The National Health Care
Summit: Good and Bad
Sometimes it seems that Canada’s
health care system
has evolved into little more than a battleground, with patient care
hanging by a thread above the fray of federal and provincial
squabbles about Constitutional jurisdiction and funding. So the
cease-fire achieved at the end of a three-day summit among the
country’s first ministers in mid-September was certainly welcome.
But was the agreement good or bad for
answer is yes--it was good and bad. Here is a brief rundown.
1. The Good
The premiers and Paul Martin reached a
that will see $41 billion in federal cash transfers to the provinces
and a plan to reduce wait list – and that promises to put the
country’s health care system on a more secure footing in the
decade. It will also move Ottawa towards a 25 per cent federal
contribution level – and a step closer to the goal of
re-establishing health care as a national (instead of provincial)
program with national contributions at 50 per cent.
One of the most important
involve the provinces at all. Prior to the health care summit the
federal government met with leaders from the Assembly of First
Nations, the Inuit Tapiriit Kanatami, the Métis National
Council, the Congress of Aboriginal Peoples and the Native
Association of Canada.
Ottawa and the Aboriginal
to a plan that will allocate $700 million over five years to
implement “specific measures to close the gap between the health
status of Aboriginal Peoples and the Canadian public.” The plan
includes $100 million for an Aboriginal Health Human Resources
Initiative designed to recruit and retain aboriginal health care
workers. The success of this agreement will obviously depend on how
much control Aboriginal people will exercise over the money, but
a good move in the right direction.
Another exciting development, which occurred in the
up to the health summit, was the successful efforts of the Canadian
Federation of Nurses’ Unions and the Canadian Health Coalition to
convince the provincial premiers to endorse a National Pharmacare
Program. The proposal called on the first ministers to
the costs of pharmacare from provincial to federal jurisdiction. As
the CFNU pointed out, most of the policies, which determine the cost
of prescription drugs in Canada--the federal government enacts such
things as drug patents and drug approvals. But Ottawa downloads the
impact its policies and regulations have on the cost of drugs to the
provinces and private payers. Over the past decade public spending on
drugs has tripled to $7.6 billion, while private spending has reached
The first ministers also agreed
provide certain home care services in the public health plan by 2006,
including short-term home care for two weeks, short-term care in
community mental health homes for two weeks and end-of life care,
with a further strategy for home care by Dec. 31, 2006.
Another plus was that Ralph Klein left the summit
2. The Bad
Despite the consensus among provincial
backed by a majority of Canadians in public opinion surveys, Martin
and health minister Ujjal Dosanjh (along with the drug industry) gave
the Pharmacare plan a thumbs down. They claimed it would cost too
much money – but the point is that Canadians cannot afford NOT to
have a national program. Despite their predictions about a $12
billion price tag, a national program that covered only safe,
effective and affordable drugs, using the essential medicines list
recommended by the World Health Organization as a starting point, is
completely within the realm of possibility.
Instead of putting all 5,000+ drugs
currently on the
Canadian market into a national drug plan, we need an arms-length
committee of progressive non-industry experts and consumers to
determine which drugs should be covered. The WHO list is a good
starting point and, in addition to tough bargaining with the drug
industry on drug prices, Canadians could significantly reduce the
amount of money we’re spending on medicine.
Fortunately, the first ministers
did agree, at
the end of the summit, to form a task force to develop and
implement a national pharmaceutical strategy by
June 2006. This gives us time to organize a mass movement in support
of a national program.
The deal also left out some of the most
identified by Canadians – the privatization of health care
and the push by Big Business to put its nose firmly in the public
insurance trough; the lack of accountability by privatizing and
delisting provinces; and the continued failure of the federal
government to enforce the Canada Health Act. There also was no
mention at all of long-term care, a glaring oversight.
The failure to address privatization was
especially given the overwhelming evidence that private for-profit
delivery of health services lowers the quality of care, increases the
rate of death especially among the most vulnerable, and costs
significantly more money. The premiers and the Martin government had
an opportunity to provide strong leadership on this question, but
instead we were treated to belligerent premiers insisting that they
wanted federal dollars with no strings attached.
British Columbia is one of the most
offenders when it comes to Canada Health Act violations, so this
issue is an urgent one for us. We got no relief at the summit table
on this issue.
We will have to continue fighting on that
issues, but we did make some significant progress this summer on the
health care front. There is more money from Ottawa, which should
enable the provinces to re-invest in long-neglected areas of social
service. We put pharmacare on the national agenda and it will be hard
for Ottawa to remove it. The fact that there was a summit at all is a
direct result of our fight to defend Medicare in the first place.
We’ve made progress – take a deep breath before the next