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Health Care - Can't Buy a Fix

“From A Mandate For Change To A Plan To Govern” shows how the federal can carve out a place in health care reform - Latest entry

Canada is an expensive underperformer

Ottawa – The cure for Canada’s ailing health-care system is not hiding at the bottom of a pile of cash. Only by encouraging reform will Canada jump from its position as a health-care laggard to a model for the world. “Money is not the issue. If spending were the key determinant, Canada would be a world leader”, write Brian Lee Crowley and Sean Speer. “Instead, Canada is an expensive underperformer”.

As the federal finance minister prepares to meet his provincial and territorial counterparts next week, health care funding is expected to be high on the agenda. Crowley and Speer advise the government to “focus on the quality of federal actions rather than the quantity of money Ottawa spends or the number of conditions it imposes.” Their new paper is the latest entry in MLI’s series titled “From A Mandate For Change To A Plan To Govern”.

“The recent past shows that federal leadership is best exercised by creating the right incentives for provinces"

Can’t Buy A Fix

The Governor General has barely risen from delivering the Throne Speech, but already the provinces and territories are clamouring for a blank cheque to spend on health care.

The federal government shouldn’t give it to them, say Crowley and Speer. Canada already spends more than most other comparable countries, yet continually lags behind in quality of care.

Brian Lee CrowleyInstead, the newly-elected Liberals should lead the way on the health-care file by encouraging reform.

How?

Flexibility.

“The recent past shows that federal leadership is best exercised by creating the right incentives for provinces, not by transferring more money or trying to dictate how the system should be run”, write the authors.

Freeing Up The Provinces

The federal government should loosen the restrictions on how provinces can deliver health-care services, giving them the elasticity to design, regulate and provide health care to their citizens within a universal and portable framework.

“The reality is that true federal leadership on the health care file does not mean Ottawa telling the provinces how to run the system"

This would both cost less and lead to better quality of care – just as it did with the welfare system in the mid-1990s.

The federal government helped reform the welfare system by limiting federal transfer payments and granting the provinces greater flexibility to undertake policy reforms that matched local needs.

“The reality is that true federal leadership on the health care file does not mean Ottawa telling the provinces how to run the system, but helping to create the right incentives for the provinces to do so”, write the authors.

To read the full commentary

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