Thirty Dollars, Please

By April D'Aubin

I was shocked when the woman behind the desk demanded 30 dollars. After all, I was at my neighbourhood health clinic, not the grocery store. Yet, in very short order I was informed that the immunizations I required for travel to the Far East were no longer covered by the provincial medical plan.

That abrupt demand for cash on the barrelhead drove home for me the fact that Canada is rapidly ceasing to be a country which affords all of its citizens basic health care and social services. Our nation is becoming a leaner, meaner type of operation in what’s fast-becoming the classic pattern for the "developed" countries. But is that what we want? And, whether we do want it or not, what will the consequences be for those of us with disabilities if it happens anyway?

John Walton (not his real name), a member of the "thirty-something" generation who has spinal muscular atrophy, had his own rude awakening in one of Canada’s finer hospitals not long ago. While the facility could treat John’s pneumonia, it was unable to provide him with essential attendant care services. Consequently, his health was put at greater risk because he was forced to remain in bed throughout the duration of his hospitalization. It’s Walton’s view that the hospital discriminated against him by failing to meet his needs.

Walton feels that, at times, his very life was in jeopardy. "One of the first things that they wanted to talk to me about," he recounts, "was whether or not I really wanted them to treat my illness aggressively. I was really quite shocked. The first time that I had pneumonia, I was at another hospital. The doctor there did not ask me if I wanted them to make me better." Walton had a further problem with the presumptuous way hospital staff regarded his quality of life during this visit. "I felt," he concludes, "that I wasn’t getting the same service as other patients; that at the non-medical as well as the medical level, I was being treated differently because I happened to have a disability." Activists within the Independent Living movement report that at some hospitals, doctors withhold information about respiratory technology from consumers with muscular dystrophy who are undergoing respiratory problems.

Yet the concern goes well beyond health care alone. For integration into work, adequate personal support services must be available in the community. Personal support services include homemaker services (i.e. household cleaning, laundry, ironing, meal preparation, shopping, banking) and attendant care services (i.e. assistance with eating, dressing, hygiene, bathing, transferring). Personal support services need to be available wherever people with disabilities find themselves: on the job, at home -- or in the hospital.

In Manitoba, consumers with disabilities use publicly funded homemaker services. Recently, however, the provincial government sought to establish a system whereby people with disabilities would be forced to buy homemaker services from community-based service providers. In 1986 --and there is no reason to suppose things are any better seven years later -- almost 57 per cent of Canadians with disabilities lived on less than $10,000. Is this a population that can foot the bill for its homemaking services? Due to a well-attended demonstration on the legislative steps composed mainly of people with disabilities and seniors, the plan was fortunately scrubbed for the time being, though there are those in the know who suggest that this apparent change of heart may be only a smoke screen.

Somewhat ironically, those same traditional services under attack in Manitoba are ones service users with disabilities have identified as quite wide of the mark in terms of their ability to respond to people’s actual needs. The choice and autonomy of self-managed systems represent what is being advocated for today by organizations like the Council of Canadians with Disabilities. Under the self-management model, government entrusts people with disabilities with sufficient funds for the purchase of personal support services. Self-managers select, hire, train and supervise their own staff. Currently, a few pilot projects are testing self-management in a variety of provincial jurisdictions. Few who have seen the model at work are unimpressed by its positive features and potential.

Yet simultaneously, those who clamour for even sterner deficit reduction measures are attempting to dismantle existing social service programs such as Home Maker Services in Manitoba. "Canada just cannot keep giving people everything they want via social programming," they say.

Well, we now have a new federal government. It must be convinced that a meaner Canada is not what the citizenry wants. The next move is ours; what’s it going to be?