Federal-provincial healthcare deal fails Canadians

There's been lots of chatter about what is now an agreed upon funding formula for healthcare between the provinces and the federal government. Some astronomical dollar figures are being thrown around and called investments in healthcare. But at the end of the day, will this deal mean better healthcare for Canadians? The sad answer is likely, no. One of the advantages(?) of being old is that you’ve lived through lots of things, and can see the past repeating itself. Case in point, in 2004 then Prime Minister Paul Martin introduced a health care “accord” that was designed to “fix healthcare for a generation." Essentially the federal government ponied up an eye-watering amount of money, and the provinces were to implement targeted programs that would: reduce wait times reform primary care develop a national home care program Provide a national prescription drug program (by 2006!) Now primary care reform did happen in Ontario, with the development of capitation-based payments to family physicians. Think of it as a salary with performance bonuses and you get the gist. There was also the implementation of some Family Health Teams. I’m unaware if any of these were implemented in other provinces. I do note, with interest, that British Columbia is only now getting around to reforming primary care with their own new payment model for family physicians. But both of these programs in Ontario were summarily slashed by then Health Minister Eric Hoskins and his servile Deputy Health Minister Dr. Bob Bell in 2015. Indeed, their unilateral freezing of the capitation model significantly damaged primary care in Ontario, and the effects of their folly are still being badly felt today by the 2 million residents of Ontario without a family doctor. Meanwhile, wait times for surgical procedures continued to rise and I have no idea whatever happened to the National Home Care program. For those of you paying close attention, the same Eric Hoskins who stopped primary care reform in Ontario, went on to chair a federal advisory council with the goal of creating a National Prescription Drug Program . . . in 2018, which hasn’t been implemented yet. I suppose being 17 years overdue is not bad by government standards. By the way, this whole process is basically recycling a failed politician to recycle a failed government promise. And politicians seriously wonder why average Canadians like me are so cynical? Read: Ontario children's hospitals, healthcare orgs ask province for $371.5 million So now, 19 years later, Canadians are being told that the provinces have accepted a federal government proposal to put an gargantuan $196 billion into healthcare, according to Prime Minister Justin Trudeau. But wait, they were committed to $150 billion anyway, so it’s really only $46 billion more. But wait, when you take out the planned budgeted increases it’s only $21 billion more. Whatever. In return, for however much money it really is, Trudeau promises there will be “tailored bilateral agreements to address": Family Health Services Health workers and the backlog of healthcare Mental health and substance abuse Modernizing the healthcare system Our politicians need to study Albert Einstein a bit more. Here’s the sad truth about our healthcare system that no politician, of any political stripe seems to be willing to admit. The system is dying and in need of radical surgery. It needs a bold, transformative vision that will completely change the way we deliver healthcare and will leverage technology appropriately. Anything less is simply more of the same, and will not stave off the inevitable collapse of the system. How then do we achieve this transformation that is essential to the well being of Canadians? I will go into some further thoughts about this in future blogs, but first I would implore our political leaders to stop listening to what old voices who have been saying for decades. If their advice had been good we wouldn’t be in this mess. It’s time to seek out some newer voices who have bright ideas on how to restructure healthcare delivery in Canada. It’s also time to wrest control of healthcare data management from the current group of bureaucrats in charge of it. We can’t transform healthcare in Canada without a robust IT infrastructure and the current group simply is not getting it done. Dr. Sohail Gandhi is a former president of the OMA and opinions are his and not necessarily the opinions of the OMA Board. This article is a reprint from his blog justanoldcountrydoctor.com.

Federal-provincial healthcare deal fails Canadians

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