Taking Aim at Fixing Health Care “For a Generation”

Just as the attention of our nation was focused on the World Cup Championships and on the stalled collective bargaining agreement talks (or lack thereof) between the NHLPA and the club owners, another drama was being played out in the backrooms of Ottawa as the First Minister's Conference took aim at fixing and enhancing the current health-care system.

There are many perceptions as to what sectors of the Cure health- care system are in most critical need of repair. Many say that wait times for surgery and other such proce- dures are far too long; others focus on shortcomings in pharmacare and homecare, while others point to the administration of funds as being one of the major prob- lems facing the system today. With a variety of con- trasting opinions, thirteen provincial and territorial leaders and Prime Minister Paul Martin, who vowed to "fix healthcare for a generation" in the most recent election campaign, met in Ottawa two weeks ago for healthcare talks aimed at hammering out a long-term deal for sustainability of our health system.

The provincial Premiers, having had the opportunity to develop a cohesive plan and a collective front on issues facing healthcare at this summer's Council of the Federation Conference and at pursuant meet- ings in Toronto, were perhaps more prepared and united than usual. Selected by their peers, Dalton McGuinty of Ontario, Jean Charest of Quebec, and New Brunswick's Bernard Lord were chosen to lead the talks on behalf of the Premiers. The main goal for the Premiers was increasing the amount of federal funding for health and to convince Paul Martin and his government that the $9 billion blueprint that had been announced earlier was simply not enough. However, there were still dis- crepancies in the views held by the various premiers: The Maritime Premiers, (Binns, Lord and Hamm) all expressed a certain level of inter- est at looking more intently at equalization payments during the meet- ings. This issue is vitally important to the Atlantic Provinces, particular- ly PEI, whose equalization share has dropped by $23 million since 2000 and which accounts for almost one-quarter of the entire budget revenue. Premiers such as McGuinty, Campbell, Calvert and Handley were also interested in the idea of further pursuing the pharmacare initiative that they discussed earlier this year.

Following up on promises he made during the election, Martin was looking to close a long-term deal that would see new monies going into healthcare across the country. He has made it clear that he wants to make reducing wait-times a top priority during his term in office.

Currently, heathcare expenditures by both the respective govern- ments and by the public sector topped $93.2 billion last year, according to the Canadian Institute for Health Information. In his health-care com- mission report, Roy Romanow emphasized that accountability for this money needs to be enshrined within the Canada Health Act so as to ensure that money is going where it should be directed. Michael Decter of the National Health Council also thinks that these funds should be monitored so as to see if focused spending is actually improving situa-

tions. "There should be a lot more value-for-money work in the health sector." He said. "I'm all for that kind of accountability."

Canadians also weighed in with thet opinions on the state of the health system, yet many remained unconvinced that the | Provincial-Federal summit would actually yield results. In a CTV and Globe and Mail poll, it was found that 59% of respondents did not expect much to come out of the meeting. "It's like a reality TV show." Said Dr. Luc Bessette, an emergency- room doctor who has worked in the system for 23 years. "They're performing for the cameras... They have to look at new ways of delivering care and defining what the security blanket is."

Christian Bourque of Léger Marketing in Montréal attributed the lack of interest on behalf of Canadians to the sheer blandness of the material being discussed. She said that average citizens would have probably been more interested had the topics remained focused on the redefining of healthcare for the future instead of simply throwing numbers around. "People are not paying attention beyond ‘What is the dollar amount?’ It [has] cornered our polit- ical elite into having a single-issue debate." She added. -

After watching cuts to health-care over the past few decades, the general consensus among many citizens was the sense that one meeting could not cure all that ails the system, and that perhaps the presence of cameras would further hinder the process suggested Darrell Bricker, president of Ipsos-Reid. Initially, all the meetings were convened in front of the cameras, a move suggested earlier this summer by Paul Martin in order to provide a degree of transparency in the system. However, by Tuesday, the second day of meetings, it was obvious that the two sides had reached an impasse and it was only after lengthy meetings behind closed doors at the Prime Minister's residence at 24 Sussex Drive that a deal began to take shape. They emerged from their final closed session early Thursday morning to announce the product of their four days of negotiations. They announced that Ottawa will transfer an additional $18 billion to the provinces over the next six years, with $41 billion over the next decade. With commitments to setting benchmarks after consultation with workers and officials in the health-care profession, the pact also outlined that by December 31st, 2005 benchmarks will have been put in place that would define reasonable waiting times for medical procedures. Equalization payments are also set to increase by $1.3 billion.

While some are cynical as to the sustainability of this current pact, the fact that all fourteen parties came away with some semblance of an agreement is in itself remarkable. However, many of the concerns mentioned in the Romanow and Senate Reports on health care remain to be addressed. The results of this meeting will not be apparent for months to come, but from initial reports, it is, at least, a step in the right direc- tion.

UPEI Cadre September 28, 2004 page 14