Wednesday, January 18, 2012

Romanov seeks public support for "threatened" health care system in Canada

More and more, there seems to be reason to trust those who know their facts on a specific file, while not currently serving in public office. Roy Romanov, former premier of Saskatchewan, and current advocate for the Canada Health Act, was interviewed yesterday on CBC's Power and Politics with Evan Solomon.
The interview came amidst other interviews at the conclusion of the Premiers' meeting in Victoria to discuss the unprecedented unilateral announcement from the federal government concerning their participation in the funding of medicare.
According to Romanov, the federal budget office has indicated that federal funding of medicare, formerely at 50% of the total, is now approximately at 20% and could drop to 10%. Further, with the federal annoucement that the funds will be pegged to provincial GDP, as Romanov points out, in good times, and with innovation, that could mean those provinces will provide health care for their citizens at a reasonable, respectable level; yet, in bad economic times, that will not be the case. And in Romanov's view, that disparity, independent of any attempts at innovation, goes to the heart of how Canada works as a federation.
Equalization, a formula that has stood the country in good stead, has provided from the rich and prosperous provinces to give a hand up to the poor provinces, and we have seen the names of both categories of province change over time, depending on the development of natural resources and the world demand for those resources.
That, under the current federal government is to come to an end during the next decade.
Telling the provinces to focus on innovation, is like a father telling his young son to 'go out back to look for his lost golfball' while the father and his cronies have a party; it is another of the federal government's patented distractions. There may be a need to innovate in terms of delivery and in terms of changing technology and the provinces have accepted that challenge.
However, to unilaterally announce what amounts to an "offloading of federal responsibility for funding health care to the provinces,"the program that 90% of Canadians consider both essential and a cornerstone of what and who Canada is, according to Romanov, generates both a threat to the sustainability of the program and an opportunity to bring the people into the debate to save the program. It is Romanov who, while attempting to avoid being "apocalyptic" (his word), told Solomon that he is concerned about the future of health care in this country. And he adds, he is not worried that it remain as it was forty years ago; he knows and accepts that the program has to change,  in the use of hospitals, in the deployment of caregivers, and in the costs of pharmaceuticals, the three engines driving rising costs.
Innovation, it would seem, the federal government's "smoke screen" for distracting attention from its primary purpose to privatize the system, could provide some savings by "tweeking" in Romanov's perspective. However, all the innovation in the world will not change the proposed dramatic shift in offloading the financial burden from the federal government to the provinces.
We have seen this movie before. Mike Harris offered a similar kind of poison to the municipalities by offloading provincial funding to the towns and cities for many essential services, and the Province of Ontario has spent the last two decades trying to 'right the apple-cart' that Harris so summarily overturned.
Harper can and will do much to this country before his mandate is up in 2015.
The destruction, even through distractions like innovation, of health care, and the substantive off-loading of the funding, and then declaring whatever federal participation to be a function of provincial GDP is not satisfactory with Roy Romanov and it must not be for Canadians either.
Write to your Member of Parliament and tell him/her about the dangers in this latest announcement. We want federalism to work, and that will require the federal government to come to the table, to listen to the premiers and to negotiate a new federal funding formula for health care tied to national standards, and separated out from provincial economic fortunes, accessible to all, regardless of ability to pay, and regardless of who occupies the Prime Minister's Office.
There is still time...the current agreement extends to 2014; yet, the clock is ticking.
And then there is this:
By Jeffrey Simpson, Globe and Mail, Jaunary 18, 2011
Health care has always been largely a provincial matter, and the provinces have always wanted to keep it that way. Meeting together, there are plenty of issues for the premiers to discuss about how to better co-operate, as in a common drug formulary, bulk purchasing of drugs, impediments to portability, interprovincial labour deals, common clinical assessments and so on.

But, no, gathered together, they just can’t resist bashing the federal piƱata, hoping it will release more money. Mr. Harper has already agreed to give transfers to the provinces indexed at 6 per cent for the next five years, falling to the range of 4 per cent thereafter.
This federal offer comes when Ottawa has a large deficit and is preparing to cut its own programs by 5 per cent to 10 per cent. Moreover, no other government program, federal or provincial, is being indexed at anything remotely like 6 per cent. When Paul Martin hiked transfers and indexed them at 6 per cent, Ottawa enjoyed a tidy surplus.
The premiers don’t seem to have noticed that things have changed. They’re dreaming up new reasons why the 6 per cent should not be continued sine die. You can see why they want to deflect attention from the challenge they don’t want to speak frankly to their citizens about.
Health-care costs rose at an annual rate of 6.5 per cent in the 2000-2009 period. Premiers are scared stiff of the hard decisions that lie ahead to bring the increases down to something more affordable, especially since the next decade will almost certainly feature slower economic growth than the decade before the 2008 recession.
Every province faces challenges. B.C. Premier Christy Clark says her province should get more money because B.C. has more seniors per capita who cost the health-care system more. The Atlantic provinces have the same problem, although the aging of the overall national population will add only about 1 per cent to the total health bill.
Newfoundland and Labrador has widely scattered outports to service, and that’s expensive. Ontario has all those newcomers, and Alberta and Saskatchewan have growing populations. Quebec is Quebec, complaining about needing more money, as always.
Quebec Premier Jean Charest is up in arms that Ottawa decided unilaterally not to hand over even more cash. Heaven forbid, however, that Ottawa should tie anything to the money it’s offering, let alone anything additional. Health care is provincial territory, so Ottawa should pay up and butt out, which is pretty much what Mr. Harper proposes.
When Mr. Martin signed his deal with the premiers in 2003-2004, a bunch of gossamer strings were attached to the money. Quebec respected none of them. It had decided not to participate in the Common Drug Review, squelched being part of the Canada Health Council, the common wait times reduction strategy, the national pharmaceuticals strategy, all in the name of its attitude toward Ottawa of pay up but butt out.
If the premiers wanted to fix something, they could get Quebec to change the clauses in its provincial drug plan that penalizes any company that negotiates a lower-cost deal with another province. This clause cripples smaller provinces trying to get lower drug prices, forcing them into “secret” rebate deals and other subterfuges with companies. Quebec has the highest drug costs in the country, because it wishes to protect brand-name pharmaceutical companies located in the province.
In any event, Quebec is not the only province that wants jurisdiction over health, as much federal cash (and tax points) as possible, but no federal say in how the money is spent. No wonder Mr. Harper wants no part of such conversations.

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