Healthcare needs collaboration, not finger-pointing

Posted on July 18, 2022 in Governance Debates

Source: — Authors: – Opinion/Editorials
July 16, 2022.   By Star Editorial Board

Anxious Canadians, in no mood for the national sport of jurisdictional mud-wrestling, will have little patience for anything less.

To hear the premiers of Canada’s provinces and territories tell it, they have ascended to a higher spiritual plane, far beyond the petty concerns of partisanship and politics.

They have no interest, the 13 leaders purred in wrapping up the annual meeting of the Council of the Federation this week in Victoria, B.C., in silliness, jurisdictional spats or trading insults through the media.

They want only to meet face-to-face, “like adults,” with the prime minister, to find solutions to Canada’s dire health-care challenges.

Oh, yes, and money. They want lots of it. And soon.

The country’s health-care system is in existential crisis, they say. The COVID-19 pandemic has shown its weaknesses and left it running on fumes. Sub-national governments cannot bear the costs of restoring and re-imagining it alone.

That the problem is massive and urgent there is no doubt.

Across the country, Canadians see staffing shortages, burnout among doctors, nurses and front-line personnel, acute-care challenges, long-term needs – in concert with an aging population and the exploding costs of new technology.

Stories are legion of emergency departments closing, of people waiting 20 hours and more in ERs to see a doctor and get admitted.

As it stands, the provinces claim, they are carrying 78 per cent of health-care costs, need $28 billion pronto from Ottawa just to bring the federal share up to 35 per cent in advance of increases in future.

As many have pointed out, this is all fun with figures.

In 1977, in lieu of earmarked cash transfers for hospitals and physician services, Ottawa gave more income and corporate taxing powers to the provinces to raise revenue.

For their own political and electoral reasons, as Ontario’s Doug Ford has so recently demonstrated, premiers have seen fit to cut gas taxes and highway tolls, hand out drivers’ licence rebates, promise billions for a highway – all while crying poor.

That’s a signal of provincial priorities.

Other premiers, it might be noted, sorely mismanaged aspects of the pandemic response with premature dropping of health protocols and early re-openings.

For his part, Prime Minister Justin Trudeau argues that no PM in Canadian history has met with premiers to discuss health care as often as he has over the last two years of the COVID-19 crisis and that he intends to continue working with them.

But Trudeau did little to allay provincial fears that any added funding would come with conditions.

“Our focus – every step of the way, and Canadians right across this country, in every province, will understand this – is making sure those dollars that we put in deliver real, tangible results for Canadians, in shorter wait times, in better services, in access to a family doctor, and that’s what we’ve been pushing on and that’s what we’re continuing to talk to the provinces about.”

B.C. Premier John Horgan, chair of this year’s conference, bristled at suggestions federal money should come with conditions.

“The so-called strings make it sound like there’s some sort of serf relationship here,” he fumed. “We are equal orders of government. There’s not a hierarchy here.”

The Council of the Federation is a remarkable Canadian construction, obscure of title, predictable and perennial in message, comprised of a rotating cast of 13 players few citizens of the country could name.

Nevertheless, it persists.

And this summer, while the premiers are risible in their self-regard and purported purity of intent, they are not entirely wrong.

During the worst of the pandemic, the premiers met remotely with the prime minister, as he acknowledged, dozens of times.

The health-care crisis is different in nature from the pandemic, but alike in urgency.

As such, it is a challenge of sufficient scale and complexity to be addressed at the first ministers’ level.

This is especially true when pharmacare and national dental care programs – the latter contained in the Liberal agreement with the NDP to keep the minority government functioning until 2025 – will require extraordinary collaboration among governments.

Collaboration on those files and addressing the crisis must involve more than cheque-writing that pours more money into systems proving inefficient.

It must involve systemic and structural reforms to help make the healthcare system more sustainable – and easily accessible.

There is one thing all levels of government need know.

Patients and health-care workers alike are suffering. The system is in tatters. It needs to be fixed. It will be expensive. But it’s past time to get on with it.

Anxious Canadians, in no mood for the national sport of jurisdictional mud-wrestling, will have little patience for anything less.

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