“It is equally common sense for our health care system to place greater emphasis on preventing disease and promoting healthy lifestyles. This is the best way to sustain our health care system over the longer term. Keeping people well, rather than treating them when they are sick, is common sense.”
- Roy Romanow, Future of Health Care in Canada, 2002
Governments keep telling Canadians how they are going to “fix” the health care system. Yet many problems are actually getting worse, including longer wait-lists for diagnosis and surgery, over-crowded emergency rooms, and increasing shortages of family doctors.
The state of our health is getting worse, too. One in five Canadian children now have asthma. Almost half of us face cancer at some time in our lives. There is an epidemic of obesity in adults and children, and along with this comes known increased risk factor for cardiovascular diseases, hypertension, diabetes, and other serious health risks. Close to one million Canadians have been diagnosed with Multiple Chemical Sensitivities. Skyrocketing costs for pharmaceutical drugs have now eclipsed all other health care expenditures. (Drugs are, in fact, the fastest rising component in health care costs.)
Throwing more money to the provinces, as has been done by the last two governments, is not achieving concrete results. The 2004 First Ministers Health Accord (http://bit.ly/2004accord) committed $41 billion to health care system improvements, including $5.5 billion over 10 years to reduce wait times. Benchmarks were established in December 2005 in five key health care areas that have been prone to longer waiting times. So far, progress is mixed, even though reducing wait times was one of only five promises made by Stephen Harper in the 2006 campaign. This Health Accord expires in 2014.
As pressure built on Prime Minister Stephen Harper to set out the plan for federal-provincial negotiation of a renewed Health Accord, the Conservatives made a bold move. Finance Minister Jim Flaherty met with the provincial ministers in December 2011 and presented a “take it or leave it” offer.
The federal government has set out a financial formula until 2024. The current 6% per year increase will continue from $30 billion in 2013-14 growing to $38 billion by 2018-19. At that point, the funding formula for federal transfers to the provinces would shift to being tied to the rate of economic growth in each province. (The actual rate is called “nominal GDP,” a measure of GDP plus inflation.) BC Finance Minister Kevin Falcon was pleased with the certainty, while most provincial ministers were angry with the unilateral nature of the federal “offer.”
What I find most troubling is that the federal offer is also “no strings attached.” In other words, the federal government is washing its hands of insisting on national health care standards. Former Saskatchewan Premier and head of the 2002 Royal Commission on Health Care, Roy Romanow, expressed his concern that the federal “no strings attached” approach was “potentially dangerous for the future of Medicare in Canada.” (“Provinces get more autonomy to drive health care reform,” Globe and Mail, December 21, 2011.)
Where all players in health care expected that as the 2014 Health Accord reached its expiration date, there would be a transparent process to negotiate standards and goals in health care, the federal government has walked away from the process, leaving its money on the table.