03/31/2014 01:43 EDT | Updated 05/31/2014 05:59 EDT

Canada Health Accord expires, prompting protest, uncertainty

Patients, caregivers and doctors say the ending today of Canada’s 10-year-old, $41-billion Health Accord highlights the growing inequity that threatens to fracture medicare.

The deal between Ottawa and the provinces and territories provided stable funding and set common goals on wait times, home care and prescription drugs.

"Ten years down the road, we’re looking back, and it’s pretty difficult to find any substantial progress," said Dr. Chris Simpson, chairman of the Wait Times Alliance and president-elect of the Canadian Medical Association.

To mark the end of the accord, the left-leaning Canadian Health Coalition organized a national day of action on Monday with 40 events planned across the country. The group said it wants to alert Canadians to how the lack of federal leadership in health care could fragment services and access to care depending on location and ability to pay.

Actress Shirley Douglas, daughter of politician and medicare champion Tommy Douglas, is scheduled to speak at a rally in Toronto. Tommy Douglas’s grandson, actor Kiefer Sutherland, also released a video to rally Canadians on the need for federal leadership to negotiate a new accord with a continuing care plan such as home and respite care, a universal public drug plan and adequate and stable federal funding.

On wait times, Simpson said there have been small successes in areas such as heart bypass surgeries and initially cataract waits in Ontario, but he adds the money didn’t really buy the change that doctors expected.

Stubborn wait times in areas such as hip and knee replacements may reflect an aging population with degenerative diseases and needs that greatly outpace resources, Simpson said.

Simpson sees a common failure to recognize interconnectedness of all the pieces needed to provide health care, from providing long-term care beds, building surgical suites or alleviating poverty among seniors.

Home care struggle

Susan Bosak of Stouffville, Ont., said the stress of providing home care to two frail, elderly patients was exacerbated by the bureaucratic and unpredictable nature of the home-care system.

For Bosak, caring for her father paralyzed by a stroke and mother with advanced dementia was a meaningful act of love, but it was also an isolating experience with little support and training. The home care struggle extends beyond a financial issue to quality of life and dignity, she said.

"Just because we get old do we lose all our rights to how we want to live?" Bosak asks.

"We really have to ask ourselves as Canadians what kind of society we want to be? When it comes to those of us who are oldest and most frail, it's a really big question that we're not even discussing."

The health-care system needs to respond as more people are sickened at home with chronic diseases such as stroke or heart failure, said Dr. Jeff Turnbull, chief of staff at the Ottawa Hospital. Turnbull also spoke at the coalition’s luncheon event in Ottawa.

Like Simpson, Turnbull fears that without Ottawa’s leadership, inequity between provinces and territories will grow.

"I’m going to have to have health insurance when I go from P.E.I. to Vancouver to cover the difference in care," Turnbull said. "That’s not what Canadians expect." 

The federal government has said it will continue health transfers to the provinces at six per cent a year until 2017-18. At that point, the transfers will be tied to the rate of economic growth and inflation.  Ottawa says the annual rate of increase won’t fall below three per cent.

There are no strings attached to the funding.

The Canadian Health Coalition is seeking a six per cent escalator.