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Months away from a federal election, no one’s really talking about the elephant in the emergency room: medicare.Â TheÂ diagnosisÂ isn’tÂ good.Â The Toronto Star’s LindaÂ McQuaigÂ hasÂ weighedÂ in, arguing that the Conservative government has quietly eroded our health care system, stacking the deck for failure and increased privatization. She argues that â€œtwo-tier medicine is a virtual certainty if the Conservatives are re-elected.â€
Pundit Susan Delancourt recently argued that health care is a “sleeper issue,” just waiting to wake up and grab the attention of voters — and politicians.
For a quick refresher, we’ve outlined five major ways the Harper goverment has eroded medicare:
To read more about each of these threats to Canada’s Medicare system, click on “Read More”:
1. No new Health Accord.
The government simplyÂ allowedÂ its 10-year accord with the provinces and territories to expire in 2014 — not even bothering with the pretense of negotiations.
That lack of federal leadership has hasÂ left the provinces to forge their ownÂ path.Â The 2004 accord saw the feds commit $41 billion over a decade, in return for provincial pledges to commit to certain priorities, such as primary care and reducing wait times.
2. No national pharmaceutical strategy.
The government backed away from developing and implementing theÂ national pharmaceutical strategyÂ outlined in the 2004 Health Accord — even though our aging population could certainly use theÂ medical and financial break.
Ten days before Christmas, Ontario’s health minister wrote an op-edÂ callingÂ for national pharmacare.
AÂ 2014 studyÂ commissioned by the Canadian Federation of Nurses Unions, posits that a national pharmacare plan would reduce drug costs and administration fees.
Data compiled by CFNU shows Canada had the highest per capita growth in prescription drug expenditures between 2000-2010, and Canadians had the second highest per capita prescription drug expenditures among OECD countries in 2011:
3. Defunding the Health Council of Canada.Â
The government stopped funding the Health Council of Canada, a major blow to national health care strategy and standards — and all toÂ save $6 million.
Michael McBane, national coordinator of theÂ Canadian Health Coalition,Â arguedÂ that, with the move, the government essentially said â€œit is time to wind down national medicare.â€ Formed in 2003 to provide coordination and accountability on national health care, the council’s elimination â€œput an end to pan-Canadian health outcomes” and “common standards across the country,â€ McBaneÂ wroteÂ in the Star.
It’s little wonder the Tories aren’t fans of the council when their reports said things likeÂ this:
“We cannot continue our disparate, tentative approaches to health care reform across the country.”
4. Painful new federal health transfer formula.
In 2011, the governmentÂ unilaterally announcedÂ that, starting in 2016-2017, the annual growth rate in federal health transfers will decrease from the fixed number of 6%, and instead be tied toÂ nominal GDP growthÂ (with a minimum of 3%).
The CHC estimates this could cut transfers to provinces and territories by $36 billion over 10 years (2017-2027). Cash-starved provincial governments would be hard-pressed to fill that void, with private health care advocates eagerly waiting to lend a “helping hand.”
Doubling down on unilateral changes, the 2014 federal budget made the equalization portion of the Health Care Transfer contingent on aÂ per capita formulaÂ — as opposed to needs-based. This move is expected to reduce transfers to have-not provinces byÂ $16.5 billionÂ over five years.
5. Offloading cost. Â
The federal share of health care spending is projected toÂ nosediveÂ from its current level of 20% to below 12% in the next few decades. The below chart, based on numbers from the Parliamentary Budget Officer, comes courtesy of the Canadian Health Coalition: