Spending on healthcare saves lives - Keith Roulston editorial
It took some nerve for four Conservative premiers to fly into Ottawa last week and hold a news conference at which they demanded the federal government increase healthcare transfers to the provinces, but they have a point.
Ontario’s Doug Ford, Quebec Premier François Legault, Alberta’s Jason Kenney and Manitoba’s Brian Pallister called for Ottawa to fork over $28 billion. They want the federal government to increase its share of healthcare costs to 35 per cent, up from the current 22 per cent. To understand the demand, it’s necessary to study a little history.
In 1967, the federal Liberals under Lester B. Pearson wanted to introduce free healthcare, but healthcare came under provincial jurisdiction. Many provinces, particularly those with Progressive Conservative governments, were opposed. To win support, the Liberals promised to pay 50 per cent of the costs.
But healthcare costs kept rising, and succeeding federal governments got tired of signing blank cheques, so they began to arbitrarily cut transfers to the provinces. Finally, in 1995 with the federal deficit threatening to grow out of control, Federal Finance Minister Paul Martin Jr. capped transfers to the provinces at $60 per resident, with an escalator of three per cent per year for inflation. But health care costs generally increase by six per cent a year, so provinces are picking up more and more of the costs – hence the reality that the original promise to pick up 50 per cent of health care costs is now down to 22 per cent.
With the extraordinary costs of the pandemic, the federal government has given the provinces an extra $19 billion to help them cope with the fallout from COVID-19, including more than $10 billion specifically for COVID-19-related healthcare costs.
So it’s easy to understand and agree with the concerns of the premiers. On the other hand, having watched some of these premiers in the past, it’s easy to imagine that if they got the extra money, some of these premiers would immediately provide a popular tax cut, and still leave themselves short of the money needed to improve health care. Then at the same time, they’re likely to blame the federal government for being spendthrift.
If ever the value of a universal healthcare program has been demonstrated, it’s during the COVID-19 pandemic. While U.S. President Donald Trump has been lambasted for his poor management of the crisis, the underlying weaknesses of the U.S. system are partly to blame for the fact more than 200,000 Americans have died, 20 per cent of deaths in the world in a country with 4.2 per cent of its population.
I was speaking with a local healthcare professional the other day who had done a work term at a major hospital in a major U.S. city. He could see more serious cases in a few months there than in a few years here in Canada, he explained, because many Americans with no employer health insurance avoided seeking care until their problems had become very serious. He can understand the high U.S. death toll when he realizes how many Americans who catch the virus have serious underlying health problems because, over the years, they haven’t been getting the care they required.
Close to home, we’ve seen the high cost of trying to cut corners in the disgraceful treatment of seniors in long-term care facilities. These vulnerable people, most with underlying medical conditions, died at tragic rates when cost-cutting measures made it too easy for the virus to get into the homes and spread. Some homes seem to not have learned lessons from last spring’s failures and are now putting their residents in harm’s way again.
A spokesperson for the Lincoln Project, a group of Republicans who feel Trump must go, pointed out last week that if the U.S. had the same mortality rate as Germany, there would be 150,000 Americans still alive who have, instead, died because of COVID-19. While some of Germany’s success no doubt came from good public health measures once the pandemic hit, that country’s excellent universal healthcare program is probably equally important in promoting healthy citizens strong enough to fight off the serious effects of the virus.
As close as we are to the U.S., Canadians tend to pat ourselves on the back for a superior healthcare system. Yet in study after study where the rich countries are compared, while the U.S. is at the bottom of the list, Canada doesn’t look so well when judged against many European countries, particularly when it comes to fast access to doctors or elective surgeries. We’ve all been told we can’t see our family doctor for a week, or had a friend wait months (or years) for an operation.
One thing the COVID-19 crisis has shown us is the value of a good healthcare system. We need to spend what it takes to make ours better.