Sunday, March 5, 2017

-On this question of provincial autonomy, the holdouts are right to hope for more. Health care is an area of provincial jurisdiction. Each province created its own health insurance system, and each manages its own system and adopts the laws that govern it. From an economic perspective, federal intervention poses a problem.----------Julie Ali · University of Alberta I disagree that the federal government should get out of provincial health care decision making. I applaud Mr. Trudeau for his courage in forcing provincial governments to put money where it is most needed--in mental health services provision. In Alberta, the mental health system is a disaster. Directed funding by the federal government is absolutely essential since the GOA has abdicated completely its duties to citizens with mental health needs. Why is it that a citizen suffering a heart attack gets a bed at a hospital but a citizen suffering from a mental health crisis is refused? This is the case in Alberta. I don't believe that provincial governments are doing a good job in terms of health care services delivery. Decentralization has not not been accompanied with innovation in Alberta. We have had costly payouts to CEOs of regional health authorities and stagnant service delivery. Centralization of health care services into two health authorities-AHS and Covenant Health has reduced some of the rich excesses of the past. Further pruning is required and it would be best if we had one health authority. The federal government is responsible to ensure that taxpayer dollars are used effectively-on patients -and not on bureaucrats, wasteful executive pay and multiple health authorities. I believe Mr. Trudeau's decision to put the money where the need is--will ensure that at least some of the cash trickles down to our most disadvantaged citizens-those with mental health issues who are treated with disrespect and discourtesy by the system. I believe that such a commitment of cash and federal oversight is long overdue. If the provincial government can't do the job, let us get the federal government to provide oversight in the form of directed cash injection into the mental health system that is appallingly underbudgeted, and in disarray.


If the provinces can't do the job of figuring out where the problems are in health care services delivery such as the major messes in the mental health care system then let us get the federal government to direct this sorry crew of health ministers who are clueless. Let us get directed funding of mental health services so that the provinces do their jobs and fulfil their responsibilities to the most disadvantaged health care consumers-those with mental health issues.
Why would we want the federal government to get out of directing the provinces in the matter of health care? It is patently clear that the provinces need all the help they can get.
Mr. Trudeau is to be commended for ensuring that directed funding goes to the most despised health care consumers--those with mental health issues that are not dealt with respectfully or responsively in Alberta and probably all over Canada.
It's time for a change and Mr. Trudeau is leading this change in mental health care services delivery.
#Mental Health Crisis #MakeTheDealABHealth


The federal government spends 50 per cent more on health care than it did 10 years ago. Do you have easier access to a doctor? Is your emergency room wait shorter? Yet the provinces alway…
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http://vancouversun.com/opinion/opinion-ottawa-should-leave-health-care-to-the-provinces


Opinion: Ottawa should leave health care to the provinces

Published on: February 21, 2017 | Last Updated: February 21, 2017 6:00 AM PST
Vancouver  B.C.  January 24, 2017  Working to save women's lives--B.C. Health Minister Terry Lake and members  Vancouver Coastal Health along with  Atira Women's Resource Society  an announced a new building for substance  treatment for women in Vancouver's Downtown Eastside.   Mark van Manen PNG Staff  photographer   see  Erin Ellis Vancouver Sun/Province  /News    stories  and Web.  00047394A [PNG Merlin Archive]
B.C. Health Minister Terry Lake MARK VAN MANEN / PNG
The federal government spends 50 per cent more on health care than it did 10 years ago. Do you have easier access to a doctor? Is your emergency room wait shorter? Yet the provinces always want more federal funds, whereas Ottawa wants to limit the growth of its contribution while also deciding how a part of the money will be spent.
British Columbia has just signed a health care deal with the federal government, with the province’s Health Minister Terry Lake saying, “I would be lying if we didn’t say we were hoping for more.” This leaves four provinces—Quebec, Ontario, Manitoba, and Alberta—still engaged in a wrestling match with the federal government. There are billions of dollars at play, but Ottawa’s insistence on targeting mental health and home care is seen as interference.
On this question of provincial autonomy, the holdouts are right to hope for more. Health care is an area of provincial jurisdiction. Each province created its own health insurance system, and each manages its own system and adopts the laws that govern it. From an economic perspective, federal intervention poses a problem.
Decentralization and innovation
As a general rule, the responsibility for a public action should be entrusted to the authority that is closest to those concerned. In political theory, this is called the principle of subsidiarity. Applied to a federal framework, it means that Ottawa should only take care of political, social, and economic problems that cannot be dealt with by the provinces. The currency and national defence cannot be administered locally, but health care can, which is why it’s a provincial responsibility. Ottawa should simply stay out of it.
A corollary of this principle is the financing of services by the authority that dispenses them. In other words, since the provinces are responsible for their health insurance plans, they alone should be responsible for collecting the taxes that finance the services associated with them. If this were the case, the current unproductive tug-of-war would not be taking place, and our provincial politicians could devote their energy to very concrete ways of improving the performance of our health care system.
More decentralized health care decisions would increase the opportunities for experiments and discoveries of the best ways of delivering services. A certain amount of competition would be encouraged between the provinces, which would allow for comparisons of results and favour the sharing of best practices. One province could decide to incorporate more home care, another could boost mental health services, and a third could choose other priorities based on its needs, its demographics, and the wishes of its population.
The important thing is to be able to compare the results obtained. Hospital performance indicators would certainly be welcome, so that the most and least efficient systems would be known, and we could draw inspiration from the former.
Finally, when there is a direct link between taxation and services, decision-makers are led to a certain moderation, and encouraged to make sure that the population gets its money’s worth. The more the federal government contributes, the weaker this link between the provinces and patients becomes. This is no way to arrive at the best decisions.
Federal Health Minister Jane Philpott was calling recently for a “transformation” of the health care system, noting that it was important “to do better, to make sure we get better value for money.” Well said.
The first thing the federal government should do to achieve this objective is withdraw from the health sector and free up the fiscal space that it occupies on this issue, making room for the provinces. Each of these could then decide for itself the best ways to provide health care services to its population, which will be better served. And they would no longer be able to blame Ottawa for their failures, which is probably the best way to ensure change!
Germain Belzile is Senior Associate Researcher and Jasmin Guénette is Vice-President at the MEI, an independent, non-partisan, not-for-profit research and educational organization. http://www.iedm.org


Julie Ali ·
I disagree that the federal government should get out of provincial health care decision making.
I applaud Mr. Trudeau for his courage in forcing provincial governments to put money where it is most needed--in mental health services provision.

In Alberta, the mental health system is a disaster. Directed funding by the federal government is absolutely essential since the GOA has abdicated completely its duties to citizens with mental health needs.
Why is it that a citizen suffering a heart attack gets a bed at a hospital but a citizen suffering from a mental health crisis is refused? This is the case in Alberta.

I don't believe that provincial governments are doing a good job in terms of health care services delivery. Decentralization has not been accompanied with innovation in Alberta. We have had costly payouts to CEOs of regional health authorities and stagnant service delivery. Centralization of health care services into two health authorities-AHS and Covenant Health has reduced some of the rich excesses of the past. Further pruning is required and it would be best if we had one health authority.

The federal government is responsible to ensure that taxpayer dollars are used effectively-on patients -and not on bureaucrats, wasteful executive pay and multiple health authorities. I believe Mr. Trudeau's decision to put the money where the need is--will ensure that at least some of the cash trickles down to our most disadvantaged citizens-those with mental health issues who are treated with disrespect and discourtesy by the system. I believe that such a commitment of cash and federal oversight is long overdue. If the provincial government can't do the job, let us get the federal government to provide oversight in the form of directed cash injection into the mental health system that is appallingly underbudgeted, and in disarray.
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