TEN GOALS FOR GOOD HEALTH
Developed by the members of the
Canadian Health Coalition for improving Medicare and the health of
1. Create Good Health. We must create conditions for good health.
That means we need public policies that make for healthy people: full
employment at decent wages, housing, a strong social safety net,
education, food, peace, a clean environment and a safe workplace. Public
policies that allow the gap between rich and poor to widen will lead to
higher health costs.
2. Preserve and strengthen the Canada Health Act, the foundation of
Medicare. The five principles of medicare must be maintained:
universal coverage, accessibility, portability between provinces and
territories, comprehensive coverage, and public non‑profit
administration. The federal government should maintain sufficient cash
transfers to the provinces to guarantee equal access to health services
as a right for all Canadians. The federal government should withhold
cash transfers to provinces that violate the Canada Health Act.
3. Make the health care system democratic, accountable and
representative. Let all Canadians participate in health
decision‑making, not just private corporations and un‑elected boards.
Bring everyone ‑ including patients, members of the public and health
care workers ‑ into the reform and evaluation of the health care system.
There should be elections for hospital and health care boards. Health
care workers should be fully involved in workplace decision‑making, not
just harnessed in "quality management" schemes to cut costs at the
expense of appropriate care.
4. Provide a continuum of care from large institutions to the home.
This means providing good quality care with appropriate treatment
and supports while providing choice of location to the patient.
Governments have used the rhetoric of moving to community care to
downsize institutional care without actually expanding non‑profit,
accountable services in the community. Health care reforms should
improve and increase services to seniors and the community.
5. Protect our investment in the skills and abilities of our health
care workers. Cutting front line workers means cutting quality of
care. We have built up a tremendous resource in the skills and abilities
of health care workers. Negotiating employment security agreements
enables displaced workers to access comparable jobs in the health care
system. Allow health care workers to retain their existing rights by
encouraging unionization in emerging health care organizations. With
secure employment workers can participate more freely in the
restructuring of the health care system.
6. Ensure fair wages for all health care providers. The burden of
providing health care is being shifted onto poorly paid workers in the
community and unpaid family care‑givers in the home, most of whom are
women. Health care reform should not rob communities of "good jobs" and
contribute to the development of a low‑wage economy. Wage parity with
existing institutional jobs recognizes that fair wages and decent
working conditions contributes to quality of care.
7. Eliminate profit‑making from illness. Public administration of
medicare has saved Canadians billions of dollars. The practice of "deinsuring"
health services by eliminating them from Medicare coverage, the move to
user fees, the creation of profit‑making clinics ‑ all these changes
create a two‑tier health care system where private insurance companies
profit. There is no room for profit and inequity in health care.
8. Reduce over‑prescribing and make drugs affordable. Drug
companies are adding millions to health care costs by driving up prices.
We need to repeal the drug patent protection legislation which prevents
competition and enact law reform that promotes lower drug prices.
Controlling over‑prescribing and drug costs would free up millions for
health care services.
9. Stop fee‑for‑service payments. We should pay health workers on
the salaried basis, not the fee‑for‑service system used by physicians,
some health care providers, and private labs. Fee‑for‑service (payment
for the number and type of services provided) encourages over‑booking,
over‑prescribing, over‑treating and the concentration of physicians in
urban areas at the expense of rural areas.
10. Expand methods of health care and the role of non‑physician
health providers. We must develop holistic approaches to health care
that expand the role of non‑physician health care providers. Nurses,
midwives and others can handle many procedures within the full scope of
their profession including areas neglected by the medical profession,
such as services for women or cultural communities. More information
should be made available to the public so they can make informed
decisions and are aware of choices in treatment.
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