When Liberals talk about equality, health care is a big part of what we mean. It’s the ground under the feet of Canadian families.

The Liberal Party’s passionate belief in universal, free, quality, timely public health care remains unshakable. We are the party that made universal, Canadian Medicare and the Canada Health Act a reality.

A stable, high-quality public health system must underpin equal opportunity in Canada in the future, just as it has in the past. That means every Canadian family must be served well, and served equally when they need care – no matter where they live. We all know there are challenges in health care – and we believe there are two challenges above all:

• Gaps and wide variations in quality and availability of care, depending on where you live, putting more and more pressure on Canadian families; and

• Provinces are struggling to contain rising expenditures, a struggle that will become even more difficult as our population ages.

Given these challenges, after five years of neglect under Mr. Harper, the next federal government must get serious and get back to the table for health care.

DIRECT HEALTH CARE SUPPORT FOR CANADIAN FAMILIES

We’re going to start by providing direct support to Canadian families facing health challenges:

• Family Care Plan: A $1,350 Family Care Tax Benefit to help low- and middle-income families with the cost of caregiving, and the Family Care EI benefit to let you take time off work to care for a loved one at home.

• Canadian Brain Health Strategy: To help families cope with the crushing pressures of dementia, a Liberal government will commit $100 million over its first two years for research into treatments and cures for Alzheimer’s and other forms of dementia, including funding for awareness, prevention, and income security issues.

• Health promotion and Canada’s first National Food Policy: To show federal leadership in improving the health of Canadian families, Liberals will focus on promoting exercise, healthy eating, nutrition, better food labeling, regulating salt and transfats, local farmers’ markets, Canadian food on Canadian plates, and improving the food inspection system.

• Improved rural health services: While some 20% of Canadians live in rural areas, only 10% of doctors practice there. A Liberal government will invest an additional $40 million over two years to improve rural health services in cooperation with provinces, territories, municipalities and medical professionals.

A LIBERAL GOVERNMENT WILL BE A STRONG PARTNER WITH PROVINCES AND TERRITORIES

In this election, Liberals are offering a change of direction: a government for all Canadians that cares about their health and health care, and that works with provinces and territories to secure equal, quality care for every family, no matter where they live.

Liberals strongly respect provincial jurisdiction for health care delivery. But we don’t leave the provinces to grapple with these challenges on their own.

All provinces are struggling with the challenges of containing costs while delivering quality, accessible, free Medicare. They will have a strong partner in a Liberal government. It’s in the best interests of Canadians that their governments work together effectively.

That partnership starts with a commitment to quality, innovation and best practices. We need to do a much better job learning across jurisdictions, based on evidence, and what works. Many exciting innovations in health care management are being tried out in most provinces. But too often they remain confined to just that one place. The federal government is very well-equipped to help spread lessons learned nation-wide, working with all governments.

Experts tell us that sharing and implementing best practices can improve quality and save money. This will also help ensure that taxpayers get full value for the money already in the system. A key example: the Canadian Medical Association is leading a charge to put the “patient first” in health care management. It’s about giving the system back to the patient. Different provinces are approaching this idea in different ways. All jurisdictions need to be learning from each other – finding out what works best through experience, and sharing that experience as widely as possible.

But even more fundamentally, a Liberal government will get to work right away on the next generation of funding arrangements for Canada’s health care system.

A LIBERAL COMMITMENT TO THE NEXT GENERATION OF FUNDING ARRANGEMENTS

The 2004 Health Accord expires in 2014 and its replacement will have to be an immediate priority for Canada’s next government. The previous Liberal government committed to historic levels of federal investment, which the Harper government loudly takes credit for at every opportunity.

The Health Accord was a landmark accomplishment, not only for the investment, but also because the unprecedented decade of stability in federal funding gave the provinces and territories breathing room to embark on real reform that would contain costs and improve quality. The Health Accord included dedicated funds for home care services and drug coverage.

However in each of these areas, the Harper government never responded and never acted on the follow-up process and the opportunities the Health Accord offered to advance reform. They did nothing. They provided no leadership. As a result, too little has been accomplished in system-wide reform.

As we outline in our platform, a Liberal government will have two priorities for health care reform:

• Home care services: Home care is an increasingly important part of health care. We must ensure high-quality care in the home, including for priority areas like mental health and palliative care, everywhere in Canada.

• Drug coverage: We will work with provinces and territories to reduce the cost of prescription drugs for the health care system and ensure that every Canadian – coast to coast to coast – has adequate drug coverage.

The provinces are coping with budgetary deficits and spiraling health care costs. It is critical that a new federal government commits to investing in health care beyond 2014, so that provinces can get on with the job of reforming our health care system. We must ensure it will be there when every Canadian family needs it.

For these reasons, a Liberal government will maintain the current 6% health care funding escalator beyond 2014.

There are many details and variables that the next Government of Canada will need to negotiate. Liberals must first earn the trust of voters, but backing away from health care now would be irresponsible. We can build on the fiscal legacy left behind by Jean Chrétien and Paul Martin’s leadership if we make better choices and turn the page on out-of-control spending like $6 billion in corporate tax cuts, $13 billion for US-style mega-prisons, and $30 billionfor untendered stealth fighters.

All governments will have to work together to do a better job of being accountable to Canadians for results, achieving value for money, and ensuring quality and equality in health care service across the country. That is precisely what a Liberal government will do.

STEPHEN HARPER’S UNANSWERED QUESTIONS ON HEALTH CARE

The Government of Canada should have long ago begun engaging Canadians and the provinces and territories on the future of health care. But Mr. Harper has been silent on his plan for health care, and has said nothing about 2014.

So the question for Stephen Harper is: What is his plan?

The clearest expression of the Conservative plan for health care is a proposal by his former Industry Minister. Last fall, Maxime Bernier said the federal government has “no constitutional legitimacy” in health, and that “ending the federal spending power… and transferring tax points to the provinces would be the right thing to do.”

These comments were not repudiated by Mr. Harper. In fact, he has advocated this approach as well. In Mr. Harper’s so-called “Firewall Letter,” he called for putting up barriers between Alberta and the rest of Canada, writing, “Each province should raise its own revenue for health care – i.e. replace Canada Health and Social Transfer cash with tax points.” When he worked for the National Citizens’ Coalition, he said, “It’s past time the feds scrapped the Canada Health Act.”

These views would mean the Government of Canada washes its hands of the Canada Health Act, and walks away from the fundamental idea that all Canadians deserve a similar level of health care service no matter where they live in this country. Transferring tax points means eliminating health care transfer payments as Ottawa hands over to each province some of its taxation room. There are two significant problems with this approach:

• The value of those “tax points” varies widely from province to province – more in wealthier provinces, less in the others. So we’d have much more of a patchwork than we have now; and

• There would no longer be a voice for pan-Canadian values and principles in health care.

Before you cast your vote on May 2nd, you have a right to know if Mr. Harper still holds these views, and what his plan is for the future of health care. Until now, Mr. Harper has said nothing about investing in health care beyond 2014.

At the same time, Stephen Harper has made major spending commitments for 2014 and beyond:

• $30 billion for fighter jets;
• $6 billion for annual, unnecessary tax cuts for large corporations;
• $13 billion – and climbing – for US-style mega prisons;
• $2.5 billion per year to pay for income splitting for better-off Canadians; and
• Expanding tax-free savings accounts at a cost that will rise to billions annually.

The fact is, with these commitments, there will not be adequate funding for health care in Stephen Harper’s Canada.

This is one of the most important issues affecting your family. Before you vote, you deserve answers from Stephen Harper. Then, you can decide for yourself – who will you trust with the future of our health care? The Liberal Party has made its commitments clear.

Sincerely,

Michael Ignatieff
Leader of the Liberal Party of Canada
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Identifying and adopting the most effective and efficient delivery methods from other jurisdictions – when undertaken broadly and systematically – can reduce costs while improving the quality of care.

The federal government is well placed to energize a Canadian effort to put quality improvement, best practices and innovation at the forefront. This has to be a national effort, and a Liberal government will make it a priority again. The federal government has established valuable instruments, including the Canadian Institutes of Health Information, the Canadian Patient Safety Institute, the Canadian Health Services Research Foundation and Canada Health Infoway serving all jurisdictions. These bodies are key to progress. Particularly with respect to health outcomes for Aboriginal people, Ottawa must make quality improvement a top priority.

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In contrast, a Liberal government will be at the table for Canadians. We will come equipped with a collaborative approach and the objectives that drive this health and healthcare platform: relieving pressures on today’s Canadian families, improving health outcomes, improving quality in the healthcare system, and containing long term costs.

Two specific areas will also be priorities for a Liberal government: home care services and drug coverage. With more and more patient care taking place at home rather than in the hospital, we’ll work with provinces and territories to ensure that Canadians in different parts of the country don’t face significant variations in drug coverage, and home care services, including priority areas like mental health and palliative care.

The Government of Canada is a major funder of healthcare through transferred tax points and cash transfers to provinces and territories. All governments must do a better job of being accountable to Canadians for results, value for money and the quality of healthcare service across the country. While provinces and territories are struggling with escalating costs, it’s far from clear that more money is the only solution. Governments must ensure we’re getting full value for the money already in the system. Management improvement and innovation, advanced through much more effective dissemination of best practices nationally and internationally, promise to contain costs and improve service to Canadians at the same time.

Canada was once thought to have one of the best health care systems in the world. Renewed commitment at the federal level, and effective partnership with provincial and territorial governments and other health sector leaders can make that true once more.
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