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Opinions About Public Healthcare from Working OPINIONS ABOUT PUBLIC HEALTHCARE FROM WORKING-CLASS LEADERS IN SASKATCHEWAN A Thesis Submitted to the College of Graduate Studies and Research In Partial Fulfillment of the Requirements For the Degree of Masters of Education In the Department of Curriculum Studies University of Saskatchewan Saskatoon By SEAN MICHAEL POLREIS Copyright Sean Polreis, December, 2013. All rights reserved. Permissions In presenting this thesis in partial fulfillment of the requirements for a Master’s degree from the University of Saskatchewan, I agree that the Libraries of this University may make it freely available for inspection. I further agree that permission for copying of this thesis in any manner, in whole or in part, for scholarly purposes may be granted by the professor or professors who supervised my thesis work or, in their absence, by the Head of the Department of Curriculum Studies or the Dean of the College of Education in which my thesis work was done. It is understood that any copying or publication or use of this thesis or parts thereof for financial gain shall not be allowed without my written permission. It is also understood that due recognition shall be given to me and to the University of Saskatchewan in any scholarly use which may be made of any material in my thesis. Requests for permission to copy or to make other uses of materials in this thesis/dissertation in whole or part should be addressed to: Head of the Department of Curriculum Studies University of Saskatchewan 28 Campus Drive Saskatoon, Saskatchewan S7N 0X1 Canada OR Dean College of Education University of Saskatchewan 28 Campus Drive Saskatoon, Saskatchewan S7N 0X1 Canada i Abstract The Canadian public healthcare system is consistently rated as highly important by the public. It is a treasured institution, and concern for its future is understandable. However, despite the valuing of the five principles of the Canada Health Act – public administration, comprehensiveness, universality, portability, and accessibility – defense of the public nature of the system seems to be waning; the appetite for a certain amount of privatization appears to be increasing. Saskatchewan, the birthplace of socialist governance in Canada as well as Medicare itself, would seem an unlikely place for this occurrence. However, despite a recent incursion of privatized elements into the healthcare system, there appears to be little in the way of fervent opposition. This lack of resistance is especially interesting among working-class people in Saskatchewan, a demographic group who stand to lose much if Canada’s healthcare system would ever transmute into something akin to the healthcare system in the United States. This study was designed to better understand how working-class people in Saskatchewan perceive the healthcare system in Canada, as well as the political, social, and economic factors influencing their beliefs. Over the course of one and a half months in the fall of 2012 I conducted 10 in- depth interviews with labour union representatives and executives. In addition to investigating the beliefs and opinions of my participants, I asked them to approximate how their membership would view similar issues and questions. The results illustrate a public that is being influenced heavily by neoliberal rhetoric, including the ethos of individualism, and mostly one-sided media messages about a so-called ‘crisis’ in Canada’s public healthcare system. It appears as though the public has grown somewhat apathetic about social programs like Medicare. This combination is a perfect storm of conditions that has the potential to fundamentally change the nature of Medicare in Canada. Everyone in Canada - as funders and users of the system - has a ii stake in the future of Medicare. Policy changes to Medicare need to be informed by a better understanding of the influences on people’s opinions of the system. iii Acknowledgements This study would have had no chance of completion without the guidance, direction, and support of my supervisor Dr. Paul Orlowski and my advisory committee member Dr. Janet McVittie. Their knowledge in social and political matters is unparalleled and they provided valuable insight throughout my study. Their dedication and encouragement provided much needed inspiration during what seemed to be a very long process. Their friendship and kindness afforded the balance and understanding needed to complete my work. I would also like to thank my external examiner, Dr. Michael Cottrell, for his valuable insights and suggestions. I would also like to express my gratitude to my sister, Sheilah Polreis, who so kindly transcribed my interviews saving me hours of time, some of which I was able to dedicate to analysis and writing. iv I would like to dedicate this study to my mother Myrtle Theis and my partner Andrea Book. My mother provided me with all of the love and support anyone could possibly imagine and more than enough for any one lifetime. In addition, her work ethic and dedication to her own education (in addition to numerous other aspects of her life) provided the kind of inspiration that leaves one little chance but to attempt to duplicate it. My partner Andrea was caring and so thoughtful throughout the process of my thesis work. She provided me with all of the enjoyable escapes I needed, the time to work on my own, and the human sounding board so valuable when ideas are coming fast and furious. Andrea’s knowledge of, and patience with, Microsoft Word were also invaluable – skills and behaviours I am light years away from mastering. v Table of Contents PERMISSIONS ......................................................................................................................................................... I ABSTRACT .............................................................................................................................................................. II ACKNOWLEDGEMENTS ......................................................................................................................................... IV DEDICATIONS ..................................................................................................... ERROR! BOOKMARK NOT DEFINED. LIST OF TABLES ................................................................................................................................................... VIII LIST OF FIGURES .................................................................................................................................................... IX CHAPTER ONE: INTRODUCTION ............................................................................................................................. 1 1.1 SOCIALIST SASKATCHEWAN? ....................................................................................................................................... 1 1.2 AUDIENCE AND DEFINITIONS ..................................................................................................................................... 11 CHAPTER TWO: LITERATURE REVIEW ................................................................................................................... 15 2.1 STATE OF MEDICARE – CRISIS OR NO CRISIS? ............................................................................................................... 16 2.2 HEALTHCARE: PRIVATE COMMODITY OR PUBLIC GOOD? ................................................................................................ 19 2.3 DETERMINANTS OF HEALTH ...................................................................................................................................... 23 2.4 GOVERNMENT INFLUENCE ........................................................................................................................................ 24 2.5 NEOLIBERALISM’S INFLUENCE ................................................................................................................................... 31 2.6 FALSE POLITICAL CONSCIOUSNESS AND HEALTHCARE ..................................................................................................... 38 2.7 SUMMARY ............................................................................................................................................................ 41 CHAPTER THREE: RESEARCH DESIGN AND METHODOLOGY ................................................................................. 44 3.1 QUALITATIVE APPROACH ......................................................................................................................................... 44 3.2 PARTICIPANTS AND INTERVIEWS ................................................................................................................................ 46 3.3 INTERVIEW QUESTION CONSTRUCTION ....................................................................................................................... 49 3.4 RECRUITMENT ....................................................................................................................................................... 50 3.5 INTERVIEWS........................................................................................................................................................... 53 3.6 DATA ANALYSIS ...................................................................................................................................................... 54 3.7 SUMMARY ...........................................................................................................................................................
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