February 11, 2003
Preliminary Analysis of Health
Accord - Ontario Health Coalition
- The exact funding that will be available is unclear.
Confusion appears to be caused by double-counting of previous accord
- A 5 year Health Reform Fund will be created targeting
3 priorities: primary health care, catastrophic drug coverage, and homecare.
- A Diagnostic/Medical Equipment Fund will be
established with some reporting provisions.
- Romanow Recommended $15 billion in new cash funding
over 3 years, $28 billion over 5 years. The "Accord" promises $13.4 billion
over 3 years, $26.8 billion over 5 years.
- Reportedly, the new funding brings the federal share
up to 16%. Our demand is for the federal cash transfer to be immediately
increased to 25%.
- There will be a dedicated health transfer by March
31, 2004 with a built-in escalator to ensure predictable annual federal
increases in the health transfer.
- Although the funding has been targeted to priority
areas, there is nothing in this deal that would prevent the mis-spending of
targeted monies as happened with the 2001 diagnostic equipment fund.
- A National Health Council is to be established in the
next 3 months. Its make-up is unclear. It appears that they will try to
develop some indicators but will report through the Premiers making real
accountability very unlikely. Consistency in reporting and data collection is
not clear here. Quebec will have its own council that will work with the
- The Health Council is troubling and warrents a closer
look. What it means for our demand of enforcement of the principles of the
Canada Health Act is unclear. Its composition is potentially extremely
troublesome as demonstrated by the short-lived rumour that Don Mazankowski
might chair the Council. (This was apparently floated by the Prime Minister
but rejected). A Health Council dominated by the privateer provinces and
including for-profit industry representatives might be more of a threat to
Medicare than anything else.
Extension & Modernization of Medicare
- A target has been set for 50% enrollment in primary
care teams within 8 years. This is not enforceable under the report.
- Coverage for post-acute or sub-acute (post-hospital)
homecare is targeted. This covers people who were formerly in hospital prior
to hospital bed cuts and is not really an extension of Medicare. The "frail
elderly" and those with disabilities are not assured improved coverage with
- Coverage for catastrophic drugs is targeted. There
is no provision to control drug costs, improve independent information on
pharmaceuticals or review the patent legislation.
- Protection of the new homecare and pharmacare from
trade deals has been flagged. However, there is nothing in the accord that
promises protection of public health care from trade deals.
- There is no plan to bring homecare, pharmacare or
diagnostics under the Canada Health Act or its principles.
- There is no Rural and Remote Access Fund as
recommended by Romanow.
- There is no cultural diversity or language barrier
removal in the accord.
- There is no attention to virtually all inequities in
access to health services.
- There some recognition of the downloading of care
responsibilities onto women and unpaid caregivers through a provision for the
creation of a compassionate care benefit through EI and job protection through
the labour code for those who temporarily leave work to care for a gravely ill
or dying relative.
- The Territorial Ministers walked out of the meetings
and did not sign onto the accord as it did not contain sufficient funding for
rural and remote access issues.
- The language pertaining to First Nations', Metis' and
Aboriginal health and control over health services is woefully inadequate.
Privatization & Profit-Taking
- There is nothing in the accord that will stem the
flow of money from public taxes to profit-seeking health care corporations.
- The increases in funding without protections against
the for-profit health industry may serve to simply strengthen and enrich the
industry rather than improving health care.