Health Policy - Op Eds

Until a few years ago, the main concern in the Canadian debate over health policy was how to control costs. When provinces managed to restrain health-care spending growth to an average rate below that of the economy as a whole (since 2010), that concern subsided somewhat; we had “bent the cost curve” and things seemed to be under control. But as a devastating pair of reports in The Globe and Mail makes clear, the cost-cutting in health care is threatening to make a mockery of the claim that access to health care in Canada does not depend on ability to pay.

As wait times even for things like urgently needed orthopedic and eye surgery become impossibly long, there are more and more desperate patients who are…

Since December, Canadians have been treated to the spectacle of provincial and territorial health ministers squabbling with their federal counterparts for more health-care dollars. As they argue over cash, they overlook a lesson from Canadian health-care history: Asking how much without also asking how those dollars will be spent is a recipe for more of the same.

The last time health ministers haggled with the feds, in 2004, they received a record $41-billion over 10 years. This so-called “fix for a generation” achieved little of the sort. Across the country, emergency departments are still as congested as ever and unhealthy numbers of hospital beds remain filled by seniors who should be receiving care elsewhere. Even waiting…

As of now, it looks like there will be no new health accord between the federal and provincial/territorial governments in the immediate future. It would be a pity if this means no reallocation of aggregate healthcare spending toward home care and mental health programs, two areas where additional spending could greatly benefit patients. Barring this, however, the failure to agree on a new accord is better than a repeat of the 2004 agreement and could ultimately lead to a better alignment of responsibilities in Canadian healthcare.

The federal government’s willingness to help provinces pay for healthcare helped establish Canada’s universal Medicare system in the ‘60s and ‘70s. Half a century later, however, our model of divided…

Last week, Canada’s federal and provincial health ministers were engaged in negotiations about the future federal transfers to the provinces for health. The negotiations appear to have ended in a standoff, with provincial governments insisting that there have to be bigger transfers in order for them to offer even current levels of care, and the federal government refusing to increase the transfers significantly unless the provinces agree to a set of conditions in a new Health Accord.

The best outcome would be to leave matters as they are: There should be no new transfers beyond those already scheduled, with or without conditions.

Jane Philpott, the federal Health Minister, should be commended for her explicit recognition…

The recent negotiations between the Ontario Medical Association and the Ontario government highlight the complex relationship between physicians and health spending. As important and trusted gatekeepers to the health care system, physicians are nevertheless a crucial component of health care costs as the total number of physicians, the volume of health services they provide and the cost per service come together. While governments such as Ontario have been focusing on reducing or holding physician fees steady as a cost control measure, health care spending is also affected by the overall number of physicians we have and the number of services each provides to their patients.

Across the country, provinces are trying to…