Senator Michael Kirby releases his committee's report on Canadian medical health care.
No more taxes … not even for health care
Ottawa - Tuesday, October 29, 2002 - by: Walter Robinson, Federal Director, Canadian Taxpayers Federation
GST hike	For several weeks the Canadian Taxpayers Federation has been stated that a three cent hike in the GST (as floated by Ottawa in September) was unlikely, but a move to hike it by one and a half cents was possible. This is what the Kirby Senate committee suggested this week as one option to finance its $5 billion pricetag for health care reform. Taxpayers shouldn’t be surprised if next month’s report from Roy Romanow offers a similar prescription.
buy change	Senator Kirby is bang-on in stating that our health care system as presently structured is not fiscally sustainable. On this issue, Roy Romanow is way offside. Sadly, many of Kirby’s proposals simply perpetuate the present system and do not “buy change.”
misguided	For example, proposals for a National Health Care Commissioner and National Health Care Council are well intentioned but misguided. One of problems in health care today is over governance; we have too many oversight bodies providing little accountability to taxpayers. Surely we can develop better accountability mechanisms for taxpayers within existing, if not, streamlined governance structures.
substantive changes	Sadly, Senator Kirby backed away from advocating substantive changes to the Canada Health Act. The current principle of public administration (which covers funding, not service delivery) must give way to public governance, universality must be clarified and new principles of quality, choice, accountability and sustainability must be added to the Act.
competitive	On the positive side, allowing regional health authorities to choose between providers — individual and institutional — in contracting for services based on price and quality is a good idea. A system of managed competition where public, private and community based providers compete for funding is long overdue.
maximum waiting times	As well, Kirby’s recommendation to mandate maximum waiting times for medical procedures acknowledges the painful reality of waiting lists. However, this so-called “health care guarantee” drops us into the classic wage and price control dilemma where setting a price ceiling ensures that it becomes a price floor. Why deliver a surgical procedure in four weeks when you don’t get penalized until week eight?
terminally ill	Kirby’s committee is right to sub-divide home care into component parts and its suggestion of extending Employment Insurance benefits to family members caring for terminally ill individuals in their final weeks deserves study. But the costs of this type of initiative must be borne through reallocation. Tightening of Employment Insurance eligibility, diverting funds from failed retraining programs and charging higher premiums to repeat Employment Insurance users should finance the costs of compensating individuals for lost wages when caring for a dying family member.
diagnostic imaging technology	Kirby’s identification of critical health care infrastructure shortages is also welcome. We come close to third-world standards in access to diagnostic imaging technology and our crumbling hospital facilities have been given scant attention in the health care debate. But these needs are best met through public-private financing initiatives; an issue on which Kirby remains silent.
priority setting	If you don’t like a GST hike, the Kirby committee proposes a national variable health care premium instead. Both ideas are non-starters. As long Ottawa continues to annually blow $4 billion on failed corporate welfare schemes and $13 billion on discretionary grants and subsidies, tax hikes, even for health care, are out of the question. Financing present and future health care needs should be met through reallocation from existing budget envelopes. It’s called priority setting.
	Walter Robinson Federal Director
References:
	The Health of Canadians - The Federal Role, Highlights
	Gilroy, Rob, $5 billion more in taxes urged for health-care, CTV October 25, 2002
	Dal Professor likes the kibry report, CBC Halifax, October 27, 2002
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