Time for a new approach to health-care financing
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Hey there, time traveller!
This article was published 07/11/2022 (210 days ago), so information in it may no longer be current.
Health ministers from Canada’s provinces, including Manitoba’s Audrey Gordon, are gathered in Vancouver this week to pound their fists on the table and demand more unconditional money from the federal government. They did the same last year and the year before, and many times before that, without much evident result.
According to Adrian Dix, British Columbia’s health minister and host of this week’s gathering, they were aiming for a grand showdown at which the premiers of the provinces and territories would present their claims to Prime Minister Justin Trudeau and compel him to fork out a hefty increase in the Canada Health Transfer. This is the program by which Ottawa pays each province and territory a standard per-capita amount each year for operating a health-care scheme that conforms with the principles of the Canada Health Act.
Those federal payments increase each year in line with the growth of Canada’s gross domestic product. Health expenses, however, have risen more rapidly along with costly new therapies and rising public expectations for care.
Provinces receive these payments whether their health-care services are good or not. Disgraceful conditions that came to light when the COVID-19 pandemic struck Canada revealed that long-term care and home care in most provinces was neither efficient nor effective.
The premiers have been saying for a couple of years that Ottawa should cover 35 per cent of Canada’s health-care spending, up from what they claim is now 22 per cent. The basis for those calculations is obscure.
The provinces maintain Ottawa has no business asking them how they will use the money or how they used the money they got last year. The delivery of health-care services and the management of hospitals, they contend, is an exclusively provincial matter in Canada’s Constitution. Ottawa should not poke its nose into health-care service questions, apart from providing more money.
This reasoning might carry the day with Canadian public opinion if provincial governments were clearly trustworthy stewards of health-care funds. This is not the case in Manitoba. Governments of this province have pursued one questionable scheme after another to achieve better health care with less expense, with the results that patients are now enduring — closed hospital beds, long waits for care, catastrophic shortages of nurses and doctors.
It is easy to argue health care deserves more money than is now being spent on it in Manitoba and in other provinces. The public wants better health care than is now provided, and the health care professionals would be able to deliver better care if there were more of them.
Where should that money come from? There is no magic in any particular percentage sharing of cost burden between Ottawa and the provinces. If provinces want more federal money, however, they should expect pointed questions about the results they are already achieving.
Instead of pounding that table and demanding unconditional handouts, provinces should be showing what innovations they are pursuing to improve service to their people. They should be showing how many more patients they could help if only they could train and employ more nurses and therapists in specific fields that cry out for improved service. They should welcome inquiries about expansion of home care and reforms to long term-care management.
Ottawa, in turn, should be happy to help with reforms, expansions and innovations that are going to produce tangible results. The currently employed table-pounding strategy, by contrast, is destined to produce little beyond sore knuckles.