Editorial, Globe and Mail, December 21, 2011
The government is throwing the ball of innovation into the provinces’ court, where it belongs. The plan is generous (six per cent in each of the first three years, at least three per cent thereafter, and possibly more, depending on economic conditions), but not so generous that the provinces can sit back and attempt to do business as usual. The deal is to last 10 years, so the provinces can plan....
Six per cent a year is unsustainable. The provinces’ budgets would eventually be swallowed by Medicare. All that cash was the wrong kind of “fix” – it induced reliance, not change. The federal government is asserting, not abdicating, its role in maintaining a public health system. Now the provinces need to get to work.
"Asserting" by telling the provinces only the dollars available, will not assure Canadians of a common national set of standards, for wait times, for available procedures, for a single-payer system, for universal access and standards that are not determined by geography or economic development.
Tying the health care dollars to a per capita formula, dependent on the GDP of the province in the future, could result in dramatically divergent federal dollars, thereby devolving to a very uneven, and thereby unfair virtually non-system.
Health care tied to economic development...that is a concept born in the bowels of hell. There is no reason for a government, any government, to link the two. People get sick, often with or without sound economic prospects in their families, their towns and villages, and their provinces. Doctors will be more attracted to those provinces that boast a high GDP where incomes are high and poverty and homeless are lower than other provinces.
By this arrangement, the federal government is signally, under the rainbow banner of "provincial autonomy and innovation," that only the economic output is and will be the determining factor in health care funding. So, now, we see the government's footprints, of the ideological, corporate, private enterprise, profit-centred approach to everything as the determining criterion for health care funding.
Innovation is certainly required in the provision of health care. Reducing costs, and providing alternative models for care, for example increased home care for the elderly along with nurse and doctor visits, and incentivizing preventive health care delivery by all practitioners are just some obvious examples. However, setting the provinces to compete with one another, when the macro-economic conditions in one region could have a significant impact on the "economic" health of the province, without any specific government holding the "blame" card for such a development, could result in significant "punishment" of that province for no reason other than macro-economic trends.
Furthermore, "asserting" is just another more polite word for "dictating"...and the Globe is wrong to call the announcement leadership.
This government cannot, simply cannot, see or bring into focus, the people of this country, whether they live in Attawapiskat or Kelowna. This government sees them (us) only as digits on a budget sheet, not as breathing and autonomous individuals, and this reduction is part of the spill-off from a globalized economy in which all bow to the corporate, for-profit, monocular....ignoring the plight, and the potential plight of families and individuals.