MayDay 2011: Public Health Care and CASH Care
Which system do you want?
Guess who’s side the Conservatives are going to be on?
Who do you want to be at the table when the Health Care Act has to be negotiated in 2014? I’m young(er) and I don’t care, but I’d hate to be a Boomer hitting retirement age and facing the prospect of privatized everything just when my cash-flow stops.
Quotes from “As health-care costs soar, business seeks a remedy”
Canadian businesses are taking a leadership role in tackling the country’s health-care crisis, launching an ambitious research project next month aimed at redirecting the public debate over how to solve the problem.
The move represents a significant and unified step into the health-care breach, an acknowledgment that costs are unsustainable and an assertion that politicians have been unable to come to grips with the long-term nature of the challenges.
Some of the country’s biggest banks, insurers and other major companies are funding the project, called the Canadian Alliance for Sustainable Health Care, which will be unveiled next month by the Conference Board of Canada. While a number of think-tanks have latched onto the health file, the new group bills itself as the largest project on the topic, and it plans to issue about a dozen pieces of research in its first year.
The idea is to evaluate which ideas can best ensure that health-care costs don’t become unmanageable for taxpayers – and for corporations.
Health care has been the number one issue for Canadians during this election, according to polls. But Federal Finance Minister Jim Flaherty said during an interview earlier in the campaign that “realistically there will be no serious discussion [on health care] this year anyway.”
“There are six or seven provincial elections this fall, I’m not sure if any of the provincial politicians are going to raise the issue,” he said on April 6. But he added that at some point, “somebody will take the lead on this.”
Although the money being committed to the new project is relatively small, at $1.6-million, the companies believe they can’t wait for government to fix the problem. The group has been working successfully to expand its roster to include hospitals and retiree groups, among others, to broaden its support.
Private sector groups see an opportunity to strike while the topic is hot and on the minds of Canadians.
“In my view, the medical system here is a total and utter mess,” said Bill Holland, executive chairman of mutual fund company CI Financial Corp., who has donated more than $46-million to Toronto-area hospitals, sometimes insisting that the money be used to reduce waiting times and improve efficiency.
Other corporate leaders are making moves as well. Fairfax Financial CEO Prem Watsa has had employees studying the health-care system, and potential fixes, on the company dime. “An open and honest debate about the future of health care in this great country of ours should be encouraged,” he said, adding that the keys are improving access, innovation and the value of each dollar spent.
While corporate Canada has a long history of philanthropic donations, executives – particularly on Bay Street, whose leaders have come to know health care intimately from seats on hospital boards – are finding an increasing appetite for their private-sector skills.
Don Drummond, former chief economist of Toronto-Dominion Bank and the man Ontario recently appointed to solve its fiscal mess, will deliver a lecture at Queen’s University on Friday, telling his audience that if they value health care they’d better start taking matters into their own hands.
“My lecture is basically saying, ‘Let’s grow up and we can actually do some things without government,’” he said. He intends to say that governments will only follow on this file, which is why it’s essential to broaden the field of engaged stakeholders. “Governments and companies are no longer willing to tolerate ever-rising health-care costs that impair their bottom lines,” Mr. Drummond will say.
Canadians spent about $191.6-billion on health care last year, up from $171.9-billion in 2008, according to the Canadian Institute for Health Information. The amount that governments are spending on health accounted for 8.4 per cent of the country’s gross domestic product in 2009, compared to 5.4 per cent in 1975. Health care is on track to account for 80 per cent of Ontario’s budget by 2030, up from 46 per cent now, Mr. Drummond says.
At the moment, fixes are being applied in a haphazard fashion. The Trillium Health Centre and Credit Valley Hospital, both in Mississauga, announced a voluntary merger this month, an unusual step that’s expected to become more common. It will result in one board, one CEO, and free up money being spent on administration so more can go towards treating patients, said Neil Skelding, who is the CEO of RBC Insurance and is on the Credit Valley Hospital’s board.
Politicians have shown little appetite for major health-care reform. Critics say the only thing federal politicians are talking about is the 6-per-cent annual increase in health transfers to the provinces, part of a 10-year deal that expires in 2013-14. “The federal government should not be thinking about 6 per cent, because this isn’t about money and we’re done,” said Jeff Turnbull, president of the Canadian Medical Association. “We need an overarching strategic plan for how we’re going to transform health care.”
The CMA is forming a panel that will recommend ways to make the system more accountable. Mr. Drummond will be on it. The Ontario government’s health-care spending, which was $43.5-billion in 2009, is ballooning, and getting it under control will be necessary to fix the province’s finances. But governments tried to cut health-care spending to fix the deficit in the 1990s and that didn’t work. This time around, Mr. Drummond wants to see real change.
“Taking money out without doing the appropriate reforms really is a two- to three-year wonder at best, and then misery after,” he said.
That’s what the corporations are hoping to prevent. The investors in the Canadian Alliance for Sustainable Health Care include Sun Life Financial, TD Bank Financial Group, Bank of Nova Scotia, Canadian Imperial Bank of Commerce, The Co-operators Group Ltd., IBM Canada Ltd., and the Hospital for Sick Children, according to a list obtained from one of those sponsors.
Amount that hospitals cost in 2010, up 6.2 per cent from 2009
Percentage of total health spending paid for by the public sector in Canada on average
Percentage of total health spending paid for by the public sector in the United States in 2008
Total health-care expenditure in Canada in 2008
Total health-care expenditure in 2010
Source: Canadian Institute for Health Information