17 York St. PerspectivePresented by: Keith Denny,Director, Research & Policy

Speaker: Keith Denny 2

The typical advocacy year for CHA begins in July and continues until recess of Parliament in June of the following year.

◦ July/August – Preparation of CHA’s pre-budget Brief to the Finance Committee

◦ August – Submission of pre-budget Brief◦ September/October – Response to the Speech from the Throne (if

required)◦ September-November – Presentation of Pre-Budget Brief to the Finance

Committee◦ February/March – Response to the Federal Budget

◦ All year - Presentations to House of Commons and Senate Committees- Monitoring the work of the House and Senate - Meetings with senior politicians and departmental officials

Cycle of Activities – Advocating for Equitable Health Care for Canadians

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1. Canada: Federal & Provincial Politics2. Canada’s Health System3. International Perspectives4. So What – Now What?

“Today’s” Perspective

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1. Canada: Federal and Provincial Politics

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Rare diseases/orphan drugs◦ Orphan drug framework for Canada◦ Orphanet

Canadian Epigenetics, Environment and Health Research Consortium (CIHR): $41M

EI changes◦For parents with critically ill/injured children

U-turn on asbestos◦ Canada will no longer oppose inclusion in global

list of hazardous substances

1. 1 Federal Policy

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Response to:◦ Senate review of 2004 10-year accord◦ HESA chronic disease & aging report◦ HESA drug supply report

1.1 Federal Policy

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1.2 Public Opinion: Federal Parties

Abacus, September, 2012

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1.2 Public Opinion: Federal Parties

Nanos, September, 2012

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1.2 Public Opinion: Federal Parties

Nanos, October, 2012

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1.3 Public Opinion: Policy Priorities

Unsure

Debt/Deficit

Education

Environment

Healthcare

Jobs/Economy

0 5 10 15 20 25 30 35

11.6

4.2

7.9

9.4

24.5

23.7

12.2

3.3

7.6

8.7

18.7

29.6

01-Sep 2012 July

Percent

Most important issues:Nanos Research, September 2012

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1.3 Public Opinion: Policy Priorities

Public Policy Importance & Confidence Map: Nanos August, 2012

IMPORTANCECO

NFI

DEN

CE

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Council of the Federation◦ Innovation and Fiscal Arrangements Working

Group reports released July 27, 2012 12 recommendations for best practices New CHT escalator will cost P/T $36B by 2024

Ministers of Health ◦ September 27 meeting

1.4 Provincial/Pan-Canadian

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1.4 Provincial/Pan-Canadian

Macdonald-Laurier Institute, 2012

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1.4 Provincial: Public OpinionAngus Reid, September 2012

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2. Canada’s Health System

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New CIHI data on the financial performance of hospitals shows hospitals are barely staying afloat:

◦ 2010 -11 total revenues = 0.12% above expenses

◦ NL, NS, NB & QC in deficit position◦ SK has best margin at 1.2%

2.1 Finances

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Ipsos Reid survey for CHSRF, CMA & IHE:◦ 82% have supplementary health coverage◦ 36% have gone without needed health care due to

insufficient coverage gap in care is highest among those in Atlantic Canada, lower-

income earners, women, self-employed, work part time workers and unemployed

◦ 50% support a public supplementary health benefits program funded by increased taxes

2.1 FinancesIpsos Reid, July 2012

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BC◦ Margaret MacDiarmid appointed Minister of Health New

powers for nurse practitioners Alberta

◦ New regulation under Health Professions Act creates College of Naturopathic Doctors of Alberta

Ontario◦ Stand off between government and OMA continues◦ New powers for pharmacists

2.3 Health System Changes

Ipsos Reid

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QC◦ Dr. Rejean Hebert appointed Minister of Health

NB◦ Hugh Flemming appointed Minister of Health◦ New department: Healthy & Inclusive Communities

(Minister: Dorothy Shephard) PEI

◦ Proposed umbrella legislation for health profession regulation

◦ May open door to regulation for some of 16 professions currently seeking it (e.g. midwives, MLTs, naturopaths)

◦ Health PEI CEO takes up new post in Saskatchewan

2.2 Health System Changes

Ipsos Reid

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Ipsos Reid survey, July 2012:◦ 53% of Canadians opt for mixed healthcare model: gov’t

pays, services delivered publicly but have option to seek and pay for treatment in private sector

◦ 39% favour a “not-for-profit” model whereby the government pays for the care delivered by the public sector

◦ 7% favour a “for-profit” model where the gov’t and individuals pay but services are delivered privately

2.3 Health System: Public Opinion

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Canada BC AB SK/MB ON QC Atl0

10

20

30

40

50

60

70

53

64

4953

5053

58

39

32

46

4143

35 34

74 5 6 7

12

7

Mixed Model Not-for-Profit For-Profit

Pe

rce

nt

Source: Ipsos Reid. Majority (53%) of Canadians prefer mixed-model healthcare, with services offered by both public and private sectors.

Media Release. June 28, 2012

“Mixed model” health care: Ipsos Reid, July 2012

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3. International Perspectives

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Canada-EU Trade Agreement◦ Latest round of negotiations ongoing◦ Ministers will meet in November◦ Aim for final agreement by end of year

Drug patent issue not yet discussed◦ Will be one of issues decided by ministers in

November◦ Industry Canada/Health Canada estimate EU

proposal could add up to $1.9B in annual drug costs

3. International Perspectives

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Affordable Care Act: Obamacare◦ Insures 32m previously uninsured◦ Could intensify brain drain for Canadian clinical

expertise

3. International Perspectives

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3. International Perspectives

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3. International Perspectives

IoM report: US health system wastes $750B pa

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3. International Perspectives

OECD Top Ten Life Expectancy, 2010

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3. International PerspectivesDoctors per 1000 population (OECD 2010)

Nurses per 1000 population (OECD 2010)

Greece 6.1 Luxembourg

16.3

Austria 4.8 Switzerland 16.0

Norway 4.1 Denmark 15.4

Portugal 3.8 Belgium 15.1

Sweden 3.8 Iceland 14.5

Switzerland 3.8 Ireland 13.1

Canada 2.4 Canada 9.3

OECD 3.1 OECD 8.7

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Council of the Federation: What next??? Follow up with Minister of Health and

critics Business Plan: Policy and advocacy

platform Partnerships: ACAHO, CCPH21, HEAL

4. So what? Now what?

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Presenter’s info:Keith Denny

Tel: (613) 241-8005E-mail: kdenny@cha.ca

www.cha.ca17 York Street

Ottawa, Ontario K1N 9J6Tel: (613) 241-8005

Fax: (613) 241-5055