Friday, September 03, 2004

Premiers, PM fumbling health care summit

VICTORIA - Are these guys kidding, the premiers and Paul Martin, as they stumble towards what's supposed to be some sort of break-through meeting on health care?
The premiers have just wrapped up their final preparations for Martin's televised summit. (Without Ralph Klein, who was too busy to show up.)
The good news is that at least they've come up with an agenda for Martin's meeting, something he apparently hadn't got around to yet.
That seems like a sign. The meeting is barely one week way, and Martin and Health Minister Ujjal Dosanjh haven't come up with a schedule of what they want to talk about. Nothing wrong with winging it sometimes, but funding and reforming health care seems a little complex to tackle without a plan.
So give the premiers credit for at least getting an agenda done. They propose spending a couple of hours late on the first day talking about accountability; a full day on the big challenges - like wait times and home care ; and the third day on funding.
Give the premiers credit for nerve, too. They're still pushing ahead with their pitch for a new, federally funded national pharmacare plan. And to pressure Martin, they hauled out a giant prop for their closing press conference, a blown-up newspaper ad from the election campaign including health care promises.
Fair enough, although Gordon Campbell and the rest should expect to see blow-ups of their campaign promises popping up. The Liberals pledge to reduce wait lists, which have climbed since the election, springs to mind.
The meeting, which was supposed to fix health care for a generation, is likely going to turn into another federal-provincial squabble over money. By the end of day three Ottawa will have come up with more cash, the provinces will be unhappy with the amount, some sort of new committee or task force will be appointed to look at a couple of high-profile issues and it will be business as usual.
That's not so so terrible really. The health care system works well enough that we're not in any crisis. Health care costs took the same amount of our GDP in 2001 as they did a decade earlier. Cost increases may be worrying; they are not any sort of critical problem.
The extra money - although it's not much - will help. The federal government has offered an extra $9 billion over five years, which would mean about $240 million more a year for B.C. Ottawa is likely to come up with more money at the meeting, probably with some sort of strings on how it can be spent.
But by the time the meeting is over attentive Canadians will likely be wondering what happened to all that talk about reforming the system, and all those reports and commissions.
Every premier deplores long waits for surgery, for example, and Martin has vowed to tackle them. But the immediate problem could be solved with money, if we chose. Eliminating the wait for hip surgery in B.C., one of the most critical, would involve a one-time commitment of $25 million. If personal taxes were increased by one-half of one per cent, or a couple of weeks' gambling revenue dedicated to eliminating the wait, the problem would be fixed.
The underlying issues could then be addressed through a national commitment to prevention, eliminating unnecessary surgery, increased efficiency, wait time guarantees and anything else that will make the system work better.
The premiers apparently think a national pharmacare program is a good thing, and they're right. A single process for approving new drugs, and a national agency could bargain much more aggressively with the drug companies, would reduce costs.
But if they were serious, they could begin work on a national pharmacare plan today, with or without Ottawa.
Those kinds of things aren't likely to get acted on next week in Ottawa. Too bad.
Footnote: The premiers came up with eight issues for day two of the talks: waiting times; a national pharmacare program; home care; human resources; healthy living; information technology; improving services in the north; and aboriginal health. It's a good list, but they've also allotted four times as much of the schedule to talk about funding as they have for a discussion of waiting times.

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