What is next for health care in Canada after the Council of the Federation

The Council of Canadians attended the annual Council of the Federation meeting in Whitehorse this week where premiers from across the country gathered to tackle some of the most urgent issues facing Canadians.

“Make no mistake, our universal public health care system is at the most important crossroads in its history,” says Michael Butler, Health Care Campaigner with the Council of Canadians. “The provincial and federal governments need to make the most of this opportunity to negotiate a robust health accord and include medicare’s missing piece, a universal pharmacare program.”

 

In an action alert and open letter to the Prime Minister and Health Minister (which anyone can sign on to here, we explained, “The federal government and premiers from across the country are discussing the future of medicare. With our national Health Accord set to expire in 2017, there are two paths these discussions could take.”

 

Canada has the distinction of being the only developed country with a universal health care system that does not include universal prescription drug benefits. One in five Canadians has trouble filling prescriptions due to cost, while Big Pharma enjoys huge profits. The current fragmented system means worse health outcomes and higher drug prices for Canadians.

 

As the CBC reports, “The final day of the premiers meeting in Whitehorse finds Canada's provinces and territories in search of a common strategy for negotiating higher health transfers from the federal government... The discussions at this year's Council of the Federation start from the common ground of agreeing that no province has enough health care funding to meet its needs.”

Further, at the end of the meeting it was reported that, “Canada's provincial and territorial leaders are calling for a meeting with Prime Minister Justin Trudeau this fall to negotiate a new health accord.”

 

The Whitehorse Star highlighted that, “Michael Butler, national health campaigner for the Council of Canadians, said health advocates came to Whitehorse from as far as Vancouver, Ontario and Newfoundland for the COF. Butler held a massive inflatable pill bottle (the prescription written on it read national drug plan for all) as he spoke about the goal of the protest – to focus on the idea of a national seniors plan and a national pharmacare plan. Too often, Butler said, Canadians can’t afford necessary medications, so they either don’t buy them, or they don’t take them when they should. “We are at a crossroads where we can get it right,” said Butler. He said the country can take steps to protect medicare for future generations, or see a two-tiered system creep in.”

        

 

Hassan Yussuff, president of the Canadian Labour Congress, was one of many to speak to the crowd stating, “Far too many citizens every day are having to make choices – do they buy food, do they pay the rent, or do they get the medication so they can continue to go to work and help make this country a productive country on behalf of working people?” he asked. Jerry Dias, national president of Unifor, said Canada is at a “critical part of our history” when it comes to the health care system. Butler said the current government has shown promising signs, but that Canadians need a firm commitment to stable, predictable long-term health care. “We need to protect and strengthen our health care but also expand it as times change,” he said.

 

In their a press release titled, ‘Health Care Sustainability,’ from the Premiers at the cessation of the meeting, they stated, “Provinces and territories continue to innovate in order to improve the effectiveness of the health care systems, but the imminent reduction in the Canada Health Transfer (CHT) escalator will put enormous pressure on PT health systems and additional investments are required to maintain sustainability. Premiers call on the federal government for an immediate increase in funding through the CHT as part of a greater long-term funding partnership on health care for Canadians.

There was also significant discussion about targeted funding from the federal government. This is a point of division with some Premiers like B.C.’s Clark stating, "Targeting money is good solution," while others like Quebec Premier Couillard believe, “By their very nature, targeted funds are temporary and generally conditional on the achievement of new initiatives that do not necessarily correspond to the priorities of the provincial governments.”

Ottawa wants to make sure the money they are giving the provinces for healthcare end up in specified areas.  This is something the Council of Canadians has called for (for more information see our blog on the last health ministers’ meeting we attended). The rub is that this needs to be done to strengthen patient outcomes and the public health care system not just the federal government’s pet projects (although they may be included if evidence based data shows a need).  We know from the last health accord that provinces often do not spend the federal transfer dollars in the areas that have the most impact, so until good faith is restored we agree with no more blank checks.  

 

As chair of the Council of the Federation this year, Yukon Premier Darrell Pasloski stated, "We stated last year that the federal government should be providing 25 per cent of health care dollars, and what we have heard from the parliamentary budget officer, with the aging population that we have, is this is not sustainable from a provincial or territorial level."

Currently, the federal government’s share of public health spending in the provinces and territories is around 22 per cent.  The Council of Canadians supports the call by many groups and the premiers for the federal government to cover a minimum of 25 per of health funding. The 3% escalator the federal government seems set on with a new health accord just won’t cut it. At the same time in some provinces (like Ontario) through reductions in provincial health care spending has made the federal share is at or over 25% without any significant and fair increases by the federal level.  This is not the situation we want to be in, both sides need to put in the investments to protect, strengthen, and expand our universal public health care.

The next five months will be one of the most crucial periods in medicare’s history.  It is time for federal leadership and responsibility by providing fair funding for a strong health accord and implementing national pharmacare.  It is also time for the Premiers to show willingness for increased accountability with the spending of health care dollars to strengthen the public health care system and patient outcomes. While the two levels of government seem to be playing chicken with eachother, it is really Canadians who are most at risk if solution is not found in the coming months.