Election 2015: The Health Care Debate
The delivery of health care may be a provincial responsibility, but the federal government also plays a significant role in funding health care and shaping health care policies.
To help Canadians compare the newly emerging health care promises, we asked the Conservative Party of Canada, the New Democratic Party of Canada, the Liberal Party of Canada and the Green Party of Canada the same five questions about top health care issues we face as a country.
National media representatives of three parties, the New Democratic Party, the Liberal Party of Canada, and the Green Party, responded to our questions. After much deliberation, we decided not to fact check or edit the responses as any edits or commentary could be interpreted as political bias. We feel that, with the election one month away, it is our role to ask the questions, and we will leave it up to our readers to judge the answers.
In the past month, we sent the questions on three separate dates to the Conservative Party of Canada. We also discussed our request with a Conservative Party’s public affairs representative twice over the phone. The Conservative Party did not respond to our questions.
1. An Angus Reid poll conducted last month found that nearly a quarter of Canadians say they or someone in their home can’t afford prescribed drugs, and that 91% of Canadians support a national pharmacare program. If elected, what would your party do to help make medications more affordable?
Green Party: Green MPs will call for a universal pharmacare program that ensures all Canadians can access the medication they need. Canada is the only industrialized country with a universal health care system that does not provide for universal coverage of prescription drugs. Without private insurance, medication and treatment are far too often prohibitively expensive. While the largest single driver for increased health care costs is pharmaceuticals, there has been no federal leadership on the issue. A national pharmacare program would enable Canada to negotiate purchases in bulk and combine administration costs, saving billions.
The Green Party will adopt the gold standard for evidence-based assessment of pharmaceuticals, by applying the approach of the UBC Therapeutics Initiative. This approach will ensure that no conflict of interest would corrupt the drug assessment process. We will ensure drugs are only registered if they do more good than harm, saving lives and millions in health care costs.
The Green Party will establish a new crown corporation to bulk purchase and dispense prescription drugs, based on a rigorous evidence-based model, and to study the feasibility of establishing a national pharmacare program that ensures that effective pharmaceuticals are available to all Canadians who need them. This program should adopt the four key recommendations of the Pharmacare 2020 Report, published on July 15, 2015: universal access to necessary medicines, fair distribution of prescription drug costs, safe and appropriate prescribing, and maximum health benefits per dollar spent.
NDP: New Democrats have for years advocated for the goal of universal drug coverage in the best interest of Canadians. Drug therapies have evolved into an essential part of our 21st century health care system. Yet the Harper Conservatives have failed to provide the national leadership expected of them. Indeed, through their inaction, they have obstructed provincial and territorial efforts to cooperate in developing such a national plan. As a result, Canadians continue to pay more for prescription drugs than those in other OECD countries with costs varying depending on where you live.
New Democrats are committed to re-engaging with provinces and territories in creating a new health accord and to working collaboratively to finally getting a national plan to lower Canadians’ costly output on drugs up and running within our public health system.
Liberal Party: A Liberal government will work with the provinces to lower drug costs. It is unacceptable that in a country as successful and prosperous as Canada, Canadians are forced to put their health at risk in order to pay for other necessities of life, like food and shelter. This has a detrimental impact on individual health, and also drives health care costs up over the long term.
We will create a plan that covers the catastrophic costs associated with major diseases like cancer, diabetes, and arthritis. We have also committed to hold meetings with the premiers to determine how to make measurable progress on the health care issues that matter to Canadians—such as wait times, the affordability of prescription drugs, and the availability of health care.
2. The Supreme Court has said that the Charter gives Canadians the right to ask a doctor to help them die. If elected, would your party introduce legislation to ensure Canadians can exercise this right before the Supreme Court’s deadline of February 6, 2016? Why or why not?
Liberal Party: Yes, a Liberal government will respect the Supreme Court’s significant decision and immediately begin consultations for physician-assisted death to meet the Supreme Court’s deadline. We will immediately appoint a special committee to consider the ruling of the Supreme Court, consult with experts and Canadians, and make recommendations for a legislative framework that respects the Constitution, the Charter of Rights and Freedoms, and the priorities of Canadians.
Physician-assisted dying is a complex and emotional issue that touches the lives of a great number of Canadians. Canadians expect their elected representatives to take a leadership role on this issue. They also expect a respectful and responsible conversation about strengthening end-of-life care and support, including palliative care.
Green Party: Greens believe that all Canadians have the right to live their final years in dignity. In order to ensure this, the government must provide supportive services and opportunities to make that possible. This includes educating the public about end-of-life issues, including the limits to artificial life support systems, surgical operations and chemical therapies to extend life. It is not the government’s place to force people to live past their dignity and their will.
The unanimous Supreme Court decision on February 6, 2015 respecting an adult’s ability to decide their own end-of-life care when they suffer from grievous and irremediable medical conditions must be swiftly implemented. Parliament should convene as soon as possible following October 19th to address this issue. The Supreme Court gave Parliament a full year – our inaction up to now is no excuse for missing the Court’s deadline and leaving doctors and patients in limbo. Legislators owe the Canadian people clear laws on physician assisted death and Green MPs will push to make compliance with the existing deadline a priority.
Green MPs will support changes to the Criminal Code to allow for physicians to assist death within the framework laid out by the Supreme Court of Canada.
NDP: If elected, Canadians can trust an NDP government under Tom Mulcair to make access to palliative care a priority, while taking immediate steps to implement the Supreme Court of Canada’s historic and unanimous Carter decision swiftly with balance, respect and sensitivity.
3. If elected, what formula would your party use to determine how much to provide to the provinces to pay for health care? Will there be any new conditions with new funding?
NDP: The Harper government unilaterally threw out the established health transfer funding formula and dictated a replacement formula that will rob provinces and territories of billions of federal health dollars. A New Democratic government will usher in a new era of federal-provincial-territorial cooperation, collaboration, and negotiation. A New Democratic government has committed to restoring the Harper transfer cuts, but a new funding formula moving forward will be forged through a consultation with other levels of government.
Liberal Party: Though during the past decade there has been a notable absence of federal leadership on health care, the federal government has a vital role to play. The absence of a federal-provincial partnership and engagement on the expired federal-provincial Health Accord was a missed opportunity.
A Liberal government will call a federal-provincial meeting to reach a long-term agreement on health care funding. In addition to reengaging in areas where there is direct federal responsibility—including health promotion, support to caregivers, and First Nations’ health—we are committed to meeting with the Premiers to talk about how to strengthen health care.
We will have more to say about this in the days and weeks to come.
Green Party: The federal government’s decision to change the federal funding formula for health care to a yearly lump-sum, equal per-capita cash transfer to provinces was much more than a simple financial adjustment. By turning health care into a mere accounting entry in the national budget, the federal government made it clear that Ottawa will no longer engage with the provinces to reform and improve our health care system as it has done in the past. In addition to reducing federal transfers by $36 billion over 10 years, the Harper Conservatives have indicated an unwillingness to meaningfully engage with the provinces on health care. Funding must be stable and predictable, but it must also be based on an understanding of the unique needs of every demographic in every corner of the country. With proper dialogue and cooperation, this is possible. It is not even necessarily more expensive, as funding coordination will ensure that no money is wasted.
The Green Party of Canada is committed to providing strong federal funding in support of health care. We support the Canadian Federation of Nurses Unions call for the federal government to fund at least 25% of public health care budgets. We will re-negotiate the Canada Health Accord and restore federal investment to support a truly universal public health care system. Green MPs will advocate for increased funding to hire and train more doctors and nurses, purchase new diagnostic equipment, expand long-term residential and home care, and for health human resources.
4. Last month, the UN Human Right Committee criticized the federal government for failing to meet the basic health needs of Aboriginal people in Canada. How would your party address the lowered life expectancy and higher rates of diabetes and numerous other conditions among the Aboriginal population in Canada?
Green Party: Poor health outcomes among Aboriginal Peoples in Canada are just one of the manifestations of Canada’s brutal colonial legacy. Indigenous Peoples in Canada are disproportionately vulnerable to diabetes, mental health challenges, and suicide. The Green Party of Canada is committed to improving health outcomes of Metis, First Nations, and Inuit by implementing all of the Truth and Reconciliation’s “Calls to Action” that fall under federal jurisdiction.
Greens will consult with Aboriginal Peoples to establish measurable goals to close the gap between Aboriginal and non-Aboriginal health outcomes related to infant mortality, maternal health, suicide, mental health, addictions, life expectancy, child health, chronic diseases, access to health services, and other factors. We will respect Indigenous rights to health and their unique health needs, and provide federal support for Aboriginal healing centres.
NDP: The health status of Aboriginal Canadians is at the bottom end of the health scale and will continue to languish there if action isn’t taken. A New Democratic government will work in partnership with Indigenous communities and leadership to start closing the gap in health outcomes.
Our emphasis on the social determinants of health holds particular significance for Aboriginal Canadians.
One in four children in First Nation communities lives in poverty – double the national average. First Nations communities are still handcuffed in dealing with this intolerable situation by the punitive 2% cap on annual funding increases for programs and services unilaterally imposed by the previous Liberal government. A New Democratic government’s nation-to-nation approach will enable the collaborative development of practical, community-based strategies to deal with poverty and its health consequences.
On the issue of food security, the New Democratic Party chose, for its Opposition Day last June, to devote a full day of House debate to improving food security in northern communities. The NDP is the only party to already have a national food strategy, developed in consultation with a broad range of groups. An NDP government will build on this strategy to ensure all Canadians have access to healthy, sustainable, quality food regardless of their income level or where they live.
New Democrats are also determined to bring relief to the 136 First Nations communities across Canada living with boil water orders. An NDP government will establish a National Water Strategy, in collaboration with provinces, territories, municipalities and First Nations to enshrine access to clean, safe water as a right of all Canadians.
And, of course, our discussions with Indigenous partners will address the life-and-death issue of youth suicide. NDP MP Megan Leslie set out a suicide prevention strategy in her Bill, C-297.
Liberal Party: A Liberal government will work with Indigenous peoples to build a renewed relationship based on trust, respect, and mutual understanding, in the spirit and intent of the original treaties.
As a first step, we will immediately lift the 2% cap on funding for First Nations programs. That limit—in place for nearly 20 years—has not kept up with the demographic realities of Aboriginal communities or the actual costs of program delivery. This is a concrete measure in closing the unacceptable quality of life gap that exists between Aboriginal and non- Aboriginal communities.
In addition, we cannot neglect the role that poverty and lack of opportunity have on health outcomes. We will work to address these social determinants with renewed investments in First Nations education, renewed commitments to Nutrition North, and other initiatives.
5. The Canadian Medical Association has called for a national strategy to improve health access and services for seniors. Does your party think a national strategy on seniors’ health care is necessary? If so, what should the key components of this strategy be?
Liberal Party: When it comes to our health and well-being, we want and expect our political leaders to make real progress on the issues that intimately affect us and our families – like wait times, the affordability of prescription drugs, the availability of homecare and community-based services, and coping with an aging population.
The absence of a federal-provincial partnership and engagement on the expired federal-provincial Health Accord was a missed opportunity. A Liberal government will call a federal-provincial meeting to reach a long-term agreement on health care funding. We will also reengage in areas where there is direct federal responsibility, including health promotion, support to caregivers, and First Nations’ health, and will meet with the Premiers to talk about how to strengthen health care.
Moreover, a Liberal government will introduce a more flexible and accessible Employment Insurance Compassionate Care Benefit so that six months of benefits are available to those who are providing care to a seriously ill family member, rather than only those caring for a loved one at risk of death.
Liberals also understand that healthy populations can only be achieved when adequate income, safe and secure food sources, housing and infrastructure are well established.
That is why, as part of a Liberal government’s commitment to a new 10-year investment of nearly $20 billion in social infrastructure, we will prioritize significant new investment in affordable housing and seniors’ facilities. We will also, among other things, restore the eligibility age for Old Age Security and the Guaranteed Income Supplement to 65 and help lift hundreds of thousands of seniors out of poverty by immediately boosting the Guaranteed Income Supplement for single low-income seniors by 10%.
Green Party: As Canada’s population ages, we are faced with the challenge and opportunity to provide seniors with independence and dignity in their health care. In order to address the many issues facing seniors, we are advocating for a National Seniors Strategy.
Under this strategy, Canada would:
- Develop a National Home Care Policy that incorporates and improves upon existing policies affecting eldercare, including but not restricted to: economic allowances (such as tax rebates), living choices, transportation, and respite care.
- Enshrine a policy that seniors’ care must be provided in the communities where they or their families live.
- Expand home support and assisted living services to support seniors with chronic care needs.
- Provide credit and loan guarantees to non-profit housing organizations and cooperatives for the building and restoration of quality, energy-efficient housing for seniors.
- Promote affordable residential options to support seniors no longer living in their own home, with the understanding that seniors have diverse needs and home care is not for everyone.
- Ensure that citizens and law enforcement officials recognize elder abuse, prevent it where possible, and proceed with appropriate charges and consequences when elder abuse has occurred.
Canadian Medical Association President Dr. Cindy Forbes applauded the Green Party’s plans for a Guaranteed Livable Income, National Pharmacare program and senior’s homecare strategy as important policy milestones in this election campaign.
NDP: New Democrats recognize that Canada needs a National Aging Strategy. We are the only political party to have taken on this important task and the strategy we have developed is the result of extensive public consultations.
We have committed to providing long-term and stable funding provinces and territories need to deliver quality health care and seniors’ care. We will invest in home care for an additional 41,000 seniors, help provinces build 5,000 more nursing home beds, and improve access to palliative and end-of-life care.
An NDP government will also launch a nation-wide Alzheimer’s and dementia strategy. Recognizing this affects many Canadians and their families, we will invest $40 million to support screening and early diagnosis, improve resources for newly diagnosed patients and their families, and to fund additional Alzheimer’s and dementia research.
Our commitment to caring for seniors is long-standing. While in opposition, four NDP parliamentary initiatives reflect the foundation of our vision for seniors’ health care.
NDP Seniors Critic Irene Mathyssen introduced motion M-529 that called on the federal government to develop a national aging strategy in collaboration with the provinces, territories and other stakeholders.
NDP MP Charlie Angus proposed a motion, M-456, supported unanimously by all parties in the House of Commons, calling for a pan-Canadian strategy for palliative and end-of-life care.
Former NDP Health Critic Libby Davies introduced a private member’s bill, C-545, The Continuing Care Act. Bill C-545 would have required the setting up of a special advisory committee to conduct a pan-Canadian assessment of Canadians’ home, long-term and palliative care needs leading to the establishment, within two years, of national standards for delivering continuing care services.
And NDP MP Claude Gravelle initiated and proposed to Parliament a national dementia strategy in Bill C-356. This was, regrettably, defeated by the Harper majority.
New Democrats will move quickly to initiate a new Health Accord with the provinces and territories to build a better public home care, long-term care and palliative care system for seniors.