Hardly a week goes by without this thorny issue being disputed between federal and provincial governments - even now that the budget has been tabled. The simple solution is that health costs should be shared, 50-50. But this solution is far from simple and very misleading.
Extra-billing in Ontario, private MRIs in Saskatchewan and user fees in Quebec: violations of the Canada Health Act are on the rise across the country. Canadian doctors are concerned about the impact of this trend not only on their patients, but on our public health care system as well.
This week the country's 14 health ministers have been gathering in Vancouver for a pan-Canadian summit to begin negotiating a new health accord. The previous accord saw $41 billion transferred to the provinces over the last decade. This next one may be even bigger.
Medicare is a defining program and a source of enduring commitment from coast to coast, and all political parties claim to support the Canada Health Act. Why are we not hearing resounding denouncement of Minister Barrette's plan to "normalize" user fees from our federal politicians?
The Liberal government's Health Accord recognized that; the Council of the Federation recognizes that; health care advocates and health professions recognize that. This is the mandate of the federal government and it is time to stop passing the buck to provinces.
The so-called "jewel of Canada's health system" is, in fact, exactly what sets us apart from the top-performing universal access health care systems across the developed world. Freeing patients to seek care on their own terms with their own resources actually more closely follows the European approach to health care where universally insured residents of countries like Sweden, Switzerland, Germany, the UK, and others have always had the option to choose private parallel care.
Expenditures on public health care in Canada appear to be slowing, raising the possibility that the health care cost curve is finally being bent and the system transformed. What does this mean? The economy will eventually recover and relax provincial health expenditure constraints, but federal health transfer growth will be reduced starting in 2017.
When Canada's premiers meet for the annual Council of the Federation this week, the future of health care is a critical item on the agenda. The role of a premier is to stand up to federal government bullying on behalf of all Canadians. We are asking them to send a strong message to the Harper Conservative Government: Get back to the table and get back on board to support public health care for all in Canada.
Medicare and the CHA have reached mythical proportions in Canada. It is an untouchable "sacred trust." Those that dare question it -- much less talk of reform -- are virtually branded enemies of the state. I experienced this first hand last year when as a candidate in the general election I had the temerity to point out a simple fact: Canada does not have the "best healthcare system in the world," as all politicians have told us for years. In fact, that is a cruel deception. And CHA is nothing more than a hollow and toothless statement of intention and principles, has been the most untouchable of scared cows of Canadian politics since 1984. All three national parties kneel at its altar.
There's been a lot of talk about reforming the Canada Health Act -- specifically losing two of the five principles. What's less frequently discussed is what we risk losing if certain principles of the Canada Health Act were to be relaxed or abandoned completely. If that happens, can anyone be confident that a high quality public system can be sustained?