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Addressing health care at the Council of the Federation

A "medicare has got us covered" red umbrella

The Council of the Federation has arrived in Halifax. And while I'd say it was the calm before the storm -- given that Wednesday and Thursday are filled with events and rallies -- it was raining cats and dogs outside! Fortunately I was able to use one of our new "medicare has got us covered" umbrellas while running across town to get all of the events' details finalized.

Wednesday was a big day for us. We had a Premiers' Puppet Parade planned through the main streets of Halifax. We teamed up with Puppets Et Cetera to create 6-foot tall puppets of each premier. The message we're taking to the streets is: Premiers, don't be puppets, stand up to Harper.

And while you'll see in other blogs that I've written that not all the premiers are puppets, if they accept the $31-billion cut to the Canada Health Transfers that Harper has proposed then they are being his puppets. If the premiers let Harper walk away from his commitments under the Canada Health Act (CHA), then they are being puppets. If they do not stand up and call Harper back to the 2014 Health Accord negotiating table, they are letting Harper destroy universal health care in Canada and forcing me to use language that my mother would disapprove of -- so let's be thankful that hope still remains.

Saying public health care could be destroyed may sound dramatic, so let me explain. Under the Canada Health Act, health care must be accessible, portable, universal, comprehensive, and publicly administered. If the federal government only plays a financial role, then there is no one responsible for ensuring provinces abide by the CHA and there is no one to enforce the conditions of the CHA, such as user fees or extra-billing on medically necessary services.

If Harper walks away from the negotiating table, provinces will be on their own to make sure each province or territory is offering a similar basket of medically necessary services -- so that health care remains portable, that no one charges user-fees or extra-bills -- which we know is happening now and the Harper government is turning a blind eye, and no one to help spread public sector innovation across the country by creating national standards and benchmarks. Harper is downloading responsibility for health care onto the provinces. The provinces will not be able to monitor one another, penalize each other for user fees or extra billing, or expand medicare into cost-saving areas like national pharmacare and home care. This really could be the end of universal public health care in Canada.

So what are the premiers doing to save medicare? Well so far they've started both a financing and an innovation working group. The finance working groups will be looking at counter proposals to Harper's take-it or leave-it $31 billion cut. We expect to see proposals such as funding provinces and territories based on the age of their population -- this is likely to come from provinces such as Nova Scotia or British Columbia. Alberta is pushing for a per capita based funding formula -- as their population is young and increasing quickly. But the premiers have promised that whatever formula they choose, it must not harm another province. Not an easy task.

The innovation group is likely looking at important areas such as team-based care -- meaning several health-care practitioners from different areas of practice work together to create comprehensive care for a patient; full-scope practice -- meaning we don't rely so heavily on just a few health practitioners and instead we let practitioners do all the jobs they were trained for -- ask a nurse practitioner what they learned in school and what they do in clinic; and the creation of more community health centres.

To implement these innovations will take time and resources. If we want Nova Scotians to have access to the same high quality of care as Albertans, then we need the federal government to provide leadership.

The bottom line is that the provinces and territories will not be able to protect, strengthen and expand medicare in Canada without the involvement of the federal government. And so we will march through the streets of Halifax telling the premiers: don't be puppets, stand up to the Harper government. Call them back to the 2014 Accord negotiating table! Canadians are watching.

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