by Terrance Hunsley, Editor, Social Canada.org
Prime Minister Trudeau and the Premiers have been taking their arguments on health care funding to the public airways lately. Good that it’s winter, as there is more heat than light generated in the exchanges. 🙂 Before the federal election last year, The Pearson Centre commissioned me to produce a report recommending federal action on seniors health care. Although my recommendations for overall federal health funding were comparable in amount to what the provincial premiers are asking, I think it is only fair to point out some misinformation that they have been fomenting.
In essence, they are asking Ottawa to increase their share of health care costs from 22% to 35%. They have been pushing these figures for many years now, and the back story begins in 1977. At that time, the federal and provincial governments reached an agreement whereby the federal government would stop sharing provincial costs on a 50-50 basis. They converted the federal share into a cash transfer equal to about 35%. To make up the other 15%, the federal government decreased federal income taxes and the provinces simultaneously increased their income tax to make it up. It was called a tax point transfer, and the benefit for provinces was that it would increase each year in value, proportionate to economic growth. So now, if they were making the point that the imputed federal share was 37% and should go up to 50%, it would more accurately show how the federal government has been underfunding health care, and I think that would be more meaningful to voters. The provinces might also acknowledge that the federal government also makes substantial health expenditures for indigenous communities, veterans, health research and food and drug safety.
Trudeau insists that he wants the provinces to guarantee service improvements such as wait times in hospitals, if he is to increase federal contributions. I agree that he should insist that provinces report regularly using coherent, publicly meaningful information. But grabbing a couple of hot button issues like wait times for hospital procedures, is not the way to do it. Clearly, wait times for specialized procedures are important. But so are the services which keep people out of surgical units, emergency rooms, or institutional long term care. We need improvements in health care, and we need them to be undertaken, not on a piecemeal basis, but across the board. We need more team-based primary care, especially for seniors who acquire disabilities and chronic diseases. We need far better home care, or we will have (mainly) women leaving their jobs and sacrificing future income to look after loved ones. We need nonprofit housing options that permit people to live independently in their community.
It appears that the Ontario government is prioritising low income and marginalized people in their health care plans, but with the intention that everyone else will be paying for an increasingly privatized system. That means that for most people, their health care will reflect their purchasing power. Not the way to go.
The federal government should insist on national health standards that state what every Canadian resident will be entitled to as a right to health care. There are health experts in the country who could come up with a template for federal-provincial agreement, and cover the peak indicators across the health system. It should be integrated with the Canada Health Act. An independent Canadian Health Standards Council reporting annually to federal, provincial and indigenous governments should be empowered to collect and report information on the standards. The Canadian Institute for Health Information and Statistics Canada could be assigned the technical information collection and collation.