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Rx for premiers: Invest in change for health care

Canada’s 13 provincial and territorial premiers will be talking about everything from internal trade to indigenous disparity when they meet July 20-22 in Whitehorse. But no matter how crowded their agenda, they must address how to stop spending so much on the same old things in health care. The time has come to start investing in change for a health care system that can provide quality care on a sustainable budget.

Here’s why: Health care now consumes half of provincial revenues because we are getting older. Statistics Canada reported last fall that there are more Canadians over the age of 65 than kids under 15. Some 16.1 per cent of us make up that age group; by 2051, it will be one in four.

How is our health care system coping? Our hospitals are now filled with more and more seniors not requiring acute care but, because Canada doesn’t have enough long-term care facilities or home care services for aging baby boomers requiring chronic care, they have nowhere else to go. We’ve come to accept long wait times for surgery, ambulances being turned away, and emergency room patients being treated in hallways. 

We shouldn’t expect this from our health care system. 

Hospitals are not supposed to be in the housing business. Yet 16 per cent of hospital beds – at a cost of over $800 per day – are tied up with seniors waiting for someplace to go. We, at the Canadian Medical Association (CMA), believe that $2.3 billion a year price tag could be better spent if seniors got the care they needed in long-term care or through home and community care.

The federal government’s plans to have a new Health Accord by the end of the year are most opportune. And this summer’s Council of the Federation meeting — an assembly of premiers and territorial leaders — is a critical opportunity to discuss how all levels of government can work together for the health of Canadians.

Admittedly, the 2004 Health Accord did little to transform a system designed more than 50 years ago when Canadians were far younger and the average life expectancy was 71 instead of the current 83 years. But a new Accord, with special emphasis on our seniors, is the best opportunity we have to improve standards of care and ensure our dollars are invested in real change for our health care system. 

Let’s start with the Canada Health Transfer. Giving money to all jurisdictions on an equal per-capita basis, as Ottawa does now, is no longer effective when provinces are facing varying issues based on age demographics. Some provinces – like New Brunswick or British Columbia, for example – have a higher proportion of seniors than other provinces and are struggling to deliver the right kind of care to their patients. 

Canada’s physicians are proposing an easy and doable solution that would allow for increased funds to the provinces that need the most help caring for aging populations. Here’s how a demographic top-up would work: Ottawa would deliver $1.6 billion in additional funding, starting in the fiscal year of 2016-17, on the basis of age demographics. This investment would help support the transformation these provinces and territories need to address the growing needs of their aging populations. Indeed every province would gain.

The CMA is also proposing that federal funding be redirected to improve and expand home and long-term care. We know Ottawa has promised to spend $3 billion over four years on home care once the Accord is signed; now it’s time for the premiers to start planning how this money will be used most effectively. 

As federal Health Minister Jane Philpott has noted, proper home care must include palliative and end-of-life care. Through our proposed Home Care Innovation Fund, the CMA has identified a wide range of deficiencies, ranging from lack of access to a shortage of trained caregivers. This fund would include benchmarks, agreed to by all signatories, so the funds would be used to achieve the best results. 

The CMA has said many times: fix care for seniors and we go a long way in improving our entire health care system. Let’s make Whitehorse a major milestone in doing that for all Canadians. 

Editor’s note: This opinion article by Dr. Forbes has appeared in newspapers across the country in advance of the annual premiers meeting in Whitehorse July20-22.

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