Health-care system due for a checkup
TheStar.com – Opinion/Editorial Opinion
Published On Fri Nov 05 2010. By Carol Goar, Editorial Board
Every decade or so, pressure builds for a review of medicare.
Like clockwork, the first calls for an inquiry into the sustainability of Canada’s publicly financed health-care system are coming now, as the 10th anniversary of Roy Romanow’s commission on the medicare approaches.
The former Saskatchewan premier, who spent 18 months examining every aspect of the system, sees no reason for a “rehash” of his work. Medicare, he says, has been “studied to death.”
The federal Liberals are cool to the idea, too. They see it as a ploy to get health care off the table before the Conservative government faces voters.
Even the provincial premiers, who have the most at stake, are equivocal. They’re certainly worried about devoting an ever-growing share of their revenue to health care — the proportion now stands at 39.2 per cent of program spending nationally, 45.7 per cent in Ontario — but they don’t want Ottawa setting their priorities.
Most of the impetus is coming from the Conservative party.
In mid-October, government officials leaked word that Prime Minister Stephen Harper was considering a task force on health care. Within days, former prime minister Brian Mulroney issued a public call for “a serious, adult discussion” on how to pay for essential medical services.
The Liberals are right that a health-care probe would allow Harper to dodge contentious issues such as private clinics and two-tier medicine on the election trail.
Romanow is right that the government has shelves of studies — including his — on how to improve medicare and keep it affordable.
And the provinces are right that a federally commissioned panel would offer views on issues for which they are responsible.
But setting aside partisanship, personal disappointment and intergovernmental turf wars, medicare does need a decennial checkup.
Since Romanow’s report was released, health-care spending has risen from $115 billion ($3,664 per capita) to $192 billion ($5,614 per capita). The federal surplus of $7 billion has given way to a $49 billion deficit. The baby boom generation, then in its peak earning years, is now on the verge of retirement. And public confidence in medicare is once again slipping.
Romanow’s prescription — a substantial investment of public funds to buy “transformative change” — is no longer feasible.
Nor is giving the provinces money to fix medicare. In 2003, the federal government increased their health-care funding by $34.8 billion so they could improve home care, strengthen community-based treatment, provide catastrophic drug coverage and accelerate the development of electronic health records. Progress has been spotty. Most of the money has been consumed shoring up the existing system.
With a weak economy and an unstable Parliament, the timing is not ideal for a medicare review.
But it’s as good as it is likely to get:
• There is no crisis. Canadians know that health-care spending must be reined in, but there are ways to do it without drastic cutbacks or a dismantling of the country’s most highly valued social program.
• There are knowledgeable people with ideas — other than privatization and user fees — about how to make the health-care system more effective. Their proposals have been tested and found to work.
• For the first time in years, the Canadian Medical Association, which represents the country’s 72,000 doctors, has a president who is fully committed to medicare.
• And there are three years left in the current federal-provincial agreement on health funding. That obviates the need for hasty, deadline-driven decisions.
It is true that an election could come within months. But with a minority government, that is always going to be the case.
It is true that money is tight. But pouring cash into the health-care system has never brought lasting reform.
It is true that handing medicare to a panel of experts for examination would be expedient for Harper.
But it would also be good — at least better than the alternatives — for Canada.
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