By Jason Fekete, Calgary Herald
Canada's 13 premiers say ballooning health costs are the "elephant in the room" and tackling it demands proactive measures from Ottawa and the provinces — but not in the form of controversial user fees.
As part of their efforts to slash health costs and improve care, premiers said Thursday they support Saskatchewan's pledge to fund clinical trials for multiple sclerosis, but are in a wait-and-see mode on whether they'll follow suit in their own provinces.
Health care and sustaining the economic recovery are the top agenda items for premiers gathered in Winnipeg for the annual Council of the Federation meeting, which wraps up Friday.
While there appears to be consensus among premiers that health-care costs in Canada are unsustainable, the prescription for fixing the ailing system isn't so clear.
"It's the elephant in the room for all of us," explained Quebec Premier Jean Charest. "Canada has a problem. The cost of health care is rising very rapidly."
Indeed, several governments are spending more than 40 per cent of their annual operating budgets on health care, making it increasingly difficult for provinces to find additional dollars for other social programs.
In Alberta, health care is gobbling up about $15 billion out of a record $38.7-billion budget. Yet, the province receives about $200 less per person in per-capita health transfers from the federal government than other provinces — amounting to a $700-million annual hit to Alberta coffers.
The federal health funding deal expires in 2014 and the premiers said they want to begin negotiations on renewing it to ensure Ottawa's health spending keeps pace with provincial medical budgets, which are growing about six per cent annually.
"We expect the federal government to be a partner in regards to health care," Charest added.
"We have to start, really strategically as provinces, looking at what are going to be the future costs in health care and what exactly is going to be our ask from the federal government," said Prince Edward Island's Robert Ghiz.
British Columbia Premier Gordon Campbell agreed health-care costs remain "a significant issue" that must be addressed if the system is to survive.
He urged premiers to dedicate more resources to preventive care, which he argues will save cash-strapped governments billions of dollars a year. Also, all provinces should follow the western premiers' lead and agree to bulk pharmaceutical purchases, he said, which will save billions more in drug costs.
"We should be looking at ways that we can bend that health-care cost curve down," Campbell said.
However, several premiers said adopting user fees in the system to pay for increasingly costly treatments and drugs is not the answer.
Alberta Premier Ed Stelmach said the health system must dramatically improve in both access and care before the provinces even consider user fees.
Saskatchewan Premier Brad Wall, Ontario's Dalton McGuinty and Charest also ruled out adopting user fees to help pay for services.
"User fees are not popular," Charest said.
McGuinty added: "They are not effective and in too many cases they act as a deterrent to patients who should have obtained that medical service."
The Ontario premier said the federal and provincial governments are wasting cash with individual drug-approval agencies, when the process could be streamlined.
"Those are luxuries we can no longer afford," he said. "We should be working as hard as we can together to ensure . . . as many of our health-care dollars as possible can go into front-line services and to patient care."
Several provinces offered moral support to Saskatchewan, which is willing to fund clinical trials for an experimental treatment for multiple sclerosis, but weren't necessarily willing to follow Wall's lead.
The so-called "liberation therapy" is based on work by Italian neurologist Dr. Paolo Zamboni, who argues a narrowing or blockage of veins in the neck that drain blood from the brain may cause MS symptoms. However, two new studies released this week raise doubts MS is a vascular disorder.
"We welcome all partnerships but we're not going to be urging anyone to do anything," Wall said.
He noted Yukon looks willing to partner if the province proceeds with clinical trials, while Alberta, B.C. and Saskatchewan have pledged to co-operate to share general MS research.
McGuinty said Saskatchewan's willingness to proceed with clinical trials is "good news for all of us," and that he's willing to share ongoing research being conducted at McMaster University.
Stelmach said he has "no problem" participating in the trials if the science justifies it, and said the province is doing its part with research at the University of Calgary's Hotchkiss Brain Institute.
The premiers' meetings come just days after a new report from Canada's doctors called for the country's health system to be "massively transformed."
The policy document from the Canadian Medical Association said the underlying principles of the Canada Health Act — universal access to health care for Canadians — are not being met.
The study called for more incentive programs, such as pay-for-performance initiatives, in which health-care providers are rewarded for achieving a set target, as well as the need for a patient charter — initiatives Alberta is already pursuing.
"We have an opportunity to show leadership to other provinces," Stelmach said.
On the economy, premiers said they are looking to maintain a strong economic recovery, find jobs for all Canadians and avoid a double-dip recession.
They're demanding provinces have a greater role in federal immigration policies, including immigrant settlement, and urged Ottawa to reconsider recent efforts to cap provincial nominee programs.
Key to a strong economy in the future is the creation of a long-term federal infrastructure strategy, premiers noted.
Federal infrastructure stimulus spending is to expire next March and the premiers hope the funding tap won't shut off if some projects aren't yet completed.
However, they agree governments have done their part to spur the economy and that it's now time for the private sector to take a larger role in job creation.
"Governments have done a lot to stimulate the economy. Now it's time for the private sector to step up and governments to try and take down unnecessary burdens for the private sector and barriers for the private sector to invest," Campbell said.
"We're going to give the baton to the private sector," McGuinty added. "We can't together (as governments) continue to stimulate the economy."