Source: Web exclusive, April 2011
Almost three years ago my mother-in-law died of cancer. While her death brought her rich life to an end, it also marked the finale of something else: six years navigating Canada’s healthcare system. My mother-in-law had her good years and bad, but countless doctor’s visits, treatments and operations kept her knee-deep in this country’s healthcare institutions the entire time she was sick.
It’s impossible to go through an experience like this and not appreciate just how integral health care is to this country. It’s no surprise that, despite a recession that saw many people lose jobs, a recent Nanos Research poll revealed that health care is still the number one issue for most Canadians.
However, during the 2011 election, the party leaders have spent more time talking about the economy and non-medical healthcare initiatives like an adult fitness tax credit being promised by the Conservatives. But anyone who has spent a few years visiting hospitals will know that health care should be a primary election issue.
One reason why health care hasn’t dominated the debate is that it’s provincial governments that set healthcare policy. The federal government’s most important responsibility is funding health care through billion-dollar transfer payments given to provinces each year.
Antonia Maioni, an associate professor of politics at McGill University, says that because health care is such a hot-button issue, party leaders would love nothing more than to let the provinces duke it out during their upcoming elections. ‘There is this idea that since health care is a provincial responsibility, maybe the general election is not the place to talk about it,’ she explains. ‘I’ve heard leaders say that.’
Health care is an especially tricky issue for this election because in 2014, Canada’s health accord is up for renewal. The accord, initiated by former prime minister Paul Martin in 2004, gives provinces $41 billion over 10 years. So far, the Liberals have said that they will maintain the current yearly six-percent increase in funding to the provinces beyond 2014 and the Conservatives have said they’ll maintain the increase until a new deal is reached. However, neither party has said exactly what they’ll do when it comes time to renegotiate the accord. The NDP has said it will negotiate a new 10-year plan, but they haven’t revealed any specifics. Maioni says she’s not surprised that the candidates are mostly staying mum on this issue. With Canada’s deficit taking centre stage as a major topic this year, any talk of spending more money on health care is risky for leadership hopefuls.
‘If you’re going to talk about money you have to talk about where it’s going to come from,’ she says. Not an easy subject in tough economic times.
The lack of debate around the accord has meant the parties are talking about other healthcare-related issues such as home care, pharmacare and compassionate leave for those who need time off work to care for ill loved ones. While those are all important topics to address, they’re not the issues most people associate with health care. ‘We’ve hard things around health care, but not specifically on funding for what the majority of people consider to be health care,’ says Maioni.
Of course, it’s unlikely the leaders will discuss exactly how the provinces should be spending their transfer payments, but Merle Jacobs, an associate professor of sociology at York University, says people still need to hold the feds accountable at the polls. ‘How can the provinces deliver if they don’t get the funds,’ she says.
A lot of people take funding for granted, says Brett Skinner, president of the Fraser Institute, a Vancouver-based think tank that studies economic and public policy issues. The government has funded health care for years‘why would that change now? But Skinner says the funding debate is more complicated than that.
He points out that provincial health spending is growing and exceeding what the provinces receive in funding from the federal government, and this overspending isn’t going to stop anytime soon. ‘Heath care is skewed,’ he says. ‘It covers things for everyone, but not expensive new technology or expensive surgeries or diagnostics that are unaffordable. People are increasingly less covered over time, yet we pay for things like affordable visit to doctor’s office.’ He also points out that Canada’s multi-billion dollar debt could put future federal healthcare funding in jeopardy.
With the accord’s renewal coming up, Canadians should do their homework and find out where the parties stand on healthcare issues, says Maioni. If it isn’t renegotiated, provinces will have to find a way to pay for healthcare and, according to a recent report released by the C.D. Howe Institute, that could include increased taxes, a two-tiered medical system or drastic spending cuts in non-healthcare related areas.
‘Billions of federal dollars are going to provinces to be used for health care. Billions more are used in public health and all activities Health Canada is involved in,’ she says. ‘Voters have every right to hold federal parties’ feet to the fire on health issues.’
As someone who’s seen our medical system at work first hand, the party who’s best suited to deal with the future of Canadian health care may very well get my vote. ‘This has to be an issue,’ says Jacobs. ‘Everyone knows someone who has had an issue in the hospital. We need to ask all three parties to talk about it.’
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