Tom Mulcair: This is why the federal health-care proposal is so disappointing
Justin Trudeau has thrown in the towel in the fight to maintain the federal role as gatekeeper of a public, universal, accessible and fair health-care system in Canada. That could have tragic consequences for folks on the lower rungs of the social and economic ladder.
It could also hurt Canadian unity because another key characteristic of our healthcare system, transportability from one province to another, could also get flushed with impunity.
Let’s start with an admission: something had to change.
Tony Blair had it right, there are only two categories in public administration: things that work and things that don’t. The corollary is: if what you’re doing doesn’t work, then try something else.
That’s the territory we’re in right now. A health system where being put on a waiting list is often the only thing they can offer you.
Canadians have always been enamoured of our medicare system. After all, it gave us one thing to brag about to our "heartless" American cousins...
I come from a very large family of ten kids. My parents both worked really hard but doctors’ bills were a reality I remember them talking about. It was expensive.
MEDICARE 'WAS A RELIEF FOR FAMILIES LIKE OURS'
When medicare was announced, it was a relief for families like ours. In Saskatchewan, Tommy Douglas won his last election on a promise to bring in medical care insurance, based on pre-payment, universal coverage, quality service and government administration.
Douglas himself had needed major medical care as a child. While he was thankful to the physician who cared for him despite his parents’ inability to pay, he wanted to ensure that healthcare would be available to kids, irrespective of their parents’ financial situation.
The CCF (precursor of the NDP) government of Saskatchewan faced a major hurdle as soon as the plan was enacted. The College of Physicians and Surgeons organized a doctors’ strike. Equally determined, the government brought in MDs from Britain and the U.S. to work under the new system. In short order, the Saskatchewan doctors returned to work and accommodations were negotiated. The first medicare system in North America was now in place. Public interest had triumphed over private profit.
A decade later, Douglas’ model was introduced across Canada, thanks to a deal between the federal government and the provinces. Unfortunately, since that time, accessibility has become a major problem that has proven vexingly difficult to address.
The original agreement was a 50-50 sharing of costs between the feds and the provinces.
A 'DISAPPOINTING' PROPOSAL
Today that’s closer to 75-25 with the provinces paying the lion’s share. The provinces needed to get the feds to 35 per cent.
That’s why this week’s federal proposal is so disappointing.
What should’ve been $28 billion this year alone is actually going to be less than $5 billion. Despite fictional numbers of close to $200 billion being spun by Ottawa, the Feds are only offering $4.62 billion a year, for ten years.
Ottawa’s press release was a masterpiece of obfuscation. Columns of figures wearing pancake makeup. They even tried to include pandemic spending in Ottawa’s contribution!
As with the very first medicare deal, the provinces gave up part of their exclusive jurisdiction over healthcare. They accepted the eminently reasonable federal request to provide transparent and objective information on things like wait times and coverage. The premiers rightly considered this to be, essentially, money without new conditions.
On the positive side, for the first time in decades we seem to have been able to move beyond debates about modalities towards an emphasis on measurable results. Outcomes.
Problem is, with the paltry sums being offered, there’s little hope, for real change that will save the essential qualities of the system. The pressure for more privatization thus baked in, it now has to be controlled in the public interest, but by whom?
The Premiers appear to have read the room correctly. The public doesn’t want squabbles, it wants access and reduced waiting lists. Federal Health Minister Jean-Yves Duclos even channelled Pierre Poilievre over the weekend saying the system was broken. On Monday Trudeau echoed that, while avoiding the "broken" wording of his minister, he said Canada's health system simply doesn’t work.
If Ottawa recognizes that this key Canadian institution isn’t working, why do they still refuse to respect the initial deal and pay their fair share? Is it because they’ve bought into the mantra that more competition, meaning private for profit care, is a panacea that will somehow fix everything?!
PUBLIC FUNDS FOR A PRIVATE SERVICE
In Canada we seem to have a penchant for two-tier government services. When provinces subsidize what are supposed to be private schools, workers wind up seeing their taxes pay for the "private" schooling of wealthier families.
Public funds for a private service. As the public system has more and more problems, parents sacrifice a lot to get their kids into the private schools. A vicious downward spiral of the public school system results.
This is the greatest fear as we talk about transferring some of the responsibility for delivering health care to the private sector.
Doug Ford sincerely believes he’s going to improve health care by subcontracting some of the more repetitive work to private clinics. It is hoped that economies of scale will reduce wait times and allow for a decent profit, while reducing government costs. Not a sure bet but one that has become almost inevitable in light of the underperformance of the public delivery system.
It’s amazing to note that Ford’s privatization proposal, that would’ve been an anathema for Mr. Trudeau just a year ago, the prime minister now cheerfully describes as being "innovative".
Promises to only need "a medicare card, not a credit card" only go so far. The real fear is that there will be two systems: one that can be accessed by those with some money and one for the less fortunate.
These clinics will have to be tightly regulated.
Private owners can’t be allowed to cherry pick the best patients, the better to claim superior outcomes. Smoker? Obese? Underlying condition? Sorry, you’ll have to go over to the public system.
The single payer will remain the government, which therefore must also remain the single wicket for sending patients to those private clinics. Otherwise, the toughest patients will be sent to the public system that will be, again, singled out for being too costly and inefficient.
Costs of necessary licensure, inspection and accreditation must be borne by the private clinics. Unlike the tragic neglect that led to the multiple horrors in nursing homes during the pandemic, provinces and territories will actually have to learn how to enforce norms on the private providers.
We have a strong emotional attachment to our medicare system because it is so egalitarian. So fair. Unfortunately, it’s become equally mediocre in too many areas. Good sentiment isn’t a substitute for timely treatment. Political dogma doesn’t provide a service to anyone. We’ve arrived at an inflection point, let’s prepare for it and deal with it correctly in the public interest.
When I hear some politicians say that if we finally bring in pharmacare it has to be purely public, we’re into an area of ideology. Quebec has, by far, the most complete coverage of prescription medication in Canada. It’s a hybrid model where private and public insurance coexist, side by side. It works.
Doctrinal purity, based on an entirely theoretical model, can’t compare to an actual positive result.
So too with health care. Like many progressives, I’ve fought the good fight throughout my career. Battling back against incursions by the privateers! But if we acknowledge that the current model can’t be fixed, at least not at a cost that can be borne by the provinces, then we do have to adapt but we also have to get it right.
When what you’re doing doesn’t work, try something else…but do it with eyes wide open, ensuring that public protection is the only value guiding any private additions to the system.
Canadians deserve the best health care. Let’s figure out how to deliver it in fact, not in theory. That was supposed to begin with the return of an appropriate federal contribution. Now that that’s not on the table, it’s time to figure out a cure for our once vaunted health-care system that doesn’t kill the patient.
IN DEPTH
Budget 2024 prioritizes housing while taxing highest earners, deficit projected at $39.8B
In an effort to level the playing field for young people, in the 2024 federal budget, the government is targeting Canada's highest earners with new taxes in order to help offset billions in new spending to enhance the country's housing supply and social supports.
'One of the greatest': Former prime minister Brian Mulroney commemorated at state funeral
Prominent Canadians, political leaders, and family members remembered former prime minister and Progressive Conservative titan Brian Mulroney as an ambitious and compassionate nation-builder at his state funeral on Saturday.
'Democracy requires constant vigilance' Trudeau testifies at inquiry into foreign election interference in Canada
Prime Minister Justin Trudeau testified Wednesday before the national public inquiry into foreign interference in Canada's electoral processes, following a day of testimony from top cabinet ministers about allegations of meddling in the 2019 and 2021 federal elections. Recap all the prime minister had to say.
As Poilievre sides with Smith on trans restrictions, former Conservative candidate says he's 'playing with fire'
Siding with Alberta Premier Danielle Smith on her proposed restrictions on transgender youth, Conservative Leader Pierre Poilievre confirmed Wednesday that he is against trans and non-binary minors using puberty blockers.
Supports for passengers, farmers, artists: 7 bills from MPs and Senators to watch in 2024
When parliamentarians return to Ottawa in a few weeks to kick off the 2024 sitting, there are a few bills from MPs and senators that will be worth keeping an eye on, from a 'gutted' proposal to offer a carbon tax break to farmers, to an initiative aimed at improving Canada's DNA data bank.
Opinion
opinion Don Martin: Gusher of Liberal spending won't put out the fire in this dumpster
A Hail Mary rehash of the greatest hits from the Trudeau government’s three-week travelling pony-show, the 2024 federal budget takes aim at reversing the party’s popularity plunge in the under-40 set, writes political columnist Don Martin. But will it work before the next election?
opinion Don Martin: The doctor Trudeau dumped has a prescription for better health care
Political columnist Don Martin sat down with former federal health minister Jane Philpott, who's on a crusade to help fix Canada's broken health care system, and who declined to take any shots at the prime minister who dumped her from caucus.
opinion Don Martin: Trudeau's seeking shelter from the housing storm he helped create
While Justin Trudeau's recent housing announcements are generally drawing praise from experts, political columnist Don Martin argues there shouldn’t be any standing ovations for a prime minister who helped caused the problem in the first place.
opinion Don Martin: Poilievre has the field to himself as he races across the country to big crowds
It came to pass on Thursday evening that the confidentially predictable failure of the Official Opposition non-confidence motion went down with 204 Liberal, BQ and NDP nays to 116 Conservative yeas. But forcing Canada into a federal election campaign was never the point.
opinion Don Martin: How a beer break may have doomed the carbon tax hike
When the Liberal government chopped a planned beer excise tax hike to two per cent from 4.5 per cent and froze future increases until after the next election, says political columnist Don Martin, it almost guaranteed a similar carbon tax move in the offing.
CTVNews.ca Top Stories
Grandparents killed in wrong-way crash on Hwy. 401 identified
A 60-year-old man and a 55-year-old woman killed in a wrong-way crash on Highway 401 earlier this week have been identified by the Consulate General of India in Toronto.
Police arrest 3 Indian nationals in killing of B.C. Sikh activist Hardeep Singh Nijjar
Three people have been arrested and charged in the killing of B.C. Sikh activist Hardeep Singh Nijjar – as authorities continue investigating potential connections to the Indian government.
Suter scores late goal, clinches series for Canucks
Pius Suter scored with 1:39 left and the Vancouver Canucks advanced to the second round of the NHL playoffs with a 1-0 victory over the Nashville Predators on Friday night in Game 6.
TD worst-case scenario more likely after drug money laundering allegations: analyst
TD Bank Group could be hit with more severe penalties than previously expected, says a banking analyst after a report that the investigation it faces in the U.S. is tied to laundering illicit fentanyl profits.
Quebec man who threatened Trudeau, Legault online sentenced to 20 months in jail
A Quebec man who pleaded guilty to threatening Prime Minister Justin Trudeau and Premier François Legault has been sentenced to 20 months in jail.
Human remains found in rural Sask. possibly a decade old, RCMP say
RCMP say human remains found in a rural area in central Saskatchewan may have been there for a decade or more.
Britney Spears 'home and safe' after paramedics responded to an incident at the Chateau Marmont, source tells CNN
A source close to singer Britney Spears tells CNN that the pop star is 'home and safe' after she had a 'major fight' with her boyfriend on Wednesday night at the Chateau Marmont in West Hollywood.
Canadian doctor concerned new weight-loss drug Wegovy may be used inappropriately
As Wegovy becomes available to Canadians starting Monday, a medical expert is cautioning patients wanting to use the drug to lose weight that no medication is a ''magic bullet,' and the new medication is meant particularly for people who meet certain criteria related to obesity and weight.
Drew Carey is never quitting 'The Price Is Right'
Drew Carey took over as host of 'The Price Is Right' and hopes he’s there for life. 'I'm not going anywhere,' he told 'Entertainment Tonight' of the job he took over from longtime host Bob Barker in 2007.
Local Spotlight
Twin Alberta Ballet dancers retire after 15 years with company
Alberta Ballet's double-bill production of 'Der Wolf' and 'The Rite of Spring' marks not only its final show of the season, but the last production for twin sisters Alexandra and Jennifer Gibson.
B.C. mayor stripped of budget, barred from committees over Indigenous residential schools book
A British Columbia mayor has been censured by city council – stripping him of his travel and lobbying budgets and removing him from city committees – for allegedly distributing a book that questions the history of Indigenous residential schools in Canada.
Three Quebec men from same family father hundreds of children
Three men in Quebec from the same family have fathered more than 600 children.
Here's how one of Sask.'s largest power plants was knocked out for 73 days, and what it took to fix it
A group of SaskPower workers recently received special recognition at the legislature – for their efforts in repairing one of Saskatchewan's largest power plants after it was knocked offline for months following a serious flood last summer.
Quebec police officer anonymously donates kidney, changes schoolteacher's life
A police officer on Montreal's South Shore anonymously donated a kidney that wound up drastically changing the life of a schoolteacher living on dialysis.
Canada's oldest hat store still going strong after 90 years
Since 1932, Montreal's Henri Henri has been filled to the brim with every possible kind of hat, from newsboy caps to feathered fedoras.
Road closed in Oak Bay, B.C., so elephant seal can cross
Police in Oak Bay, B.C., had to close a stretch of road Sunday to help an elephant seal named Emerson get safely back into the water.
B.C. breweries take home awards at World Beer Cup
Out of more than 9,000 entries from over 2,000 breweries in 50 countries, a handful of B.C. brews landed on the podium at the World Beer Cup this week.
Kitchener family says their 10-year-old needs life-saving drug that cost $600,000
Raneem, 10, lives with a neurological condition and liver disease and needs Cholbam, a medication, for a longer and healthier life.