Our recovery cannot rest on hope – it depends on investments in people and public services

Last fall, I was rushed to a hospital with a completely unexpected, and absolutely life-threating, illness. I was in hospital for about three weeks, receiving excellent care from our health care workers.

Over the past year, the state of our health care system has constantly been in the public eye. While my situation had nothing to do with COVID-19, the circumstances I saw demonstrated that the strain we are seeing in our public services started well before the pandemic.

Here’s an example: there were not enough commodes (those are bedside toilets for those that can get out of bed, but maybe not quite to the washroom) nor bedpans for patients. Nurses used their own money to buy toothpaste for patients. One would imagine that our hospitals would have the facilities necessary for patients to go to the washroom or brush their teeth. They are essential to feeling like a human being with dignity.

Canadians hold our public health care system close to our hearts. We see it as a universal human right, even if it is not directly codified in our Charter of Rights and Freedoms. To see the health care system under such distress during the pandemic, as are so many other public systems, is a wake-up call.

For decades, governments across the world have focused on the trade-offs they are willing to make between investments in public services and “efficiency.” And in the dogged pursuit of efficiency, the quality of our public services eroded. As a result, our trust and confidence in the ability of government to deliver the supports and public systems we need also eroded.

In Ontario, governments of all political stripes have boasted about how low our per-capita spending on public services is, relative to other Canadian jurisdictions. The fact that this has become a bragging right is telling. It tells us that we have lulled ourselves into believing that we don’t need to invest in the services that enable our ability to live with dignity. In doing so, we’ve rationalized the extreme rationing of care, the inadequacy of income supports, and the utter unaffordability of housing. We tell ourselves that we can’t do what it takes to raise the revenue we need to invest in our communities and systems.

The pandemic not only forces us to think about our collective values, but also requires us to ask whether our governments are making policy decisions rooted in evidence. And the evidence demonstrates that investments in our people and systems is what helps make us and our economy resilient against, and through, shocks like the pandemic.

In a recent analysis of how OECD countries fared in the initial phases of the pandemic, governments that imposed “restrictions early and severely, keeping deaths per million low, also had a low decline in GDP.” In contrast, governments that tried to protect jobs by loosening restrictions “haphazardly” had some of the most significant declines in GDP. Even the IMF has called on governments to invest in people, public systems, and firms to support the post-pandemic recovery.

Politicians enter politics because they feel they can make things better for people. But feelings and evidence should work hand in hand. And when the evidence weighs against ideology, a change of course and contrition is required. The continuing damage outweighs the political risks of not changing course.

Controlling the spread of the virus requires stopping transmission at the source, and requires public policy responses outside of health care. This includes measures to support those who lose their jobs, those living in poverty, and ensuring protected paid-sick leave for workers. The Ontario government’s failure to implement such measures has enabled the high transmission of the virus in workplaces and shelters. It has had significant and unequal health and economic impacts on lower-income families and on racialized communities. While the Ontario government continues to abdicate its responsibility on these fronts, we’re deepening the impacts of the pandemic and making our recovery more challenging.

During my stay in hospital, I was lucky to have had family and friends drop off care packages with necessities like toothpaste. I am privileged to have a great employer and an insurance plan that enables me to afford most of my medicines outside of the hospital. But I know that the same grace is not afforded to millions of others.

We have relied for far too long on the hope that governments—guided either by their values or evidence—will do the right thing. But hope doesn’t build public systems. Investments do.