Summary of Healthcare Policies in Canada

In Canada, the healthcare system is under the control of both the federal and provincial governments.  The federal government provides funding and places conditions that the provincial government must meet to receive that funding.  The federal government’s responsibilities towards the health of Canadians, and the conditions and responsibilities placed on the provincial government are laid out in the Canada Health Act of 1984. The Healthcare act describes these responsibilities as establishing “criteria and conditions in respect of insured health services and extended health care services provided under provincial law that must be met before a full cash contribution may be made.”  These criteria and conditions fall into five areas: public administration, comprehensiveness, universality, portability and accessibility.  For example, under the heading of public administration, provincial healthcare must be non-profit and be run by an administration that has the legal authority to administer a part of public life. Under universality, the Healthcare Act demands that healthcare services be available to all people in the province that qualify.

The Effect of Canada’s Healthcare Policies on The Province of Ontario

In the Province of Ontario, healthcare is greatly affected by the policies of the federal government.  Primarily in that the province must function within the conditions of the Canada Healthcare Act to receive federal funding.  Unfortunately the funding is inadequate.  The transfer payments to the province do not take into account our aging population, who will have increased healthcare needs as they grow older.  The Premiers of Canada agree that the federal government needs to provide sustainable funding at an increase of 5.3% annually, however, the province of Ontario itself is not providing sustainable levels of funding.   In the 2019 provincial budget they have only increased healthcare spending by 1.6%, which does not reach the level of inflation, let alone provide additional funding for increased needs.  Just like the federal funding, the provincial funding does not take into account the aging population.  The demand for new technologies and advanced procedures are also not accounted for at the current funding level.

Obstacles and Challenges Facing Ontario

In January of 2019, the Premier’s Council on  Improving Healthcare and Ending Hallway Medicine released its first report.  The report discusses a multitude of factors that challenge the province when trying to improve healthcare.  The primary factor is that there are not enough long term care beds available.  When there are no beds to move to, patients remain in the emergency department, and other patients end up on extra beds in the hallways.  When elderly patients are ready to be released from the hospital, there are not enough long term care spaces for them to move into and not enough home supports available so that they can return to their homes.  A lack of mental health services in the community, where they are best dealt with, is also a factor.  Mental health patients also clog up the emergency departments and beds in Ontario.

It is unlikely that  healthcare in the province will improve in the near future, as Doug Ford  has already made multiple cuts to the healthcare budget.  In July of 2018, he cut planned mental health funding  by $330 million.   Funding to the College of Midwives of Ontario was cut in December of 2018 and two long term care home funds were cut by $34 million in June of 2019. This funding would have  provided programs, services and equipment that would allow seniors to stay in their homes longer, which is less expensive than having them in long term care facilities. These cuts are just a few examples of the many cuts to healthcare already made by the Ford government.

Proposals to Improve Healthcare in Ontario

The Federal Liberal government has made proposals to improve healthcare in the form of promises they will keep if elected again. They have committed to a family doctor for every Canadian, as well as increased mental health services.  If elected they will work further on a national pharmacare program to reduce prescription drug costs.  Trudeau used the announcement of his healthcare plan to plug for a Liberal Federal Government by commenting “ the question becomes for Canadians, ‘Who do you want negotiating with Doug Ford when it comes to your health?”

In June of this year, The Premiers Council on Improving Healthcare and ending Hallway Medicine released its second report.  The report discusses four areas in which the Provincial Government should focus its resources to develop solutions..  First, the system should be better integrated to provide user friendly service that provides easy access to medical services for patients.  Second, the homecare system should be improved and flexible and telemedicine opportunities increased.  Third, partnerships between medical and social services need to be strengthened, and digital information should be easier to access.  Finally, capacity must be increased.

Concluding Remarks

The Ontario Medical Association supports the recommendations made in The Premier’s Council on Healthcare and ending Hallway Medicine, however, The Ontario Nurses Association understands that these plans will cost millions of dollars and provide no assurances that there will be any improvement in patient care for Ontarians.

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