and Carl Pursey
The unbelievable COVID-19 death rates (approximately 80 per cent) in long-term care (LTC) facilities throughout Canada happened mostly in privately owned facilities.
We are grateful that this has not been the case on P.E.I. At the same time, this province must heed calls from across Canada for senior care to be part of Canada’s public health-care system.
Canada needs a national seniors' strategy that sets consistent standards and staffing levels across the country. The provincial government’s 2018-19 budget decision to establish 100 new private sector LTC beds and no new public ones has to be changed and more money needs to be invested in assisting senior home care. The ratio of public and private LTC facilities in this province has shifted in favour of the private sector (approximately 52 per cent private to 48 per cent public), without any public input.
We recommend that the Department of Health’s internal study of LTC facilities be opened to public participation.
The Canadian and P.E.I. Health Coalitions are asking for: dedicated funding to the provinces as part of the Canada Health Transfer; consistent care and staffing levels across the country; national standards as a condition for federal funding; based on criteria similar to the Canada Health Act (CHA) — universal, public, comprehensive, accessible and portable. Seniors care needs a skilled workforce with decent pay and decent working conditions. It took the COVID-19 to expose the tragic indifference and neglect of Canada’s seniors especially the frailest. Some critics even recommend that the whole system should be rebuilt. There are some good for-profit homes but the general pattern is cutting labour to ensure profits. It is surprising that the P.E.I. 2020 provincial budget is adding 12 more private beds, with no mention of new public beds given the shortages, long wait times, high costs including increased out-of-pocket expenses and professional staff shortages.
Canada’s public health-care system is based on Canadian values of need regardless of ability to pay.
Health care is a basic right, a public good not a commercial commodity. With privately delivered health care you pay more to get less. Since the 1990s federal cuts to health-care transfers have negatively affected delivery of provincial services as private interests mostly in large cities try to pry their way into our universal Medicare system. Some private, for-profit clinics double-dip by charging the patients and the government for the same procedure. This is forbidden in the CHA, which requires the federal government to penalize the offending provinces.
Private clinics increase costs to the public system by: skimming the healthiest, highest-profit patients and leaving the high cost need patients to the public system; leaving the public system with fewer resources to care for sicker patients; poaching scarce health professionals such as physicians, nurses and technologists; and in general, charging more than twice as much as delivery costs in the public system.
Before the C0VID-19 hit, at least 20 per cent of households had trouble affording their prescribed medication. Now millions more workers laid off because of the pandemic are without their workplace plans and without affordable medication. Canada is the only country in the world with a universal health-care system that doesn’t have a universal medical drug plan. We also have the third highest drug costs in the world. Canada’s patchwork of drug coverage needs to end. We need a national pharmacare program.
Trade agreements recently signed by Canada fail to respect the CHA, which assures health coverage regardless of ability to pay. Health care should have a general carve out in trade agreements, which are based on “free-market” principles and profit-making rather than on patient need. The mix of private and public in Canada’s health delivery makes it difficult to draw a clear line and causes problems with interpretations of trade agreement reservations and exemptions.
CETA (Canada-E.U. Comprehensive Economic and Trade Agreement) has extended patents for European pharmaceutical products that will cost Canadian taxpayers anywhere from $800 million to $1.2 billion annually because it delays the cheaper generic drugs from entering the market. The new NAFTA (USMCA) could also increase the cost of medicines by extending patents on biologics (injected treatment for autoimmune diseases) from eight to 10 years. This decision could increase drug costs by hundreds of millions of dollars and have a negative overall effect on Canada’s already underfunded health-care system. Trade agreements are all the more reason why Canada needs a universal pharmacare plan and the implementation of Phase 2 of Medicare as envisioned by Tommy Douglas and Justice Emmett Hall.
Mary Boyd, Mona O’Shea and Carl Pursey are with the P.E.I. Health Coalition, a member of the Trade and Justice Coalition.