The Health Accord talks: what it’s about, why it matters, and how it affects the future of public health care
Post by former CYH blog team member Jannie.
While our federal and provincial/territorial governments argue amongst themselves over renewal of our Health Accord, civil society groups are demanding more public participation in the process. But amidst the political maneuverings and economic formulas, there are few reader-friendly resources to learn about and engage in the Accord. This summary of the current status of the negotiations will hopefully contribute to more public discussions in the important months ahead.
The Health Accord is the national agreement that determines how much federal money will be transferred to the provinces and territories for health care – the Canada Health Transfer (CHT). The current ten-year Accord will expire in 2014, and negotiations for renewal were set to begin this year. But before these meetings could take place, the federal Conservative government undermined the process by imposing a health funding package on the provinces/territories without consultation or discussion. Under the new plan, federal health funding will continue to increase at the current rate of 6% per year until 2017. After this time, subsequent increases will be tied to growth in nominal Gross Domestic Product (the rate of economic growth plus inflation), with minimum increases of 3% per year. CHTs currently account for about 20% of provincial/territorial health budgets (compared to 33% in the 1960s), and the new funding formula will mean a further decrease of about $21 billion. To make up for the shortfall, Stephen Harper instructed the provinces and territories “to innovate and to reform” (paving the way for privatization).
Furthermore, the equalization program – which transfers additional health funds to less wealthy provinces – will also end in 2014. This has been the primary means of promoting equity across the provinces, enabling those that face unique challenges (due to, for example, remote communities, a smaller tax base, the decline of a major industry, etc.) to provide public services at “reasonably comparable levels” with the other provinces. After this program ends, the amount of federal health funding for each province will be determined on a per-capita basis (calculated based on population size). All provinces will see a decrease in their health funding except for Alberta, which will receive around $850 million more in health funding. The federal government does not have plans to renew the equalization program.
And finally, the Health Accord is not just about money. The Canada Health Act is the federal legislation intended to protect the core values of publicly-funded health care (Medicare), and provinces/territories that violate any of its criteria or conditions are penalized with a reduction in their CHT. However, the federal Conservative government is stepping away from their responsibility to enforce the Act, as the new health funding package will be transferred to the provinces/territories with no restrictions on how it is spent. Increasing cases of violations by private medical clinics are escaping penalty, inciting calls for more national leadership to ensure that Medicare remains universal and accessible to everyone.
These are important decisions that are being made about how our public funds will be used towards our public health care system. The recent developments are setting a new precedent where health is viewed not as an essential service and national priority, but rather a secondary consideration that is contingent on the state of the economy. What role do we have as the people who pay for and use Medicare? A recent action outside the provincial/territorial premiers’ meeting in Victoria brought the message that youth want to and should be more involved in these discussions. A number of roundtable discussions and town hall meetings are strategizing around how we can strengthen Medicare through the Health Accord process. Others have been active in collecting petition signatures, organizing a letter-writing campaign to Members of Parliament, and planning future activities at the next premiers’ meeting in Halifax this July. Check Your Head’s health care workshop has also served as a means to share information and dialogue about Medicare.
These are just some of the many actions that civil society is engaging in, and this can also be a forum to continue the conversation. Feel free to share other initiatives, resources, or your vision for Medicare in the Comments section below.