Council of Canadians chairperson Maude Barlow and health care campaigner Adrienne Silnicki are now in Victoria for a critical Council of the Federation (the provincial and territorial first ministers) meeting to be held on January 16-17 (at the Inn at Laurel Point) focused on the Canada Health Accord.
Tomorrow, Sunday January 15, Barlow will participate in a roundtable at 10 am PT at the Hotel Grand Pacific organized by NDP health care critic Libby Davies. UBC professor Dr. Kimberlyn McGrail and Canadian Centre for Policy Alternatives research associate Marcy Cohen will also take part in the roundtable discussion. The next day, Monday January 16, Barlow will be speaking at a media conference at 9 am PT also at the Hotel Grand Pacific on the need for a health accord that will protect, strengthen and extend Medicare. Vince Terstappen of Check Your Head, Val Avery of NUPGE, and Dr. Vanessa Brcic of Canadian Doctors for Medicare will also be speaking at the media conference. And that same day at 6:30 pm PT, Barlow will be speaking at a public forum at the Da Vinci Centre. The other speakers will be Diana Gibson of the Parkland Institute and Mike Luff of NUPGE. This public forum will be video-taped and posted to our website.
Overall mainstream media framing
Mark Kennedy of Postmedia News reports, “Spending has been running rampant in recent years, cutbacks are on the way, long-promised national reforms are nowhere to be seen and an aging and growing population is putting even more strain on the system. The premiers are looking for a solution to their problems and some are hoping Prime Minister Stephen Harper’s Conservative government eventually comes to the table with cash to assist in reforms and initiatives such as home care and seniors care. But so far, Harper is cautiously standing back – giving provinces a long-term funding plan that falls short of what many premiers had wanted, urging them to get their spending under control and stressing the importance of keeping the future system financially sustainable.”
Federal funding plan means $31 billion shortfall
In terms of numbers, Kennedy reports, “In December, federal Finance Minister Jim Flaherty unilaterally unveiled a non-negotiable funding plan that runs to 2024, but which falls short of what provinces had hoped for. Federal health-care transfers will continue to increase by 6% until 2016-17. After that, increases will only be tied to economic growth including inflation -currently roughly 4% – and never fall below 3%. This week in Ottawa, parliamentary budget officer Kevin Page released a report concluding the plan will place a huge financial burden on the provinces. He expects cash transfers to the provinces to grow at 3.9% annually, on average, from 2017-18 to 2024-25 – compared to provincial-territorial health bills, which he forecasts will grow by 5.1% a year. Moreover, if the funding plan stays in effect beyond 2024, the implications are stark: The federal share of medicare spending would gradually fall from its current level of 20.4% – eventually hitting 13.8% in about 40 years, and then 11.9% two decades after that.”
Postmedia’s Jason Fekete adds, “The smaller annual increases in health transfers will cost the provinces approximately $31 billion over the life of the new 10-year health plan, Page said. Under such a scenario, federal finances would be sustainable over the long term, allowing Ottawa to balance the books much more easily. However, the financial health of the provinces would only worsen – forcing provincial and territorial governments to either raise taxes to generate more revenue or cut programs and services, Page said.”
Differing views among the premiers
Kennedy points to the differing views among the First Ministers, “That new approach from Ottawa – a stark contrast to previous Liberal federal governments that sought to ensure national standards are in place for medicare – has left premiers scrambling with different reactions. Western premiers don’t necessarily mind Harper’s hands-off strategy, while some other premiers have voiced concerns that medicare could be headed toward a patchwork-quilt system that lacks equity between regions.”
CBC reports this morning, “B.C. Premier Christy Clark says announced changes to federal government health-care transfers to the provinces won’t work for British Columbia, where a rapidly growing senior population is dramatically increasing medical costs to the province. The federal finance minister announced last month that after the 2016-17 fiscal year, Ottawa will institute a change in the per-capita funding system that would be tied to Canada’s gross domestic product, but is guaranteed to be at least three per cent. …Clark told CBC News Friday that provinces will need ‘an age-adjusted per capita formula implemented’ in order for the federal plan to work sufficiently. …Clark said the fastest growing demographic in B.C. is people over 85, and the province would be especially hard hit unless the per-capita formula changes. …B.C. Finance Minister Kevin Falcon said B.C. would lose as much as $250 million a year under the new formula as it’s currently conceived. …(That said), Clark did praise the federal decision to give provinces more responsibility for health-care policies, saying it is a step in the right direction.”
Jane Taber of the Globe and Mail reports, “Saskatchewan Premier Brad Wall is planning to push his provincial colleagues to band together and ask Ottawa for a health care innovation fund that would provide extra money for projects to improve patient care. …He will take his proposal to the premiers’ meeting in Victoria next week, and told The Globe and Mail that he believes the federal government has left the door open to doing more on health care than it is currently offering. …More than 40 per cent of Saskatchewan’s budget goes to health care; other provinces’ budgets are similarly consumed. Mr. Wall noted the new accord has divided the premiers – MOST in the West like it and those in the East are not so happy. Nova Scotia’s Darrell Dexter, for example, believes the new funding formula will hurt smaller and less wealthy provinces such as his. Mr. Wall said an innovation fund could be used to help finance projects such as Saskatchewan’s program to reduce waits for some kinds of surgery, such as orthopedic. …He said an innovation fund could also help the provinces set up electronic health records. ‘Here is a way to drastically improve health care in a country that is still very rural…electronic health records can really improve health care delivery and make the system much more efficient and probably in the long term save a lot of money,’ he said. All provinces, he argued, are facing ‘massive’ costs in terms of converting to digital records.”
Federal-provincial tensions over health care
Janet Davison of CBC News reports, “Several big issues loom this year and they threaten to ratchet up the federal-provincial stress levels; though probably not to the extent they were during the days of Pierre Trudeau or Brian Mulroney. ‘We’re in, I think, for reasonably tense times between the levels of government,’ says Richard Simeon, a professor emeritus of political science and law at the University of Toronto. …Topping the list of 2012 stress points is health care and paying for it. Federal Finance Minister Jim Flaherty dropped a health-care funding bombshell in December that split the premiers and set off loud complaints about the lack of any negotiation. ‘There was time, everyone thought, for a process of consultation and conversation,’ says Michael Prince, a social policy professor at the University of Victoria. But ‘this is a prime minister who has not been very keen on holding first ministers’ conferences.’ …The (Harper government’s) take-it-or-leave-it plan ‘is obviously going to be very, very controversial,’ Simeon says.”
Small federal role + less federal funding = privatization
Last week, Postmedia’s Kennedy reported, “Prime Minister Stephen Harper must join Canada’s premiers at the negotiating table to discuss medicare reforms or the country’s public health care system will grow weaker, medical privatization will spread and national unity will be imperilled, says Roy Romanow. The former Saskatchewan premier, who led a royal commission on health care a decade ago, said in an interview that he is worried the Harper government has adopted a deliberate strategy of leaving health care to the provinces – possibly to foster the development of more private, for-profit medical companies. His concerns come in advance of a premiers meeting in Victoria next week on health care and as Harper maintains his distance over direct involvement in the first ministers’ talks. …(Romanow) said that his commission found that Canadians viewed health care as a ‘social good’ and that the national medicare system should be built on that foundation. …’To say, ‘Goodbye and good luck’ could be the beginning of the end of a reformed modern-day functioning health care system,’ said Romanow. ‘If that argument is advanced, we have a prescription for a patchwork-quilt series of programs by the provincial governments based on their fiscal capacity. It will mean more privatization in more provinces, or some combination of private and public.’ …Romanow said Harper’s interpretation of how the Constitution spells out responsibility for health care to provinces is wrong. He said there is a long history of federal prime ministers – dating back to Conservative John Diefenbaker and Liberal Lester B. Pearson – using the federal spending power to help build a national health system. Romanow said only the federal government can provide the leadership to set programs and standards.”
Bilateral agreements?
Jessica Murphy of Sun News reports, “A possibility are separate bilateral federal-provincial deals rather than a broad multilateral agreement along the lines of the original health accords, which expire in two years. ‘The answer’s not obvious,’ the University of Ottawa’s Patrick Fafard said. ‘Do we have one health care system or do we have several?'”
The Council of Canadians
No to inequality and privatization
We were in Halifax on November 24-25, as reported by Karen Howlett in the Globe and Mail then, for the first in “a series of high-stakes discussions that will lead to a new health funding deal between Ottawa and the provinces… Efforts to identify priorities will begin here, be continued next month by provincial and territorial finance ministers and culminate with a gathering of premiers in January. …The series of meetings starting in Halifax are being cast by defenders of public health care as a key point in the battle to prevent privatization. Council of Canadians chair Maude Barlow linked it to the recent Occupy movement and expected it to be a ‘galvanizing fight’ across the country. …Ms. Barlow, with the Council of Canadians (is) linking this fight to the broader issue of inequality. ‘What we’re saying here is that we’ve watched this erosion [of equality] but we’re not going to put up with it with health care,’ she said. ‘I think it’s going to be a galvanizing fight across the country. And you just watch how excited Canadians are going to get about defending their health care system.’”
Yes to a 10-year accord with six percent increases, as well as pharmacare, continuing care and dental care
Keith Doucette of the Canadian Press reported at that time, “Maude Barlow of the Council of Canadians said the federal government should commit to a 10-year health transfer plan with the provinces that would see a six per cent increase in funding annually. ‘At the moment, the Harper government is only committed to 2016, so we are very concerned that they have no intention of carrying it beyond that,’ said Barlow. She told a news conference that the Canada Health Act must also be enforced to stop private health care services from eroding the system. Barlow also called for health care coverage to be broadened to include pharmacare, continuing care and dental care.”
Yes to at least 25 percent federal funding
We have also indicated our support for the Romanow Commission on the Future of Health Care in Canada recommendation that the federal government should not pay less than 25 per cent of provincial health costs. This is notable given the Parliamentary budget officer’s statement that if the Harper government’s funding approach were to extend beyond 2024, “The federal share of medicare spending would gradually fall from its current level of 20.4% – eventually hitting 13.8% in about 40 years, and then 11.9% two decades after that.”
Yes to public solutions
Health care campaigner Adrienne Silnicki has written in the Chronicle-Herald, “Public solutions such as a national Pharmacare program could save Canadians $10.7 billion a year, but the Harper government refuses to recognize its responsibility for health care, claiming it is ‘provincial jurisdiction’. Without federal leadership and tied Canada health transfers, it is unlikely any of the needed health care programs — such as home care, long-term care or Pharmacare — will be realized across the country.”
Yes to a single omnibus accord that strengthens our public system
Last June, Barlow wrote in the Huffington Post that, “It is with trepidation that Canadians should anticipate the approach of 2014, the end of the 10-year health accord signed in 2004 between the federal government and the provinces, necessitating a new round of negotiations on federal transfer payments for health care. The 2004 accord set out an extra $41.2 billion in dedicated funding for health care issues such as waiting times, expanding home care and dealing with high drug costs as well as a six per cent increase in health transfer payments each year form the federal to the provincial governments. However, when the accord expires, this annual increase is no longer guaranteed. Many worry that the Harper government will take this moment to fundamentally change the nature of health care delivery in Canada, giving more authority to the provinces but finding ways to down load the fiscal responsibility at the same time. …It is essential that our movements for social justice begin now to prepare for this coming fight and put out our key demands for a single omnibus accord as well as what it should look like. The 2014 negotiations should be used to strengthen our publicly funded system, which has proven itself to be both cost effective and fair, and we should be calling for a ‘Canada Health Accord Plus’ that includes home and senior care, aboriginal health and a pharmacare plan. …Canadians cherish our public health care system. With a Harper majority, it is now urgent that we stand on guard for it, lest it be destroyed by stealth in complicated negotiations and lost in a myriad of betrayals.”
For Council of Canadians blogs on the Canada Health Accord, please see http://canadians.org/blog/?s=%22health+accord%22.
