Provincial health ministers should stop bickering on transfers

KAMLOOPS — The provincial health ministers should resolve in the New Year to stop bickering, take the money from the feds, and use it as intended.

It’s a recurring bad movie says Canadian Medical Association president Granger Avery: “The Groundhog Day-type discussions where political leaders bat around percentages and figures at meetings in hotels have to stop. Our system needs better, and most important, our citizens deserve better (Globe and Mail, Dec.19, 2016).”

The provinces have had thirteen years of increases from the feds at 6 per cent a year to improve health delivery. “The transfers have been growing quite generously,” says Livio Di Matteo, a health-care economist at Lakehead University in Thunder Bay. “If you go back to about 2007, if you look at public-health spending, which is largely provincial, it’s grown about 40 per cent. The Canada Health Transfer to the provinces has grown about 70 per cent.”

We need to spend smarter. Canada spends more on health care than Australia, for example, with poorer outcomes as measured by life expectancy and infant mortality.

The provinces have not fixed the problem during times of plenty and now are faced with problems of an aging population. In addition to increased funding at 3.5 per cent a year, the feds have offered $11.5 billion for home care and mental health. I don’t know who writes the province’s absurd scripts: let’s refuse the offer, even though it’s what we want, because we want more.

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Provincial health ministers don’t get it. B.C. Health Minister Terry Lake worries that if B.C. were to take the money offered, and start home care programs, that the programs wouldn’t be sustainable when funding dries up. That would be true if hospital costs remain the same when home care programs are added.

Home care programs would reduce hospital costs. Hospital beds cost $1,100 per day whereas home care is one-quarter that cost according to the Canadian Institute for Health Information. Seniors take up 85 per cent of those expensive hospital beds and one-half of them remain in beds even though they are well enough to be moved because there are no long-term care facilities or home care.

Take the money spent on hospitals and spend it in the community. That would mean that four seniors would be cared for at the same cost as one in a hospital — and they would be happier.

The politics and perception of health care would have to change. Hospitals have become a measure of a politician’s success because they are highly visible monuments to health care; something that you can be sure the B.C. minister will point to often in the campaign leading up to the provincial election next May.

It’s a problem of perception, too. Home care is virtually unseen except by the few affected. It’s hard to point to the thousands of seniors happily living at home as a measure of success. British Columbians will have to change perceptions of health, from hospitals as shrines were doctors are the high priests, to a flatter hierarchy where care is diffuse and in the hands of other professionals.