The CMA says the problems facing Canada's health care system can be solved by prescribing “ASA”: accessibility, sustainability and accountability.
In a news conference held at the Ottawa Hospital – General Campus Jan. 27, President Dana Hanson said the CMA's “action plan” was designed to ensure that Canadians had access to care by seeking, among other things, a national strategy to address the shortage of physicians, nurses and other heath care workers. Hanson, accompanied by presidents or representatives from all 12 divisions, also proposed a “care guarantee” that would allow Canadians to seek publicly funded care outside their province or territory if they cannot get access to certain procedures within a set time.
Dr. Lynn Doyle, president of the British Columbia Medical Association, said her patients now wonder if they will suffer a stroke or other setback while waiting for a test or surgery. “We must get on with the job.”
The CMA wants an immediate federal payment to the provinces of $155 million in the fiscal year ending Mar. 31, 2003, and an additional $4 billion in 2003/04. This money would go to “core” areas such as human resources and capital infrastructure. “We must shore up the core,” said Hanson.
The plan calls for a total federal injection of $31.5 billion in new funds over the next 5 years. Hanson says this is less than half the projected federal surplus for the same period.
The CMA also wants a Canadian Health Charter and an independent health council to oversee the system and move it out of the political arena. Hanson dismissed accusations from several provincial premiers that the council would interfere with provincial and territorial jurisdiction. “The provinces are not looking at the broader picture,” he said.
Dr. James Fritz, president of the Saskatchewan Medical Association, said the plan would draw attention to issues that weren't emphasized in the Romanow report. “Mr. Romanow wasn't convinced that there is a health human resources problem,” he said. “Come and work [in Saskatchewan], and we'll show you.”
The action plan is part of the 100-Day Challenge the CMA launched Nov. 29, the day after Romanow released his report. The main goal is to have governments deliver a comprehensive action plan in response to Romanow within that time frame. As part of the challenge, physicians have been asked to return post cards urging prompt action. More than 10 000 had been returned by Jan. 31.
Doyle said finding consensus on an action plan among the 12 divisions was not too difficult. “It didn't take too long once we got our heads around to what's really important,” she said. “I think that's what everyone has to do.”
As this issue was going to press, Ottawa and the provinces agreed upon $25 billion in new federal funding over 5 years. After the 12-hour meeting ended Feb. 5, Hanson said the deal “seemed to be a step in the right direction.” However, he described the lack of a plan to address the critical shortage of health care workers as an “abject failure.” — Brian Whitwham, CMAJ
Figure. CMA President Dana Hanson with divisional presidents and thousands of members' postcards Photo by: Steve Wharry