can be mass town hall meetings; it can be web campaigns; it can be door-to-door campaigns; it can be protests; it can be media events. It really should be all of the above, moving the public to actually do something concrete about it – be it as simple as signing a petition or as deeply committed to attending an occupation, sit-in, rally or protest.

But in order to actually move forward a progressive agenda that creates more democracy and moves reforms forward, we need a deeper strategy of coalescing around some key demands, and pushing those forward through both our society and governments.

THIS: What would those demands be?

MEHRA: We have to win is some democratic process reform… One of the ways we stopped the closure of rural hospitals is we asked for the government to hold hearings. They didn’t, so we did. The meetings were massive – we ended up with over 500 written submissions, which is unheard of in a parliamentary process. There was just huge participation all across the rural parts of Ontario. So where they refused to do it, we did it anyways. One good way, historically, of winning rights is to act as though you have them.