Government Relations Report Issue 53

Winter 2004 CSANews Issue 53  |  Posted date : May 16, 2007.Back to list

On September 15, 2004, Prime Minister Paul Martin and the first ministers collectively announced the 10-Year Action Plan on Health. To accelerate and broaden health renewal and reform, the government of Canada pledged to strengthen the Canada Health Transfer (CHT) by announcing $41 billion in new federal funding in support of provincial and territorial medicare. The new CHT level reflected a commitment to deepen progress on home-care services and catastrophic drug coverage, as well as an investment in the Wait Times Reduction Fund for the monitoring and implementation of strategies to reduce the lengthy waiting times that many of us have encountered in hospitals and clinics across Canada.
Critics of the announcement pointed to a lack of direction on privatization or two-tier services, and the lack of targeted money or enforcement mechanisms. Yet the infusion of federal funding was nevertheless welcomed by the provinces and territories, whose healthcare delivery had been seriously challenged by the gradual eroding of federal funding since the inception of the Canada Health Act. Estimates of federal health-care spending had placed the funding figure as low as 16 per cent only a few years back. The report by the Royal Commission on the Future of Health Care in Canada, also known as the Romanow Report, had recommended an increase to 25 per cent, the difference becoming known as the "Romanow gap." In its Action Plan press release, the Privy Council Office acknowledged and addressed the Romanow gap—a truly rare acknowledgement of misjudgement by a government that had been unfaithful to the long-standing spirit of 50-50 funding as mandated by the Canada Health Act. The Prime Minister and first ministers even agreed that the Action Plan was based on the following principles: universality, accessibility, portability, comprehensiveness and public administration. That is, the five founding principles of the Canada Health Act.

This response was exactly what the CSA intended in our correspondence and congratulatory messages to the Prime Minister, and to health and seniors ministers across Canada throughout 2004. With the integral principle of portability in mind, our letters prior to the federal election, our letters of congratulations to the newly elected members of Parliament, and our letters to the first ministers prior to the Council of the Federation meeting in Niagara-on-the- Lake carried our issues of concern and asked our politicians to state their stand on the Canada Health Act. The Action Plan reaffirmed their commitment to the act. The CSA took that affirmation to provincial ministers this fall.

The CSA met with representatives from three of the four western provinces this fall. Only Saskatchewan was unable to meet with the CSA, and our disappointment with this province, the birthplace of Medicare, was conveyed to that government through our subsequent correspondence and through the media. We are confident that Saskatchewan will meet with us in 2005. Representatives of British Columbia, Alberta and Manitoba welcomed the CSA, and for details of these successful meetings, I ask that you read the President's Message. While progress was made with the respective governments, our primary issue of concern remains the inadequacy of many provincial reimbursement rates.

West of Ontario, the per diem reimbursement rates for out-of-country emergency health expenses are the worst in Canada and, on a declining scale, the further west one resides the worse the situation. Manitoba's reimbursement rate depends on the number of beds in the hospital to which one is admitted, but its middle rate is $360. Saskatchewan and oil-rich Alberta offer out-of-country emergency inpatient reimbursement rates of just $100. British Columbia's reimbursement rate is the lowest in Canada: $75. Go west? Not likely.

As you will read in the President's Message, the CSA raised the issue of reimbursement rates during our October meeting with John Gerretsen, Ontario minister responsible for seniors. Ontario is a monetary, as well as geographic dividing line between the East and West. The Ontario out-of-country emergency inpatient reimbursement rate is $400 per day for hospital care, but when you consider that the 2004 Ontario Budget cited $851 as the average cost of one night in an Ontario hospital, it becomes apparent just how inadequate is the current reimbursement rate of $400.

That's why the 10-Year Action Plan on Health and the reaffirmation of the integral principles of the Canada Health Act are so important. Provinces such as Ontario can no longer "cry poor" after the $41-billion federal infusion into provincial coffers. What Ontario decides to do with its increased federal funding will ultimately be judged by the electorate, but the electorate includes a significant majority of people who travel and these decisions will be especially important to snowbirds like you and me. The CSA will continue to hold the provinces and territories to the integral principle of portability. Fair and equitable reimbursement of out-of-country emergency medical expenses is the right of all Canadians under the Canada Health Act.