Liberal Leader Justin Trudeau announced a number of promises on Monday to improve Canada‘s healthcare system, but experts say the plans so far lack key details and may not result in the deep changes that are needed.
The Liberals are promising that, if re-elected, their government will allocate $6 billion in funding over four years to reduce wait times, ensure access to family doctors, and implement a national pharmacare program, among other initiatives. The Liberals did not provide specific timelines.
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“We’ve seen similar sets of promises before,” Colleen Flood, director of the Ottawa Centre for Health Law, Policy and Ethics, told Global News.
“The old approach of attempting to do it this way, where the Liberals just promise more dollars over time, does nothing to fundamentally change the dynamics of the system,” she said.
The Liberals have not released their full election platform for 2019, but a statement from the party’s 2015 platform mirrors Monday’s announcement: “We will make home care more available, prescription drugs more affordable, and mental health care more accessible.”
The party has faced criticisms for not having every new promise analyzed and costed by the Parliamentary Budget Officer, as other parties have done.
Flood would like to see more specific information from the party, and said if re-elected, the Liberals should provide more concrete strategies such as any financial incentives they would provide to provinces and territories that met minimum wait times.
“I don’t care how many dollars they’re going to just throw at something. The question is how are you going to actually do it,” she said.
Without more detailed commitments, she worries that not much will change. And there is a lot at stake.
“People have lost faith and trust in the healthcare system,” Flood said. “The state of access to family doctors is very patchy and many people are without a regular family physician. And this certainly compromises the quality of their care and it’s simply unacceptable.”
Trudeau was asked by a reporter at the announcement on Monday what he would say to concerns that the plan is not concrete.
“We know that there is always much more to do,” Trudeau said. “We are putting forward concrete investments that will lead Canadians to be able to find a family doctor that will remove that impossible choice between groceries and medications for so many Canadians and will provide mental health care for more Canadians right across the country in times of crisis.”
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Dr. Joel Lexchin, an emergency room physician in Toronto and professor emeritus at York University’s School of Health Policy and Management, echoed Flood’s sentiment there there are deep issues in the healthcare system that need to be addressed.
While access to acute care for people living in urban and suburban areas is pretty good, he said that the system lacks strong organizational oversight.
“The reason why people have long waits or can’t find general practitioners is not necessarily because we don’t have enough resources, it’s because the resources that we do have are poorly managed,” Lexchin said. “We cover hospitals and doctors, but everything else is a mixture of some provincial government funding, some private insurance, and some out of pocket.”
He added that when it comes to wait times and access to primary care, the federal government can only do so much as most of the details and funding allocations are overseen by the provinces and territories.
Lexchin said he would encourage voters to demand further details on healthcare from all parties and candidates.
“These kinds of promises are very attractive to political parties because they have so few details and if you get elected you can claim that you’ve done everything that you’ve promise, which is effectively nothing,” he said.
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For Dr. Sandy Buchman, a family physician and president of the Canadian Medical Association, the Liberal announcement is welcome, and he is pleased to see that federal party leaders are recognizing that health care is a top concern for voters. He has long been concerned that millions of Canadians are without a family doctor.
NDP Leader Jagmeet Singh has promised to implement a universal pharmacare regime within one year if his party forms government. Conservative Leader Andrew Scheer has promised that his government would increase health and social transfer payments by at least three per cent every year, and has vowed to boost funding for medical equipment. Green Party Leader Elizabeth May has promised to implement universal pharmacare and provide dental care for low-income Canadians.
“All the governments could have done better in the past, but at least we’re now at a point where they’re recognizing this,” Buchman told Global News from New York, where he is attending the United Nations conference on universal health coverage.
“Constitutionally, the provinces do have responsibility for healthcare. But really, it’s a shared responsibility with the federal government, which can put conditions on provincial transfer payments and can direct specific funding with strings attached,” Buchman said.