It was September 1997, Madison Square Gardens in New York. Bret "The Hit Man" Hart - a Canadian, a foreigner - had beaten their favourite. Worse than that, he was rubbing it in. He actually had the nerve to wrap himself in a Canadian flag and taunt them. He roared at the fans about how great it was to be Canadian, to live in Canada. He boasted about our way of life. He told them about Medicare.
The fans went nuts.
That's the way it is with Medicare. It's like maple trees, the Rockies and the Great Lakes. It's one of the things that defines us. We know it - and so does the rest of the world.
But there's one big difference between Medicare, maple trees and mountains. The maples and mountains were here when we got here - Medicare wasn't.
Medicare is something we made up, something we decided we needed to have to make life up here a little less treacherous, something we decided to do for each other.
IT DIDN'T COME EASY. Medicare, the idea, is almost as old as Canada. Medicare, the reality, has only been around since 1968 - just 32 years. And it's been under attack for most of that time.
The fact is Big Money (insurance companies, medical service corporations) doesn't much like Medicare. They fought hard to keep it out of Canada. They even sent out American public relations hit squads to sabotage the original breakthrough drive to establish Medicare in Saskatchewan. They fed the news media distortions, half-truths and outright lies to try and stop Medicare. It didn't work.
It didn't work because we know what we want, what we need and what life was like before Medicare. It can't work so long as we remember all that.
Medicare is ours. We made it. We like it. We want to keep it.
To talk of anything less is like talking about Canada without maples and mountains. It's simply not the way we want Canada to be. It's simply not us.
Back in the bad old
days before Medicare
Insights
Universal Medicare
still our best value
STUDY AFTER study shows that Canada's universal health care system is more fair, cost-efficient, and effective than any private health care system.
Before Medicare, Canada and the United States spent an equivalent amount of money on health care. Today, Canada spends about 36% less than the States and gets a whole lot more. Individual Americans now spend an average of $3,701 (US) annually for a health system where 43 million people have no health care coverage and another 50 million have inadequate coverage. In Canada today we spend about $2,050 (US) per person for a health system in which each and every one of us is covered.
High impact
OUR DAILY news is full of the impact of these cuts:
IN ADDITION, the change in the federal government's funding formulas to the provinces not only triggered deep cuts to health care spending, but they also meant that provincial governments were no longer required to spend federal health dollars on health care.
Medicare a big boost
for Canadian business
AMERICAN employers pay anywhere from three to five times more than Canadian employers to fund employee health and social benefits.
That figure includes the taxes they pay for those benefits in Canadian dollars.
Action Required
Feds must take
final responsibility
RESTORING federal support immediately is necessary not only to address Canadians' anxiety about the strains in our health care system, but it must be done simply to ensure the survival of our system.
It's simple: the federal government must commit itself to restoring cash transfers for health to a significant share of health spending and it must do this while recognizing the changing needs of Canada's population.
OBJECTIVE #2:
Facts
NEVER FOR PROFIT
Governments continue to chip away at Medicare by:
Insights
Kill not cure
TURNING illness, pain and suffering into big business is the surest way to kill, not cure, our Medicare. Allowing corporations to come in "just a little" and do "just a few things" is like injecting yourself with just a little cancer. It can't help but spread to infect and endanger the whole system. Medicare rests on the rock solid principle that we would not allow a two tier system: one health care system for the rich and another for the rest of us. Money would not be allowed to enter into it - not for patients, and not for health care providers. Every Canadian citizen was to get the best care there was, all the time. Period.
The fear of two tier
IT IS A cruel joke that those most in favour of a two tier system offer it as a way to rescue Medicare. It is not.
A parallel private health care system for those "willing and able to pay" will not take the pressure off Medicare. The truth is it will only make matters worse:
THIS RACE to a U.S.-style health care system must be stopped.
The federal government must:
The test we must not fail
The aim of long-term care must be to provide a full life's worth of health and support services adequate to preserve and protect the health and well being of our old people in body, mind and spirit. Long-term care, therefore, must not be limited to homes for the aged with 24-hour on-site medical care. It must also include: in-home visiting nurses, therapists, homemakers, day programs, supportive housing, Meals-on-Wheels and attendant services for people with disabilities.
Going from bad to worse
THE QUALITY and quantity of long-term care in Canada makes a short life seem almost desirable. The crazy quilt of provincial government standards within and across provinces offers little comfort. For example, in Ontario, "nursing homes" are subsidized and regulated while "retirement homes" are not.
Lack of regulation simply leaves those who require care beyond hospitals subject to arbitrary decisions, related more to funding restrictions than anything else.
For people in facilities this can mean care goes first to acute patients in need of more intensive types of care. Those who require less intensive support are passed over.
When it comes to people still able to get by with care in their home, however, those who require minimal care get priority. The elderly with longer-term at-home care needs go to the back of the line. What makes matters worse is a new fear now gripping aging Canadians. It is the fear that our country's health care system won't be there for them when they grow to need it.
Action Required
THE FEDERAL government can make a real, positive difference in the future of long-term care by taking two steps:
OBJECTIVE #4:
Facts
ADD HOME CARE
The need and desire for home care (providing medical care for people in their own homes) is growing all across Canada.
There is no, rhyme or reason to the way we are meeting that need. Across Canada we see a crazy quilt mixture of:
It cost $600 per day to operate an acute care hospital bed.
A long-term care bed costs $200 per day.
It costs about $50 per day to care for a patient in their own home.
The largest share of the burden of home care falls to family members, usually women.
Insights
Two major challenges
THE NEED and desire for home care is obvious. The challenge is to overcome government reluctance to add home care to our overall health care system and to avoid the perils of a private home care delivery system.
Despite repeated commitments, the federal government continues to delay action. For their part provincial governments will not commit sufficient resources to home care.
The corporations move in
CORPORATE players are eager to exploit Canada's home care market. Olsten Corporation has a contract to provide home care services to new long-term clients in some areas of Winnipeg. Olsten is the largest provider of for-profit health care in the USA.
Olsten's business practices alarm many. For example:
Action Required
THE FEDERAL government must make good on its promises to set out a national Home Care strategy. It must move immediately to:
Canada is not the only country in the world with a national health care program. However, it is the only nation with such a program that does NOT cover the cost of prescription medicines.
Canadians now spend about as much on drugs as they do on physician services. This adds up to about $362 per person per year.
The growth rate of the cost of drugs is higher than the rate of increase for hospital and medical services. Overall, the rate of increase in the cost of prescription drugs is four times the rate for all other goods and services in Canada.
Prescription drugs now account for 14.4% of health care spending.
Employers and governments continue to shift drug costs to individuals. The drug plans that do exist seldom provide 100% coverage for all drugs needed.
Marketing and advertising - not scientific research and development - account for much of the increase in drug costs.
Insights
PEOPLE are sent home from hospital these days quicker and sicker. It is no surprise that the use of prescription drugs is on the rise. The surprise is we have done little about it. Even more of a surprise is that what we should do was made plain 36 years ago.
In 1964, Emmett Hall's Royal Commission on Health Care recommended that the national Medicare plan be expanded, to include, among other things, prescription drugs.
This would be good social policy. It makes economic sense as well. Many studies have shown that a National Pharmacare Program can help control health costs up front and therefore save costs on the back end.
Many elderly people can't afford the medicine they need. These patients will often try to "stretch" prescriptions or skip them in an effort to save money. The result is a patient who gets sicker and sicker. This is bad for the individual and winds up driving the cost of treatment far beyond the cost of any prescription.
The current drug system has many weaknesses. And the greatest impact of those shortcomings is going to be felt down the road, as the baby-boom generation becomes a generation of seniors.
Action Required
Ottawa must act
on Pharmacare
The federal government promised Canadians a National Pharmacare Program during the 1997 federal election. It's time for Ottawa to live up to this promise and this responsibility. It must:
Write:
Talk to the world:
Visit our web site: www.savemedicare.com