Tag Archives: Health Accord

We won’t have Medicare II without federal leadership — Himelfarb

Alex Himelfarb.

Alex Himelfarb.

Alex Himelfarb understands the 2004 10-year health accord better than most. At the time it was negotiated, he was the highest ranking civil servant in Ottawa.

The $41.3 billion Accord was supposed to fix health care for a generation. It would reduce wait times, provide catastrophic coverage for costly prescription drugs, focus on strategic health human resources, invest in first dollar coverage for home care, conduct primary health reform, and increase accountability and reporting to citizens through the Health Council of Canada.

Himelfarb, now director of York University’s Glendon School of Public and International Affairs, doesn’t dispute that it failed to reach expectations, but argues that has a lot to do with the Harper government which never wanted the plan to work.

“They didn’t do all they had to do as a government, then said it didn’t work,” Himelfarb said last week at a luncheon held by the Canadian and Ontario Health Coalitions.

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Was Monday really a tipping point?

Honking for Health Care on University Avenue in Toronto.

Honking for Health Care on University Avenue in Toronto.

On Monday I saw Ontario Health Coalition Director Natalie Mehra at a noon-hour rally on University Avenue. As far as rallies go it wasn’t a big one. About 50 people showed up to hold up signs urging motorists to honk for a new health accord. So many motorists did just that it became, at times, hard to hear each other speak.

Mobilizing people around the health accord is not the easiest sell. The health accord is a complex issue about planning, standards and funding. When you really strip it down, however, it’s really about the future of Medicare in this country.

I was recently asked by a gas station attendant about a button I was wearing with a red umbrella and the text “Canada Needs A New Health Accord.” With customers waiting behind me I had to explain in 30 seconds what it was about. That’s not so easy and made me think if I found this difficult, what about a 10-second sound bite?

March 31st we all were wondering if we just bit off more than we can chew.

Mehra has been circling the province in recent weeks working on five regional campaigns intended to pressure the government to back off on a plan to contract selected hospital services to private clinics. The campaigns are due to culminate this weekend in Windsor, London, Kitchener, Sudbury and Peterborough. Her enthusiasm has been infectious as she tells us of all the cards that have been collected to date.

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The wake for the Health Accord was great, but what’s next?

Actress Shirley Douglas shares the stage with Tabby Johnson, Jackie Richardson and other performers from Holler 4 Health Care.

Actress Shirley Douglas shares the stage with Tabby Johnson, Jackie Richardson and other performers from Holler 4 Health Care last night at the Trinity-St. Paul Centre in Toronto.

There’s got to be a morning after.

Yesterday more than 40 communities across Canada marked the end of the 10-year health accord between the provinces and the federal government.

Listening to actress Shirley Douglas speak last night at one of those events in Toronto, its clear many Canadians believe there is much more at stake than a framework agreement that trades health care objectives for cash.

Before the rally began last night, the daughter of Medicare founder Tommy Douglas told the Toronto Star that her father had warned of the slow strangulation of health care, telling her “if you don’t get up and fight for it, you are going to lose it.”

With her 80th birthday just a couple of days away, Douglas vowed to fight on for the next decade if necessary, pausing to add the caveat provided she’s still around.

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Premiers form committees to change no to yes

Former Saskatchewan Premier Roy Romanow calls them tepid.

Finance Minister Jim Flaherty is saying no means no.

There is likely more frustration at Victoria’s Premiers’ meeting this week than among the coaching staff of the wilting Toronto Maple Leafs.

The Premiers first arrived after discovering the Federal government had unilaterally decided on what the funding side of the next health care accord would look like.

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Premiers Meeting: On Language, Meaning and Secrets

It is very possible Canadians are confused about what the Premiers want from the federal-provincial meetings taking place this week in Victoria, BC.

A lot of it has to do with language and meaning.

For example, some provinces are saying they want the new federal-provincial health accord linked to innovation.

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Unilateral Federal funding decision shouldn’t be a surprise, even if it makes little sense

Less than a week before Christmas Federal Finance Minister Jim Flaherty marched into a luncheon meeting of his provincial counterparts and told them what the Federal contribution to health care funding would be to 2024.

“They just landed this on the table over the lunch hour,” Manitoba’s finance minister told the Globe and Mail. “It caught us all by surprise.”

The “take it or leave it” deal includes:

  • a six per cent annual funding increase for three years to 2017
  • funding increases tied to nominal* GDP beginning in 2018 with a three per cent floor
  • new funding would be on a per capita basis only – weighting for equalization would be removed from the Canada Health Transfer
  • no strings are attached, although provinces are “encouraged” to experiment with private delivery of public health care

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Governments followers on health care — CMA President-elect

When it comes to health care, government tend to be followers, not leaders, says Dr. John Haggie, president elect of the Canadian Medical Association.

Speaking at the Canadian Health Professional Secretariat in Ottawa May 19, Haggie says the CMA is trying to become a catalyst of change through its current consultation process.

“We decided to leave Ottawa and talk to people,” he said.

OPSEU's Rick Janson with Dr. John Haggie, president-elect of the CMA.

The CMA and Maclean’s magazine have been holding a series of regional forums on health transformation. Forums have already been held in Halifax, Toronto, Edmonton, and Vancouver. One more forum is scheduled to take place in Ottawa during the month of June.

The CMA is trying to frame a series of principles by which Canada’s health system should evolve, recognizing that the present system does not always fulfill its present obligations under the Canada Health Act. The CMA is looking for a framework that would build upon the five principles of the Act – universality, accessibility, portability, comprehensiveness and public administration – principles that at present only apply to hospital and physician services.

That includes such issues as developing a system that is more patient-focused, that is quality driven, that supports prevention initiatives (including social determinants of health), is equitable, sustainable and accountable.

Haggie has been asking what kinds of services should be covered under Medicare “basket,” including whether gaps should be filled in such areas as pharmacare and dentistry.

“The health care sustainability debate has focused on money,” he says. “It has not gone back to first principles. What are we trying to sustain?”

The CMA has heard from Canadians who have a strong commitment to Medicare and said he was surprised at how well-informed those who have been attending the forums are.

The public have told them that the system needs adequate resources, including good IT to not only provide information, but to monitor outcomes. They want coordinated health human resources, evidence-informed decision-making at policy and clinical levels, and active involvement of the public.

“We are abysmal at sharing excellence,” he said, noting many initiatives are already taking place that provinces could be learning from.

Haggie says the CMA has studied other international systems of which universality is a consistent feature. He questions whether Canada is spending its health care funding wisely, especially when European countries often have a greater scope of public coverage.

With the expiry of the current Health Accord in 2014 these discussions are very timely. Haggie says he would like to see a commitment to a Health Action Plan that would mimic the current Federal Economic Action Plan.

The CMA President-elect says there is a need for an evaluation of the current health accord, and that Canadians still favoured a strong bilateral accord – something the new Harper government may need some convincing to do.

“The Federal government spends more on direct health care than six provinces,” he says. “They need to be constantly reminded of this.”

The new accord should look ahead to provide stable and predictable funding, include a strategy for “plugging the holes,” and some level of accountability.

“Canadians want to know where the dollars went,” he said.

Haggie suggested that while the Federal government has made a commitment to renew the Accord, it may instead take the form of a series of bilateral agreements with provinces.This may be an attempt to divide and conquer, putting the first province to sign such an accord in a difficult situation.

He doesn’t believe that much will happen until after a series of provincial elections take place in the fall, predicting the Harper government will prefer to wait and see who is in office.