Poverty and the Lack of Health Care Related

Michèle Raymond
Monday February 25, 2008

POVERTY AND LACK OF HEALTH CARE RELATED — RAYMOND

Thirty-five years ago, I was waiting for the train in a small New England town. Two well-dressed women were sitting near me in the station cafe, talking. One asked after the other’s grandson.

“He’s all right,” said the grandmother. “But he’ll never walk. We can’t afford the surgery.”

I’ve never forgotten that overheard moment. Even in this prosperous world, people knew that money alone would make the difference between a life fully lived, and one deeply compromised.

Since then, I’ve had many chances to see what happens when people realize that no matter what happens to them, no one will help, and I’ve come to believe that once that knowledge is born in a community, it gnaws its way through every layer of society.

The devastated centres of many American cities are the signs of that knowledge. The barred windows and doors of businesses first defended, and finally abandoned are the immediate backdrop of poverty, but they also form the background of other neighbourhoods, where people live who can afford to move ‘away’. Everyone knows they are there, even if they’re only the mythical place, ‘Don’t go there’.

I had the chance to visit Vancouver recently, and to talk with the local representative for the Lower East Side, where the deeply poor and desperate have congregated. The Lower East Side seems to have reached a critical mass, and to have become more than a gathering of individuals, but an entire community of despair. Lack of health care is a common theme.

Some of the tragedies of the Lower East Side have reached our national consciousness. We know it as the place from which women can be taken with impunity, and simply vanish, and it seems impossible to imagine any such thing happening here.

We’re fortunate that in Nova Scotia, until very recently, we haven’t seen many such places. Yet even here, people do disappear from the radar, and it makes them vulnerable. There are people living in HRM without birth certificates, without homes, without school for their children, without food, or without heat or electricity.

When I hear that our current provincial government plans to investigate ‘alternative service delivery’ in medical care, and the possibility of giving public funds to private health care providers, I worry. I’m reminded of the Auditor General’s 2003 report, which recommended the Department [of Community Services] should “monitor rents being charged by housing sponsors [landlords receiving public money to provide subsidized housing] and assess them for reasonableness in comparison to the market rates”.

In other words, the auditor was saying that if we’re going to pay someone to deliver public services, we’d better at least have a handle on what’s being charged. That recommendation was made five years ago, and to the best of my knowledge, the province hasn’t acted on it yet.

Now the province is talking about expanding that approach to include access to health care, where the stakes are even higher. It’s not that long since Canadians had to save up to pay for medical care. Some of the children whose parents couldn’t afford it, are still suffering the effects.

It’s not as far away as it seems. Lack of access to medical care is one of the surest and straightest roads to the deepest of poverty, and that road runs through every part of the community.

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