Thursday, September 16, 2004

Big hopes, small results from health summit

VICTORIA - I try to be positive, but Paul Martin's health summit strikes me as a dumb exercise.
Not that the people are stupid. B.C.'s delegation is probably typical, and the politicians and senior staffers are dead bright and fully committed to making health care better.
But I started to write this Wednesday evening. I had spent the day looking after two boys, four and one, reading stories, frying up cheese sandwiches and wreaking minor havoc in the local Toys'R'Us.
This meeting was supposed to be all about those boys. The goal was to fix health care for a generation.
It didn't.
The result - useful enough - is a little more money from the taxes you pay to Ottawa, so the taxes you pay to Victoria don't have to rise. Martin succeeded in getting the provinces to offer a nod towards accountability, for which we should be thankful.
But fixing health care for a generation? Not a chance.
The bare bones of the deal are pretty simple. Ottawa will come up with about $3 billion a year more as its share of health care funding. That translates into about $400 million a year for B.C., or enough to fund a 3.3-per-cent spending increase.
That's welcome, although hardly revolutionary. If $400 million a year was enough to fix health care for a generation, the B.C. government had half-a-dozen ways to raise the money. (Just dedicating the extra cash from the Liberals' gambling expansion to health care would produce a similar amount.)
Martin talked a lot about accountability in the unproductive run-up to the summit.
But based on the sketchy details released so far, the deal did little to ensure greater accountability to you - the consumer of the services, and the one who pays for them.
The premiers did promise that by the end of next year they would come up with standards for the wait time for key treatments, and begin reporting on how they are doing at meeting those standards. The idea is that British Columbians may be able compare their wait for hip surgery with people in P.E.I. Provinces making their citizens wait for long times will have to explain why.
But the promise is still vague, and premiers didn't commit to "meaningful reductions" in waits for critical health care like cancer treatments and knee and hip replacements until March 31, 2007.
Health ministers are going to talk about a national prescription drug strategy and report on their progress in June, 2006. The premiers say they'll phase in some sort of minimal guaranteed home care standards, if they can afford to, and report on their progress by the end of 2006.
It's all useful. But it's also the kind of thing Canadians have heard before, in the same context of federal-provincial financial wrangling.
The summit highlighted just how bizarre the health care model remains. You buy home insurance, and you know what you get. Car insurance, the same. But you pay for health insurance - about $2,700 each year per British Columbian - and you're promised nothing.
You pay, and the government makes up the coverage rules on the fly. Maybe hip replacements will be a political or medical hot button, and you'll wait three months. Maybe tax cuts will be the priority of the day, and you'll limp for a couple of years.
There is generally little information about how well, or poorly, the system is working, partly because health care providers have remarkably little useful data about what they do and what it costs.
Martin and the premiers took some small steps to improving accountability.
But mostly the meeting seemed like another federal-provincial money wrangle. Despite the promise of an open meeting, with Canadians able to see the issues being discussed, the real deal was done behind closed doors in the usual last-minute round of dealmaking.
And that will not fix health care for a generation.
Footnote: The premier's idea for a new federally funded national pharmacare plan - credited in part to Premier Gordon Campbell - never made it out of the starting gates. Campbell was one of four premiers - along with Ontario's Dalton McGuinty, New Brunswick's Bernard Lord and Quebec's Jean Charest - who represented the provinces in behnd-the-scenes talks.

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