17 York St. Perspective

1. 17 York St. Perspective Presented by: Keith Denny, Director, Research & Policy

2. Cycle of Activities – Advocating for Equitable Health Care for Canadians Speaker: Keith Denny • The typical advocacy year for CHA begins in July and continues until recess of Parliament in June of the following year. • July/August – Preparation of CHA’s pre-budget Brief to the Finance Committee • August – Submission of pre-budget Brief • September/October – Response to the Speech from the Throne (if required) • September-November – Presentation of Pre-Budget Brief to the Finance Committee • February/March – Response to the Federal Budget • All year - Presentations to House of Commons and Senate Committees - Monitoring the work of the House and Senate - Meetings with senior politicians and departmental officials

3. “Today’s” Perspective Speaker: Keith Denny Canada: Federal & Provincial Politics Canada’s Health System International Perspectives So What – Now What?

4. 1. Canada: Federal and Provincial Politics Speaker: Keith Denny

5. 1. 1 Federal Policy Speaker: Keith Denny • Rare diseases/orphan drugs • Orphan drug framework for Canada • Orphanet • Canadian Epigenetics, Environment and Health Research Consortium (CIHR): $41M • EI changes • For parents with critically ill/injured children • U-turn on asbestos • Canada will no longer oppose inclusion in global list of hazardous substances

6. 1.1 Federal Policy Speaker: Keith Denny • Response to: • Senate review of 2004 10-year accord • HESA chronic disease & aging report • HESA drug supply report

7. Abacus, September, 2012 1.2 Public Opinion: Federal Parties Speaker: Keith Denny

8. 1.2 Public Opinion: Federal Parties Nanos, September, 2012 Speaker: Keith Denny

9. 1.2 Public Opinion: Federal Parties Nanos, October, 2012 Speaker: Keith Denny

10. 1.3 Public Opinion: Policy Priorities Speaker: Keith Denny

11. 1.3 Public Opinion: Policy Priorities Public Policy Importance & Confidence Map: Nanos August, 2012 CONFIDENCE IMPORTANCE Speaker: Keith Denny

12. 1.4 Provincial/Pan-Canadian Speaker: Keith Denny • Council of the Federation • Innovation and Fiscal Arrangements Working Group reports released July 27, 2012 • 12 recommendations for best practices • New CHT escalator will cost P/T $36B by 2024 • Ministers of Health • September 27 meeting

13. 1.4 Provincial/Pan-Canadian Macdonald-Laurier Institute, 2012 Speaker: Keith Denny

14. Angus Reid, September 2012 1.4 Provincial: Public Opinion Speaker: Keith Denny

15. 2. Canada’s Health System Speaker: Keith Denny

16. 2.1 Finances Speaker: Keith Denny • New CIHI data on the financial performance of hospitalsshows hospitals are barely staying afloat: • 2010 -11 total revenues = 0.12% above expenses • NL, NS, NB & QC in deficit position • SK has best margin at 1.2%

17. IpsosReid, July 2012 2.1 Finances • Ipsos Reid survey for CHSRF, CMA & IHE: • 82% have supplementary health coverage • 36% have gone without needed health care due to insufficient coverage • gap in care is highest among those in Atlantic Canada, lower-income earners, women, self-employed, work part time workers and unemployed • 50% support a public supplementary health benefits program funded by increased taxes Speaker: Keith Denny

18. Ipsos Reid 2.3 Health System Changes • BC • Margaret MacDiarmid appointed Minister of Health New powers for nurse practitioners • Alberta • New regulation under Health Professions Act creates College of Naturopathic Doctors of Alberta • Ontario • Stand off between government and OMA continues • New powers for pharmacists Speaker: Keith Denny

19. Ipsos Reid 2.2 Health System Changes • QC • Dr. Rejean Hebert appointed Minister of Health • NB • Hugh Flemming appointed Minister of Health • New department: Healthy & Inclusive Communities (Minister: Dorothy Shephard) • PEI • Proposed umbrella legislation for health profession regulation • May open door to regulation for some of 16 professions currently seeking it (e.g. midwives, MLTs, naturopaths) • Health PEI CEO takes up new post in Saskatchewan Speaker: Keith Denny

20. 2.3 Health System: Public Opinion Speaker: Keith Denny • Ipsos Reid survey, July 2012: • 53% of Canadians opt for mixed healthcare model: gov’t pays, services delivered publicly but have option to seek and pay for treatment in private sector • 39% favour a “not-for-profit” model whereby the government pays for the care delivered by the public sector • 7% favour a “for-profit” model where the gov’t and individuals pay but services are delivered privately

21. “Mixed model” health care: Ipsos Reid, July 2012 Source: Ipsos Reid. Majority (53%) of Canadians prefer mixed-model healthcare, with services offered by both public and private sectors. Media Release. June 28, 2012 Speaker: Keith Denny

22. 3. International Perspectives Speaker: Keith Denny

23. 3. International Perspectives Speaker: Keith Denny • Canada-EU Trade Agreement • Latest round of negotiations ongoing • Ministers will meet in November • Aim for final agreement by end of year • Drug patent issue not yet discussed • Will be one of issues decided by ministers in November • Industry Canada/Health Canada estimate EU proposal could add up to $1.9B in annual drug costs

24. 3. International Perspectives Speaker: Keith Denny • Affordable Care Act: Obamacare • Insures 32m previously uninsured • Could intensify brain drain for Canadian clinical expertise

25. 3. International Perspectives Speaker: Keith Denny

26. 3. International Perspectives IoM report: US health system wastes $750B pa Speaker: Keith Denny

27. 3. International Perspectives OECD Top Ten Life Expectancy, 2010 Speaker: Keith Denny

28. 3. International Perspectives Speaker: Keith Denny

29. 4. So what? Now what? Speaker: Keith Denny Council of the Federation: What next??? Follow up with Minister of Health and critics Business Plan: Policy and advocacy platform Partnerships: ACAHO, CCPH21, HEAL

30. Presenter’s info: Keith Denny Tel: (613) 241-8005 E-mail: kdenny@cha.ca www.cha.ca 17 York Street Ottawa, Ontario K1N 9J6 Tel: (613) 241-8005 Fax: (613) 241-5055