September 21, 2012 – Another new front opened in 2012 – national health care reform. The federal government’s refusal to negotiate a new Health Accord left the provincial premiers pushing a rope. Their response six months later was to finally adopt some best clinical practices and purchase a few generic drugs in bulk. Really!
The federal government’s refusal to re-negotiate the Health Accords gave the provincial premiers the first taste of the options available to a government unconstrained by the threat of confidence motions. With the current Health Accords expiring in 2014, the anticipated re-negotiations could have set a new national direction for badly needed healthcare reforms. Instead, the federal government unilaterally set its share of healthcare costs for the immediate future and put it on the table on a “take it or leave it basis”.
With no federal leadership or involvement in setting national standards or priorities, Canadians are relying on the provinces to set national standards of care, resolve structural inefficiencies and regional differences and get health care spending and drug costs under control. What the provinces came up with six months later – bulk buying of some generic medicines and adopting some best clinical practices – while welcome – is no national vision.
The real importance of the Health Accords was not to keep the provinces happy but to keep Canadians healthy – by fundamentally redirecting the country’s health care resources to that end – regardless of what had been done in the past, or whose ox would have to be gored. It requires leadership, innovation and cooperation and consensus if necessary but not necessarily consensus.
Imagine first dollar basic drug coverage for all Canadians funded by massive savings in drug costs through a single national purchasing agency with an independent drug review process that can demand fair drug pricing across the country. People living in small provinces should not have to move to access coverage available to other Canadians.
Imagine an integrated continuing care system that ensures that we can all get the care and services we need to live independently as long as possible without leaving our homes or communities. That means stable funding and mandatory standards of home care, income support for caregivers, especially those providing heavy care, geriatric care, assisted living services at home and in affordable housing, equitable access to decent nursing homes and quality end of life care.
Canada’s health care system is still a patchwork eight years and billions of tax dollars after the Health Accords. Provinces have stooped to poaching doctors and nurses from each other.
Rather than wait for the provinces to get it together, here’s what CARP is proposing: Entitled “One Patient” – CARP’s proposal for an integrated care continuum targets the fractured nature of our current health system, which has patients chasing care options in moments of crisis rather than facilitating straightforward access to necessary treatments. When a family is suddenly faced with home care or chronic care needs – a fall, a stroke – they are running from pillar to post trying to figure out what to do next and to get the services they need for their loved one – who is likely languishing in some hospital bed being called a “bed blocker” by the staff.
CARP’s Care Continuum is person-centric and takes into consideration the full spectrum of health needs – emotional, mental, social, and physical – from first diagnosis, through acute and long term care, to end of life. That means stable funding and mandatory standards of home care, income support for caregivers, especially those providing heavy care, geriatric care, assisted living services at home and in affordable housing, equitable access to decent nursing homes and quality end of life care.
This generation of seniors is more demanding and willing to accept innovative solutions. Addressing the issues that resonate with them will also improve the system for everyone else. If the market and political clout of CARP members and older Canadians is to have any meaning, it must be used to help politicians face down the sacred cows blocking innovation now. The Status Quo is not going to change itself.