Federal health dollars must come with accountability and national standards
OTTAWA — As Canada’s premiers and the federal NDP ramp up the pressure on the Trudeau government, Health Coalitions across Canada are demanding that any increase in public health funding be used in the public interest and not be used to privatize health care.
The Health Coalitions support the call for a long-term increase to the Canada Health Transfer (CHT). However, the federal government must also enforce a robust accountability framework agreed to by the provinces, in addition to funding, to ensure that provinces and territories invest this money in public health care, and not hand over our vital services to for-profit corporations. The Coalitions note that private virtual care companies and for-profit clinics are brazenly violating the Canada Health Act, some with the full support of their provincial governments. While other provinces allow it to continue, only British Columbia has acted, as British Columbia's Medical Services Commission is seeking an injunction against a Telus Health program, alleging its billing model violates the province's Medicare Protection Act. The Coalitions demand that the provinces use federal funds only in ways that uphold the Canada Health Act which prohibits user fees and extra billing of patients for services such as seeing a doctor or getting MRIs, blood tests, cataract surgeries, and colonoscopies.
Recently the federal government announced more than $9 billion in new funding for long-term care. It is a cruel irony that after thousands of Canadians died, many preventable, most of them in for-profit long-term care homes, the national standards that were supposed to accompany that funding evaporated and billions of those dollars are being used to build new for-profit long-term care homes.
Canada’s universal, public health care system requires federal leadership and provincial accountability. Millions of Canadians have joined the call for stronger, not weaker, federal standards and provincial accountability. In the past, some provinces have taken federal funding increases while engaging in real dollar cuts to public hospitals, continuing care, long-term care or other services. Some provinces have given away billions in corporate tax cuts and tax cuts for the wealthy. An agreement without strings attached to ensure that money goes to care, and not to profits, would not be acceptable.
While each province has its own unique needs and priorities, in this time of unprecedented staffing shortages and multiple pandemics emerging at the same time, our political and public health leadership must act to restore capacity and rebuild the resilience of our health care institutions and services.
Public health care is our best defence against the COVID-19 pandemic and other health crises. However, this system has been eroded through decades of austerity budgets, privatization, and inadequate planning. Even during “normal times,” our health care system is at capacity. Today the short sightedness of those decisions is haunting us. We cannot respond to this crisis by doing more of the same.
The pandemic has revealed both the necessity of having a strong public health system, and the devastating consequences of under-investing in public health care. Health coalitions across Canada recognize the federal government’s extraordinary contribution of resources and support during the pandemic. However, this time-limited and targeted support does not address the structural inadequacies of federal transfers left by the failure to negotiate a new Health Accord in 2016/17.
At this pivotal moment in our nation’s history, the federal government must reaffirm its commitment to public health care by making long-term, substantial increases to the CHT while the provinces agree to accountability mechanisms attached to those increases to ensure our public funding goes to improving care, access and equity. Any federal-provincial-territorial deal must ensure that people in Canada will access high-quality public health care on equitable terms, based on their needs and not their income, no matter where they live. It must unite the country around our shared vision for public health care, which is based on the principles of equity and compassion.