Health Accord Expires; Equitable Access to Services at Risk

Tommy Douglas, “Courage, my friends; 'tis not too late to build a better world.”
04-1-14

March 31st marks the last day of the current Canada Health Accord.  Signed by the federal and provincial/territorial governments in 2004, this 10-year plan brought $41 billion in financial transfers to provincial health systems with the goal of equitable access to services and the promotion of national health standards.  In place of this accord the federal government unilaterally imposed a new funding limit on health transfers starting in 2017, which will result in loss of $36 billion over ten years.    It is no wonder that rallies and protests took place across Canada yesterday in an effort to a strong health care system remains in place.

Organized by the Canadian Health Coalition, March 31 became a national day of action to protest the cuts to health funding and raise awareness of the effects less money for health would have across the country.   The website of the Coalition notes that the “lack of federal leadership in health care will lead to 14 different health care systems. Access will depend on where you live and your ability to pay.”  This goes against the grain of the values of medicare; a system many people in Canada cherish.  Our current health system allows for individuals to receive equitable care no matter where they are in Canada, but with the loss of funding as well as equalization payments that helped boost provinces not doing as well others, services you would receive in one part of the country may not be the same as what is available somewhere else.

Michael McBane, Coalition Executive Director, was quoted in a CBC interview as saying, “The voice of Canada is the federal government, not the provinces. So national standards, to ensure equity of access not based on where you live or your ability to pay, is a strictly, uniquely federal role. Nobody else can play that role”.

Protests included an event in Toronto featuring actress Shirley Douglas – daughter of Tommy Douglas the ‘father of medicare’ and also a video message from Shirley’s son, actor Kiefer Sutherland on behalf of the Stand for Medicare campaign.

The New Funding Arrangement

Under the new system imposed by the federal government provinces and territories would continue to receive health transfers with an increase of 6% per year (as under the 2004 health accord) until 2017.  After that time increases would be tied to inflation and economic growth.  Considering the recent recession, the effects of which are still being felt across the country, it is hard to imagine the government would make the decision to remove funding consistency to one of the most vital systems in Canada.  Health and well-being should not be based on the stock market or the decisions of business.

CWP wrote on this issue in 2011 when then federal Finance Minister Jim Flaherty dropped the bomb that funding beyond 2017 would not be consistent or increase automatically.  Our blog looked at the link between poverty and health and how the cost of poverty is impacting the current health care system:

“Poverty and health go hand-in-hand. People in poverty are more likely to use the health care system because of physical and mental health issues or illness, and be more likely to face an early death. Stress, poor nutrition, inadequate housing, and unstable social environments are a few reasons for this.

Known as the social determinants of health, these issues can lead to increased pressure on the health care system. Current healthcare spending that is associated with poverty is estimated at approximately 20 per cent. This fact demonstrates the weight that socio-economic disparities have on health systems and the importance of discussing both the future of the CST and CHT together.

While the debate on the future of the CHT has garnered media attention in the past few weeks, little commentary is surfacing on the funding of the CST, which directly impacts programs that benefit people with low-income.

The CST specifically supports provincial and territorial social assistance, post-secondary education, and reaches other social programs such as housing and childcare. Adequately funding these programs and reducing poverty saves money — the federal government could save $7.6 billion annually on health costs, and $2.9 billion in Ontario alone according to the Ontario Association of Food Banks (OAFB) Cost of Poverty report.” 

Last July, the Canadian Medical Association affirmed the connection between income and health when they released their report “What Makes Us Sick?” which examined poverty and health and offered recommendations, including a national poverty strategy.

The loss of the 2004 health accord is a worrisome event that suggests the topic of health care is not at the top of the current governments’ priority list.  The lack of commitment to the future of the health system in Canada and ensuring equitable treatment across the country goes against the foundation of the medicare system itself.   This debate will likely not end today with the death of the 2004 Accord, and as the next election approaches, may only increase in intensity.