Active federal participation in health care remains essential

Canadians take pride in their health system but are aware of its shortcomings.

By Danielle Martin
TheStar.com
April 14, 2012

I don’t know about you, but in my house we don’t each buy our own toothpaste. It’s not a good use of money to have multiple small tubes scattered around the sink — not to mention the wasted time if each family member makes a separate trip to the drugstore. We agree on a brand, buy one big tube, and save our money and time. Ditto with planning meals: one person buys the groceries. We may each be responsible for feeding ourselves, but we all have access to whatever is in the fridge.

I share this just in case the prime minister and premiers do things differently at their houses and might find the approach instructive. Because it’s clear that when it comes to health-care policy, they’re wasting the family budget buying multiples of everything, and everyone is cooking a different dinner. To make matters worse, the person who’s supposed to be the head of the family has left an allowance on the table and gone on vacation. Indefinitely.

Whose job is it to co-ordinate health-care reform in Canada? Canadians expect our federal government to play that role. We want to know that wherever we live, we will have access to an equivalent basket of services. We want to know that our governments are buying in bulk whenever possible, maximizing savings. And we want assurances that some basic standards are being met from coast to coast to coast. Health care may be a provincial responsibility, but we know there’s a need for a family to co-ordinate its efforts.

So when the Harper government plunked a 6-per-cent escalator on the table and walked away from its role in health care, I was disappointed. And it seems I wasn’t the only one.

A recent Environics poll on health care showed a sea change from 10 years ago — 62 per cent of Canadians think that health care is about more than just money, it’s about what our leaders do with it. That’s up more than 20 per cent from 2002.

And the Senate report released last month, “Time for Transformative Change”, urged the federal government to take an active role in transforming the health-care system, and ensure that funding is used as an incentive for change. The report assessed the impact of the 2004 health accord, and showed clearly that a 2014 accord is needed to further improve our system.

Senator Art Eggleton echoed this point, saying that the federal government can’t just put the money on the table and walk away — it needs to be a key partner in leadership on health care.

Meanwhile, the 2012 federal budget cut Health Canada, and said nothing about meaningful change. The only nod to improving the system was a three-year, $6.5-million study on cost-effectiveness in health care.

But that ignores the mountains of evidence we already have about how to improve our health-care system while making it more efficient. It’s becoming baffling to Canadians as to why our federal government wouldn’t co-ordinate a national pharmacare system that could save billions. Everyone knows you get a better deal if you buy in bulk.

Cost-effectiveness can also be found by making the right choices around a more caring and appropriate system for our elderly. We need a spectrum of continuing care, from long-term care, assisted living, home care and palliative care that alleviates pressures on hospitals and puts the patient first. We should be shifting as a nation toward a system that puts less pressure on acute resources, and respects the choices of our seniors.

The Environics poll also shows that those Canadians who have the most frequent interactions with the health-care system are most pessimistic about it. We’re not doing as well as we could be for people with chronic conditions, and improving community care and self-management is another win-win — it’s cost-effective, and better for patients.

But the poll also showed that Canadians are still optimistic about our health-care system. Most of us believe it’s the best in the world. We’re happy with a publicly funded system. A lot of us think that it takes care of our most vulnerable, and that it will be there for us if we’re ill or injured.

It makes you wonder why the federal government wouldn’t want to fight for that system, and lead the transformation needed to keep Canada ahead of the pack on health care. Canadians take pride in their health-care system — so should their government.

Danielle Martin is a family physician in Toronto and Chair of Canadian Doctors for Medicare.