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Roundtable on Health Care in Victoria

So here we are in sunny and snowy (which is rare, I`m told) Victoria, B.C. for the Council of the Federation meeting. The first ministers from across Canada are arriving in Victoria tonight and tomorrow morning to discuss the 2014 health care accord and likely decide what their response is going to be to a Federal government who is calling for accountability in health care from the provinces but walking away from their own responsibilities.

This morning Maude, Ava (B.C. Regional Office) and I joined with pro-medicare allies and health care Critic Libby Davies at a roundtable conference on health care.

The roundtable included presentations by Dr. Kim McGrail (University of British Columbia) and Marcy Cohen (CCPA) on the myths of health care in Canada. Kim looked at the financing versus delivery side of health care and using data from CIHI and Statistics Canada, she countered several myths:

  1. Myth: Canada is spending too much money on health care.
    Fact: Canada is a relatively low funder of health care when shown with comparator OECD countries. Canada needs to restructure the delivery of health care- by moving to community clinics, team based practices, setting up a national pharmacare program, etc- so that we make the most of the money we put into health care.
  2. Myth: The aging population is consuming all of the health care resources.
    Fact: The aging population contributes to a 0.8% increase in funding expenditure. The real growth in health care spending comes from an increase in the use of health care overall especially in expensive areas such as pharmaceutical drugs, new technologies and keeping people in hospitals beds instead of providing them with more appropriate continuing care options.
  3. Myth: Everyone in Canada pays the same amount for health care.
    Fact: Those who are sick and in poverty pay more because of services not covered by medicare (ie, prescription drugs, home care) than those who are healthy. Because of the social determinants of health, it is more likely for people living in poverty to fall ill and therefore they are often paying more for non-medically necessary services because they use them more often.

Mary Cohen gave a background on the 2004 health accord and highlighted several shortcomings which include:

  1. The funding for target areas such as continuing care and primary care was never tracked and therefore it’s unclear where the money was spent.
  2. The plan for a national drug strategy fell in 2006 (the same year the Harper government came to power).

The area that was met was the reduction of wait times and this is likely because of the federal push to reduce wait times and track spending. When the federal government pushed the provinces and allocated appropriate funding, wait times were reduced.

Cohen suggested that we need more accountability across services. All health care professionals should feel engaged in their workplace and accountable for their decision making (including prescribing practices, etc). This has been shown to happen in community clinics where health professionals are engaged in decision making more broadly.

Additionally, Cohen argues that we need integrated and shared budgets across services so that funding follows the patient throughout their health care experience.

What I have really taken away from the meeting today was just how in agreement the pro-medicare community is with one another. People in the room talked about the need for community care centres, pharmacare, continuing care, prevention and wellness programmes. We agree on where the problems and challenges lie and that the private for-profit sector is driving our health care costs and therefore we need to invest in public health care where costs have remained stable for over three decades! And finally, we agreed on the need for federal leadership for the next health care accord. The federal government is responsible enforcing the principles of the Canada Health Act which ensure accessibility, portability, comprehensiveness, public administration, and universality of the medicare system. And we agree that medicare needs to be protected, strengthened and extended.

The NDP promised to campaign more strongly on medicare and the 2014 accord. I hope it’s a promise they’ll keep, we need and invite all voices to stand up to Harper and demand federal accountability in health care now and for the next accord.