FSNA Presentation to the Kirby Commission received with enthusiasm and interest
PRESENTATION TO THE STANDING SENATE COMMITTEE ON SOCIAL AFFAIRS, SCIENCE AND TECHNOLOGY
PRESENTED BY: REX GUY, NATIONAL PRESIDENT
FEDERAL SUPERANNUATES NATIONAL ASSOCIATION
OTTAWA, 21 FEBRUARY 2002
Speaking Notes For Rex G Guy
Thank you for this second opportunity to appear before your Committee.
Committee members who were present at the consultation meeting in Fredericton on 8 November 2001 will recall that, for logistics reasons, we were not able to make our presentation, although we tabled it for your consideration.
It is not my intention to repeat what is contained in that presentation. I will, however, expand on the points that are raised in that document and discuss some other points and, of course, I will be pleased to reply to questions at the conclusion of this brief presentation.
Here, at the table, with me is Roger Heath, who was with me in Fredericton. Roger is a research officer with our Association and he has been analysing the whole debate on the future of our health care system. I am also supported by the Association’s Executive Director, Jean-Guy Soulière and the Deputy Executive Director, Keith Patterson.
As you already have the background information on the Federal Superannuates National Association and who it represents, let me move right into my presentation.
OUR PRINCIPAL MESSAGE:
The majority of our members lived in Canada before the introduction of medicare, some 40 years ago. They know and understand the hardships that many Canadians and Canadian families faced.
Many of the individuals who are crying for drastic changes to the system were born after medicare was introduced. Many do not understand the dire consequences of destroying our system.
Our first message is: It is paramount that a comprehensive, efficient and effective public health care system be available to all Canadians, now and in the future.
OUR MAJOR FEAR:
To ensure that we implement a fair, equitable, efficient and effective health care system resulting from the on-going review, there must be the political will to make it happen.
The continuing useless, meaningless, and dangerous bickering between federal and provincial politicians must stop.
We urge our politicians to rise above who is right and do what is right.
MAJOR RECOMMENDATIONS OF FSNA
We have followed the debate on the future of our health care system very carefully and we have conducted research in many areas.
We have consulted our more than 120,000 members in the 80 branches across the country. We have discussed the issues with the 11 other seniors groups who form the Congress of National Seniors Organizations.
The 12 members of the Congress represent approximately 2 million older Canadians.
Based on this, FSNA is making the following recommendations:
1. That the five principles of the Canada Health Act be reaffirmed
The five principles are objectives and, as such, do not prevent innovation or reform, as many have complained. The five principles are to be considered as the basis for policy. They must be uniformly understood across the country, and uniformly applied to eliminate what now exists throughout this country – a different medicare system in each province and territory.
There is no doubt that the principles need re-definition to reflect today’s context and environment.
For example, “medically necessary” has a different meaning in different provinces. This alone prevents a consistent approach to the provision of uniform services across the country.
2. That more funding be provided to health care
It is our conclusion that Canadians are willing to pay more to ensure a quality health care system.
That the funding comes from federal taxes, provincial taxes, or directly from individuals is of little consequence – the taxpayer pays for everything. The money comes from your wallet and mine.
However, the money must go to health care and we must ensure that all necessary changes are made to the existing health care system. There are many changes that can be made to ensure savings and efficiencies.
I will make a few recommendations on how the system can be made more efficient and how savings can be realized.
3. That a universal Pharmacare program for all Canadians be implemented
It is our view that the implementation of such a system would save money. It is evident that there could be an increase in governments’ cost.
But, the overall cost to those who pay, you and me, we estimate would be less.
Why is that?
If the whole country buys most of its drugs in a coordinated way, very significant discounts can be achieved.
The program could encourage practices that would economize – such as reference drug prescribing.
Moreover, effective drug use reduces the demand on other parts of the system.
Furthermore – as the Committee has pointed out – we have a problem because Canadian governments have little experience with user-fees and mechanisms that truly integrate public and private insurance.
Private insurance and user fees for drugs are common in Canada. A national Pharmacare program could give us experience in such arrangements.
4. That home care be made part of the Canada Health Act
Like Pharmacare, some provinces provide home-care to some people and some provinces do not. Again, this illustrates how the current principles of the Health Act are interpreted differently and raises the issue of equitable services for all Canadians.
The restructuring of health care in the 1990s, and the ever-growing practice of earlier discharges from acute care hospitals, has resulted in an increased demand for home care. In spite of this, home care has not received sufficient funds to keep up with hospital discharges. The current investment in home care is woefully inadequate.
Government funding for home care would be seen by many as replacing private funding. This is a consideration. Let me quote from a recent presentation made by the Congress of National Seniors Organizations, of which – as mentioned earlier – we are part, to the Romanow Commission:
“Home care and home support services help seniors maintain their independence. These services delay and even prevent institutionalization while promoting the social integration of seniors.
Home care can contribute to lower costs for the health care system by reducing the pressure on acute care beds for convalescent patients; by reducing the demand for long-term institutional care by allowing some aging Canadians to maintain their independence and dignity in their own home; and by allowing palliative care patients to spend their final days in the comfort of familiar surroundings.”
5. That as much emphasis be given to healthiness as is given to health care
Healthiness, as your Reports clearly demonstrate, requires more than a well-run health care sector and involves more ministries than the ministry of health. For example education can impart valuable life-skill that will support individuals for decades. Community programs for elders can prolong independent living.
Even in its narrow definition, health care is linked to decisions that are sometimes beyond the control of health sector. For instance, easing of drug advertising rules, now under consideration by the federal government, could have a very significant impact on drug costs – especially households’ out-of-pocket expenses.
Were health care imperatives properly coordinated in the federal system, rules that limit the advertising of prescription drugs in Canada would not be eased and US ads would be blocked from Canadian cable TV.
FSNA therefore, strongly supports the Committee’s comments on the need for better co-ordination among departments and the public on health care issues.
CONCLUSION:
Health care is currently a topic of discussion in almost every household in Canada.
We are subjected to daily bombardment by news media reports predicting the end of the health care system. Reports that, on the one hand, claim that the health care system is in crisis, and on the other hand that it is not. That provinces will “go it on their own” and that we cannot afford the health care system are all, to say the least, confusing and terrifying to most Canadians.
There is need for order and objectivity in the debate. Your Committee, we feel has tried to achieve this, and we are grateful for that.
Canadians need to receive correct information if they are to participate actively and purposefully in the debate.
Again, I thank the Committee for inviting us here, but I would also like to add one last thought.
Everyone who has followed the work of this Committee must be impressed by the quality of most of the submissions that were made. There is a great deal of commitment, understanding, and common sense outside the health sector. Moreover, the Committee’s pessimism about the possibility of achieving significant efficiency gains stems not from their impracticality, but, in part, from “the attitude and the behaviour of those with vested interests in the health care system”.
We as the Federal Superannuates National Association strongly urge this Committee to recommend mechanisms for continual public involvement in health care policy. Giving people the opportunity to defend their interests may be the only way to break the present impasse.
Again, thank you for making it possible for us to meet with you today.
