A federal surplus is costing us medicare

1. A federal surplus is costing us medicare • Adrienne Silnicki • National Coordinator • Canadian Health Coalition

2. Medicare firsts in Saskatchewan • First Municipal doctor in North America, 1915 • First Municipal doctor in legislation in North America, 1916 • First Municipal hospital legislation in Canada, 1916 • First travelling TB clinics, 1923 • First universal testing and treatment for TB, 1929 • First cancer control agency in Canada, 1930 • First government-sponsored cancer clinics in North America, 1930 • First statistically controlled BCG vaccination among newborn aboriginal infants, 1932-1949 • First legislation in Canada to allow personal taxation for health purposes, 1934

3. Medicare firsts in Saskatchewan (continued) • First BCG vaccination among student nurses, 1934-1943 • First province with sufficient beds (three per TB death), 1942 • Lowest TB rate in Canada • First in North America: Saskatchewan’s Cancer Control Act, 1944 • First comprehensive health plan for pensioners and widows, 1945 • First comprehensive health care and the first comprehensive hospital plan in North America, 1946 • First province to provide capital grants for hospital construction, 1945 • First full-time cancer physicist, 1945 • First region in Canada to combine public health with medical care, 1946

4. Medicare firsts in Saskatchewan (continued) • First concerted clinical use of the betatron in the world, 1949 • First regional hospital board in Canada, 1951 • First use of calibrated cobalt-60 in the world, 1951 • First universal medicare in North America, 1962

5. Starting point: Public is best • Only financially sustainable model • Safest • Most just- provides care to everyone

7. Private Care is Unsustainable

8. CIHI, 2012

9. Public health care is safer • According to several studies by Dr. PJ Deveraux, you are more likely to die in for-profit hospitals than public, not-for-profit ones

10. Private-for-profit health care costs more and delivers less 1. Takes health workers out of public system 2. Shortages get worse and wait lists get longer 3. Charges user-fees for insured services 4. Undermines access in rural and remote areas 5. Sells queue-jumping 6. Increase death rates 7. Provide lower quality services 8. Only treats low-risk patients- “cherry picking” 9. Sells unnecessary and harmful procedures

12. Medicare Works

13. I would favour the elimination of all for-profit facilities and health care businesses…. The facts are that no one has ever shown, in fair, accurate comparisons, that for-profit makes for greater efficiency or better quality, and certainly have never shown that it serves the public interest any better. Never. • …Markets can't solve problems like health care and, in fact, make them worse.…You must not allow investors in to the delivery system. They will ruin your health are system as they have the American system. • - Dr. Arnold Relman, Prof. Emeritus, • Harvard Medical School

14. Health Care and Harper

15. Overview • Federal changes 2013-2014 • Provincial impact and fight backs 2013-2014 • Solutions • How do we win?

16. Health care is a provincial and federal responsibility • Guardian • Funder • Regulator • Provider • Coordinator

17. Changes to federal policy • Federal government abandoned and jettisoned onto provinces: • Refugee Health Care • Long-term care for veterans • RCMP health care

18. Cuts to Federal Health Care Research • Health Council of Canada • Health Canada library “Health Canada library changes leave scientists scrambling Main Health Canada research library closed, access outsourced to retrieval company” By Laura Payton, Max Paris, CBC News Posted: Jan 20, 2014 5:00

19. The Loss of a Health Accord • $36 billion lost from Canada Health Transfer • No equalization payments • No adjustment for aging populations • No national standards • Longer wait times • No new pan-Canadian programs like: pharmacare, home and community care, dental care, or mental health care

20. The loss of $36 billion by 2024 • Total cut in funding over • 10 years: $36 billion

21. Saskatchewan

22. Nova Scotia $902 million

23. New Brunswick $715

24. Ontario $14 billion

25. ALBERTA $4 billion

26. British Columbia $5 billion • $497,000 to patients • $66,000 to patients and MSI for the same service (double billing) • took the BC government to court • arguing doctors should be able to bill whatever the free market will allow

27. Federal Surplus

28. New Trade Agreements: CETA and TPP • $865 million- $1.65 billion annually will be added to the cost of medicines by CETA alone (CCPA, 2013)

29. New Health Minister

30. We have the solutions, we now need to implement them

31. 1. Stop and reverse privatization

32. Privatization Reversals: • Alberta MRI clinics: -saved radiologists, money, quality, capacity & safety • Cancer care Ontario: -saved $500 per procedure • Ontario MRI clinics: -saved radiologists, money, quality, capacity & safety • Winnipeg Pan Am Clinic: -saved $300 per cataract procedure • Prince Albert regional laboratory: -saved $400,000 annually

33. Public Innovation

34. Reduced consultation waiting time by 85 % – to less than six weeks from 35 weeks • Slashed surgery waiting time by 90 % – to less than five weeks from 47 weeks • Cut the length of stay in hospital by almost one-third – to 4.3 days from 6.2 days. • Patients are more engaged in their treatment, Importantly, patient recovery is faster. The same dollars provided faster, more satisfying care.

35. 2. Expand public health care

37. Universal Pharmacare would save $11.7 billion per year • And everyone could access the medicines they need

38. Home and Community Care Grace Denyer, 2012 “But two weeks later, owner Karen Cazemier asked for a 43-per-cent increase in fees. The new monthly bill: $5,000” Edmonton Journal, 2012 “Woman with dementia, 80, dumped at ER,” ICI Radio Canada, 2012

39. Investor-owned nursing homes provide worse care and less nursing care than do not-for-profit or public homes. - American Journal of Public Health, 2001

40. Solutions • Recruit & retain more health professionals in the public system. • Fix wait time problems within the public system. • Expand Medicareto include pharmacare, home and community care, dental and mental health care. • Stop contracting out hospital support services. • Improve health care delivery. • Keep people healthy in the first place. • Enforce the Canada Health Act and stop two-tier health care.

41. How do we win?

42. 1. Join the Campaign! Sign up at healthcoalition.ca 2. Get informed 3. Talk to your family, friends & co-workers 4. Meet or write your local MP during National Medicare Week (November 23-29)