In Canada, we have the Prime Minister and the Premiers of each of the provinces engaged in a ritual of negotiations over money transfers from the Federal Government to the Provincial Governments for health care funding. The sad part of this is that the negotiations are being played over the medium of TV and under scrutiny by the press as well. The parties are coming with different agendas and ideas as to how much money is enough.
Canada has a publicly funded health care system that is starting to show cracks from the strains of:
1) An older population profile as the baby boomers march on the demographic path to older age
2) Decreasing health measures – increased obesity, lack of exercise, inappropriate food consumption patterns
3) Climbing cost of drugs and big pharma where costs are going up faster than GNP growth squeezing the rest of the system
4) Competitive lure of the U.S. in hiring Canadian doctors and nurses – higher wages to our south has drawn some medical personnel out of Canada
There are other factors but the above are the major considerations
Here is the article in full:
OTTAWA — If it weren’t about something as important as health care, the rancorous first ministers’ meeting being broadcast from here would provide the raw material for reality TV or even a pretty good sitcom.
For drama, there is the Prime Minister’s reluctance to talk specifically about Ottawa’s funding proposal until tomorrow even though money is foremost in the premiers’ minds and press conferences. And for humour, viewers can choose between Ralph Klein’s stunningly insensitive reference to the role of “herbs and berries” in aboriginal medicine, or Ujjal Dosanjh’s laughably loose grip on his federal health portfolio.
But this summit isn’t supposed to be entertaining or darkly funny. Promoted as an historic attempt to fix medicare for a decade, this first ministers’ meeting is proving to be more an exercise in exploring gaps.
First there is the yawning gap between the health of aboriginal people and that of other Canadians. Then there is the gap between the cutting-edge public system the country wants and the deteriorating one it now has. And finally there is the one that separates what Paul Martin promised in the election campaign and what he is now apparently willing, or able, to deliver.
Of those, the most dispiriting is the first and the most contentious is the last.
In stark detail and without the disagreements characterizing the rest of this meeting, the Prime Minister, premiers and native leaders defined a problem that is no less than a national shame.
Whatever yardstick is used — life expectancy, infant mortality, suicides or access to clean water and decent housing — too many aboriginal people live in conditions that contradict the country’s smugly satisfied self-image.
To his credit, Martin never lets those issues slip from his long list of top priorities. Despite the notable absence of any political advantage, the Prime Minister continues to push an aboriginal agenda and yesterday laid out a $700 million federal plan aimed at addressing problems as diverse as health promotion and increasing the number of aboriginal health workers.
Those are, as most delegates conceded, small but useful first steps that will lead first ministers to another and long overdue meeting focusing on broad aboriginal issues.
But they are not the steps that will determine if this summit is ultimately judged a success.
Bigger and much more treacherous, those steps require Martin to somehow find the common ground between the care Canadians demand and the system federal and provincial governments are willing to build and fund.
Judging by the first formal day of talks, that is decidedly problematic.
Along with being separated by as much as $50 billion, Martin and his provincial peers are far apart on everything from the stillborn pharmacare plan and public accountability to the format of a meeting billed as public but whose key negotiations are largely taking place behind closed doors.
As usual, those differences are manifesting themselves in a contentious debate about the size of the health-care bill and who will pay it.
Speaking for the provinces as well as for Ontario, Dalton McGuinty told Martin that the federal offer falls far short of rising costs and the pressing need for stable, long-term funding. Repeatedly reinforced by his colleagues, McGuinty’s charges not only rang true, they indirectly questioned the Prime Minister’s wisdom in creating a televised forum for a predictable provincial tongue-lashing.
Worse still, the Prime Minister’s problems go beyond money and many are of his own making, first as a finance minister who slashed health funding and then as a Prime Minister struggling to win a difficult election.
In desperately searching for traction on health care during the last campaign, Martin not only set expectations impossibly high, he focused on hard-to-hit targets.
That makes him vulnerable to premiers demanding more money than Ottawa is willing to spend as the price for the shorter waiting times the Prime Minister promised and only the provinces can provide.
Martin’s position is made even more precarious by the uncertain future of his minority government.
Along with the Prime Minister, the premiers know Liberals cannot face the electorate again without proof that medicare is on the road to recovery.
Even so, it’s too early to tell if the first ministers are on the threshold of something that will pass as more than another Band-Aid. As recent health-care accords demonstrate, when billions are on the table, compromise is in the wind.
But the difference this time is that Canadians now know that agreements, no matter how gloriously trumpeted, are not necessarily precursors to progress. Little has changed since the first ministers last met except the tolerance of patients, taxpayers and voters.
What that means for Martin is obvious.
While he again spoke optimistically about reaching familiar goals — reducing waiting times, improving primary and home-care systems, training more doctors and insulating patients from catastrophic drug costs — what he needs is measurable results.
Those results won’t be achieved as easily as Martin suggested in the election campaign or as cheaply as his government now hopes.
But with the nation presumably watching, the Prime Minister will have to find his fix or face the consequences he and his party so narrowly escaped in the June election.
For Martin, that would strip all unintentional humour from yesterday’s carefully contrived television show, adding instead the elements of a political tragedyPowered by Sidelines