Provinces need to have a plan for health-care funding — or they shouldn’t get the money

Posted on August 15, 2022 in Governance Policy Context

Source: — Authors: , , , – Opinion/Contributors
August 15, 2022.   By Armine Yalnizyan, Contributing Columnist, Pat Armstrong, Marjorie Griffin Cohen, Laurell Ritchie, Contributors

Provinces want $28 billion more from the feds for health care. Before they get a penny, they should detail how they’ll use the infusion to buy change.

Every day brings fresh evidence of profound mismanagement in health care: closing emergency departments, burned-out nurses quitting the profession, fewer Canadians with family doctors, hospitals full of older people with nowhere to go.

Meanwhile, premiers want the federal government to ship them another $28 billion for health care, no questions asked — on top of the $45 billion they already get yearly.

What’s wrong with this picture? Accountability.

With our most critical social program in chaos in every part of the country, it’s not enough for provinces to say “just give us the money.” What’s the plan to use more public money to buy lasting change? We’ve learned over the past year that you can’t buy change unless there’s an explicit agreement about the transformations you’re buying.

The early learning and child-care deals used an infusion of federal cash to achieve specific goals within a clear time frame. Every jurisdiction has agreed to three goals: lower parent fees, expanded availability of licensed care and improved working conditions.

It’s not a cookie-cutter approach. Some provinces emphasize recruitment and retention, others the need to add spaces in care “deserts.” Some are cutting parent fees faster. But the cash is only handed over when there’s a plan for — and reports on — progress in affordability, access and quality care.

We need the same approach to health care. A common framework. Measurable outcomes. Written agreements. Dedicated funding for mutually negotiated goals in recruitment and retention, improved primary care and new services. Multi-year action plans that can prevent the erosion of high quality not-for-profit and public care. Consequences if goals are not met.

As premiers raise the heat on the feds, both journalists and citizens need to raise more pointed questions about the lack of plans. Here are five areas that desperately need a blueprint for change.

How will you reduce your reliance on temporary workers, including migrant workers and workers from agencies? What is the plan to hire sufficient staff in all areas — from cleaners, laundry, dietary and personal care workers to registered nurses and surgeons — so we have the appropriate person, doing the appropriate job, at the appropriate time?

Yes, health care needs more funding. But negotiations need to focus on producing better results. Our premiers need to do more than just acquire more money — they need to govern our public resources, and show us their plans for using an infusion of federal dollars so we can buy change.

No plan? No money.

Pat Armstrong, Marjorie Griffin Cohen, Laurell Ritchie and Armine Yalnizyan are members of The Care Economy group.

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