Want real health-care reform? Rip up the Canada Health Act

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During the First Ministers conference, Prime Minister Justin Trudeau announced a new health funding deal totaling $196.1 billion over the next 10 years. This would include $46.1 billion in new funding, an “unconditional” $2-billion top-up to the Canada Health Transfer (CHT), wage increases for personal support workers and money for Indigenous health concerns and challenges.

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Trudeau triumphantly declared this deal to be a “major federal investment in health care.” The premiers were far less enthusiastic in their response. Quebec Premier François Legault, Saskatchewan Premier Scott Moe and others depicted the PM’s offer as “disappointing.”

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That being said, the provinces will ultimately accept the additional funding. The premiers know their backs are against the wall when it comes to saving their crumbling provincial health systems. They’ll begrudgingly go along with Ottawa’s plan, and continue to press for more money, staff and resources.

Yet, this is the wrong strategy — and has always been the wrong strategy.

Canadian health care has been a political and financial boondoggle for decades. Several recurring themes include: heavily bureaucratic process; long patient wait times for major and minor surgical procedures; shortage of doctors, nurses and other staff; lack of available hospital beds; inadequate stock of life-saving medicines and vaccines in hospitals (especially during COVID-19); and so forth. It’s led to an enormous waste of taxpayer dollars, structural inefficiencies and significant drops in patient satisfaction.

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For those who still cling to the foolish belief that Canada’s universal, single-payer health-care model is the gold standard for the world to admire, emulate and replicate, you would make a better case comparing it to cheap aluminum siding.

This isn’t to say that public health care should be eliminated in Canada. Far from it. What we need to do is reduce our reliance on universality and move towards a balanced two-tier health-care system.

“Oh, the horror!,” some of you may be thinking. “How could you make this insinuation, you vicious right-wing columnist? We would never dream of privatizing health care! It’s the third rail of Canadian politics: touch it, and you will die!”

Yet, in spite of the cadre of union leaders, New Democrats, left-leaning Liberals and other progressives who will scream bloody murder and feign outrage at the they thought of changing Canadian health care, they know better behind the scenes.

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It’s the third rail of Canadian politics: touch it, and you will die!

Contrary to popular belief, private health care exists in the Great White North. This includes laser eye surgery, MRI and diagnostic clinics, hernia operations (such as Ontario’s Shouldice Hospital), long-term care facilities, and private surgery clinics. As noted in a 2021 health-care policy paper by Shoo K. Lee, Brian H. Rowe and Sukhy K. Mahl, “Canada is considered ‘middle of the road’ among OECD nations, with a 70%:30% public–private split of health-care expenditures, slightly below the OECD average (73 per cent public and 27 per cent private).”

There’s no reason our health-care system couldn’t eventually become a balance of 50 per cent public and 50 per cent private. This would help reduce wait times for appointments and surgeries, use taxpayer dollars more prudently, wisely and effectively, and give sick patients the care they need and deserve in both health systems.

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The best way to kick-start this process is to rip up the Canada Health Act.

Passed in 1984, this statute is the most significant piece of legislative protection for universal health care. It’s an iron-clad agreement between Ottawa and the provinces when it comes to CHT funding. As stated in Section 10, “In order to satisfy the criterion respecting universality, the health-care insurance plan of a province must entitle one hundred per cent of the insured persons of the province to the insured health services provided for by the plan on uniform terms and conditions.”

You either play ball with Ottawa, or you’ll strike out

While the Canada Health Act doesn’t determine the specific delivery of health services, it ensures that provincial governments have no wiggle room when it comes to using federal health transfer payments. You either play ball with Ottawa, or you’ll strike out when it comes to holding your hand out.

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Meanwhile, premiers are restricted from considering significant health-care reform initiatives. Ontario Premier Doug Ford, for example, had to reiterate that Ontarians will “never have to use their credit cards” to pay for straightforward surgical procedures like hip and knee replacements being shifted to private clinics to clear the backlog caused by COVID-19. They’ll be covered by the publicly funded Ontario Health Insurance Plan.

The Canada Health Act serves no practical purpose in this country, other than to make public health advocates feel warm and fuzzy inside. It doesn’t relieve doctors and nursing deficiencies. It doesn’t free up more hospital beds. It doesn’t eliminate the bureaucratic nightmare that adults and young children face in doctors’ offices and hospital emergency wards. It doesn’t help sick patients get healthier. It doesn’t stop the enormous waste of hundreds of billions of taxpayer dollars in a bottomless universal health-care pit.

That’s why the premiers should switch gears and push for their elimination. Trudeau clearly won’t do it. Maybe Conservative Leader Pierre Poilievre, if he becomes prime minister, will do the right thing and kill him.

National Post

Michael Taube, a columnist for Troy Media and Loonie Politics, was a speechwriter for former Canadian prime minister Stephen Harper.