Election 2011: The Disappearance of the Debate on Health Care
Canadians regularly rate health care among the most important issues for their consideration. Yet, aside from a mention in the leaders’ debate, and until this week, debate on health care has been noticeably absent in the current election campaign.
The issue was essentially ignored in the federal budget presented the week before the election was called. Nonetheless, the two front running parties quickly moved to pre-empt debate on their health care platforms by offering exactly the same policy prescription: a promise to increase federal health transfer payments to the provinces by 6%. Simply stated, this is an echo of the current funding arrangement, negotiated by Paul Martin’s Liberal government and meant to last a decade. Now, with two weeks left in the campaign, Liberal Party televised ads have appeared, sporting the accusation that Mr. Harper’s Conservatives cannot be trusted to preserve the public health care system so many Canadians value.
So health care has finally appeared on campaign agenda – but perhaps in one of the least helpful ways possible.
There are many important details concerning federal transfers to the provinces and territories, especially with regard to financing important social programs such as health care, social welfare and post-secondary education. Whichever party prevails on May 2nd will need to immediately begin serious negotiations to deliver a new deal by 2014. Yet, while the benchmark of 6% annual increases has been advanced, for a couple of years at least, this only describes the quantity of the pot, leaving aside important, detailed considerations as to the role and purpose of these transfers. By not debating these deeper issues, the politicians are denying Canadians a golden opportunity to consider, compare and contrast their best prescriptions for Medicare’s ills.
A public justice stethoscope: listening to the heart of the matter
For communities of faith, according to Janet Somerville, formerly a CPJ staff person and General Secretary of the Canadian Council of Churches, “Medicare can be the Good Samaritan parable writ large.” Somerville has also stated that, “Medicare is as if our whole society had heeded John the Baptist explaining how to make straight the way of the Lord by consistent sharing in response to need: “Whoever has two coats must share with anyone who has none, and whoever has food must do likewise.” (Luke 3:11)”
There is little doubt that the Canadian health care system is one of the most important social programs in this country, allowing shared risk and responsibility to be addressed by neighbourly concern. Some have even referred to Medicare as the most effective poverty reduction strategy in our history. One has only to remember the horror stories of a mere half century ago, when health care was not available to all Canadians, or to consider the fate of tens of millions of people in America who still remain without medical coverage to know that universal health care must be a primary building block of any nation’s poverty reduction strategy.
The Christian churches in Canada have long known this to be true. As early as the 1950s, Synods of the Anglican Church and General Councils of the United Church were calling for national health insurance programs. In the next decades, Catholics, Lutherans and Presbyterians also advocated for a health care system to cover all persons living in Canada. And the churches, working together in ecumenical fora, have continued to defend the integrity of the system’s five principles as expressed in 1984’s Canada Health Act: universality, affordability, comprehensiveness, portability and public administration.
Issues for Election 2011
Health care should not be seen as a political football, something to be tossed into the air of electoral whims. Health care is a moral enterprise, a social good and a service to people who are in need. Health care cannot be viewed as a mere commodity, exchanged for profit or provided only to those who can afford to pay. Thus, recent calls for “experimentation” in the system, to allow “creative” solution-seeking, should be critically reviewed if they mask intentions to privatize or limit access to medically necessary services.
It is also important to ensure that the health care system meets the full continuum of needs – stressing prevention measures and the social determinants of health, and expanding to meet the contemporary needs for homecare, chronic and palliative care. Although it has not been prominently mentioned in the current campaign, a national drug plan could save billions of dollars for the system, as well as expanding access to medication.
Finally, the federal government must be challenged to not only provide resources in transfer payments, but to “buy change” with these commitments. Essentially this means the federal government must monitor and enforce the principles of the Canada Health Act, so as to ensure adequate and comparable service delivery across the country.
Dr. Nuala Kenny, a religious sister, has emphasized that the health care encounter is a place of moral meaning. A probing and serious debate of the important issues facing health care in Canada today could also be a privileged place of meaning in the current election campaign.
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