Canadians want federal health-care role

OttawaCitizen.com – news – Provinces need to be accountable for spending, poll says
January 16, 2012.   By Mark Kennedy, Ottawa Citizen

A strong majority of Canadians believe the federal government has an “important” role to play in the healthcare system and to ensure provinces are accountable for the money spent on medicare, according to a new poll.

The national survey by Ipsos Reid was commissioned by the Canadian Medical Association, which represents the nation’s doctors. It was released as the premiers gather in Victoria for a two-day meeting to discuss the healthcare system.

Prime Minister Stephen Harper is not at the meeting, but his Conservative government has announced billions of dollars in long-term medicare payments that fall short of what the provinces had wanted, but which carry no conditions on how the funds are spent.

Among the poll’s findings:

– 97 per cent of Canadians think the federal government’s responsibility for the Canada Health Act is important. In return for receiving federal money, provinces must adhere to the principles of medicare as outlined in the Act. Those principles include accessibility to services, universal availability, and portability from province to province.

– 70 per cent say they are “wor-ried that without accountability to the federal government, provinces will have no incentive to achieve health care efficiencies.”

– 88 per cent are worried that “without national standards, Canadians will have different levels of health care depending on where they live.”

– 74 per cent believe that health care is a shared responsibility between the provincial and federal governments. Few believe it is solely a provincial (13 per cent) or federal (11 per cent) responsibility.

The telephone poll of 1,000 Canadian adults was conducted Jan. 4-9. With a sample of this size, it has a margin of error of 3.1 percentage points, 19 times out of 20.

As the premiers begin their summit, they are divided over a simple but critical question: Should Harper be at the table?

They have differing views about the federal government’s hands-off approach to the social program – a departure from previous Liberal governments that actively used their financial clout to set national standards.

Western premiers aren’t complaining about the shift, but others worry Harper’s stance will ultimately lead to the balkanization of medicare into a patchwork-quilt system with varying standards. Postmedia News interviewed several premiers in advance of the summit. The two leaders articulating the divide most succinctly are British Columbia’s Christy Clark and Dalton McGuinty, of Ontario.

Clark said “what they are essentially doing is they are vacating the policy field for premiers. And so the challenge ahead of us is going to be how much courage are we going to show in taking up that challenge.”

She said provinces have long said they want to design health care because it’s their constitutional role. “Now the federal government is giving us a chance,” said Clark. “To me, this is really a huge opportunity for premiers to step up and to take the reins on health care in a way that we haven’t been really welcomed to do, I think, for decades.”

Last month, federal Finance Minister Jim Flaherty unilaterally unveiled a nonnegotiable funding plan that runs to 2024. Federal healthcare transfers will continue to increase by six per cent until 2016-17. After that, increases will only be tied to economic growth including inflation and never fall below three per cent.

The move effectively scuttled the prospect of healthcare negotiations: Flaherty is placing no demands on how the money is spent, and Harper has no plans to attend a first ministers meeting.

McGuinty said this is a “missed opportunity. “I believe it would have been better for us to come together to so that we could better grapple with the challenge and lay out a plan forward.”

He said the federal government has become “a passive presider” in health care and there will be no one with a national voice to ensure equity.

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