| CLHIA Report on Health Care Policy - Towards a Sustainable, Accessible, Quality Public Health Care System
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CLHIA Report on Health Care Policy
Towards a Sustainable, Accessible, Quality Public Health Care System
June 3, 2009
EXECUTIVE SUMMARY
Few issues are as significant to Canadians as health care, and even fewer have as much impact on their lives. However, rising health care costs, service delivery limitations and looming human resource issues are undermining the health care system in this country. Spending on health care continues to outpace growth in government program spending and in overall economic terms, while the system performs only moderately well when measured against other developed countries. Some provinces project their health care spending to consume 70% of total revenues by 2020, severely compromising investments in other areas of the public purse such as education, childcare, infrastructure and innovation. Given these trends, Canada's health care system is not sustainable.
It is the purpose of the health care system to assure that every individual enjoys healthful conditions of life and has timely access to appropriate care from high-quality health personnel and facilities. Thus, in order to be comprehensive, the health care system should be guided by the following five principles: availability of essential health services across a range of disciplines, accessibility of health services for all Canadians, timely receipt of health services, high quality of health services provided, and affordability of health services.
The Canadian life and health insurance industry believes it is critically important to design a health care system to enhance not only the health of Canadians, but also ensure their economic future and prosperity. A healthy workforce and an effective public health system will support Canada's productivity and competitiveness in a global economy.
Our health care system has been conducted as a shared public-private responsibility in both delivery and financing, and has proven to be beneficial to Canadians for many years. The vast majority of health care services – providing universal, comprehensive coverage for core hospital and physician services – is financed publicly by government, with roughly 30% of services privately funded through private insurance or out-of-pocket payment.
Our industry strongly supports the fundamental role of the public health care system. We see private health benefit coverage as a complementary service to the public system, supplying private insurance plans and private care involving services such as dentistry, prescription drugs and optometry, as well as paramedic and work-related injury care, prosthetics, travel health and accident insurance, ambulance charges, private or semi-private hospital beds, and critical illness and long-term care coverage. Without this extensive array of private health and disability insurance coverage to supplement public health care, pressures on already scarce public resources would be even greater.
To enhance the sustainability of Canada's health care system, our industry proposes to build on the successful public-private partnerships that are already an integral part of the system. To ensure that all Canadians have access to quality health care, our industry recommends that governments work towards:
- a patient-focused approach to health care;
- affordable prescription drugs;
- an increased emphasis on wellness and disease prevention; and
- increased support for long-term/continuing care.
CLHIA believes that from both a delivery perspective and in financial terms, federal, provincial and territorial governments must take a patient-focused approach to health care to lower costs and improve health outcomes. A full range of health care services must be available to all citizens regardless of their ability to pay, and this can be achieved – as many developed countries demonstrate – through a blend of public and private arrangements. Thus, we recommend that governments seize more opportunities for strategic partnering with the private sector to increase efficiencies and fill gaps in delivery of services. As a first step, governments in Canada can develop a list of services to be delivered in public-private partnership and procedures that can be funded privately, as has been done in Quebec.
A patient-focused approach also means that governments must invest in technology, for instance, establishing an Electronic Health Record for all Canadians and enhancing connectivity for health care professionals to achieve better outcomes for patients and the system. In addition, the ready availability of experienced health care providers is essential in a patient-focused system. Our industry recommends that governments work with professional associations to improve health human resource planning for the long term. To fill service gaps caused by current shortages and better use resources, we further recommend that governments re-evaluate scopes of practice and current processes for the integration of health care professionals trained abroad.
Under the Canada Health Act, health care is universal, while access to affordable drugs is not. Consumers continue to face prescription drug costs that can become staggering. While supplementary insurance provides some drug coverage assistance, not all Canadians have such insurance. The federal, provincial and territorial governments must ensure that no Canadians need take on undue financial hardship as a result of prescription drug costs. Our industry further recommends that catastrophic drug coverage be established for all Canadians, that drug pricing be equitable across private and public programs, and that a healthy generic drug program that is open to competition be created. Consistent access to the most cost-effective drugs and the establishment of a minimal formulary are vital in order to achieve fiscal benefits and improve health outcomes for individuals regardless of where they live.
Another critical factor for the sustainability of the health care system is the need to move beyond a focus on episodic acute care. Public health professionals across Canada have long argued for a greater emphasis on disease prevention and health promotion within the system to improve health and lower costs. Our industry agrees. More investment by governments in a wellness and disease prevention approach will achieve better health outcomes for Canadians and contribute to the long-term sustainability of Medicare by reducing pressure on the system. Also, our industry calls on governments to provide financial and tax incentives for individuals and corporations to assist in enhancing and maintaining the physical and mental health of Canadians. Finally, we believe that more health promotion policies and more direct assistance to health promotion programs can reverse the trends of higher disease risk for children, such as the high rates of obesity that we are seeing at this time.
As the population ages and life expectancy increases, the need for continuing care is on the rise in Canada. However, continuing care is not currently available on a universal basis, and what support does exist, varies widely. Our industry recommends that governments increase support to Canadians for their continuing care needs. Specifically, governments need to ensure that those living with a chronic illness receive health care services that are integrated across the primary care system and are coordinated by their family physician or health clinic team. In addition, governments should provide tax and financial incentives for Canadians to assist them in taking greater responsibility for the care of aging and/or ill family members at home through the purchase of private insurance.
The Canadian life and health insurance industry feels strongly that the time for reform and revitalization is now. Our full report entitled CLHIA Report on Health Care Policy outlines in more detail the analysis and recommendations of the industry. CLHIA stands ready to play its role in supporting governments and other stakeholders to build a health care system of which we can all be proud.
Lengthy text; please download the PDF file to review this report.
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