Transcript What is the Health Accord

Secure the Future of Medicare
A Call to Care
Presentation to the NB Nurses Union
By Michael McBane
Canadian Health Coalition
5 Questions
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What is the Health Accord?
How does it work?
What does it mean for the provinces?
What about Harper proposal on the renewal
of the Health Accord and what would this now
mean for NB and other provinces?
• What can we do to prepare for 2014?
Background to Health Accord
• Following major federal cuts to health
transfers in 1995
• Following the Romanow Commission Report
in 2002
• First re-investment in 2003 Health Accord
• Second re-investment in 2004 Health Accord
2004 Health Accord
• In September 2004, first ministers signed a 10year plan to strengthen the health care
system.
• $41.3 billion in new federal spending,
beginning in 2004-2005.
• 6% annual growth in federal transfers
2004 Health Accord
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Reducing Wait Times
Health Human Resources
Home Care
Primary Care Reform
Access in the North
National Pharmaceuticals Strategy
Improvements to Aboriginal health
Prevention, Promotion and Public Health
Health Innovation
Accountability and Reporting to Citizens
National Pharmaceutical Strategy
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catastrophic drug coverage;
National Drug Formulary;
Strengthen drug safety and effectiveness;
bulk purchasing strategies;
improve the prescribing behavior;
broaden the practice of e-prescribing;
accelerate access to generic drugs;
address cost drivers and cost-effectiveness.
Canada’s Drug Problem
• Prescription drugs is a leading cause of death;
• >8 million Canadians lack affordable access;
• Rx’s in Canada are 30% more expensive than the
international average;
• Harper negotiating to increase the cost of prescriptions
by $2.8 billion a year;
• Harper preparing legislation to weaken drug safety;
• federal government fuels inappropriate prescribing by
allowing illegal advertising and off-label promotion.
-April 2010, Astra-Zeneca settled for $520 M on charges of ghostwriting
promotion for Seroquel (300$/month, most expensive of its category).
-November 2010: J&J in discussion to settle over off-label marketing of R
-One market niche to be developed was ADHD and Bipolar disorder in ch
Illegal off-label promotion to MD’s
in Canada
(Kirkey 2010)
Universal Pharmacare
will save $ billions
1. Replace U.S.-style plans with universal, first-dollar coverage
2. End the price-fixing and public subsidies of Big Pharm
3. Establish a National formulary
4. Bulk purchasing and negotiate competitive pricing
5. Pay only for drugs that are safe and cost-effective
6. Improve prescribing and use appropriately
7. Enforce a complete ban on advertising and off-label promotion
• Federal pharmaceutical management is a
failure that threatens the integrity and
sustainability of all aspects of health care
including: primary, hospital, home and
continuing care.
• By derailing the national pharmaceutical
strategy, the Harper government is severely
impeding overall health care reform.
2004 - 2014
• 2004 Health Accord is up for renewal in 2014
• F/P/T negotiations were expected
• Instead, the Harper government unilaterally
announced changes to the funding
Harper Announcer Cuts to Health Care
• Dec. 19th, 2011 Finance Minister announces
unilateral changes to health care funding
• 6% escalator until 2016/17 and then an
average 3.9% annual growth in CHT cash
transfers between 2017/18 to 2024/25
• move to per capita funding in 2014
• no plan for renewal – cash with no strings
Canada Health Transfer (CHT)
A Windfall for… Alberta
Harper’s plan would kill medicare
• The Harper government has set in
motion a strategy that will lead to
the unravelling of Canada’s national
health system. All Harper has to do is
nothing. By abdicating the essential
federal responsibilities in health care,
the system will fragment on its own
into 14 separate pieces.
Role of the Federal Government
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Guardian
Funder
Regulator
Service Provider
Promoter of national approaches
Guardian
• As guardian of national standards the Federal Minister
of Health is supposed to ensure that provinces are in
compliance with the Canada Health Act and are not
allowing queue-jumping, extra-billing or user-fees for
medically necessary services.
• The Act also says no Canadian should face a financial
barrier to care - regardless of where they live.
Increasingly flagrant violations of the law are occurring.
The federal government plays dumb as patients and
the sick are exploited or denied access while wealthier
Canadians jump the queue.
Funder
• The federal government is a funder and
transfers over $40-billion a year to provinces
and territories for health care.
Regulator
• Health Canada is responsible for health
protection, including the safety of products (food,
pharmaceuticals, medical devices, natural health
products, consumer products, cosmetics, and
chemicals).
• Poor regulation of food & drugs is making people
sick and killing thousands of Canadians annually.
This regulatory negligence also puts enormous
strain on provincial health care resources.
Service Provider
• The federal government is the fifth largest
service provider in the country. Health Canada
provides basic primary care services in
approximately 200 remote First Nations
communities, home and community care in
600 First Nations, and support for health
promotion programs in Inuit communities
across four regions.
Promotes National Approaches
The federal government is supposed
to work closely with provincial and
territorial governments to develop
national approaches to health
system issues and promotes the panCanadian adoption of best practices.
- e.g. national approaches to HHR
November 19, 2005
The war on medicare
Preston Manning: win the battle over language rearrange the terms so that what appears moderate
today is redefined as extreme and what appears
extreme is recast as moderate. Then it will be politically
easier to completely dismantle national medicare, have
the federal government hand over more taxing power to
the provinces and let them handle health as they please.
…Start with a vulnerable target…Quebec.
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Beware of Code Words
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‘Innovation’ = Commercialization
‘European Model’ = U.S.-style, 2-tier
‘Experimentation’ = No Experiments (WTO)
‘Flexibility’ = Operate Outside of CHA
‘Choice’ = For the Wealthy & Healthy
‘Partnership’ = Public Pays More & Get Less
‘Activity-Based Funding’ = Profit-Based Motive
‘Modernization’ = Life Before Medicare
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What the few want
- Open up the delivery of health services to
market rules and divert public funds to the
profit seeking private enterprise.
- Segmentation of ‘markets’, access,
coverage.
Trader ethic:
-exploit vulnerability (the frail elderly)
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What most people want
- Canada Health Act removes the delivery of
health services from market rules to ensure
access based on need.
- ‘Un-profitable’ services, populations and
regions are not abandoned.
Guardian ethic:
- protect the vulnerable
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Support for Public Solutions in
Healthcare
QUESTION: Thinking about the future of Canada’s public healthcare, would you
support, somewhat support, somewhat oppose or oppose public solutions to
make our public healthcare stronger? - Nanos Research, May 2010
Health Care: Values in Conflict
Public Ethic:
Guardians
For-Profit Ethic:
Traders
Health care is a human right
Health care is a commodity
Protect the vulnerable
Exploit vulnerability
First, do no harm
First, maximize profits
Keep people healthy
Profit from illness
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More private means less public
• Draws off resources from the public system
• Increases costs overall
• Introduces the inequities of the U.S. system
Source: Marcia Angell, MD, “Privatizing health care is not the answer”,
Canadian Medical Association Journal, 2009.
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Medicare Works
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Towards A Strong Federal Health
Accord in 2014
□ Federal leadership for a new 10-Year Health Accord to ensure that it
reflects the needs of Canadians in all regions, including:
□Pharmacare;
□Home Care;
□Residential long-term care; and
□Palliative Care
□ An Accord that ensures access to health care, based on need and not
ability to pay.
□ An Accord that ensures improved accountability with secure and
predictable funding.
What can we do to prepare for 2014?
1. Get informed
2. Sign the Medicare Pledge
3. Endorse the Call to Care
4. Talk to family, friends & co-workers
5. Write a letter to the paper – call-in radio
6. Write, call and meet your MLA and MP
7. Run for office!
Medicare …
fight for it!