Harper government is abandoning leadership in health care

Posted on April 19, 2013 in Health Policy Context

TheStar.com – opinion/editorials – The federal government has effectively abdicated its essential role in shaping the direction of our health system.
Apr 19 2013. Editorial

The death by federal defunding of the Health Council of Canada is being widely mourned, but in truth the body had nothing to live for.

Established in 2003, the council was given its eventual raison d’etre the following year: to monitor the implementation of the 10-year, $41-billion health accord that then-prime minister Paul Martin negotiated with the provinces. Next year, that accord will expire and the federal government has given no indication a new one will be sought. And in the absence of such an agreement, there really wouldn’t be much for the council to do.

Killing it makes good sense in this context – after all, the government will save $6.5 million a year by doing so. It’s the context that’s cause for concern.

The federal government has effectively abdicated any role in shaping the direction of our health system. It vowed to continue to increase funding to the provinces, but without even trying to put conditions on those payments. And it determined the new funding formula unilaterally, without any consultation with the provinces. It certainly did not lead the development of a national pharmacare strategy, as the 2004 accord mandated. All of this is a reflection of Stephen Harper’s oft-expressed view that the federal government has no part to play in the provincial jurisdiction of health-care policy.

Except that view is wrong. The federal government is the fifth-largest health-care provider in the country, delivering services to more than a million people, including aboriginals living on reserves, members of the Canadian Forces and federal prison inmates, among others. Moreover, only the federal government, by attaching strings to transfer payments, can secure pan-Canadian standards and thus ensure that provinces aren’t pitted against each other. Otherwise, any jurisdiction that might choose to aggressively privatize, for instance, would inevitably suck talent from the rest of the country.

Most important, If we believe that some things – say, universal access to quality health care – are so fundamental to citizenship that they should be guaranteed for all Canadians, wherever in the country they may be, who will see to it if not the federal government? As Roy Romanow has warned, for the federal government “to say, ‘Goodbye and good luck’ could be the beginning of the end of a reformed modern-day functioning health-care system.” A national medicare system cannot work with an empty chair at the head of the first ministers’ table.

The Health Council of Canada may not have had the mandate or the resources to deliver on its founding idea. But as the strain on the system continues to increase and the challenges become more complex, that idea – that information-sharing, cooperation, and national standards are key to successful health care – is more important than ever.

It’s the death in Ottawa of that concept, more than of the council itself, that should be mourned.

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