Ottawa can lead the way

TheStar.com – opinion/editorial
Published On Thu Jun 02 2011.

Canadians spend some $200 billion a year on health care, yet many worry that the system isn’t sustainable. That’s a challenge to Prime Minister Stephen Harper, who likes to think that “Conservative values are Canadian values,” as he told his new crop of MPs on Wednesday. There’s no more Canadian value than medicare.

Apart from managing the economy, Harper can make good use of his solid new majority to provide the national leadership that has been lacking on the health scene.

In a new survey the Health Council of Canada makes what amounts to a strong case for Ottawa taking a leading role in driving transformative change in the system, to make it more efficient. The immediate problem isn’t money: there’s plenty of that.

But “if the federal government does not play the oversight and collaborative role of bringing the provinces together (to boost efficiencies) the gaps in accessibility and quality and sustainability… will widen,” cautions council chair Dr. Jack Kitts.

That’s not to suggest there hasn’t been progress in recent years. The council cited shorter wait times for key procedures, and there’s been improvement in primary care, electronic records, catastrophic drug coverage, reduced drug costs and smarter monitoring. Even so, we could do a better job of managing the people who deliver care, strengthening home care, public reporting and ironing out persistent disparities.

What sort of reform is needed? Consider this:

Chances are your doctor is stuck in the buggy-whip era in terms of record keeping. More than half still rely on paper records for primary care. Patients lose out because electronic records can improve care coordination, curb errors and bolster efficiency. Sustained federal funding in 21st-century technology is the key to moving forward.

Then there’s drugs. Ottawa and the provinces agreed in 2004 to develop a national strategy to create a common list of approved drugs, to study options for catastrophic coverage and to contain costs by pooling their purchasing power. But the initiative stalled. We’re left with patchwork provincial plans. Who cares? People who can’t afford to fill a prescription, or who have had to skip a dose, for starters.

Finally, smarter management can bring important dividends. The council approvingly cited a call by the premiers to pool-purchase not only drugs but also supplies and equipment. It said pharmacists can play a bigger role in containing costs. And that some people waiting for procedures such as MRI scans, for example, don’t need them. With innovative management, health dollars go further.

If Harper truly does want to champion “Canadian values,” this is a good place to start. National leadership is the key to a comprehensive pharmacare program, to funding innovation and research, and to promoting best management practices. We know what works. Now Ottawa needs to take the lead.

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