Harper's hands-off approach could be the most important change to health policy since Tommy Douglas.
Last week, the provincial premiers disclosed how they would respond to the Harper government's exciting new approach to medicare. The response indicates that, yet again, provincial politicians just don't understand the scale of the problems we face. Indeed, the group of premiers we currently have running the provinces may be too out of it, and too ideologically pre-programmed, to grasp the opportunity Prime Minister Harper has given them.
First, some background: The federal government helps the provinces pay for health programs, which our constitution stipulates are a provincial responsibility. The arrangement dates back at least to 1957, when prime minister John Diefenbaker's Tory government began subsidizing certain provinces' public hospital insurance programs. The Diefenbaker subsidy freed up enough cash for Tommy Douglas' provincial government in Saskatchewan to go ahead and fund the expansion of that province's hospital insurance program to include primary care, such as doctor's bills. The result? Saskatchewan led the country toward medicare.
In recent decades, the federal government has provided the health subsidy in exchange for the provinces fulfilling certain conditions. For example, Pierre Trudeau's 1984 Canada Health Act made the subsidy conditional on five principles. If the provinces didn't adhere to those principles, the feds wouldn't fork over the money. As a National Post editorial adroitly put it recently, "the entire structure of the Canada Health Act ... is essentially based on extortion."
Back in December, federal Finance Minister Jim Flaherty presented a new arrangement between the provinces and Ottawa. All the premiers grasped the implications of the overt, financial component: The Harper government pledged to continue the six per cent increases in federal health-care funding until 2017, then committed to increases equal to economic growth plus inflation until 2024, with a minimum annual increase of three per cent.
What few of the premiers seem to have understood is the more exciting, second part of the announcement: Harper and Flaherty told the premiers they were handing over the money without conditions. For the first time in decades, the deal was: no strings attached.
If the extortion is over -- if the Harper government truly means what the Prime Minister has said, and there truly aren't any restrictions on the money that the feds pay to the provinces -- then Harper's pledge would seem to effectively suspend the legislation that has defined Canadian health care for the last 27 years.
Even if Harper is merely signaling a looser interpretation of the Canada Health Act's five principles -- public administration, comprehensiveness, universality, portability, and accessibility -- this could usher in a new age of Canadian health care. Harper is challenging premiers to compete with one another in the pursuit of health-care excellence, and providing them with the freedom to innovate as they see fit.
But rather than accepting the challenge, thus far the premiers are doing the opposite. They are convening something called the Health Care Innovation Working Group, which will be chaired by PEI's Robert Ghiz and Saskatchewan's Brad Wall. According to one report, the group "will attempt to explore more co-ordinated management and to address competition across health systems" -- the goal being to avoid "competition" in regard, for instance, to health-workers' salaries.
That's just the sort of market-averse, socialist thinking that got us the problems we have today. "Competition" is a good thing, and the provinces should embrace it. Competition is how federalism is supposed to work. Federalism is a race among the provinces to achieve excellence. Since 1984, the Canada Health Act has hampered that race. No longer. Harper has fired the starter's pistol, even if none of the premiers appear to have heard it.
This article originally appeared in the National Post
Follow Shaun Francis on Twitter: www.twitter.com/@shaun_francis
This article and the government's proposals are completely ideological based and have nothing to do with helping Canadians get the treatment they deserve. Both the government and the author should be ashamed of what they are advocating, while the author is entitled to his opinion the government is elected for one purpose to make life better for it citizens not promote ideology. ,
In this article the reasons for that willful avoidance are another issue entirely. Perhaps what has been proposed is not worth listening to in the first place.
Talk about a slippery slope.
Way to go Canadians - you elected this guy to a majority and now you get what you paid for ... well done....
I'd much rather have it as "I'm a Canadian, and it doesn't matter where I am in Canada I hope to get the same service from coast to coast."
competition is a good thing like 1929 like 2008
consciousness is agood thing
competition had created the best health care system 5 000 years ago true story
consciousness is agood thing
Shaun Francis should lead a parade in honour of the great King Friedrich's 300th birthday anniversary
capitalist bosses love the musik he composed
http://www.youtube.com/watch?v=1wM8pTDUbtQ&feature=related
http://www.youtube.com/watch?v=r-P-BAebl1c&feature=related
a big company is just so much smaller than a million people anyon eof which can outcompete any gargantuan company
competition is a word for warfare even though it literally means to strive together [ a company ]
what fosters exellence is consciousness and co-operation
if america' system wernt worse than canada's then the word socialist might sound like a sane thing to say
my good friend Diefenbaker tells me that King frederick II actually started Canada His alliance with england let to the 7 years war in which england took quebec but King George the 3rd ,grandson of the kingof Hesse, had to raise taxes to pay for iraq pardon me and then the tea party made america; so old fritz made canada and america; if fritz's son, frederick the 3rd, had helped the british ,america would be part of Canada
true story , call me sane if you like
Chairman and Chief Executive Officer
Shaun Francis is Chairman and Chief Executive Officer of Medcan Health Management, Inc., a leading healthcare services provider. Established over 20 years ago, Medcan’s primary purpose is “keeping busy people healthy” by providing outpatient based preventive, diagnostic, and primary healthcare services to corporate executives, individuals and families. In 2010 Medcan was featured in the Globe and Mail as one of the Top 100 employers in the Greater Toronto Area and in 2011 Medcan was featured in the National Post as one of Canada’s 50 Best Managed Companies. Prior to rejoining Medcan, Shaun was one of the founding employees and Senior Vice President of Strategy and Business Development for Dallas based Broadlane, Inc., a leading business process outsourcer for over 900 US hospitals. In 2010, Broadlane was sold to MedAssets for US$850MM. Prior to joining Broadlane, Shaun served as Vice President and Chief Financial Officer of Medcan. Shaun also worked for Morgan Stanley’s New York and Toronto investment banking division where he managed equity, debt and mergers and acquisitions transactions. Shaun received his MBA from the Wharton School at the University of Pennsylvania and he received a nomination from President Reagan to attend the United States Naval Academy in Annapolis, Maryland as a Canadian.
Will HP listen?
As a National Post editorial adroitly put it recently, "the entire structure of the Canada Health Act ... is essentially based on extortion." ---- I'm sure it was based on following the rules for universal healthcare
Harper is challenging premiers to compete with one another in the pursuit of health-care excellence, and providing them with the freedom to innovate as they see fit.----- So we are going to see at least several different ways . Shouldn't we have the same care across the entire country ie universal. Will I have to get extra privite insurance to visit other different parts of Canada?
That's just the sort of market-averse, socialist thinking that got us the problems we have today. ---- let the market decide on our healthcare? You mean do it the American way? NO THANKS. I suppose you want to privitize our socialist armed forces, police and fire departments too.
Competition is how federalism is supposed to work. Federalism is a race among the provinces to achieve excellence.----Competition means what each province can do best.ie cancer in bc, heart surgury in Alta, frostbite in Sask, Mosquito bites in Manitoba, etc. Shouldn't they work together? You know "many hands lighten the load".
How about going to other top rated countries, see what they do best and adapt it for Canada.