OK to compromise on health funding

Re Get back to the table: Editorial, Dec. 21 Today’s editorial and two other fine opinion pieces that appear on the same page, one by Star columnist Thomas Walkom and the other from Dr. Virginia Walley, OMA president, are all in agreement that our federal government and provinces should compromise on achieving a better healthcare system. Although they have somewhat different opinions on how this goal should be achieved, there is a common call for action.

Walkom makes an impassioned plea for the eventual deal to be crafted to meet two key criteria, for Ottawa to cover 25 per cent of medicare costs and for the inclusion of home care and pharmacare. The pharmacare issue has still not been resolved, which is especially surprising to me, as I’ve received personal responses from both our federal and Ontario health ministers in support of pharmacare. The key decision-makers agree with published Canadian studies showing that pharmacare can actually save Canada $3-$5 billion per year.

Although it is of paramount importance for the provinces and the feds to resolve the pressing health-care dilemma, it would be counter-productive if the recommended intergovernmental compromise led to the wanton misuse of healthcare funds, due to unconscionable wastage and mismanagement that continues to plague provinces such as Ontario. Rudy Fernandes, president, Global Health Strategy, Mississauga Much of the current discussion on Ottawa’s offer to the provinces suggests it would result in a decline in the percentage of Canada’s overall public health expenditures being paid for by the federal government.

At first blush, that might seem to be the case, as there is an annual difference of about half a billion dollars between the 3.5-per-cent increase Ottawa is offering and the 5.2 per cent the provinces say they need to stabilize the federal role.

But, and this is a very big but, the $1 billion a year in targeted health-care dollars Ottawa is offering on top of the 3.5 per cent more than makes up the difference.

I cannot help but conclude that the provinces are blowing a lot of smoke in this regard and trying to mislead us. Simon Rosenblum, Toronto A historic commitment of $5 billion was on the table to improve access to mental-health services across the country. This would have been particularly helpful in Toronto, where there are 12,000 people waiting for supportive housing and more than 2,000 waiting for case management services following discharge from hospital.

Ten years ago, Sen. Michael Kirby proposed a $5.3-billion mental-health transition fund and we are still waiting for provincial agreement while wait lists grow.

While provinces were getting 6-per-cent annual healthtransfer increases, they failed to make substantive investments in mental-health and addiction services, but did use federal funds to make massive investments in other areas of health care.

Is this yet another example of what Dr. Heather Stuart calls structural stigma against people living with mental illness? Let’s hope that this winter of discontent gives way to an agreement for accessible mental-health services and sustainable health care. Steve Lurie, executive director, CMHA Toronto Re Provincial health ministers describe federal funding offer as lacklustre

ultimatum, Dec. 18 Federal Finance Minister Bill Morneau has refused to increase the annual escalator of health transfers from 3 back to 6 per cent. He possibly might increase it to 3.5 per cent and provide an additional $11 billion over 10 years — earmarked for home care and mental health.

When most provinces are in deficit, it makes no sense for them to demand that Ottawa increase its own deficit beyond the projected amount of nearly $30 billion.

Clearly, in fairness to health professionals and patients, new sources of revenue must be found. Various pieces of provincial legislation and the Canada Health Act should be amended so as to permit Canadian patients on long wait lists for diagnostic and surgical procedures to obtain them by paying directly for them in their own province, even if they are not in a special group, such as a politician, athlete, federal prisoner, member of the RCMP or WSIB patient.

Additional operating rooms should be opened and run 24/7 and hospitals should be permitted to perform elective joint replacements on Americans and other foreign patients. This would provide new employment for our nurses, technicians and MDs. It would provide extra revenue that would shorten wait times for all and help to relieve the current financial strain on hospitals and health ministries. Charles S. Shaver, MD, Ottawa If the federal government is going to run a deficit in order to transfer money to the provinces for health care, then the feds should be able to direct where that money is spent. I may go as far to say all federal transfers should be directed. If provinces are unhappy, they are free to increase taxes or run a larger deficit than Ottawa. Don Haines, Markdale