In federal election, health care is far from urgent

Posted on in Health Policy Context

WinnipegSun.com –
August 22, 2015.   By Tom Brodbeck, Winnipeg Sun

You’ve probably noticed health care hasn’t figured prominently in the federal election so far.

And it won’t, for a variety of reasons.

Sure, there’s plenty of political hyperbole to go around when it comes to the health care file. Inflammatory claims by the federal NDP and their union allies, for example, that the Harper government is “destroying medicare” and allowing it to morph into a two-tier “American-style” system are entertaining but not supported by even a modicum of evidence.

The truth is, very little has changed in health care over the past several decades where the federal government is concerned. Politically, the biggest issue to emerge in recent decades was in the mid-1990s when Ottawa, under a Liberal government, slashed transfer payments to the provinces by $6.2 billion a year. Since then, health care transfers have not only been restored, they’ve increased well beyond the rate of economic growth.

The result is that total health care spending in Canada now represents about 11% of the country’s gross domestic product, according to an October 2014 Canadian Institute of Health Information report. That’s up from 9% of GDP in the mid-1990s and 7% in the 1970s. Canada now spends more on health care as a percentage of its economy than it ever has. And globally, Canada is in the top quartile of health care spending, compared with OECD countries.

But what about private health care, that insidious cancer critics say is eroding the very foundation of the country’s most cherished social program, the one that will supposedly see Canadians soon receive health care services “based on the size of their wallets?”

That’s a myth, too. Publicly funded health care makes up about 70% of total health care spending in Canada, according to CIHI. That’s about the same as it was in 1997. No change there.

So why all the howls of protest from people like Toronto NDP candidate Linda McQuaig who writes things like “How Harper killed medicare and got away with it”?

It’s cheap, low-level, pass-me-the-Kool-Aid partisan politics. You make things up about your opponent, no matter how baseless, and hope some of it sticks, which it usually does with core party supporters.

Medicare is embodied in the federal Canada Health Act. The act sets out the five principles provinces must follow in order to receive federal funding. It hasn’t changed in any material way in years. Harper hasn’t touched it. And no other political party wants to touch it, either, largely because the political risks of proposing change of any kind to the CHA are too great.

Which is why health care is not a big issue in this election campaign, as it hasn’t been in recent federal races. Nobody wants to talk about real reform to the system because it’s too complicated, too sticky and too cumbersome to message on.

There will likely be some campaign chatter about federal funding levels to the provinces in future years through the Canada Health Transfer. The Harper government has been increasing the CHT by 6% a year but plans to tie it to economic growth beginning in 2017, with a minimum 3% hike per year.

The current 6% escalator, implemented in 2004, was a temporary measure to restore health care funding after the cuts of the mid-1990s. It wasn’t expected to last forever. If Ottawa was to maintain the 6% increases in perpetuity, taxes would have to rise to pay for it. So any party proposing to maintain the 6% increases would have to tell voters how they plan to pay for it.

Constitutionally, health care is a provincial responsibility. The federal government doesn’t run health care. They help fund it and set the broad parameters under which provinces can receive federal funding. But they’re reluctant to intrude on what is clearly a provincial jurisdiction.

Which is why federal parties don’t usually debate health care policy beyond the cheap sound bytes, including during election campaigns.

And this one will be no different.

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This entry was posted on Tuesday, August 25th, 2015 at 10:16 am and is filed under Health Policy Context. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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