Future of Canadian health care needs attention now

B.C. Health Coalition co-chair Rachel Tutte says that enhanced home care and a national drug program would save public-health dollars.

Kim Stallknecht

Ordinary Canadians are losing their say about the future of an institution that’s central to their national identity: universal health care.

With Ottawa absent from the negotiating table, prospects aren’t encouraging for the creation of a new health accord to replace a 10-year agreement between the federal government and the provinces and territories. The pact expires in 2014.

Without a renewed deal, opportunities to make the system more efficient will be squandered, according to the co-chair of the B.C. Health Coalition, a network of organizations that support public health care.

“We can make it completely sustainable,” Rachel Tutte told the Georgia Straight in a phone interview. “There are changes that need to be made to the system, but it’s totally doable. We don’t have to succumb to private health care.”

A physiotherapist who works at a Vancouver hospital, Tutte identified two areas where federal, provincial, and territorial governments can work together to make public health care cost less.

One is a national pharmaceutical program. “That will save money across the board, and, of course, the more provinces that are doing it, the better leverage they have with the pharmaceutical companies,” she said.

Another is a Canada-wide program providing care for people in home and community settings. “We need to keep people out of hospitals if we can,” Tutte said. “Hospitals are expensive.”

These two measures were among the 46 recommendations made by a Senate committee that reviewed the 10-Year Plan to Strengthen Health Care agreed to on September 16, 2004.

In its March 2012 report, the Senate committee on social affairs, science, and technology called on the federal government to work with the provinces and territories to develop a “national pharmacare program” as well as a “pan-Canadian Homecare Strategy”.

The committee recognized that “continued dialogue and collaboration” and “federal leadership” were key to its recommendations.

The report followed in the wake of a December 2011 announcement by the federal government of a change to federal health transfers to the provinces and territories starting in fiscal year 2017-18.

Under the funding formula laid out by Finance Minister Jim Flaherty, Ottawa will continue to increase the Canada Health Transfer by six percent per year until 2016-17. After that, CHT cash transfers will grow in line with the rate of economic growth plus inflation, with guaranteed funding increases of at least three percent per year.

Even though health transfers will no longer be tied to provinces’ meeting certain conditions (including the reduction of wait times), as was stipulated in the 10-year accord, Health Minister Leona Aglukkaq claimed subsequent to the funding announcement that the federal government will still have influence over health policy. Aglukkaq has also talked about laying the groundwork for discussions with provincial and territorial ministers regarding the improvement of health-care standards after the 2004 accord expires next year.

Although Canada ranks above average in per capita health spending and expenses in relation to GDP among nations belonging to the Organisation for Economic Co-operation and Development, it lags behind its OECD counterparts on a number of indicators. According to OECD figures released last year, Canada had 2.4 doctors for every 1,000 people in 2010, compared to the OECD average of 3.1 doctors.

With a federal funding scheme already set, SFU public-policy professor Sharon Manson Singer doubts future talks will be productive.

A B.C. deputy minister from 1997 to 2001, Manson Singer suggested that Canadians have a “lot to be concerned about” because they and their elected provincial and territorial representatives have been prevented from having a meaningful conversation about the future of health care.

“We’re not paying attention because we think that it is all okay,” Manson Singer told the Straight in a phone interview. “I mean, ‘Oh well, we’ve got universal health care. Been there, done that. So it’s all finished, right?’ It’s not true.”