Let's take medicare down the right path

Last week the federal health minister met with her provincial counterparts to discuss the future of medicare. The Council of Canadians joined other health allies at the meeting and shared our priorities with the ministers at the meeting.

The Council of Canadians calls for:

  • A new Health Accord for an adequate period of time (a ten year period or comparable length to the 2004-2014 Accord).
  • Increased funding at a minimum of a 6 per cent increase per year (as with the previous Accord)
  • Reaching a minimum 25% federal share of health funding by 2025
  • Conditional funding to uphold the CHA and an accountability framework to ensure funding reaches needed areas of the public health system
  • Funding to support and strengthen the universal access to publicly funded and delivered medicare
  • A national senior’s strategy.
  • Focus and adequate funding on a continuum of care from the hospital to the home.
  • Established through stand-alone legislation, with Canada Health Act standards, minimum staffing standards and a program to phase out for-profit delivery.
  • A comprehensive national pharmacare program that is universal and provides first dollar coverage.
  • Access must be based on a patient’s need and not their ability. The program must cover the full cost of covered drugs without deductibles or co-pays.
  • Public administration for the program ensuring appropriate use of drugs, public education and monitoring
  • An evidence-based national formulary drawing on the best clinical and economic facts. All drugs on a national formulary must be covered under the program.
  • ‘Carving out’ health care from harmful international trade deals and a creating mechanism addressing the impacts of negotiated deals.


(Council of Canadians rally with allies for health care outside the health minister's meeting)

This meeting was about more than federal/provincial wrangling, it was really about the future of medicare in Canada.  Make no mistake, the next year is perhaps the most important period for our universal public health care system since its creation.

It is important that the provincial and territorial governments, along with their federal counterparts, start out moving in the right direction.  We know that once momentum starts moving down one path with governments, it is difficult for them to change direction.  It is for this reasons that the Council of Canadians will be lobbying federal MPs this week with our priorities to ensure our elected representatives act in medicare’s best interest.


(Council of Canadians rally with allies for health care outside the health minister's meeting)

Back to the health minsiter’s meeting.  An announcement of shared health priorities between the provinces/territories and federal government was made at the conclusion of the meeting. During the talks the provinces continued to push for a minimum of 25% federal funding for health care by 2025 (which should include a 6% escalator) and while no dollar value was set at the talks the joint statement that ‘new resources’ are needed. In an interview with CBC, Minister Philpott stated that there is no timeline in regards to signing a new health accord and she wouldn’t commit to having it done by October of this year (she did not there will be talks in the coming months). The coming months will be extremely important to show if Ottawa is still committed to universal public health care.

It seems little talk occurred regarding Canadian Health Act (or atleast not publicly) and tying federal funding to adherence.  While the provincial ministers seemed eager to talk about scrapping the Harper governments per capital version of the Canadians Health Transfer, more talk and federal leadership will be needed to come up with a solution.

 
(Council of Canadians, National Health Care Campaigner, Michael Butler speaks to the media)

We heard a lot about ‘transformation’ in the health care system.  While the meaning is vague, we demand that any such transformation be guided by patient outcomes and supporting our public system (as opposed to transformation as adoration of business management models and buzzwords as the miracle cure for our health system).

The ministers did agree to work on home care, mental health and innovation over the next several months. Much of the talk surrounding this involved expanding health care being delivered in the community and meeting the Liberal government’s $3B election promise to improve home care.  The worry which we raised going into this meeting is that evidence-based studies show that we need a continuum of care.  This means we need to invest in a full continuum of care, from acute care to community care, to provide for the best health outcomes; governments want to offload acute care outside the hospital so care falls outside the CHA and opens the door for privatization and lower standards.  



(Health Care supporters sent in their hopes for health care which were strung up at the action)

To be fair, some things are certainly changing for the positive (although after years of the Harper government the bar has been set so low you can trip over it...).  Minister Philpott began her trip by visiting Vancouver’s long-standing supervised injection site on Vancouver's Downtown Eastside and it has been reported she called the experience "incredibly moving."  This is in stark contrast to the conservative party who spent huge resources fighting safe injection sites for political gain, than actually trying to support policy that saves lives.

There was also some promising movement on the pharmacare file.  The federal government will join the provinces in their bulk-purchasing initiative through the pan-Canadian Pharmaceutical Alliance, which negotiates lower drug prices on behalf of public drug plans.  This is a baby step in the right direction, but as we pointed out earlier, it only partially contains costs while not addressing accessibility and health outcomes for patients.

 


 
(Health Care supporters sent in their hopes for health care which were strung up at the action)

While no concrete plan for universal pharmacare with first dollar coverage came out of the meetings, a working group was set up to address "accessibility, affordability and appropriate use" of pharmaceutical medications. Minister Philpott highlighted the formation of a working group to discuss a national pharmaceutical strategy, saying she had "considerable" discussions with her colleagues about a potential shared approach.

While questions remain on who would establish the national formulary (there are murmurs private industry being involved, which creates significant pitfalls to the equity and access of medications), we still don’t know what direction the federal government and the provinces/territories will go.  Will they stop at catastrophic coverage in the working group. which will not address access issues and may create many more problems? Will they cover only some drugs and not others?  Will harmful trade deals that hurt the chance of pharmacare be addressed? These and many question still remain.


 
(Hope for Health Care messages given to Health Minister Philpott)

On a positive note, Ontario Health Minister Ed Hoskins says he’d like to see a national drug plan in place by 2017 as a fitting achievement for Canada’s 150th birthday and the 50th anniversary of medicare. In another interview (on CBC Toronto Metro Morning which is worth a listen to for those who aren’t up early) Minister Hoskins outlined how the issues of fairness, equity and access need to be addressed through the working group which every health minister agreed to form.  He also goes on to mention that it is not just cost elements we need to look, but we need to move beyond a patchwork approach and finally provide fairness and equity to Canadians through pharmacare.


(Press conference concluding the Health Ministers meeting)

There is a lot of work to be done in the near future to push the governments to put patients and our universal public health care system first.  The Council of Canadians will be in Ottawa this reminding MPs that we need a robust health accord, a strengthened continuum of seniors care, and a universal comprehensive pharmacare program.

For more photos visit here.