It's federal budget time again and everyone from the Council of Canadians to allies, politicians, news outlets and the Twitterverse seems to be abuzz with concerns over what this Harper budget will contain. The world of health care is equally concerned, although much of its fate was laid out by Flaherty at the Finance Minister's meeting in mid-December.
Much like with the health care accord, the federal government is able to tie federal dollars to new programs, services, national standards and benchmarks at any time. The budget gives the Harper government an opportunity to strengthen and expand health care in Canada -- but I'm feeling rather pessimistic that they'll take this opportunity.
There are lots of things I'd like to see in the federal budget, like a commitment to enforce the Canada Health Act, the setting of new national standards on care, the implementation of new universal programs like pharmacare, dental care, mental health services. I'd like for there to be a continuing care plan in Canada that ensures every province and territory is able to help Canadians age with dignity and give Canadians options on how they want to age (i.e. to stay in their own home, get a bed at a long-term care facility, access care at a community centre).
I'd also like to see the federal government acknowledge that it plays a very important role in Canadian health care and I'd like to see them go even further by recognizing that social determinants of health -- such as poverty, education, affordable housing, unemployment, and environment -- play a fundamental role in people's health and well-being as well. But I doubt in yet another austerity budget we're about to see Harper offer any assistance to those who are in most need.
But here's what we do know: Canada has been increasing its use of health-care services. This is partially a result of decreased wait-times and partly because of an expanding range of services (see the Canadian Centre for Policy Alternatives' Alternative Federal budget for a good breakdown of this). Canadians are living longer (yay!) which means a broader range of services are accessed for a longer period of time. So, with more demand and more supply, the costs increase (see Professor Rowe -- I'm figuring out this whole economics thing!).
The problem is then, how do we pay for the services? Well if you listen to the right -- and I'm sure when we all tune into the budget today -- we'll hear that we can't pay for it, it's too expense and it's -- here comes my least favourite word -- unsustainable. But that's just incorrect.
It's nice that the budget comes just after the release of the Senate Committees review on the 2004 health care accord. Now, I'm not a fan that the Senate reviewed the 2004 Health Accord. I firmly believe that it should have been done by the Parliamentary health-care committee -- the Harper government didn't have a majority in Parliament at the time but they did have control of the Senate and so in typical Conservative anti-democratic fashion, the review was struck in Senate. Several of our pro-medicare allies -- including the Canadian Health Coalition and unions and groups representing health care professionals- asked to present to Senate and were turned down. But in a surprising move to many of us, some of the Senates recommendations weren't terrible! In fact, the Senate and I even agree that: Harper and his government need to be responsible and accountable for health care in Canada, pharmacare is necessary and the federal government should take the lead, and we need a continuing care strategy for the country. Whoa!
So if Harper was to listen to the Senate (they have not endorsed all of these recommendations), or to the Alternative Federal Budget, or to the Council of Canadians and our pro-medicare allies they might hear that in this next federal budget we want:
1. Canada needs to implement pharmacare -- a universal drug care coverage plan. Pharmacare would save Canadians $10.7 billion a year or 43 per cent of current expenditure on drugs. Savings would come from bulk-purchasing, using new cost comparator countries for pricing drugs, a single universal public insurer, and a national formulary of essential drugs.
2. A continuum of care strategy is needed to help aging Canadians access appropriate care. An expansion of community-based care, home care and long-term care is needed to reduce wait times across the country.
3. The federal government needs to recommit to the principles of the Canada Health Act: universality, accessibility, public administration, comprehensiveness, and portability.
4. Some provinces are allowing clinics to operate illegally by charging user fees and extra-billing for medically necessary services. The federal government needs to stop this from happening by penalizing those provinces through dollar-for-dollar deductions in cash transfers.
5. The creation of stand-alone legislation for pharmacare, continuing care, dental care and mental health services is essential for truly comprehensive and universal health care across Canada.
6. The federal government needs to negotiate a 2014 health care accord with the provinces and territories that includes: national standards and benchmarks tied to the Canada Health Transfers, pharmacare, continuing care, expanded mental health services, and dental care. The new accord should include a 6 per cent escalating transfer for the duration of a new 10-year accord.
I wish I could tell you that I'm hopeful that all of this will occur. But to be honest, I'm not. I do, however, have the date October 19, 2015 (the next federal election) dance in and out of my thoughts most days. Until then, we'll just keep hammering away with our demands for truly universal and comprehensive health care in Canada. Maybe we can even bug them so much that they give in to our demands and realize that the one per cent isn't worth the suffering of the 99. Too optimistic? I think not.
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