Election fever and a primer in the Canadian health care system

While the US is in the middle of a pretty intense election, Canadians are also getting ready to cast ballots on October 14, 2008. This election was only called recently, and while I am sure that a number of you are not schooled in Canadian political science and are wondering what that means, here is not really the place to explain election cycles (although I can, and I will, if you want – all you have to do is ask!). Just know we Canucks operate in a different system called the “Westminster” model based on the British system of government. But, I digress; I thought, in light of our different health care systems, it would be interesting to contrast the health care plans being put forth by Obama and McCain with the health care proposals being put forth by the three main Canadian parties: the Liberals, the Conservatives, and the New Democratic Party (NDP).

Canada’s health care system is very different from its US counterpart, so while the two Presidential candidates here bicker over how to change the current system of health insurance, leaders of Canadian political parties don’t have to worry about what structure this system will take – everyone already has health insurance that is provided by provincial governments. The fundamentals of the Canadian universal health care system that we have today were hashed out in the middle of the 20^th century by Tommy Douglas, a provincial leader in Saskatchewan, so the governments (Provincial and Federal) have had about a half a century to refine program parameters. These parameters are called the Five Principles, and are set out in the Canada Health Act, which stipulates that each province must have a health care program that is universal (covers all citizens), portable (so when a person leaves his or her home province, he or she is covered in other provinces, as well), and publicly administered (although delivery of certain services can be private). Each program must also be comprehensive, which means that each province must cover, at minimum, all insured services offered by doctors, hospitals, and dentists. The comprehensiveness requirement does not mean that all medical services are covered, but only that a list of services (the “core”) must be covered by a province – many Canadians have additional health care coverage in order to pay for things like eye glasses or certain dental procedures. The last of these principles is accessibility, which guarantees reasonable access to insured services by Canadians. Every province must have these principles in place to receive health care funding from the Federal government. In sum, the situation confronting Canadian politicians is drastically different than that facing McCain and Obama. Given this, what are Canadian leaders focusing on in their health platforms?

The Liberal party leader recently announced that, if elected Prime Minister, his government would implement a $900 million catastrophic drug plan to ensure that Canadians facing “catastrophic” drug charges due to serious illness are not crushed by the financial burden of expensive pharmaceutical treatments. Pharmaceuticals are not in the “core,” so they are not currently paid for by the government. The leader of the Liberal party did not lay out the exact parameters of his plan, but said they would be negotiated with the provincial premiers in the event that his party wrests power from the ruling Conservatives. Other measures that the party would take in the health care realm are not outlined on their website. For more on the Liberal plan, go here: http://www.liberal.ca/ story_14602_e.aspx.

The Conservative Party, which has been in power for the past two years, has no health policy plan on their official website (http://www.conservative.ca/?section_id=2444 &language_id=0). Instead of steps that they will take if they are re-elected, the “health care” section of their website focuses on what they have accomplished since coming to power, and attacks the poor records of the other major parties. This attack includes a list of what the Liberal Party (the Conservative Party’s main opponent, and right now Canada’s second most popular party) failed to accomplish in the health care realm when it was in power from the early 1990’s until 2006.

The NDP (http://www.ndp.ca/home) want to improve the Canadian health care system by implementing universal prescription drug coverage, building provincial capacity to train doctors and nurses, creating more long-term care spaces and expanding home care coverage for seniors, and stepping up disease prevention efforts. Based on their websites, the NDP has the most comprehensive platform of the three parties. However, the NDP is the only three of these parties that has never formed a government at the Federal level in Canada, and this is unlikely to change come October.

It is important to note that these are not the only three Canadian political parties – there are others, including the Green Party and the Bloq Quebecois. However, the Conservatives, the Liberals and the NDP are the only three national parties that have a presence in the national legislature. The Green Party has never had a member of its party elected to the House of Commons, and the Bloq is a separatist party from Quebec that maintains a substantial presence in the House of Commons, but will never be a majority because it does not run candidates outside of Quebec (and will, therefore, never form a government).

The three parties each talk about health care, but their plans (if they even offer one) are not central to their platforms, because health care is not as acute an issue in Canada as it is here. The reforms outlined above all tinker with what already exists – they are not as bold as the plans of the Presidential candidates here, but they don’t really need to be, as the issues that Canadians face are not as acute as those that Americans must grapple with. It will be quite interesting watching both elections unfold, and if you want to know the Canadian results, come and see me on October 15^th!