Protecting Canada’s Health Care

Written by Harold McNeill on September 17th, 2021. Posted in Tim Hortons Morning Posts, Editorials


Canada’s Healthcare System Explained 

This video is of US origin, however it is an interesting perspective from an outsider, particularly one from the United States. There are other equally interesting health care video’s in the series.

1. Canada and Public Health Care

One of the many defining features of Canada is our Public Health Care system. While the system continues to provide high-quality care to a broad cross-section of Canadians (rich and poor), funding cuts have led to longer wait times and other shortfalls in service. This has become particularly evident during the current pandemic as Covid19 patients fill beds normally be set aside for ongoing treatments. (What is happening in our hospitals Ref Part’s 3 and 6)

While trying to balance decreasing budgets, many hospital boards have were forced to.. “contract out services deemed outside the “core mandate” of the hospital system such as food, cleaning and laundry services. Despite extensive complaints about the quality of services they provide, global corporations draw billions of dollars from Canadian hospitals, turning them into conduits for public taxpayer dollars for Wall Street and major stock exchanges. In 2015 alone, one health authority, Vancouver Coastal Health, forked over nearly $35 million to Sodexo, a French food services and facilities management company, amidst rising complaints about the awful food in BC hospitals. One investigative reporter who tried to get information about what was in Sodexo’s food and where it came from was blocked by Coastal Health, which said that the information was subject to the commercial confidentiality clause of its contract with the company.”

Note: August 30, 2021 

Province reverses privatization of cleaning and dietary work in B.C. hospitals

“Health Minister Adrian Dix announced on August 30, that privatized hospital cleaning and dietary workers will be brought back in-house as health authority employees. The Hospital Employees’ Union says the move will help restore fairness and stability in the health care system.” (BC Reverses Privatization)   

While both Liberals and Conservatives must shoulder blame for the ongoing shortfall in funding, it has left hospitals few options over the past two decades. “In 2006, a reinvigorated Conservative Party led by Stephen Harper was elected. A staunch opponent of universal medicare, Harper utterly failed to monitor provincial compliance with the Canada Health Act and rejected a renewal of the Health Accord. Instead, the federal government unveiled a new funding formula in 2012 that continued the automatic, unconditional annual 6% increase in cash transfers to the provinces for health, but only until 2016–17. Thereafter, transfers were slated to grow by 3.9% annually, well below the 5.1% annual increase expected in provincial and territorial spending. These cuts are slated to reduce the federal share of expenditures from 20.4% to 18.6% by 2025, cutting federal transfers by an estimated $36 billion over the first 10 years.”   The Liberals who followed have not done much to improve the situation.

Link here for an explanation of the funding history: “20 years later: How corporations took over Canada’s health care system”

2. Protecting the Canada Health Act

During the current election campaign, the three leading parties have pledged a substantial infusion of money into the public system in amounts ranging to $60 billion. A large part of this funding would be in transfers to the Provinces. Only one party, the Conservatives, have refused to state whether they would protect the Canada Health Act. This left open the question of whether they would leave open a path to privatization. The Conservative government in Alberta have already made clear they want to cut back on the private system. In this process, only a change to an NDP Provincial government or intervention by the Federal government could hold the line on the public system.

Following is a summary of federal responsibility to enforce the Act along with an organizational chart.

“The Canada Health Act is Canada’s federal legislation for publicly funded health care insurance.” The Act sets the primary objective of Canadian health care policy, which is to, “protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers. The CHA establishes criteria and conditions related to insured health services and extended health care services that the provinces and territories must fulfill to receive the full federal cash contribution under the Canada Health Transfer (CHT). The aim of the CHA was to ensure that all eligible residents of Canada have reasonable access to insured health services on a prepaid basis, without direct charges at the point of service for such services.”

Read more on the Canada Health Act  particularly the Q&A section

3. Why is this important?

 One of the longest-running challenges to overturn Health Acts in Canada and B.C. began in British Columbia when Dr Brian Day opened the Cambie Health Centre in Vancouver. The centre catered to those who could pay extra fees to bypass wait times in the public system. While the BC Medicare Protection Act “prohibits doctors from billing the government for work they do in the public system while also earning money from private clinics as well as billing patients or their insurance companies” Dr Day bypassed this requirement.

 “Day opened the Cambie Surgery Centre in 1996 and launched court action against the B.C. government in 2009 over sections of the Medicare Protection Act. It prohibits doctors from billing the government for work they do in the public system while also earning money from private clinics as well as billing patients or their insurance companies.” Day also, “claimed that prolonged wait times for medical procedures violated two charter rights, including the right to life, liberty and security of the person,” And, further, “that patients have a constitutional right to pay for private care when wait times in the public system are too long.” 

The case wound its way to the B.C. Supreme Court where, last year where, “Justice John J. Steeves dismissed both charter claims, noting the B.C. Medicare Protection Act is focused on medically necessary care, not ability to pay.”  (CBC News)

(Note: The CBC article mistakenly listed this ruling as being made by the Supreme Court of Canada).

Dr Day has not yet indicated whether he will appeal to the Supreme Court of Canada, but that seems likely. Given the case has cost him (Day and the Clinic) hundreds of thousands of dollars to this point it seems his supporters have deep pockets who would prefer to see the standards of the Canada and B.C. Health Acts, overturned. 

A telling side effect of public health being squeezed out by the private system surfaced during the current pandemic. While the US private system has realized windfall profits over the past eighteen months, the public system has struggled for funding. As a consequence, a broad cross section of disadvantaged in the US have born the brunt of poor outcomes (lack of access to care and disproportionate number of deaths). Link: A struggle for funding.

This is a troubling outcome for a nation that spends three times as much on health care as does as the average of other G7 nations and over twice as much as Canada. (Chart Below)  A video from the same source as the introductory video provides an overview. (US health care system explained)  Following is another dreadful outcome of life and death in the US health care system, another statistic the leaves the US as an outlier in the G7.

“In February 2021, The Lancet published a long critique of the U.S. pandemic performance. By then 450,000 Americans had died. The Lancet pointed out that if the COVID death rate in the United States had simply tracked the the average of the other six G7 nations, 180,000 of those people would still be alive. “Missing Americans” they called them.” (p.XV, “The Premonition” by Michael Lewis, A Pandemic story. (Summary of the book)  Given the trend in the US from February 2021, to September 2021, the final outcome is likely to be far worse.

Another article, How Canada compares to other countries on Covid-19 cases and deaths,  provides an excellent background material which the author outlines how many of the challenges faced in Canada are related to cut-backs in health care funding. On that front, it is noted that 85% of the Covid-19 deaths in Canada occurred in Long Term Care facilities.

4. The Canadian political party promises for expanded health care funding in 2022 and following

While election promises are always subject to back-tracking, it is important to at least have some idea of how each party intends to hold the provinces accountable for funds received. In this battle, the Conservative Leader, “… Erin O’Toole has vowed to “never challenge” provincial laws, a sweeping statement that carries potential implications in areas ranging from abortion access to secession rights, marking a sharp break from the Liberal tack.” And, of course, this would extend to holding provinces accountable public health care dollars.

We must all pay attention and take action where we can in this evolving story.

Harold McNeill

September 17, 2021

 

(28)

(Visited 31 times, 1 visits today)

Trackback from your site.

Leave a comment

 

Comments

  • Harold McNeill

    October 18, 2021 |

    This email from Pal Slavid in Norway received October 10

    I simply must tell the following story; before a flight from Aberdeen to Bergen/Norway (it must have been around 2005), I had purchased a couple of “Pilot’s Notes” in a bookshop in Aberdeen. Among these one for the Mosquito. At the flight I was reading some pages in the biography of Douglas Bader (Reach for the Sky), and suddenly this elderly gentleman sitting beside me points to the book and says: “I knew this guy”. This gentleman turned out to be Mr. Bert Ramsden, and I was fortunate enough that he shared some of his story with me on this flight. And when I was able to pick up from my bag, a copy of the Pilot Notes which he had used during his training, we read it more or less together, and he commented with great knowledge. As an WWII aviator geek, this flight became a great memory for me, and I even got his signature on the Pilot Notes.
    With great respect,
    Pål

  • McNeill Life Stories Protecting Canada's Health Care - McNeill Life Stories

    September 20, 2021 |

    […] One of the many defining features of Canada is our Public Health Care system. While the system continues to provide high-quality care to a broad cross-section of Canadians (rich and poor), funding cuts have led to longer wait times and other shortfalls in service. This has become particularly evident during the current pandemic as Covid19 patients fill beds normally be set aside for ongoing treatments. (What is happening in our hospitals) […]

  • Harold McNeill

    July 25, 2021 |

    Glad you enjoyed Craig. It was fun researching and writing that particular post. It seems I was in school many years before you, the 1950s to be more precise. Cheers, Harold

  • Craig Patterson

    July 18, 2021 |

    Thank you for sharing this. I grew up in Cold Lake (former town of Grand Centre) and we’d heard many stories over the years. Today I was talking to my Mom about the Kinosoo and I came to this article when I was searching images of the fish — I recall when I was in school in the 80s where was a photo supposedly taken (I think it’s the one of the ice fisherman above).

  • Harold McNeill

    January 15, 2021 |

    Wow, Graham, I was taken by surprise (but then again that’s not too hard). Having all you fine folks (my children by other fathers and mothers) would have been great. I’m hopeful that sometime in the not too distant future, we can reprise that trip. Perhaps we’ll just set aside a time for someone else’s landmark day, and we can surprise them. Love to you two. Harold

  • Graham and Nazanin

    January 15, 2021 |

    How could we miss this historic event my friend!!!
    Nazy and I were booked for that cruise Harold, we were looking so forward to it.
    We will be together soon! We both wish that continued unconditional love you receive from everyone to continue as you are that special someone that makes a difference in this world.
    Happy birthday sir, cheers!

  • Harold McNeill

    January 7, 2021 |

    Glad you found the site and that Dorthy enjoyed. I’ve added a lot of school photos in other locations linked to the High School Years stories. Cheers, Harold

  • Shelley Hamaliuk

    January 2, 2021 |

    Hi there, I am Dorothy Marshall’s (nee Hartman) daughter. Mom was quite excited when she discovered this site while surfing the net yesterday, so excited that she told me to have a look! She quite enjoyed taking a trip down memory and seeing old pictures of herself.Keep up the great work!

  • Harold McNeill

    April 14, 2020 |

    Hi Rick,
    Great to hear from you and trust all is going well. Our family members are all doing well but it must be pretty tough for a lot of people. I had once heard you were going to do some writing but never heard anything further. I would be most interested, but do you think the OB News have archives back to that time. Any link or information you could provide would be greatly appreciated. Did you keep copies? Regards, Harold

  • Rick Gonder

    April 14, 2020 |

    Hi Harold
    About 22 years ago I spent several weeks going through the OBPD archives. I wrote several stories that were published in the OB News. Feel free to use if they are of value to what you are doing.
    Keep this up, I’m enjoying it and it brings back memories.