January 16, 2012

Vancouver Observer

David P. Ball

But Prime Minister Stephen Harper told CBC's The National that he is unwilling to budge on the government's decision.

“I'm not looking to spend more money,” Harper said. “I think we've been clear what we think is within the capacity of the federal government over a long period of time.

“I hope that we can put the funding issue aside, and they can concentrate on actually talking about health care, because that's the discussion we’ll be having. What I think we all want to see now from the premiers who have the primary responsibility here, is what their plan and their vision really is to innovate and to reform and to make sure the health-care system's going to be there for all of us.”

Quebec's premier, Jean Charest  – speaking before he joined other leaders around a cramped hotel conference table – was scathing in his opposition to the Conservatives'  approach. Charest's tougher tone stood in contrast to Clark's more conciliatory invitation to dialogue, revealing perceived divisions Clark has been playing down between premiers.

“The federal system is not a unilateral system,” said Charest. “You cannot just announce decisions without dialogue.

“This isn't complicated – if at the end of the day, we're going to increase funding in one envelope and reduce it in another, we want to know. Canadians should know. I'm at a loss to why the federal government wouldn't want to have that discussion.”

Charest also broached the topic of equalization payments from resource-rich provinces.

“There are two realities in Canada,” he said. “There are the economies of oil, gas and potash – and others.

“That's the financial situation of the country. Once we know that, we need to be able to make decisions accordingly. If we're going to go towards per capita funding, that's one thing – then we need to look at equalization also.”

Charest's words were echoed several blocks away by advocates at an event hosted by the BC Health Coalition, which is pushing to strengthen public health care. Participants expressed concern that the new funding approach moves Canada towards a patch-work of unequal care, since provinces must shoulder more of the financial burden in the face of rising costs.

“Undoubtedly our system is becoming more strained, because we haven't been working hard enough to reform it,” said Vanessa Brcic, a Vancouver family physician and researcher, representing Canadian Doctors for Medicare. “A unified decision to approach the federal government ... needs to happen.

“As a family doctor myself, I can see how this plays out on the patient level. We can look all across the country and see most of the solutions to the problems that we have, but it will require cooperation. A commitment to work together is key. Of course, that's very difficult to do in the absence of federal leadership.”

Speaking to the Vancouver Observer, Valerie Avery, with the National Union of Public and General Employees  (NUPGE), acknowledged much is broken in Canada's medicare system. But the solution, she said, is not cutbacks or downloading responsibilities to provinces.

“The health care system does need some change – it does need modernization, some creative innovation,” Avery said. “It was never the vision of medicare that it would stop with the acute care system. When you implement one part of a vision and not the rest of it, and this is where you get stuck.

“Now the feds would love to say, 'It just costs too much to implement the rest.' If you had a national pharmacare strategy and could bring your costs down by $12.7 billion a year ... that could be redirected into home care services. It'll take some innovation but it can be done.”

Outside the premiers meeting – set to make its first press conference early this afternoon – a group of young activists and new medical professionals held red umbrellas, starkly contrasting against the night's snowfall.

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