Looking ahead to a new Health Accord

Looking ahead to a new Health Accord

Postby Oscar » Mon Jul 04, 2016 5:38 pm

Looking ahead to a new Health Accord

[ http://canadians.org/blog/looking-ahead ... lth-accord ]

June 30, 2016 - 4:31pm

With the Health Accord set to fully expire in 2017, Federal Health Minister Jane Philpott has said, “that she would like a new Health Accord to be signed, sealed and delivered by year’s end. If that’s going to happen, negotiations have to begin in earnest now and the two (or more) sides have to make their positions clear by the time the First Ministers meet in Whitehorse in July.” [ http://www.theglobeandmail.com/opinion/ ... icle+Links ]

The last federal budget pushed healthcare spending down the road (which we wrote about in depth here [ http://canadians.org/blog/budget-2016-s ... itmus-test ] ), but it looks like serious and tough negotiations are about to begin on the matter (2017-2018 budget projections have the health transfer at an abysmal 2.8% [ http://www.theglobeandmail.com/opinion/ ... e29388708/ ]). As the Globe notes, “There is much work to be done to negotiate a new Health Accord (or accords), and it’s pressing. If there are to be monies and specific allocations in the winter 2017 federal budget, decisions have to be made now, during budget-building season.” [ http://www.theglobeandmail.com/opinion/ ... icle+Links ]

This week, the CBC reported the held rumour that Ottawa favours targeted health-care spending over increased transfer to provinces. Minister Philpott stated, “I'm not convinced that putting more money in through the transfer is the most effective way for us to transform the health-care system in the way that it needs to be done.” [ http://www.cbc.ca/news/politics/philpot ... -1.3649864 ]

There are two important pieces here. The first is that Ottawa wants to make sure the money they are giving the provinces for healthcare end up in specified areas. This is something the Council of Canadians has called for (for more information see our blog on the last health ministers’ meeting we attended [ http://canadians.org/blog/lets-take-med ... right-path ] ). The rub is that this needs to be done to strengthen patient outcomes and the public health care system not just the federal government’s pet projects (although they may be included if evidence based data shows a need). We know from the last health accord that provinces often do not spend the federal transfer dollars in the areas that have the most impact, so until good faith is restored we agree with no more blank checks.

The important piece is in regards to the Canadian Health Transfer (CHT). The Liberal government has taken a page out of the Harper government’s playbook and wants to keep their proposal of an escalator drops to three per cent a year or the equivalent of GDP growth, whichever is greater. So in times of economic hardship when people need healthcare the most, there is less money for our medicare. Interestingly, while the Saskatchewan government was diligent sycophants to the Harper government remaining largely silent on this matter, recently Saskatchewan health minister, Dustin Duncan has stated, “If the federal government is serious about seeing the continuation of the medicare system in Canada, they need to be partners at the table.” [ http://www.cbc.ca/news/politics/philpot ... -1.3649864 ] In this regard, Duncan is correct, the federal government needs to put some skin in the game. When medicare began the federal government vowed to cover 50 per cent of costs, but that never fully materialized. Currently, the federal governments share of public health spending in the provinces and territories is around 22 per cent. The Council of Canadians supports the call by many groups and the premiers for the federal government to cover a minimum of 25 per of health funding. The 3% escalator the federal government seems set on with a new health accord just won’t cut it.

In a CBC interview [ http://www.cbc.ca/news/politics/jane-ph ... -1.3538055 ], Philpott also highlighted that any deal negotiated with the provinces will address home care, a pharmacare strategy, improved mental health services and a commitment to bolstering palliative care. "We will come to those agreements, and the money will be there," she added. What the final product will look like is anyone’s guess at the moment. Will the homecare commitments be based on a rational continuum of care, or will it simply be infrastructure spending for private long-term care services (when patients in long-term care leave the hospital or public facilities they are no longer covered under the Canadian Health Act, so this commitment could be a Trojan horse). As well, it remains to be seen if the federal government is invested in a universal, comprehensive pharmacare program with first dollar coverage, or if they are more interested in playing the shell game with insurance plans and using the ‘some drugs’ approach (i.e. only picking the low hanging fruit while the larger issue of access to medicines and price gouging remain). Lastly, will the federal government implement stronger penalties to violations of the Canadian Health Act or sit by and watch as more two-tiered American style health care creeps into Canada’s public health system.

The remainder of this year will be incredibly important for the future of medicare in Canada and will set the policy framework for years to come. Stay tuned....

To learn more about the Council’s of Canadians priorities see here:
[ http://canadians.org/blog/prime-ministe ... ealth-care ]

Michael Butler's blog
Council of Canadians Health Care Campaigner
[ http://canadians.org/blogs/michael-butler ]
Oscar
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Re: Looking ahead to a new Health Accord

Postby Oscar » Sat Jul 23, 2016 11:18 am

What is next for health care in Canada after the Council of the Federation?

[ http://canadians.org/blog/what-next-hea ... federation ]

July 23, 2016 - 1:04am

The Council of Canadians attended [ http://canadians.org/media/premiers-nee ... -canadians ] the annual Council of the Federation meeting in Whitehorse this week where premiers from across the country gathered to tackle some of the most urgent issues facing Canadians.

“Make no mistake, our universal public health care system is at the most important crossroads in its history,” says Michael Butler, Health Care Campaigner with the Council of Canadians. “The provincial and federal governments need to make the most of this opportunity to negotiate a robust health accord and include medicare’s missing piece, a universal pharmacare program.”

In an action alert and open letter to the Prime Minister and Health Minister (which anyone can sign on to here [ https://secure.canadians.org/ea-action/ ... n.id=53627 ], we explained, “The federal government and premiers from across the country are discussing the future of medicare. With our national Health Accord set to expire in 2017, there are two paths these discussions could take.”

Canada has the distinction of being the only developed country with a universal health care system that does not include universal prescription drug benefits. One in five Canadians has trouble filling prescriptions due to cost, while Big Pharma enjoys huge profits. The current fragmented system means worse health outcomes and higher drug prices for Canadians.

As the CBC reports, “The final day of the premiers meeting in Whitehorse finds Canada's provinces and territories in search of a common strategy for negotiating higher health transfers from the federal government... The discussions at this year's Council of the Federation start from the common ground of agreeing that no province has enough health care funding to meet its needs.” [ http://www.cbc.ca/news/politics/premier ... -1.3690500 ]

Further, at the end of the meeting it was reported that, “Canada's provincial and territorial leaders are calling for a meeting with Prime Minister Justin Trudeau this fall to negotiate a new health accord.” [ http://www.cbc.ca/beta/news/politics/pr ... -1.3690500 ]

The Whitehorse Star highlighted that, “Michael Butler, national health campaigner for the Council of Canadians, said health advocates came to Whitehorse from as far as Vancouver, Ontario and Newfoundland for the COF. Butler held a massive inflatable pill bottle (the prescription written on it read national drug plan for all) as he spoke about the goal of the protest – to focus on the idea of a national seniors plan and a national pharmacare plan. Too often, Butler said, Canadians can’t afford necessary medications, so they either don’t buy them, or they don’t take them when they should. “We are at a crossroads where we can get it right,” said Butler. He said the country can take steps to protect medicare for future generations, or see a two-tiered system creep in.” [ http://www.whitehorsestar.com/News/marc ... iors-plans ]

Hassan Yussuff, president of the Canadian Labour Congress, was one of many to speak to the crowd stating, “Far too many citizens every day are having to make choices – do they buy food, do they pay the rent, or do they get the medication so they can continue to go to work and help make this country a productive country on behalf of working people?” he asked. Jerry Dias, national president of Unifor, said Canada is at a “critical part of our history” when it comes to the health care system. Butler said the current government has shown promising signs, but that Canadians need a firm commitment to stable, predictable long-term health care. “We need to protect and strengthen our health care but also expand it as times change,” he said. [ http://www.whitehorsestar.com/News/marc ... iors-plans ]

In their a press release titled, ‘Health Care Sustainability' [ http://www.canadaspremiers.ca/en/latest ... ainability ], from the Premiers at the cessation of the meeting, they stated, “Provinces and territories continue to innovate in order to improve the effectiveness of the health care systems, but the imminent reduction in the Canada Health Transfer (CHT) escalator will put enormous pressure on PT health systems and additional investments are required to maintain sustainability. Premiers call on the federal government for an immediate increase in funding through the CHT as part of a greater long-term funding partnership on health care for Canadians.

There was also significant discussion about targeted funding from the federal government. This is a point of division with some Premiers like B.C.’s Clark stating [ http://www.cbc.ca/beta/news/politics/pr ... -1.3690500 ], "Targeting money is good solution," while others like Quebec Premier Couillard believe, “By their very nature, targeted funds are temporary and generally conditional on the achievement of new initiatives that do not necessarily correspond to the priorities of the provincial governments.”

Ottawa wants to make sure the money they are giving the provinces for healthcare end up in specified areas. This is something the Council of Canadians has called for (for more information see our blog on the last health ministers’ meeting we attended: [ http://canadians.org/blog/lets-take-med ... right-path ]). The rub is that this needs to be done to strengthen patient outcomes and the public health care system not just the federal government’s pet projects (although they may be included if evidence based data shows a need). We know from the last health accord that provinces often do not spend the federal transfer dollars in the areas that have the most impact, so until good faith is restored we agree with no more blank checks.

As chair of the Council of the Federation this year, Yukon Premier Darrell Pasloski stated [ http://www.cbc.ca/news/politics/premier ... -1.3690500 ], "We stated last year that the federal government should be providing 25 per cent of health care dollars, and what we have heard from the parliamentary budget officer, with the aging population that we have, is this is not sustainable from a provincial or territorial level."

Currently, the federal government’s share of public health spending in the provinces and territories is around 22 per cent [ http://canadians.org/blog/looking-ahead ... lth-accord ]. The Council of Canadians supports the call by many groups and the premiers for the federal government to cover a minimum of 25 per of health funding. The 3% escalator the federal government seems set on with a new health accord just won’t cut it. At the same time in some provinces (like Ontario) through reductions in provincial health care spending has made the federal share is at or over 25% without any significant and fair increases by the federal level. This is not the situation we want to be in, both sides need to put in the investments to protect, strengthen, and expand our universal public health care.

The next five months will be one of the most crucial periods in medicare’s history. It is time for federal leadership and responsibility by providing fair funding for a strong health accord and implementing national pharmacare. It is also time for the Premiers to show willingness for increased accountability with the spending of health care dollars to strengthen the public health care system and patient outcomes. While the two levels of government seem to be playing chicken with each other, it is really Canadians who are most at risk if solution is not found in the coming months.


Michael Butler's blog
Health Care Campaigner of the Council of Canadians
[ http://canadians.org/blogs/michael-butler ]
Oscar
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Re: Looking ahead to a new Health Accord

Postby Oscar » Tue Sep 13, 2016 8:18 am

Doctors want funding for seniors care in new health accord

[ https://www.thestar.com/news/canada/201 ... ccord.html ]

The Canadian Medical Association is calling for more resources to care for Canada's aging population.

By The Canadian Press Sun., Aug. 21, 2016

VANCOUVER — Canadian doctors want the federal government to make sure health care professionals have the resources they need to care for the country's aging population, says the president of the Canadian Medical Association.

Dr. Cindy Forbes said the group has been working hard on creating a strategy to care for aging seniors, and wants to make sure funding for care is covered in a future health accord, which would set out how federal health care money is distributed to provinces.

The association has developed several recommendations it would like to see in a new agreement, including more funding for provinces with larger populations of seniors, coverage of prescription drugs, and funding for long-term care, home care and for caregivers, Forbes said.

Doctors are already seeing the effects of an aging population and those issues will only continue to grow over the coming decades, she added.

- - - SNIP - - -

Doctors aren't the only ones calling for seniors to be a predominant focus in the new deal. Provincial politicians, too, have said they need more money to care for the medical needs of their aging populations.

Premier Dwight Ball of Newfoundland and Labrador has said his province faces a spike in medical costs as the population ages, and New Brunswick Health Minister Victor Boudreau has said populations in Atlantic Canada are aging faster than other regions, which adds to health-care costs.

Canada's last health accord expired in 2014 and, after refusing to renegotiate it, the previous Conservative government declared that the annual six per cent increase in social program funding to the provinces would end in 2017.

The Liberals promised in their election platform to restart negotiations, but the details have yet to be determined.

The CMA is "optimistic" about a new health accord, but it's important to have debate in order to make sure funding is adequate, Forbes said.

"This is a real opportunity," she said. "We really want to make sure that when it is negotiated, it will make a difference in our patients lives, that it will really impact the patients of Canada, the people that we serve."

Asked what they would like to see in a new agreement between the federal and provincial governments, doctors at the CMA's annual meeting in Vancouver Sunday said they wanted a focus on universal access to drugs, preventative medicine and emphasis on the quality of senior's care.

Dr. Avery Granger, the CMA's incoming president, told the crowd that negotiations for a new accord represent a chance to set a new vision of health care for all Canadians.

"(CMA) is in a real position to get these discussions off the ground," he said. "If we don't use this opportunity to engage various levels of government to achieve overall system change, then we'll have missed a very important opportunity."
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