It’s time for this generation’s political leaders to tackle the hard issues in Canadian health care

Posted on December 15, 2021 in Health Debates

Source: — Authors: – Opinion/Contributors
Dec. 12, 2021.   By Robin V. Sears, Contributing Columnist

The Council of the Federation made the extraordinary declaration that Canada’s premiers are ready to work with Ottawa, calling for a national summit.

No one ever said, “I’m so happy, I just found a really cheap heart surgeon for my dad.” It underlines one of the drivers of cost in every developed nation’s health care system. We understandably always demand the best, i.e. the most expensive. Drugs, equipment and services all rise faster than inflation.

A second cost driver is the heavily stovepiped nature of the health sector: hospitals compete, specialists fight turf wars and all fight change that might undermine their place in the health care hierarchy, creating duplication and frustrating innovation.

There are some solutions, with broad support from health experts, that await only the political will to implement them. One is for Ottawa to reward innovation and collaboration across sector and provincial boundaries. Instead, they demand better bookkeeping by the provinces to account for how they spend federal health-care support. Ottawa has a “glass house” problem when it comes to spending accountability.

A second solution is to stop wasting money on new digital medical systems and databases that do not follow common standards, metrics or even access rules. As an expert study group pointed out this week, systems that cannot communicate across departments and borders are a stupid waste of scarce health-care dollars.

Provincial health-care systems differ widely over titles, practices, pay and performance metrics. Their contribution to wider sharing of best practices could be agreeing to some shared definitions, targets and an agency to measure performance.

In a statement Thursday night, the Council of the Federation made the extraordinary declaration that Canada’s premiers are willing to go down that road with Ottawa: “All agree … to focus on outcomes, to be accountable to our own residents for the responsible investment of their tax dollars.” Unanimously, they called for a national health-care summit early in the new year, at the first minister level.

One of Canada’s health-care gurus, David Naylor, has in recent articles pounded home the need to look again at foundational issues in health care. He has detailed the array of changes that have emerged since the last serious federal/provincial debates more than 15 years ago, and how current spending restrictions frustrate change.

The wisdom of his appeal has been starkly revealed in how badly stretched and shaken our health care has been during the pandemic, and how frustratingly slow most governments were in providing urgently needed equipment and financial support.

Several political leaders’ courage in forcing change on the health-care sector became important to their legacy: Tommy Douglas’s creation of Canada’s first hospital insurance program in 1947; Conservative Premier John Robarts’ courage in reversing his earlier opposition to medicare, enraging many in his own party; Monique Bégin and Pierre Trudeau and the Canada Health Act. Now it is this generation’s turn.

As we pray that we begin to see the light at the end of the pandemic tunnel, there is no more important “build back better” challenge than transforming health care. Do we not owe those who put their lives at risk daily, those who lost parents and children, at least that?

Yes, it will cost more money, and yes, the struggle over who pays for what will be a typically Canadian federal/provincial bunfight, but as COF chair John Horgan declared, “We need a renewed and reinvigorated partnership for health-care funding in Canada.” It does need to be a unanimous national partnership for standards setting and shared best practices — as the pandemic revealed, provinces in a health-care crisis must support each other.

The premiers acknowledged that experience has given them new confidence all Canadian governments can work together and build “public health-care systems … sustainable for generations to come.”

Now is the time for today’s leaders, over the inevitable opposition of the usual defenders of the health-care status quo, to create a stronger, more connected, more resilient and innovative Canadian health-care system for a new generation. One that will cost more, but one that can reliably deliver better health outcomes.


Tags: , , , ,

This entry was posted on Wednesday, December 15th, 2021 at 11:27 am and is filed under Health Debates. You can follow any responses to this entry through the RSS 2.0 feed. You can skip to the end and leave a response. Pinging is currently not allowed.

Leave a Reply