Friday, July 27, 2012

On cooperative efforts

The reports on fiscal arrangements and health care developed in the lead up to this weekend's meeting of Canada's premiers have both received some coverage. But there are a couple of points worth noting which seem to have been largely neglected so far.

On the fiscal arrangement side, we now have agreement among the provinces as to the effect of the Cons' unilateral changes to health care. And while those paying attention may have known all along, Table A.10.B. neatly lays out how Alberta is receiving $8.3 billion in new health care funding over 10 years while every other province faces cuts ranging from moderate to massive.

So no, the Cons aren't merely cutting back on promised health-care funding. Instead, they're actively diverting health-care dollars away from areas of need toward the wealthiest province in the country.

Fortunately, the premiers do seem to recognize that there's a problem when dollars dictate who has access to care. And perhaps the most striking part of the health care report is that even while discussing "innovation": (which is so frequently a code word for selling off pieces of our health care system), the provinces seem to have formed a consensus on a need for cooperation rather than allowing beggar-thy-neighbour market forces to dictate the terms of access to health care providers (italics added):
It is recommended that Premiers endorse the following Guiding Principles for Health HUman Resource Management:

a) Share Evidence: Provinces and territories should share health human resource labour market information to support effective decision-making.

b) Seek Innovation: Provinces and territories should share leading practices and work closely together on innovative approaches to managing labour costs and reducing competition.

c) Respect Interdependence: Provinces and territories should recognize that health human resource management decisions made by individual jurisdictions may have an impact on other jurisdictions.

d) Make Informed Decisions: Provinces and territories should explore and act on areas of mutual interest and common approaches to health human resource management.

e) Integrate Planning: Provinces and territories should work together to strive for an appropriate supply of health human resources at the provincial and national levels.
Of course, all of those recommendations would be far more easily put into effect if we had a federal government interested in supporting a functioning health care system. But at the very least, they seem to reflect some acknowledgment that gratuitous competition is a problem rather than a solution when it comes to ensuring access to health care - and the same principle would seem to be no less applicable within smaller health-care jurisdictions.

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