More money is not the answer for medicare

TheStar.com – opinion/editorialopinion
Published On Tue Apr 19 2011.   By Carol Goar, Editorial Board

It began with unsettling silence, erupted into a multi-billion-dollar bidding match and became the most regrettable debate of the campaign.

There won’t be a winner, but there are already 34 million losers: Us.

Here is how health care burst onto the election agenda. Two weeks into the campaign, Michael Ignatieff made a high-stakes bid for the role of guardian of medicare. He announced that a Liberal government would raise provincial health transfers by 6 per cent a year for the foreseeable future.

Within hours, Conservative Leader Stephen Harper matched his promise. Not to be outdone, New Democratic Party Leader Jack Layton chimed in that he, too, was committed to a 6 per cent escalator clause.

So, no matter whom we elect on May 2, we’ll be locked into a costly federal-provincial deal that does nothing to fix medicare.

We already know what high-priced intergovernmental accords produce. In 2004, former prime minister Paul Martin promised to “fix medicare for a generation.” He signed a 10-year, $43-billion agreement, guaranteeing the provinces a 6 per cent annual increase in health-care funding. In return, they pledged to:

Cut wait times for cancer treatment, heart surgery, diagnostic imaging, joint replacement and sight restoration.

Create a national home-care system.

Launch a national pharmaceutical strategy.

Move quickly toward a national network of electronic health records.

Things started well. The provinces reduced wait times for the specified procedures (often at the expense of other surgeries).

But the other priorities fell by the wayside. Ontario misspent billions of dollars on e-health, skimped on home care and ignored pharmacare, using the federal cash to bail out overbudget hospitals, meet doctors’ fee demands and alleviate bottlenecks in emergency wards.

At the seven-year point, very little has changed.

Meanwhile, the gaps in the system are growing. Elderly patients — brutally described in hospital parlance as “bed blockers” — have to wait months to get into nursing homes. They can’t live on their own and they can’t get enough home care to live safely with their distraught spouses or children. So they fill hospitals beds that accident victims and post-operative patients need.

Drugs costs are pushing some families into financial distress. Five million Canadians don’t have a family doctor. Those who do, often have to wait weeks for an appointment, pushing them to use private, for-profit clinics.

We need leadership. What we’re getting from the men seeking to be prime minister are identical promises to throw more money at the problem.

We already spend $192 billion a year, or $5,600 per capita, on health care. That is 11.7 per cent of our national income.

In fairness, the leaders have proposed a few reforms.

Ignatieff says he would introduce a program to help low-income caregivers and a national food plan to promote healthy eating. As prime minister, he would convene a meeting with the premiers before the end of June to discuss further reforms.

Layton says he would spend $25 million immediately to hire more doctors and nurses and initiate a new long-term transfer to the provinces.

And Harper says he would lift the cap on medical expenses for which Ottawa will provide a tax credit. (It now stands at 3 per cent of net income.)

These ad hoc initiatives won’t fix an overstressed health-care system. Nor will they induce the provinces to make badly needed improvements.

But the federal leaders have spent our money and squandered their leverage with the premiers. Now they’re devoting their energy to depicting each other as destroyers of medicare.

Silence, with all its worrying possibilities, was better than this.

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