Dr. Jeff Turnbull, president of Canadian Medical Association, is shown at Ottawa General Hospital on Dec. 13, 2010.Dave Chan for The Globe and Mail
Canada's doctors want to expand the national health-care umbrella to include pharmacare and long-term care, and they want ordinary Canadians to join them in pressing their case to the government.
The Canadian Medical Association announced on Monday that it is beginning a public dialogue to let decision makers know what Canadians want in their health-care system - a consultation that will take place as provinces, territories and the federal government look ahead to the expiry of the Canada Health Transfer Program in 2014.
That program requires Ottawa to increase the amount it gives the provinces for health services by 6 per cent each year.
"We are very concerned that that transfer won't continue," Jeff Turnbull, the CMA president, told reporters. "It's a very significant amount of money for provinces who are already struggling to deliver health services."
But the association doesn't want to talk about financing at this juncture. Instead, it wants to persuade politicians that other services should be publicly funded - specifically drug costs and long-term care for patients who are taking up beds in acute-care hospitals. If those beds could be vacated, emergency-room backlogs would drop, said Dr. Turnbull.
The doctors know their message stands a better chance of being heard if the consumers of health care get involved.
"Once we get a consortium of individuals, other allied health professionals, doctors, patients, community members, then we'll actually have clout, then we'll have our decision-makers listening," Dr. Turnbull said.
To mobilize the public, the association has created a website on which Canadians can give their opinions about the health-care system.
The doctors will also hold town-hall meetings across the country to discuss the issues. They will commission policy papers and write to newspapers. And the 77,000 physicians who are CMA members all have patients, Dr. Turnbull said. "We would hope that those doctors as well would be out there informing their patients about the important aspects of the health-care system."
The CMA will appoint a committee to weigh the responses it receives and hopes to prepare an action plan by next fall. Once the vision of the health-care system has been shaped, then it will be time to talk about how to finance it, Dr. Turnbull said.
The Conservative government in Ottawa has given no indication that it is anxious to begin a dialogue about what will happen after 2014 - or to confront the competing pressures of rising budgets and an aging population.
When asked on Monday if the government plans to extend the health transfer after 2014, Jenny Van Alystyne, a spokeswoman for Health Minister Leona Aglukkaq, refused to answer directly. "We will continue to work with provinces, territories and health care professionals to look for ways to improve the health care system," she said.
Pamela Fralick, the president of the Canadian Healthcare Association, a group that advocates for sustainable, publicly funded care, said the discussion about the health-care needs of Canadians does not need to be linked to the deadline of 2014.
"So many things could happen at the political level that I don't think we should ever be tied completely to those sorts of milestones, Ms. Fralick said.
Her organization agrees with the CMA that pharmacare should be part of the Canadian system. "We are out of step with the rest of the world, or at least comparable countries, on that one," she said. Finland, Belgium, Great Britain, Ireland and Sweden, Germany, New Zealand, Australia and France all have national pharmacare programs.
In addition, the Canadian Healthcare Association says home care and respite care are should be discussed along with long-term care, Ms. Fralick said. And her group advocates more funding for illness prevention and health promotion.
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Three Questions
The Canadian Medical Association is asking Canadians for their thoughts about the health-care system of the future. The association wants the public to respond to three questions, which have been posted on the website healthcaretransformation.ca.
1. The law underpinning our system - the Canada Health Act - dates back to the 1980s. It covers only doctor and hospital care. Do you think it should be broadened to include things like pharmacare and long-term care?
2. It's important for citizens to feel they are receiving good value for their health care. What would you consider good value?
3. Patients and their families play an important part in their health care. What do you think Canadians' responsibilities are, now and in the future, regarding their health?