Election 2004 – The Liberal Party of Canada’s health care reform plan
The Liberal Party of Canada just released their plan for health care reform.
It has been described by the Prime Minister as the cornerstone of the Liberal election platform and he has said that implementing the plan would be their top priority if re-elected as the federal government.
The Liberal plan commits $9 billion additional dollars (above the commitments in the 2003 Health Accord) over five years in six priority areas.
The following brief analysis compares the Liberal plan and its commitments to the priorities for reform set out by the National Union and its Components in our medicare campaign as well as some of those put forward by Mr. Romanow.
1. Stable, Predictable, Long Term Federal Funding:
The Liberals have committed to the recommendation of the National Union and Romanow that the federal government should pay 25% of health care costs and establish a built-in escalator into the funding mechanism.
· The Liberal plan provides for new short-term funding to address the “Romanow Gap”. This amount is an extra $3 billion on top of commitments already announced in the last budget and in the First Minister’s Accord on health care renewal. At the end of 2005-06 (after this new money has been transferred to the provinces),
federal cash transfers for health will have increased more than 70% from 2002-03. At the end of 2005-06, the federal transfer for health will be over $16 billion per year (using the funding formula set out by Romanow), thus exceeding the “Gap” which Mr. Romanow identified as a base of $15.3 billion in federal transfers by the end of 2005-06. If one applies
the funding formula the federal government uses (i.e. including tax points and health funding for aboriginals on reserves and veterans), the federal share easily exceeds the Romanow Gap by the end of 2005-06.
· The Liberal plan also commits to establishing a fair and objective escalator formula to ensure a steady increase in federal support i.e. stable, predictable long-term federal funding.
2. Waiting Times:
The Liberals address several of the concerns the National Union and Romanow identified here. We argued that private clinics or care guarantees were not the solution; instead, it was to set wait-time targets and provide the additional funding needed to hire more professionals and provide more service.
· The Liberals are calling this part of their strategy “the five-in-five” plan. In the short-term, it commits to reduce waiting times in five areas: cancer, heart disease, diagnostic imaging, joint replacements, and sight restoration. They commit to setting targets in these five areas and meeting them by the end of 2009. Most
importantly, the Liberal plan commits to providing $4 billion in new federal money to meet the targets in these five areas.
· The Liberal plan also commits over the long-term to making public waiting time data, working with health professionals to establish reasonable wait times, identifying where they are too long, and then taking action.
3. Primary Care Reform:
The Liberals address some of the concerns we identified under our “Blended Care” priority, which Romanow also identified in his section on primary care reform. The key priority for us on this issue was to improve access to frontline services by setting up networks of health providers that would be available 24-7 and provide a
range of services under one roof.
The Liberal plan commits to work with the provinces to make primary care reform a top priority and to provide financial incentives for the provinces to carry-out certain reforms.
· The Liberal plan suggests some of the $4 billion in the Waiting Times Reduction Strategy Fund could be used for primary care reforms.
· It commits to accelerating the qualification of new immigrants with medial credentials, making major improvements on training new health professionals and giving an expanded role to nurse practitioners.
4. National Home Care Program
The Liberal plan doesn’t go as far as our recommendation (i.e. to make a comprehensive home care plan part of the Canada Health Act). However, it does meet the Romanow recommendation of taking a modest first step of providing a national program to cover priority home care services.
· The Liberal plan commits to consulting with the provinces and introducing legislation to create a national home care program to cover three priority areas: (a) post-acute patients – including medication and rehab services; (b) home mental health and intervention services; and (c) palliative home care services.
· To get the ball rolling, the Liberal plan commits to creating a new Home Care Fund of $2 billion over 5 years to assist the provinces in making the relevant reforms.
5. A National Pharmacare Program
Again, the Liberal plan doesn’t go as far as we recommended, but it does address one of the main Romanow recommendations in this area. The problem with this part of the Liberal strategy from our perspective is they say nothing about reforming Canada’s patent laws. We’ve argued this must be the first step in any strategy to
reduce drug costs.
· The Liberal plan does not commit to any new funding for a national pharmacare program at this point. Instead, it says they will work with the provinces to create a national strategy by 2006 that will provide all Canadians with a basic level of coverage, and catastrophic drug coverage as recommended by Romanow, and also
contain overall drug costs.
· Moreover, once the strategy has been set, the plan commits to implementing appropriate federal legislation and providing appropriate federal funding.
· And, as noted above, under the home care section of the Liberal plan, they commit to providing needed drugs free of charge for post-acute patients receiving care at home.
6. Canada Health Act:
The Liberal plan does not meet the Romanow recommendation of amending the Canada Health Act to include a 6th principle of accountability. However, the Liberal plan does contain the right rhetoric with respect to enforcing the Act and it does make a specific commitment to make it easier for the federal government to do so.
Both the National Union and Romanow urged the federal government to find a way to better enforce the Act as a way to reduce the ability of provinces to privatize services.
· The Liberal plan commits to establishing a new dispute resolution mechanism to better investigate alleged violations and to enforce the Canada Health Act.
What the Liberal plan does not address
With respect to the 10 priorities the National Union and its Components outlined in our medicare campaign, the Liberal plan does not address the following:
· A plan to reduce the costs and improve the quality of long-term care;
· Specific measures to ensure women’s equality in health care;
· A commitment to ensure health care is excluded from international trade deals.
And, while the Liberal plan states they are committed to “publicly-funded, universally available health care,” it does not take a stand in the debate on public v. private delivery of services or the issue of Public-Private Partnerships in health care.
Clearly, we will have to continue the struggle to make progress in these areas.
10 priorities for reform identified by the National Union and its Components
· #1 – Adequate, stable, long-term public funding
· #2 – Never for profit
· #3 – Debunk private health care myths
· #4 – A national health human resources strategy
· #5 – A system of blended care
· #6 – Home care added to the Canada Health Act
· #7 – Long term care added to the Canada Health Act
· #8 – A national pharmacare program
· #9 – Health services excluded from all international trade deals
· #10 – Women’s equality in health care
Election 2004 Index
