There has been a lot of debate of whether the federal or provincial government should take a leading role in health care. This essay will argue that the federal government should take initiative and play a leading role in health care. The federal government should take a leading role for the following reasons; in order to reflect how the health care system should run in the country as a whole, as they are also the main financial contributor to the medical system, and to avoid any unequal services based on location. The federal government initiated the medical system and established Medicare in Canada. They have run and set up most of the policies for which the provincial governments should follow, they have also over watched over the program for the longest to make sure everything runs smoothly nation wide. In addition the federal government is the main financial contributor to the provincial governments even though they can opt out of the government policies and plans in exchange for not receiving any funding if they wished but they have all relied on the federal government for funding and have followed their policies. Thirdly if the medical system was provincially based it would mean that different provinces would have different advantages, and in worst case scenarios one province could switch over to private medical care, meaning that not everyone would be covered anymore and looking at the country as a whole some people would not have the same rights to receive medical care as others.
Firstly, the federal government took the first step and iniated the current policy and created the medicare that we know today. The Health Canada act was first passed in 1984 generating universal health care for all Canadian citizens. They passed a set of policies that all provincial governments have to pass in order to receive medical funding, “insurance must be universal …, comprehensive… , portable across provinces, administered by a public enterprise…, and free of user charges for core services.”(Sessions and Detsky 2) These policies indicate that everyone should receive equal benefits from medicare for all Canadian citizens and that no one person will receive any more special benefits than the next; that every person will receive any necessary core-medical procedures for free such as visits to a practitioner, hospital visits and related procedures; that every person has the right to medical services no matter their originating province. The federal government also tries to run campaigns to focus on health concerns on certain aspects of society, such as tobacco, alcohol, and obesity in young children. The federal government has taken initiative to address these issues by advertisements and campaigns in smaller and bigger communities to raise awareness about the issues. People also seem to be trust and rely on the federal government with their health care plans and policies,
The Canadian Constitution does establish that all provinces should have sufficient resources to provide citizens with reasonably comparable levels of public services for reasonably comparable levels of taxation,… moreover, said to have the duty of upholding the “sacred trust” of preserving the key principles of the health insurance program(France 24)
even though the provincial governments handle all of the main insurance plans and care incentives of the medical facilities in the province, the citizens of the nation trust the federal government to be an “overseer” of operations. Another reason for the federal government to reflect how the health care system should run is because they are the main financial contributor, which is my next point.
The provincial government does not have to listen or oblige to anything that the federal government has to say when it comes to medicare, they can choose to solely set up any system they want at the cost of losing the federal funds. Though most provincial governments cannot sustain the cost of the whole medical system by themselves due to other cost-heavy provincial projects so they end up relying on the federal funding for medicare and although the federal government is the main financial contributor to the health care system, they are not the leading insurance planners. The insurance plans are left up to the provincial government to construct, and as long as they follow the five main points of the Canadian Health act, they would get the freedom to use the funds as they liked and would receive funding from the federal government without having to pay back any surplus. There are many issues with having provincial governments decide what their policies might look like, first off the system may not look the same in each province,
The range of variation in this regard… is greater than would be implied by overall levels of public funding… the highest spending province (Alberta spent about 30 percent more per ca pita than the lowest spending province (Quebec)… [yet] Quebec has the highest rate of physicians per ca pita than any other province – (Tuohy, 23)
Quebec, the lowest spending province has the most amount of physicians, this could mean a variety of things such as: lower wait times at clinics and hospitals, greater choice of doctors to pick from, and more care for the ageing population as more of the baby boomers reach retirement. Thus Quebec could have a greater advantage during the upcoming few years as more and more people reach the retirement age and as they have more physicians to provide care for them unlike their provinces as it is a pretty common problem, “The number of doctors per ca pita in Canada will decline by 2015 without more foreign-trained doctors”(“Canada’s doctor shortage”) With more people hitting the retirement age (even the doctors themselves) this could prove to be a big problem without some implementation of the federal government if not dealt with before the problem becomes too big to solve. Another issue is that some provinces in Canada receive more funding than others, “Some provinces receive additional federal funding through Equalization payments. Equalization payments enable provincial governments to provide reasonably comparable levels of public services at reasonably comparable levels of taxation. “(Health Canada) If tax payers pay more in one province compared to the next and receive unequal benefits or different advantages over one another, that means one province could be favoured over another for health care benefits or wait times while the point they are trying to strike with federal medicare is universality and equality along all citizens. When it comes to taxes also every province pays GST thus every citizen’s money is being pooled towards a portion of the Canada Health Act that their citizens are paying, “health care entitlements are due to Canadians not on the basis of social citizenship, but rather are owed to them because they have purchased them in advance through their taxes,” (Bhatia 6) depending on the province and their population more taxes would go towards the government, yet the funding on medicare is spread unevenly (as seen in an above citation) showing that there is an inequality, especially since Alberta is getting the most funding yet their citizens pay no HST or PST just GST, with the Albertan government not getting any taxes from their citizens since it is all going to the federal government, and since they are receiving the most funding from the federal government creating an imbalance along the nation which leads me to my next point about inequality of medical insurance throughout the country.
Inequality between provinces brings me up to my next point. Having one province be preferred in medical services would mean that some people would prefer to live in one province rather than another, which would force existing citizens to migrate from one place to another hurting the economy when they are all suppose to have equal oppourtunities. The government also has many campaigns for trying to improve the health and well being of the nation, they have had several meetings and discussions with leaders yet not everyone attends these meetings, “the federal government advocated a consultation process that included the provinces and consultations of the population and was aimed at establishing a set of national public health goals in Canada. (Quebec did not participate in this process.)” (Bernier 6) when a province does not participate in campaigns that help benefit the community as a whole the people living in that state tend to suffer due to less awareness of a certain matter such as obesity or the effects of smoking tobacco. As a result people could be less healthy and as a consequence the state may need more funding in the end result due to disregarding such meetings or consultations. Another issue is with the deal between the federal and provincial governments is the ending of contracts or deals that the two systems might have set up,
One time bomb is set for 2013, the expiry date of a deal between the federal government and the provinces to transfer C$25 billion a year into provincial health coffers… Quebec added a health tax to its 2010 budget, requiring individuals to share a burden directly that was previously paid out of general public revenues… And like most rich countries, Canada’s population is ageing, and the demands on its health system will soar when the baby-boom generation retires (“Follow the leader”)
when Quebec sets up a new tax that means the citizens have to pay more out of their own pocket to receive health benefits, though this is considered fair by the federal government since a province can choose to pay for it’s own medicare and not receive funding instead of having to follow the policies and guides that it has set up. Though again, this can causeone province to be favoured more than another between citizens, if the citizen’s of Quebec do not want to pay the extra taxes or think that they can receive better or equal benefits for a cheaper price than they might be enticed to move to another province or territory. Even more importantly is that medicare can apply to all citizens where ever they are in the country, and with different systems being constructed in one part of the country than another, a citizen from a certain province may have absolutly no right to free medical attention when visiting or travelling elsewhere in the country which would incredibly decrease the quality of medicare.
An opposing argument for a strong federal role in health care is that the federal government should focus more on the security of the nation rather than the well being of the country since Canada’s military is not one that would stand out on the global standpoint. With that being said people believe that the federal government should pour more of its funding towards military spending then have more expenditures on health care. However there are many issues with changing the government shift’s in funds. Firstly increasing military funds, would mean decreasing funds on other sectors of finance, and to say the least the funds of war are not cheap, “Canada’s efforts in Afghanistan will carry a total price tag of about $14-billion to $18-billion by the time troops are withdrawn in 2011 “(“Price tag”) The war in Afghanistan has been a very costly war, and if we expect the federal government to finance more military expenditures than the provincial governments would have to rely on themselves for funding possibly causing an imbalance in medical insurance plans. Secondly, Canadians generally see themselves belonging in more peace-keeping missions than war itself, “Canadians see themselves as global peacekeepers, and this is reinforced in the Canadian press, vividly displayed on their currency, and echoed in conversations on the street “(Nunez 2) With that being stated we can say that the general public would prefer Canada to continue on its peace keeping roles in the world and still hold that image of peace keeping among nations rather than create a new name for itself as a strong military leader. Not only do the citizens like the strong peace keeping role that Canada has upheld in the last few decades, people also want the federal government to rethink their role in health care, “A recent poll by Ipsos Reid conducted for the Canadian Medical Association… reveals that Canadians want the federal government to re-think its priorities to include health care. “(“CMA”) When the citizens also want the federal government to get included in health care they are most likely going to elect representatives who share their points of views in order to make it happen. One purpose of having an elected government is to represent the view of the majority of the nation. If the representatives do not listen to the citizens then this could provide some problems for the nation, however there are always up coming elections to elect new electives in the house of commons, but the issue of the senate being appointed for life by the Prime Minister still stands.
Another opposing argument is that the provincial governments have been running their medical insurance plans for years without any direct interference from the government and that everything has been running smoothly without any direct reform. My rebuttal to that argument would be that since the federal government is the head government role in the nation, they would have the right to implement any plans or reforms that they wish to do. There are still many issues with the current health care system such as: long hospital wait times for emergency walk-ins, decreasing amounts of physicians with an increasing senior age population, not enough beds, extremely long wait times for necessary procedures and surgery. Most of these issues are going to need to be addressed within the next few years, if not the medical system will no longer be able to sustain itself the way it is functioning today. The reason the federal government should taking a leading role when it comes to there matters is because these issues effect the whole nation equally and not just one specific province. The federal government also has several agencies and branches to research and study statistics when needed, and out of any form of government in Canada they would have the most funding to go out and learn about the expenditures needed for these cases. Another issue that has been brought up is experimentation between provinces in seeing what could possibly help benefit the medical system in a better way. Some provinces have tried new technologies or different procedures to help improve the system. Yet not all provinces have put themselves out there and tried something new, new experimentation projects could be lead by the federal government as well passed out to provincial governments to be used as test subjects. This could potentially help us see what can improve or even worsen our medical system by examining results of these experimental procedures, systems, or policies. For example if we give each province a different set of policies to implement in different sectors of the health care system and one province shows that one policy can improve the medical system, we can take that policy and pass it on to other provinces to improve efficiency.
In conclusion, this essay discusses reasons for why the federal government should take a leading role in health care. Firstly, it is because that they are the leaders of the country, the representing role models for the nation and the highest form of government that exists in the country. Secondly it is because the federal government financial contributor to the health care system and it’s where all of the funds come from, it should be the job of the government to have a say in where that money could go instead of leaving it all up to the provincial government. Thirdly, when having plenty of different provinces, and most of the policies being made up by the provincial government, there is a large potential for the provinces to have unequal benefits compared to one another. With unequal benefits comes unequal coverage when going from one place to another. If the federal government took a leading role it could represent a new and better health care for Canada and the issues of misspending or unequal coverage would be eliminated creating a surplus in the economy.
From the creation of the Canada Health Act in 1984 the federal government has been the over looker of the policies and has created the medicare we know today, they have set up the bases and of the foundation of Canadian health care and no one says they cannot construct the building, they have poured billions of tax dollars and given it to the provincial government to decide how to spend the funds, this is a system which could be improved by the federal government if they put more labour force towards it and set up more narrow policies compared to the broad ones today. If the federal government focuses on where the spending goes than they can cut wasted spending achieving a surplus for other government services. Then there is the portion of taxes paid by the people that are not recieved back due to uneven distribution of heath care funding. This creates an unfair advantage between provinces, especially if one province has a more efficient system while the less efficient system receives more funds, if the federal government were to overlook operations more carefully each province could be working at an optimal rate, another thing that would improve the health care in the province is that the federal government could give some provinces trial or experimental procedures where we could learn what could potentially improve the system and pass it along to other provinces bettering the health system of the nation as a whole. These are the main arguements for why the federal government should take a leading role in health care.
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