When the premiers were first called to a sit-down lunch to talk about health care with Prime Minister Trudeau, there was plenty of talk about the potential for systemic change, innovation, and accountability.
It seemed that Canadians and their leaders were finally on the same page in recognizing that health care, as it is, is largely broken and money alone isn’t going to fix it.
But the meeting has come and gone, and there were no new ideas and no talk of change. Trudeau offered the premiers a big wad of cash over a two-hour luncheon and the key message was “take it or leave it.”
Trudeau’s offer of $196.1 billion sounds like a major investment, but it isn’t. The premiers asked the federal government to increase its share of health spending from 22 percent to 35 percent (the equivalent of $28 billion per year).
Given Trudeau’s rampant spending spree over the past seven years, that was never going to happen—but little did the provinces expect the offer to be less than a 1 percent increase in federal funding.
The $196.1 billion is an overwhelming figure which, once dissected, is little more than smoke and mirrors. The money covers a 10-year period which only means that the provinces shouldn’t bother to ask Ottawa for more health care money each year. It includes just $46.2 billion in new money which, over 10 years, leaves just $4.6 billion in new spending each year to be divided amongst the 10 provinces and two territories.
Of the $46.2 billion in new spending, $2 billion was earmarked for urgent needs in children’s hospitals and emergency departments, $17.3 billion is to provide a funding boost over the next decade, $1.7 billion will top up salaries over five years, and $25 billion over 10 years will be negotiated with each province independently after it submits a specific health-care delivery plan for the money.
Apparently, these plans will be necessary (and sufficient) to check the accountability box on the federal budget sheet.
Billions of dollars are always a substantial investment but, in this case, it suggests a shocking lack of leadership and vision at a time when it seems that Canadians are looking for wholesale changes that will ensure timely care.
An Ipsos poll that came out just prior to the premiers’ meeting showed that Canadians’ attitudes to health care are shifting rapidly.
A full 85 percent of respondents said that “drastic changes” are needed to the health-care system and six-in-10 (59 percent) support the private delivery of publicly-funded health services. The same number (60 percent) said that those who can afford private care should be able to use it.
Finally, one-third of Canadians (32 percent) said they would go to the United States and personally pay to receive routine health care, while 29 percent would do so to receive urgent or emergency care.
The numbers represent a changing perspective on health care, and that means politicians should be listening.
For 60 years, Canadians have pinned their hopes on the symbolic and non-tangible principle that universal health care will take care of our medical needs. We may have to wait a bit longer than those in other countries, but universal access to health care works and it is the Canadian way.
But a two-year pandemic and a rapidly aging population are chipping away at that ideal, and Canadians are finally realizing that this underlying principle is not enough to provide access (let alone timely access) to medical care.
According to a recent report from the Fraser Institute, more than 1.2 million Canadians were on wait lists for various surgeries and procedures in 2022. More than one in five Canadians cannot find a family doctor. Access to non-emergent mental health care takes years, and the media routinely cover deaths related to waitlists for care and/or overwhelmed emergency departments.
There is limited access to diagnostic medical technology (CT, MRI, and PET scans), even though their use is routine in other developed, wealthy nations. We need doctors, nurses, and other health-care workers. We are far behind other nations in terms of transitioning to electronic records and the use of virtual care for remote areas.
Yes, the system needs money. But it also needs leadership. Trudeau seems content to let others deal with a broken system, and the Conservative party has had little to offer at a time when the appetite for change runs deep. The NDP’s proposed pharmacare would only create more pressure on an overburdened system.
Health care is in desperate need of creative leadership and the job remains open to anyone with an innovative spirit. Apply within. Please.
