Ontario Health Coalition

1. Enforce the Canada Health Act and its principles of universality, accessibility, comprehensiveness, portability, and public administration. Enforce the prohibition of extra-billing and two-tier access.

Currently, one of the federal government’s major roles in the health system is enforcement of the Canada Health Act to ensure that people across the country have access to a national health system under the principles of the Act.

Conservative Party

Enforcement of the Act is not in the platform.

In the past, the federal government has stopped provinces that have allowed extra-billing and two-tier healthcare through using the Canada Health Act. If the provinces are not held accountable for providing public coverage for a universal, accessible, comprehensive range of medically necessary health services, the national health system would be put in jeopardy.

Would appoint a three-person expert panel to resolve disputes concerning contraventions of the Canada Health Act. No details on how this panel would be appointed.

Negotiation with the provinces over contraventions of the CHA falls short of enforcement. The lack of details about who appoints the disputes resolution panel is a concern also. The Liberal government has come under criticism from the Auditor General for failing to enforce the Act. If the Liberals do not promise to stop two tier access, and to ensure the provinces provide a comprehensive range of medically necessary health services on a universal and accessible basis, the national health system is in jeopardy.

New Democratic Party

Would enforce the Canada Health Act more vigorously. Would strengthen the Act to prohibit private for-profit hospitals. Would define diagnostic tests such as MRIs as "medically necessary services" under the scope of the Act.

There is a clear promise here to enforce the Act. Ensuring that diagnostic tests fall under the scope of the CHA would mean that provincial governments would have to ensure public funding to these services and prohibit two-tier access.

All parties commit to restoring the federal portion of health funding to 25%. The differences are in what this will include and whether it is sustaining funding that will grow with population increases and inflation.

Conservative Party

Would increase transfers to $36.8 billion as per the 2003 Health Accord, including funding for a catastrophic drug coverage plan. There is no promise to maintain funding levels through setting a base transfer at a particular point with escalators to take into account population growth and inflation once that goal is met.

The platform includes a series of tax cuts as well as the promise for health spending. Whether the numbers work out or not, there is no clear formula to ensure that funding remains at 25% or more after the initial promise is met. There is no clear proactive mechanism in this platform to ensure money is spent on target areas. The promise is, instead, to report on spending after the fact. Therefore, provinces could continue to misuse health funding on tax cuts or non-health services, or to pay for more expensive private for-profit health care.

Liberal Party

Would increase federal portion of spending to 25% within 2 years not including their catastrophic drug coverage plan. Would provide additional funds in 2006 for drug plan as worked out with the provinces. Would increase the base transfer and implement an escalator. No details on what that escalator would be or whether it would maintain the transfer at stable levels.

There is no clear formula to ensure that funding remains at 25% or more after the initial promise, although the plan does explicitly call for an increase in the base federal transfer with an unspecified escalator that will continue after the initial promise is met. There is no clear proactive mechanism in this platform to ensure money is spent on target areas. The promise is, instead, to report on spending after the fact. Therefore, provinces could continue to misuse health funding on tax cuts or non-health services, or to pay for more expensive private for-profit health care.

New Democratic Party

Would increase federal share of spending to 25% within 2 years. It is not clear whether or not this would include a new pharmacare plan. There are no details on an escalator.

There is no clear formula to ensure that funding remains at 25% or more after the initial promise. There is no clear proactive mechanism in this platform to ensure money is spent on target areas. Therefore, provinces could continue to misuse health funding on tax cuts or non-health services. However, some private for-profit delivery will be stopped.

All parties commit to creating a catastrophic drug coverage program. The differences are in who will be covered and whether or not cost-control mechanisms are instituted to make drugs more affordable. This could be done through stopping direct advertising to consumers by pharmaceutical corporations, stopping the practice of evergreening i.e. changing the recipe for a drug very slightly so as to extend patent protection and keep the price high, tighter regulation of drug marketing practices, tighter controls on new drug prices, and bulk purchasing.

Conservative Party

Propose a catastrophic drug plan (targeted to those with drug costs of $5,000 or more per year) to be provided by the federal government onto which provinces could sign if they want. Would reduce the federal regulatory regime for introduction of new drugs and natural medicines. No promise on reducing costs of drugs.

The proposals to reduce the regulatory regimes for approval of drugs and natural medicines are also notable as they could result in fewer protections for consumers.

Liberal Party

Propose a catastrophic drug plan to be worked out between the federal government and the provinces. No promise on reducing costs of drugs.

There are few details about this plan. Notably, there is nothing in the platform to address the rising cost of drug plans.

New Democratic Party

Propose to take steps to control the price of drugs including stopping the practice of evergreening (see top of page), increasing public research, instituting bulk purchasing, establishing a pharmaceutical crown corporation to research & provide drugs at cost, and examining the drug patent legislation. Propose a catastrophic drug plan as an initial step to be expanded later. Would establish a Royal Commission to look into drug prices. Would remove the GST from children’s medicines, and from medical equipment. Would strengthen the food and drug approval process.

Contrary to the promise of the Conservative proposal, the NDP would strengthen the federal review of drugs and food before approval.

As care has been moved out of hospitals into the community, the modernization of public health care in Canada relies upon the creation of a set of criteria covering homecare services based on the principles of the Canada Health Act. Inclusion of personal support and homemaking services that help prevent illness and injury and enable elderly people, persons with disabilities and those with chronic illnesses to live independently would be a major gain for Canadians.

Conservative Party

Promise to create a definition of what services would be covered under a Home Care Plan. No details on this. Promise to meet the Health Accord commitments to funding for Home Care. Propose an array of tax credits for families to take care of elderly at home.

There is no promise to ensure this is a non-profit program based on CHA principles and including supportive care.

Liberal Party

Propose a new program that will include post-acute homecare, rehabilitation, palliative care and mental health. Propose to establish a clear basket of services to be covered. Propose funding and tax credits for families to take care of elderly and others at home.

There is no promise to ensure this is a non-profit program based on CHA principles and including supportive care.

New Democratic Party

Promise homecare program as a priority, including supportive care for the elderly. Promise to ensure public non-profit delivery of these services. Propose enhanced tax credits for families to take care of elderly and others at home.

Supportive care is included here. There is no clear promise of providing these services based on the principles of the CHA.

There is significant new funding promised by every party. Ensuring that the new funding is not wasted by funneling funds into the profits of private health companies will enhance the sustainability of the public health system. There is no country in the world able to deliver a universal health system through for profit corporations because it is simply too expensive and reduces democratic control.

Conservative Party

"We also support the exploration of alternative ways to deliver health care. Moving toward alternatives, including those provided by the private sector, is a natural development of our health system." Stephen Harper, Toronto Star article "Why Fear Private Sector" October 2002.

During the election campaign Mr. Harper has said that privatization of health care delivery is up to the provinces. Such privatization threatens the future of our comprehensive, universal, accessible public health system.

Liberal Party

There is no promise to stop privatization in the platform. Mr. Martin has appointed Bruce Young, a prominent lobbyist for health care privatization as a senior campaign organizer in B.C. Mr. Martin also appointed a parliamentary secretary for private public partnerships who mused publically about private ownership of hospitals.

Such privatization threatens the future of our comprehensive, universal, accessible public health system.

New Democratic Party

Would stop for-profit hospitals and establish public non-profit homecare.

This is a start. However, other privatization including in primary care, diagnostic clinics and other health services must be stopped and rolled back.