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CLHIA REPORT ON HEALTH CARE POLICY:
TOWARDS A SUSTAINABLE, ACCESSIBLE, QUALITY HEALTH CARE SYSTEM A KEYNOTE ADDRESS BY FRANK SWEDLOVE PRESIDENT CANADIAN LIFE AND HEALTH INSURANCE ASSOCIATION Presented June 3, 2009 National Press Club Newsmakers Lunch Today, it is my pleasure to release an important report on our health care policy by the Canadian Life and Health Insurance Association. Its overall conclusion is that Canadians deserve sustainable, accessible, quality health care services. As we all know, health care is a highly-charged political and emotional issue for Canadians. And I won’t pretend that some of the things I have to say won’t be contentious to some. So let me preface those remarks with the life and health insurance sector’s position on health care and our commitment to Canadians: Canada’s life and health insurance companies are committed to a quality health care system that is accessible to all Canadians and sustainable for the future. Canadians have a health care system unique to their own needs. It should stay that way. But we do not believe in simply throwing money into that system. We believe in making it better for Canadians – something that requires making changes. There are three key messages from this report that I would like you to take away from this speech:
The need to be mindful of costs is more pressing today than it was when Tommy Douglas, who we all know is largely viewed as the father of universal health care in Canada, raised that concern in the Saskatchewan legislature in 1961. Today, sharply-rising health care costs, together with limits on service delivery and human resource issues, are undermining a system Canadians have grown to expect will always be there for them. In the meantime spending on health care in Canada continues to outpace growth in government program spending thanks to an aging population, a rise in chronic diseases, emerging diseases most of us hadn’t heard of a generation ago, rising consumer demand and new technologies. In 1975, health care spending accounted for 7 per cent of GDP. Today it is over 10 per cent. In terms of per capita spending we are well above the OECD average, and if this trend continues, provincial spending on health care will consume more than half the total revenues from all sources in 6 of 10 provinces by the year 2020. We are now told the Ontario government will spend 70 cents on every dollar of its revenue on health care by 2020. B.C. is projected to spend 71 per cent of its revenues on health care by 2017. Costs like that simply aren’t sustainable. Clearly it is time we as a nation did the math on what health care costs will do to the other things that are vital for a healthy society – education, childcare, infrastructure and innovation. Sustainability of the health care system is of vital interest to all Canadians. Not only should the system protect the health of Canadians, it should also ensure an economic future and prosperity. A healthy workforce and an effective public health system support productivity and a globally competitive country. Next, let’s talk about refocusing our aims. Instead of worrying about how to fund institutions, let’s look at those who are most important in our health care system – Canadians themselves. An approach that puts patients first means that the funding follows those receiving treatment and care rather than bankrolling institutions. Repositioning patients to the centre of the health care system will improve outcomes and lower costs. As part of this, governments must invest in technology for such applications as Electronic Health Records for all Canadians. This would connect health professionals so that they can work together to produce better results for the patients and a sustainable system. It may be hard to believe that a country with an aging population like Canada would have a shortage in health human resources, yet it does. Our industry recommends governments work with professional associations to improve resource planning. In addition, we believe a truly patient-focused system means we must fill service gaps by rethinking scopes of practice and processes to better assimilate health professionals who are trained abroad. With respect to private-sector involvement, I realize Canada’s health care is commonly viewed as an exclusively public system. However, 30 cents of every dollar of health care services is paid for either through private insurance or by Canadians out of their own pockets. Simply put, Canada’s health care system already is a public-private partnership. It has been a shared public-private responsibility in both delivery and financing. It has proven beneficial to Canadians for many years regardless of what the myth may be. A good example is the privately-owned but publicly-funded Shouldice Hernia Centre in Toronto. What we are bringing to the table now are a number of possible approaches that we believe will lead to a better public health care system for all Canadians. To that end, we want to see funding that focuses on the patient and we want to build on the successful partnerships between the public and private sectors that are already an integral part of the system. We call on governments to seize more opportunities for strategic partnering with the private sector just as they have been doing to update Canada’s badly-worn infrastructure. On the third message, public health professionals have long argued for an emphasis on disease prevention and health promotion. We couldn’t agree more. Prevention and education are the ultimate way to lower costs and improve the health of Canadians. Both the public and private sectors should be focusing on overall wellness and prevention. Statistics have shown that for every dollar invested in wellness there is a $3 return. Our industry is urging government to provide financial and tax incentives for individuals and corporations to assist in enhancing the physical and mental health of Canadians. We are particularly concerned about higher disease risks in children such as obesity. Canada needs more health promotion policies and more direct assistance to public health programs to reverse this disturbing trend. As the population ages and life expectancy increases, there is rising need for continuing care. Yet continuing care is not available on a universal basis and what continuing care is available varies widely. Governments in Canada need to ensure that those living with chronic illness receive health care services that are integrated across the primary care system and co-coordinated by the family physician or health clinic. They also need to provide incentives for Canadians to manage their long-term and home-care needs, including through the purchase of private insurance. On the topic of prescription drugs, we are urging the federal government, the provinces and the territories to work with the insurance companies to ensure that no Canadians need take on undue financial hardship as a result of prescription drug costs. Our health care system was originally devised to ensure all Canadians could get the medical treatment they need without facing financial ruin. Should we not be just as concerned that Canadians get the medications they need in catastrophic illnesses without facing financial ruin? Nobody should have to choose between the drugs they need and putting food on the family table. Under the Canada Health Act, health care is universal. But access to affordable drugs is not. Access for all Canadians to prescription drugs was part of what Tommy Douglas called Phase Two in the development of Canada’s health care system. We believe it is time we finished the mission. That means establishment of catastrophic drug coverage for all Canadians, equitable drug pricing across public and private programs and a healthy generic drug program that is open to competition. Indeed access to drugs is vital to achieve fiscal sustainability and improve health outcomes for Canadians regardless of where they live. It has been quite a shopping list of changes that I have given you today. I would like to conclude by invoking Tommy Douglas’s name once again. His vision of universal health care was in two parts. First was the implementation of a public financing of the medical system. The second phase was an accessible and universal health care system beyond acute care – the very things we have been talking about today. Were he here today I’m sure he would acknowledge the first phase of his dream has been achieved. But the second phase is decades behind schedule. Our full report, entitled CLHIA Report on Health Care Policy: Towards a Sustainable, Accessible, Quality Health Care System, outlines in fuller detail the analysis and recommendations of the life and health insurance industry. I invite you all to read it. We may not have all the answers. But the time has come for meaningful and intelligent public policy discussion. We need to find some common ground rather than continued polarized debate. I’m sure most Canadians would agree. Thank you. |
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