A sign is displayed in front of Health Canada headquarters in Ottawa, Jan. 3, 2014.Sean Kilpatrick/The Canadian Press
The federal election campaign has been dominated by talk of Donald Trump’s tariffs and the related cost-of-living and sovereignty issues.
But we’re finally beginning to hear a bit about health care, a perennial top-of-mind topic for Canadians, especially as the system struggles to deliver the most basic of care.
Over the weekend, New Democratic Party Leader Jagmeet Singh promised that if his party is elected, every Canadian will have a family doctor by 2030.
That’s a lofty promise in a country where 6.5 million Canadians are “unattached” (a euphemism for being denied reasonable access to primary care) and the system is in the midst of a labour crisis.
It’s a political reality that the less likely a party is to be elected, the more grandiose and unrealistic the promises.
But to his credit, Mr. Singh fleshed out and costed the promise, saying it would take about $10-billion to hire an additional 7,500 family doctors, and funding would be provided through increased federal transfers.
The NDP Leader also pledged to provide 1,000 new residency spots for international medical graduates and streamline the process for hiring U.S. doctors who want to escape Mr. Trump’s dystopian America.
The real value of his promise, though, is that it should force other party leaders to propose their solutions to the primary-care crisis and perhaps deign to talk about other health care issues.
The federal party election platforms offer up a pretty thin gruel when it comes to improving health care. The ruling Liberals, leading in the polls, have essentially vowed to “keep in place” existing programs, including the new pharmacare and dental care plans, both born of Justin Trudeau and Mr. Singh’s “supply-and-confidence” agreement. Zero ambition there.
The Conservatives have also vowed to retain the dental care, pharmacare, and daycare programs launched during the Trudeau years – the implication being they won’t expand them either.
Pierre Poilievre’s most detailed and oft-repeated health care promise is “defund federal drug dens” (read: abolish supervised consumption sites and safer supply programs) and invest instead in treatment programs.
Also over the weekend, he elaborated on that plan, saying that, if elected, his government would spend $1-billion over four years to make “drug recovery programs” available to 50,000 Canadians.
The Bloc Québécois, which only runs candidates in Quebec, has no chance of forming government, but it has nonetheless made the boldest proposals in its platform, promising that it will push the next federal government to increase health care transfers to 35 per cent of provincial spending, from the current rate of about 20 per cent.
That would see the Canada Health Transfer jump to about $92-billion a year, from the current $52-billion.
The other major parties have yet to make promises of increased funding, but that will come closer to election day (April 28).
Let’s not forget that in 2023 the Liberals offered the provinces an additional $192.1-billion over 10 years, including $46-billion in new money, with an escalator clause of 5 per cent for the first five years and 3 per cent for the next five.
With the system struggling and health costs soaring, the provincial Premiers will definitely be coming back for more.
Yet, there will be intense pressure – and fiscal imperatives – to keep health spending down. Health care already consumes, on average, 42 per cent of provincial budgets.
Tariffs will drive up the cost of procurement of everything from prescription drugs to equipment, and as a recession looms, government revenues will drop, causing budgetary pressures.
And we’re still not talking about the COVID-19 financial hangover, never mind the lingering pandemic itself – the burden that long COVID is placing on the health system, the sorry state of home care and long-term care, and so much more.
A vigorous federal election campaign could be waged on health issues alone – at least in our dreams.
As important as health is, individually and collectively, politicians are often reluctant to talk about it. As former Newfoundland and Labrador premier Joey Smallwood famously said: “I never had a conversation about health care that didn’t lose me votes.”
But as our wannabe PMs wrap themselves in the flag in response to Mr. Trump’s threats, we should not forget that there is nothing more quintessentially Canadian than medicare.
This is an ideal time to shore up medicare, to embrace and bolster a program that distinguishes us from Americans like no other. That’s what political leaders should be vowing to do.
Medicare can’t be an afterthought, especially in the wake of Mr. Trump’s disturbing musings that Canadians would have “much better” health care if the country became the 51st state.
André Picard will be at Election 2025: Steps to heal Canada’s health care system. This free Globe and Mail webcast will be taking place on April 15 at 12:30 p.m. To register, please visit www.globeandmailevents.com/election2025.