OTTAWA — Canadians believe the health care system is "overburdened" and they want the federal government to assume a broader "leadership role" to fix the problem, a new report commissioned by the Harper government has found.
Moreover, while many Canadians still believe medicare is "compassionate" and is among the best of the world's health care systems, it is not working effectively and is showing signs of decline that make it "unreliable" and "wasteful".
The public opinion research report finds Canadians are frustrated — despite many promises by political leaders — about the lack of action on improving medical wait times, a shortage of doctors and nurses, and cutbacks in medically available services.
The analysis delivered to Health Canada comes as Prime Minister Stephen Harper's Conservative government is under pressure to change its hands-off approach to medicare and adopt a more aggressive stance in ensuring that provinces are held accountable for the billions of dollars they receive annually in federal health-care transfer payments.
In December, the government surprised premiers by revealing it is cutting back the future growth rate of funds it gives them for medicare, and Harper said it was up to the provinces to control spending and find innovative solutions to improve health care.
Since then, political critics, a Senate committee, and the Canadian Medical Association have all called on the government to play a more central role in ensuring provinces adopt much-needed medicare reforms. But there has been no clear signal for Harper's cabinet that it is prepared to exercise any clout by jumping into the health-care fray.
Meanwhile, it is being told through a $127,916 report — entitled "Canadians' Attitudes toward the Health Care System" — there is a public appetite for such action.
The March 2 final report, prepared by The Strategic Counsel, is based on a major national public opinion survey, and a dozen focus groups held in six cities across Canada last November.
"Most participants support a broader role for the federal government in health care, focusing on standardizing access and quality of care across the country, but also providing a range of other services," the report revealed in its summary of the focus group findings.
Indeed, the report notes the "perception" about the federal government's current role in health is "somewhat limited, or vaguely understood."
However, there was a "widely expressed consensus" that the government "could, and should, take on a much greater leadership role" without establishing new bureaucracies or adding to administrative costs.
Among the areas cited for federal leadership:
- Conduct "audits" of the provincial health care systems and work to reduce "waste and inefficiencies".
- Act as a "bulk purchaser" of prescription drugs, hospital supplies and equipment to lower the costs.
- Negotiate drug prices and reduce patent protection to create a market for cheaper generic drugs.
- Promote community or home-based care.
- Accelerate national certification for foreign-trained physicians.
- Promote the use of other health-care professionals — nurses, nurse practitioners and pharmacists — in place of doctors.
- Use the tax system to promote healthier lifestyles, by taxing "junk foods" and subsidizing gym memberships.
- Regulate food companies to eliminate additives known to be harmful or contribute to obesity.
The report also touched on the federal government's controversial plan for paying a reduced share of medicare's bills.
In December, federal Finance Minister Jim Flaherty unilaterally unveiled a non-negotiable funding plan that runs to 2024.
Federal health-care transfers will continue to increase by six per cent until 2016-17. After that, increases will only be tied to economic growth including inflation — currently roughly four per cent — and never fall below three per cent.
The focus groups revealed people are not keen with this approach.
"Participants held the view, for the most part, that funding should be linked to needs rather than economic growth," the report said, adding most people want an approach with more "stability and predictability."
"Many were worried that the variable nature of tying spending to economic growth would necessarily mean a lower level of care in periods of downturn."
Also, the research found outside of Quebec, people were "firmly of the view that there should be some accountability linked to the transfer of health care dollars from the federal government to the provinces."
"Few believe that putting more money into the system will solve the problems," says the report. "Note, however, that this does not mean there was support for reducing health care budgets."
Instead, people said they think money can be saved by eliminating waste in the system, cutting back on administrative costs, and preventing "system overuse and abuse."
The report said a near-unanimous consensus emerged at the focus groups that health care is a "significant issue that requires a significant response" from both the federal and provincial governments.
"For some, the sense that a greater degree of privatized care and business-like approaches appears to be creeping into the public health care system were singled out as specific causes for concern."
Another concern was that Canada is not prepared for an "impending crisis in aging".
"Many expressed fear that Canada is facing a permanent fiscal shortfall due to an aging population (and shrinking tax base) and that this incongruity can only have a negative impact on the levels of patient care Canadians can expect in the future."
http://www.montrealgazette.com/business/Canadians+want+feds+assume+leadership+role+health+care+report/6661075/story.html
