According to the Canadian Medical Association (CMA), the country’s single-payer health care system is stretched too thin, putting Canadian patients at risk as a result.
Dr. Sunil Patel, the new president of the doctors’ organization, said even before the SARS crisis, it was clear Canada was paying far too little attention to public health and emergency preparedness.
“SARS and other emerging threats have clearly illustrated the dangers of being complacent,” Patel told the House of Commons finance committee. “This summer we paid a tragic price for our collective complacency.”
Warnings about the poor condition of the single-payer health care system have gone unheeded by Canadian government officials. “Instead of addressing the issue, things went from bad to worse,” said Patel.
The CMA is calling for $1.5 billion in new federal spending on public health initiatives over the next five years. It says the country’s top health priorities should be emergency-focused: creating a communications system to improve dissemination of crucial information to health officials during emergencies, and increased investment in emergency medical supplies.
Health Minister Anne McLellan, who said her department had been forced to trim budgets, predicted the SARS experience would mean more spending on public health programs. While admitting the disease put a strain on the system, she insisted Canadians have not been endangered by under-funding. She defended the single-payer system, saying, “We have one of the best health care systems in the world, with pretty much the healthiest people in the world, who live the longest.” (See “Patient Patients.”)
It’s the Bureaucracy
Patel was quick to criticize federal and provincial governments for squabbling over a national health council to monitor health policy and accountability. Federal and provincial officials are bickering over a $2 billion special health fund they approved last year, and the health council won’t be put in place until the money issues are resolved.
Mike McBane of the Canadian Health Coalition said the national health council is doomed to failure because it expands the bureaucracy’s power over health care. “It’s designed not to have any independence. It’s designed to be unwieldy and it’s designed to ensure no governments are held to account.”
According to the Canadian media, the $2 billion would be distributed to the provinces only if the federal government’s budget surplus was large enough. But some provinces, including Ontario, have already allocated the money. Provincial Liberal Leader Dalton McGuinty (Renfrew, Ontario) said he will “fight like hell” to get Ontario’s share of federal health care dollars since Ottawa may be looking to renege on money for the provinces. “I’ll tell you this much,” McGuinty stated. “The feds are going to have to come to the table with more health care dollars.”
William Tholl, chief executive for the CMA, supported McGuinty’s position, saying health care is the top priority of Canadians. Tholl emphasized, “We need to service the health care needs of Canadians before we service the debt.”
The government’s position was less than encouraging. Prime Minister Jean Chrétien said it was unclear whether the money will be available and warned provinces not to count on it. “If they’re spending money they don’t have, it’s like buying a Rolls Royce right away, but you don’t have the money to pay for it,” Chrétien said.
Conrad F. Meier is managing editor of Health Care News. His email address is [email protected].