A few weeks ago, in anticipation of the federal election, Globe and Mail columnist Jeffrey Simpson called health care the third rail of Canadian politics. It’s an American term, borrowed from subway parlance, for an issue that no politician will go near. Like the electrified third rail in a subway, if you touch it, you’re dead.
Simpson surmised that all the politicians would be talking about health care in this federal election, but there would be no meaningful discussion about revamping the Canadian health care system. It’s a sacred cow, and any politician who even hints at looking at private health care options is chastised – by other politicians, media commentators and the public in general.
The Canadian health care system is also in desperate need of an overhaul. Waiting times for some diagnostic and surgical procedures have grown far too long. And the waiting periods have opened the door to abuse of the system. In some instances, where an accident requiring medical attention occurs will determine where the patient is placed on the waiting list for a medical procedure. If an injury that inhibits but is not life threatening, such as torn knee ligaments, occurs on the job Workers Compensation may pay to have the repair surgery done immediately at a private clinic. But if the same injury happens off the job, the patient may have to wait months for operating time in a hospital.
But a more substantial threat to the Canadian system is the ever-increasing cost of health care. Add in an aging population – we are still a few years away from the day when the first baby boomers reach retirement age – and the combination threatens to overwhelm governments across the country. Health care already accounts for nearly 50 per cent of all spending by the B.C. government.
There was an opportunity to address the fundamental problems of Canada’s health care system. In 2001 Roy Romanow led a commission whose mandate was "to engage Canadians in a national dialogue on the future of heath care and to make recommendations to preserve the long-term sustainability of Canada’s universally accessible, publicly funded health care system." The commission’s final report, Building on Values: The Future of Health Care in Canada, was released in November of 2002. It comprised 47 detailed, recommendations, including costs and implementation time frames. The Readers Digest version of the report was that $15 billion was needed over three years to preserve the public system.
This week, on just the third day of the campaign trail, Prime Minister Paul Martin announced the Liberal health care platform. It includes another $3 billion in funding to the provinces over the next two years, $2 billion for a national home care program, a new legislated pharmacare plan by 2006 (with the federal government picking up "an appropriate share"), and $4 billion for a national waiting times reduction strategy. And all of this will be done with no tax increase.
The new money, announced just a couple of months after Finance Minister Ralph Goodale presented a budget that offered little new money for health care, will restore federal funding to 25 per cent of the cost incurred by the provinces in operating the health care system, just as the Romanow commission called for.
As the Globe and Mail’s Simpson pointed out again this week, health care has become all-consuming for governments. "So voracious is the health-care budget, and so frantic are politicians to feed it, that Finance Minister Ralph Goodale has already pledged any extra federal revenue from higher gas taxes for purchasing more medical equipment. But didn't Ottawa in the 2003 budget create a $1.5-billion medical diagnostic-equipment fund, on top of the $1-billion fund for the same purpose in the 2000 budget? Does it ever end? Heaven help us if the economy enters a period of slower growth, let alone a mild recession, in the next decade or so."
And while money is a critical aspect of health care, there is, as of yet, no discussion of reforming the system. Martin has promised more money, opposition politicians have challenged his figures and his credibility (since he cut health care spending in the mid-90s as finance minister), but everyone is towing the national line that a universal public health care system cannot be questioned. The solution to any problems, politicians are saying and Canadians seem willing to accept, is to pump more money in. Aging boomers hope it’s so; those under 40 might wish for a better solution.