Canada's deteriorating health-care system needs at least $5 billion more each year to guarantee adequate care for patients, according to a Senate report released Friday.
The committee, headed by Senator Michael Kirby, concluded that Canada's medicare system is not fiscally sustainable through existing funding levels. Kirby says new taxes are likely the only way to ensure the survival of public medicare in Canada.
"We want to make the entire process substantially more accountable and transparent than it is now," Kirby said. "The recommended new money will permit governments to finally address the waiting time crisis in health care."
"Canadians should not have to wait excessively long periods of time to receive medically necessary services. But they do, and sometimes with tragic results."
The report, titled The Health of Canadians - The Federal Role, said the money should not come from the existing federal surplus. Instead, it says the money could be raised by either adding a 1.5 per cent sales tax on top of the existing GST, or through insurance premiums levied on income tax.
Later Friday, Finance Minister John Manley told the House of Commons he has "no intention of proposing an increase in GST." However, Manley did hint that another type of tax increase to fund health care could be outlined in the next federal budget, due in February.
If the government opted to introduce insurance premiums, they would be based on an individual's income, the Senate report recommends. Canadians in lower incomes could pay as little as 50 cents per day while Canadians in higher incomes may pay as much as $4 per day.
The actual breakdown would be as follows:
Up to $31,677 - 50 cents per day ($182.50 per year); $31,678 to 63,354 - $1.00 per day ($365.00 per year); $63,355 to $103,000 - $2.00 per day ($720.00 per year); More than $103,000 - $4.00 per day ($1,460.00 per year). The report also calls for the establishment of maximum waiting times. It adds that if a patient cannot receive proper care within a reasonable time, provinces should pay for the cost of sending patients wherever they can receive that care -- even if that means a trip to the United States.
Canadians should also be protected against devastating prescription drug costs, the report suggests. It suggests having the federal government pay 90 per cent prescription drug costs that exceed $5000; the remaining 10 per cent would be paid by either a provincial/territorial or a supplementary private insurance plan.
It also calls for a home care program for patients recovering from a major illness that would be funded 50-50 with the provinces and says Ottawa should contribute to the cost of palliative home care for terminally ill Canadians.
"Another cornerstone of Canada's medicare system is the principle that no Canadian should suffer undue financial hardship because they have to pay health care bills," said Senator Marjory LeBreton, one of the report's co-authors. "It is a principle that our committee holds dear and virtually every Canadian considers part of his or her birth right."
"Yet, for far too many people in this country, this fundamental principle rings hollow. The gaps in Canada's publicly funded health care safety net are growing wider and an increasing number of Canadians are slipping through them," she said.
The report warns that without more funding, Canadians could expect more difficulty in obtaining "timely access" to health care. Under this scenario, the report says courts would likely decide that Canadians would have the right to pay for health services and that a parallel private health-care system would emerge.
"Such a development would be highly regrettable," the report says.
The Senate report, which was two years in the making, comes about a month before former Saskatchewan premier Roy Romanow releases his much-anticipated report on the future of medicare.
His study is also expected to recommend an expanded medicare system with more transparency. He is also likely to urge the federal and provincial governments to put aside long-standing disputes over health-care funding and work together to ensure the best use of tax dollars.
Canadian Alliance Health Critic Rob Merrifield agreed with the Kirby report's call for greater health-care funding but rejected the idea that taxes should be raised to pay for the increase. He says existing federal resources should fund the increase.
"Canadians reject higher taxes, especially the GST, but the committee failed to look at options other than raising taxes," said Merrifield in a release. "It should have looked at how governmental priorities could be changed."
Kirby's report wants the government to spend $2 billion over five years to develop a national system of health records. However, it cautions that safeguards must be developed along with the project to ensure the privacy of medical data.
Canada is also falling behind other OEDC countries in the amount it spends on new medical technology, the report says, and wants another $2.5 billion spent over five years to give Canadians the benefits of new medical equipment.
The report also addresses the expected future shortfalls in the number of doctors and nurses needed to care for an aging population. It wants Ottawa to spend $160 a year to boost medical school enrollment by 640 students to 2,500 a year by 2005. It also wants 2,600 more nurses to graduate each year by 2008.
The government should also consider offering short-term tax incentives for expatriate health care professionals who want to return to Canada, the report says.
The Canadian Medical Association called the report "a giant step forward" and urged Ottawa to strongly consider its recommendations.
"We need to turn the corner and move from debate to real action," Dr. Dana Hanson, president of the CMA, said in a release. "Canada's physicians are prepared to continue to work with other stakeholders to embrace change that is in the best health interest of Canadians."
With a report from Canadian Press