Premiers and Ottawa must focus their efforts on issues that promote equity, unity

DR. CHARLES SHAVER “This is a country that is divided on a number of key issues right now. … There’s a need for more than words; there’s a need for action.” — Manitoba Premier Brian Pallister

After a divisive federal election, provincial leaders should now concentrate on resolving differences in areas such as pipelines, building infrastructure to mitigate climate change, and various health care issues.

Pallister added: “Social progress depends on economic progress.” Andrew Scheer proposed a national energy corridor that would minimize environmental impacts and transport hydroelectricity gas, oil, and telecommunications. Premiers Jason Kenney and Scott Moe, when they meet with Quebec Premier Francois Legault, should remind him that in 2016, he actually favoured the Energy East pipeline proposal and stated, “We’re aiming for zero equalization and one way to get there would be to receive royalties on the oil transiting through Quebec.”

Of note that for 2018-19, Quebec’s surplus was $4.8 billion; for 201920, it will receive $13.1 billion in equalization payments — about 67 per cent of the total. Thus, were it not for the generosity of Canadians (especially those in Alberta), Quebec’s surplus would turn into an $8 billion deficit.

The premiers and territorial leaders will meet in Toronto on Dec. 2. Several health issues need to be discussed.

Pallister emphasizes the need to reduce interprovincial trade barriers. This also requires that those visiting another province or territory on business or vacation can rely on fully portable hospital and medical benefits. Yet Quebec still refuses to pay “host-province” rates for medical care in other provinces, a violation of Section 11 of the Canada Health Act. In view of its current surplus, it has no excuse not to sign the reciprocal billing agreement. The other premiers should pressure Legault to do so.

The premiers should agree to targeted funding in areas of health care in which Ottawa has jurisdiction. These include reimbursing persons for the cost of health care in other countries up to the level for such services in Canada. Only PEI and the three territories are obeying the CHA. Coverage for the other provinces could be achieved by an additional one per cent increase in the Canada Health Transfer.

Backorders of drugs are worsening, and can invalidate travel insurance policies not only for “snowbirds,” but for many younger persons with diabetes, hypertension, and heart disease. Many of them are Indigenous or new Canadians especially from South Asia, the Philippines, Middle East, Latin America, and the Caribbean. These groups might have voted for the political party that offered increased government health coverage outside of Canada.

Pharmacare will certainly be discussed. A national program (likely excluding Quebec, which already has its own) would require co-operation of the provinces, and would take years to implement. In view of the drug shortages, Ottawa must play a role in insuring that backorders are not exacerbated by bulkpurchasing of generic drugs and the forced slashing of prices. After all, many drug companies may simply divert their limited supplies of medications to the U.S. or other more profitable markets. A solution

There is a time for a nation to come together and that time is now

may entail setting up Canadian government-run production of certain vital medications. In the short-term, those lacking private or government plans should be covered.

The election was indeed divisive. Yet those advocating separation should consider one irrefutable side-effect. Canadians take for granted their portable health benefits. Those from Quebec and Alberta who threaten independence should be aware that if they achieved their goal, they would now become isolated, especially those who — because of chronic illnesses or a recent change in medications — were unable to qualify for travel insurance. Hospitals across Canada have a special rate for “Non-residents of Canada.” For example, the per diem rate for a standard room or one in the ICU are $3,760 and $14,535 at the Vancouver General Hospital, $4,600 and $6,000 at major downtown teaching hospitals in Toronto, and $4,350 and $18,540 at QEII Hospital in Halifax.

Winnipeg MP Jim Carr recently stated: “People are seeking unity in the country. There isn’t much of an appetite for division and for divisive politics. There is a time for a nation to come together and that time is now.” Ottawa physician Dr. Charles S. Shaver was born in Montreal. He graduated from Princeton University and Johns Hopkins School of Medicine, and returned to Canada in 1970. He is PastChair of the Section on General Internal Medicine of the Ontario Medical Association. The views here are his own.