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Politicians Avoid Addressing Medicare's Long-term Challenges

Author: Walter Robinson 2000/09/17
If you believe that Ottawa and the provinces solved or even addressed Canada's health care crisis well then you probably believe that the earth is flat and that Elvis was in line at the bank machine last night.

Yes, some problems were solved yesterday, but nothing was truly accomplished that will have a long-lasting affect on your family's health or avert emergency room crises and hallway medicine this winter, or next winter or the winter after that.

To be fair, the PM and the Premiers inked a funding deal that will restore transfers to the provinces over the next five years. An immediate cash infusion of $2.8 billion will start in fiscal 2001 with a 4% annual escalator clause boosting funding from $15.5 billion (today) to $21.1 billion by 2005. And Ottawa will also pony up another $2.3 billion for other needs. Of this amount, $1 billion will be allocated for new technology over the next two years to purchase equipment such as MRIs, lithotripters and modern dialysis pumping units, just to name a few. In addition, $800 million will be allotted for primary care reforms. And another $500 million is earmarked to build an electronic health record infrastructure.

No one seriously discounts the need for these expenditures but this money - and there is a lot of it - still does not address the five underlying structural problems in health care:

  • patient choice, utilization and expectations;
  • demographic shifts and consequent results;
  • technological and pharmaceutical cost drivers;
  • the simple mathematics of capitalization; and
  • modernizing the Canada Health Act.

But let's look at the problems that were solved yesterday. First and foremost, the federal Liberals have solved a ballot question problem. No longer will health care serve as a wedge issue where the Liberals were extremely vulnerable. After acting like Dr. Jack Kevorkian and slashing federal transfers, it would have stretched credibility to the extreme for the grits to prop up Jean Chretien as the defender of Medicare.

The other problem solved is that collective political cowardice is not revealed. With health care removed as a major election issue, they don't have to engage in a true debate on this subject and are saved from telling Canadians the truth about our health care system.

The truth being that on a variety of measures by various organizations, our health system is not the best in the world, it is mediocre at best. The truth being that the five "sacred" principles of the Canada Health Act (universality, accessibility, comprehensiveness, portability and public administration) are for the most part, violated every day. Yes we all have the universal right to queue up on a waiting list.

But if you live in Saskatchewan you wait twice as long for some cancer therapies as compared to Ontario. Accessibility A function of geography. IVF treatments are covered in some provinces but not in others. Comprehensiveness Also a function of residency. Portability Sure, as long as you have your chequebook handy to cover fee differences between provinces. As for public administration, heaven forbid we'd allow the private sector to engage in more active delivery of health services. Those evil corporate barons are already effectively running ambulances, nursing homes, air traffic control and other public services, when will it end

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Franco Terrazzano
Federal Director at
Canadian Taxpayers
Federation

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