Many countries offer sophisticated medical care and universal coverage and yet have very different health-care models. And, more importantly, several of these countries achieve better health outcomes. To be fair, international health care rankings never offer a consensus on which country truly has "the best" system. But there is one area where these rankings are consistent: they usually place Canada and the U.S. mid to low pack. I believe both countries can do so much better.
The report of the Ontario Social Assistance Review Commission, released October 24, offered some important steps toward health-focused change. Its release was set to spark a badly needed discussion on reform of a broken and anemic system. The surprise resignation of Premier Dalton McGuinty changed that -- this debate has been conspicuously absent.
The Canadian Medical Association's 145th annual meeting is taking place this week. The mantra of the meeting is health equity, and Sir Michael Marmot, the white knight of social determinants, undoubtedly provides the human and scholarly element the issue of inequality deserves. There may be no better person to articulate Canada's barriers to better health outcomes.
The Harper government may choose to believe that a divided society is not bad for the economy, or that wealth will trickle down. Canadians from across the country may have to assure him that health will surely not. Canada has fared better than other nations in the global economic crisis, but success stories have not followed those who prescribed austerity.
The implementation of Obamacare seems anything but straight forward. Costs have soared despite the fact that most reforms don't kick in until 2014; several states have effectively rebelled; one basic reform (the long-term care insurance) was already scrapped. The debate over American health care seems no closer to resolution.
Harper's unilateral offer promises increases in federal funding that are unsustainable. With health care set to eat up 80 per cent of provincial budgets by 2035, if no substantial reforms are implemented we will have serious consequences for the ability of provinces to spend on departments other than health care.
Health care, which pollsters insisted was the issue of greatest concern to voters in the federal election, was summarily dismissed by our political parties with a unanimous promise made up of two simple words: "more money." But throwing ever-larger amounts of taxpayer dollars at the problem without measuring value often simply results in more waste and duplication.