On April Fool’s Day 1984, the Canada Health Act (CHA) was adopted by the federal government. It dealt directly with the transfer of funding for health care from the federal government to the provinces and territories. The CHA set five principles that every province and territory must comply with in order to receive transfer payments. Those principles stated that health care must be: publicly administered, comprehensive, portable, accessible, and universal.
These principles have meant that while provinces and territories across Canada have different GDPs and therefore different abilities to pay for health care, the CHA’s portable and universal principles, along with the transfer of federal funds, have ensured that Canadians receive comparable access to health-care services across the country.
In the last twenty-seven years Canadians have boasted about their ability to walk into a hospital and get the care they require for any medically necessary service without worrying about their ability to pay. Yet, the increasing privatization of our health-care system and the suggestion to experiment with “alternative service delivery” (another term for privatization) from our prime minister has left our system being drained of its resources, people are queue jumping, and the values upon which we built our health system are beginning to crumble.
Increasingly, violations against the Canada Health Act have been occurring across the country. Private clinics have been springing up and forcing exorbitant user fees for patients requiring medically necessary services.1 Dr. Brian Day’s Cambie clinic is an example of how for-profit clinics take advantage of Canadians and our health-care system. Dr. Brian Day was recently involved in a charter challenge in the B.C. courts. He was arguing to dismantle our health-care system, and at the same time refusing the right for the province to look at any of his clinic’s accounting records. He eventually admitted under oath that he was double-dipping and charging both patients and the province for the medically necessary services his clinic provided. This ended up costing Canadians privately and publicly. Not exactly sound fiscal management, but an appropriate example of what for-profit health care is all about: greed.
It is the responsibility of our federal government to enforce the provisions of the CHA which do not allow for user fees and double dipping. Yet our government, under the leadership of Harper and his conservatives have been turning a blind eye. As Shirley Douglas, daughter of the late “Father of Medicare” Tommy Douglas, said to a crowd of 500 in February of this year: “Harper will never, never say he’s against the Canadian health-care system, but the results are all around you…(the system is) being starved to death.”2
While civil society must demand Harper to enforce the minimum requirements of the CHA, other parties are hinting that their platforms will expand the current Act and include some elements of homecare, pharmacare, and long-term care. These elements would prepare Canada for the challenges that we are encountering (and will increasingly encounter) as our population ages. Here’s why:
1. Most Canadians have dealt with long wait times when needing surgery. What most Canadians don’t know is that while they wait to be admitted, beds across Canada are being used by elderly patients waiting to get into a long-term care facility.
2. While waiting for surgery, many Canadians are again, waiting to access a bed in the hospital so that they can recover from their procedure. If homecare were more widely available, Canadians would be able to leave the hospital earlier (which has shown to increase their recovery time) and free up beds so that others can be admitted for their surgery.
3. In New Brunswick, one-third of the province’s hospital beds are being occupied by people waiting for placement in a long-term care facility or for adequate homecare.3
4. There is a lot of rhetoric about Canada not being able to afford its medical system. Yet, the increase in the public health system is minimal. The costs of the public health care system have remained fairly stable at about 5-7% of GDP from 1980-2009.4
5. Where most of money has been spent is in the private sector, especially due to the increasing rise (7.5%-10% per year) in the cost drugs.5
6. This past year 8% of Canadians admitted to not filling their prescriptions because of financial barriers.6 As a result, they often turn to emergency rooms or occupy beds in hospitals in order to get the help they need. If the CHA were expanded to include pharmacare, emergency rooms visits and hospital stays would decrease, making wait times shorter, and costs lower for all of us.7
On the 27th birthday of our Canada Health Act, while our federal government is in the midst of campaigning for a May 2nd election, let’s all unite to be defenders of the CHA. We need to pressure all candidates the enforce and expand the CHA. Access to universal health care is the best birthday gift any of us could ask for, and that’s no joke.
1 Although private clinics are not a violation of the act, those which charge people needing medically necessary services, are in direct violation.
2 PM starving health care, declares Shirley Douglas. Published On Fri Feb 25 2011. Isabel Teotonio Staff Reporter. Toronto Star.
3 André Picard. Globe and Mail. Health system ‘makes a mockery’ of medicare values. Last updated Thursday, Mar. 10, 2011 11:14PM EST.
4 These figures include public health, publicly funded dental care and prescription drugs.
5 Canadian Doctors for Medicare. Neat, Plausible, and Wrong: The Myth of Health Care Unsustainability. February 2011.
Marc-Andre Gagnon. The Economic Case for Universal Pharmacare, 2011.
6 Marc-Andre Gagnon. The Economic Case for Universal Pharmacare. 2011
Adrienne Silnicki, Health Care campaigner, Council of Canadians