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Health care should be federal election issue - Dr. Peter Zalan

With the passage of the Medical Care Act in 1966, the government of Canada declared that all Canadians should be able to obtain health services of high quality according to their need, irrespective of their ability to pay.
With the passage of the Medical Care Act in 1966, the government of Canada declared that all Canadians should be able to obtain health services of high quality according to their need, irrespective of their ability to pay.

It meant having access to all medically necessary doctors’ services in their offices and in hospitals without fear of receiving overwhelming bills or losing insurance coverage.

By 1972, all the provinces were participating in a 50/50 cost sharing arrangement with Ottawa. Yet, by 1976, the federal government switched to block funding for health in order to cap spending at sustainable levels, a problem that has refused to fade away, as true today as it was in 1976.

1984 saw passage of the Canada Health Act, legislation that reaffirmed the federal government’s commitment to the principles of medicare and that banned user fees and extra billing. Nevertheless, 1995 saw further cuts to the federal financial support for health.

A number of major health reports were released across the country in the last decade. They include Alberta’s Mazankowski Report in 2001, the Senate’s Kirby Commission in 2002, and the federal government’s Romanow Commission in 2002.

They recommended renewed federal leadership and new programs: creation of a national home care program; the re-positioning of primary care and prevention strategies at the forefront of the health care system; the creation of a national drug formulary to deal with rising drug costs; and the provision of a catastrophic drug plan to assist Canadians needing expensive drugs.

Unfortunately, successive federal governments made deficit reduction their main priority and did not act on the recommendations.

Medicare in 2011 is stressed and fraying around the edges. Emergency departments have long wait times - a hospital in British Columbia needed to use its Tim Hortons to look after patients.

Patients who have finished their acute care in hospitals cannot leave because of lack of support in the community; as a consequence, new patients are sometimes admitted to hospital hallways.

There are long wait times for some elective surgeries and diagnostic procedures like MRIs. Timely access to family physicians is problematic; some of our most complex patients coming out of hospital go to walk-in clinics to renew their medications.

User fees are back, illegal as per the Canada Health Act, but tolerated nevertheless.

We are now in the midst of a federal election campaign. This is the time to ask our candidates and parties their vision for health care. Former Prime Minister Brian Mulroney called Medicare a sacred trust in 1983. What do our leaders call it in 2011? What is the future role of the federal government in health care?

Does it see a role in revitalizing legislation that is now 45 years old? Does it want to set new national standards?
Instead, does it want out of the game altogether and leave health care solely to the provinces?

This is important for the public to know because the Canada Health Act is up for re-negotiation in 2014. Canada may not see another federal election before that date. What better time than now to begin the dialogue?

Dr. Peter Zalan is president of the Sudbury Regional Hospital medical staff.

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