Wednesday, August 9, 2006

Federal Politicians and Health Care: Time To Go For Broke?

It is well known that, according to polls, Canadians believe Health Care is the Number One issue today. Every federal party, from the New Democrats, to the Conservatives, to the Liberals (Google cache, can't find anything on their current website), and so on.

However, Health Care, as most of you may know, is a jurisdiction of provincial government, not the federal government, as per Section 92(7) of the Canadian Constitution.

So how is it that Federal politicians are involved in Health Care then? Enter the Canada Health Act. The Canada Health Act establishes national standards for the provinces to follow. But the provinces, constitutionally, do not have to follow these standards. Then why do they do so? Because another thing that the Canada Health Act allows for is a transfer of funds from the Federal to the Provincial Governments specifically for health care expenditures. If a province strays from the standards of the Canada Health Act, then the federal government "fines" that provincial government and gives less "health care" funds.

Now one can say that Canada has a national health care system, cobbled together by a combination of provincial health care systems and federal money. The way is this system is cobbled together could make it arguably hard to add new variables into the mixture.

It seems, though, that the federal politicians have done just that, by adding such promises as "shorter wait times" to the list. It would seem to me that actually doing something about such things as shorter wait times and so on would have to be done by the provinces, and not the federal government; the only thing that the federal government can control is the money.

Maybe this is the reason why the Liberals and Conservatives have not been successful at really making any changes to the health care system. Maybe this is why Harper and the Conservative have replaced "Priority 5: reduce wait times" to "Priority 5: strengthening our country".

So. The federal politicians have come to the point where they are promising improvements in the health care system, but cannot really implement them because the provinces have control. How do we solve this problem then? I see four plans of action:
  1. Change the constitution so that Health Care is a federal jurisdiction: If Health Care is really so important on a federal level, then maybe it should be under the control of the federal government. If one can say that doing so would improve the health care system, maybe the public would go for it. However, there are arguments that Health Care is better handled at a more local level, and besides, the provinces would fight tooth and nail to prevent the federal government from taking "their" power.
  2. Possible Loophole in the constitution?: If you read Section 92(7), there is an exception: "Marine Hospitals". Now, I've tried to search legislation, and could not define what a "Marine Hospital" is. So, what if the federal government defined it in such a way that made it possible to have Marine Hospitals in Saskatchewan that does not have to attend to the medical needs of sailors? Then what if the federal government made a nationwide network of them, using funds that used to go to provinces. Well, I not sure if one can even use such a loophope in such a way in the first place; even so, I hope that this plan of action is not taken upon. I mean, you'd have to deal with very ticked off provinces. Provinces that may decide to separate.
  3. Admit Defeat, leave it to the provinces: Maybe Federal politicians just have to say that they cannot do anything more with the Health Care system, and direct citizens to lobby the provincial governments for better Health Care. But politicians tend not to say that they are wrong...
  4. Status Quo: Maybe it would result in continued broken promises, but this is probably the easiest way out.
So I really don't know what the solution is. I am a supporter of universal national health care, but all I see are brick walls in every direction. Maybe one of my facts are wrong or I'm missing an important piece in the puzzle here...

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