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TEN GOALS FOR GOOD HEALTH

Developed by the members of the Canadian Health Coalition for improving Medicare and the health of Canadians.

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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