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Canadians consistently rank healthcare as one of their top priorities, yet healthcare has barely registered as an issue in the federal election. The current government contends that healthcare is administered by the provinces, and therefore the federal government has no role to play in reform and innovation.
However, two-thirds of Canadians are now worried that our healthcare system is falling behind, and those of us in the medical profession, and even most provincial leaders, see a host of healthcare issues that are in urgent need of national leadership.
This includes concerns about the federal government’s plan to slow the growth of provincial health funding provided through the Canada Health Transfer, the Supreme Court’s decision that Canadians have a right to physician-assisted death, and the flagging health of our Aboriginal people.
But I want to focus on two very specific issues.
The cost of drugs
We have universal healthcare, which means that you can see your doctor and get the prescriptions that you need, but we don’t have universal pharamacare, which means that up to a quarter of Canadian households can’t afford to buy them. This makes no sense.
Provinces have tried to make up for this with their own plans, but we’ve ended up with a patchwork of plans that vary greatly from one province to the next. I practice in both Quebec and Ontario, and I see these differences every day. It doesn’t seem fair that one patient is fully covered for a drug in Quebec, while my Ontario patient with the same condition has to pay a huge amount out of pocket.
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The cost of a national pharmacare plan sounds daunting, but there are also many potential cost savings. Merging the various provincial drug plans can reduce the costs of drugs by increasing our bargaining power with pharamaceutical companies. In one study, it was estimated that a national strategy could actually save the system over $7 billion in drug costs.
What have the parties said? Well the Conservatives contend that pharmacare is a provincial issue. The Liberals have suggested that they would bring in a universal plan for catastrophic costs (i.e. the kinds of drug costs that might bankrupt a family), and would “work with the provinces to lower drug costs.” The NDP has fully committed to crafting a national pharmacare plan.
This year, seniors outnumbered children for the first time in the history of this country. And as we live longer, we require more and more care and consume more and more healthcare resources. Seniors account for 16 per cent of the population and consume 47 per cent of healthcare costs, which is projected to increase to 62 per cent of spending within 20 years.
Part of the problem is that our system is built for acute care rather than chronic care. About 15 per cent of Canadian acute care beds are occupied by patients awaiting transfer to an appropriate facility.
This creates a domino effect whereby I might have a patient on the medical ward who is completely stable and waiting for long-term care, and at the same time have a seriously ill patient in the emergency room whom I can’t accommodate on the ward. To put this in context, a Canadian hospital bed costs about $1,000 a day whereas home care costs about $50 a day.
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What the parties say
The Conservatives have proposed a six month Employment Insurance Benefit for people caring for a seriously ill family member.
The Liberals have proposed a six month Employment Insurance Benefit for people caring for a seriously ill family member, investments in seniors’ facilities, and boosting the Guaranteed Income Supplement for single, low-income seniors.
The NDP have tabled a motion for the federal government to develop a national aging strategy and have provided plans to invest in home care beds, nursing home beds, and improved access to palliative and end-of-life care.
The bottom line is that healthcare affects all of us and our healthcare system desperately needs federal leadership. Consider this when you cast your ballot.
Visualization is based on Twitter data and should not be considered scientifically accurate. Data has been made available via a partnership with Twitter Canada.