CHA’s ADVOCACY WATCH

Presented by:Keith Denny, Director, Policy & Communications

Cycle of Activities – Advocating for Equitable Health Care for Canadians

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

“Today’s” Watch

1. Federal Funding and Aftermath

2. Provincial/Pan-Canadian Response

3. Federal Politics

4. What Are Canadians Saying?

5. Canadian Healthcare: A Brief Profile

6. Canadian Challenges

7. Ontario Update

8. International Perspectives

9. So What – Now What?

1. Federal Funding and Aftermath

Federal funding announcement

From 2017-18, CHT will grow with nominal GDP, expected to be approx 4% a year. Although it could be higher, it will not be allowed to drop below 3%. - Dec, 2012

1. Federal Funding and Aftermath

Parliamentary Budget Officer Report – The loss in revenue (from the new CHT escalator) will add to the financial burden of the provinces and territories. - Jan, 2012

P/T will need to institute measures amounting to 2.4 per cent of GDP to raise revenue, reduce program spending, or both, in order to create sustainable financial conditions.

1. Federal Funding and Aftermath

Health Minister’s follow-up

“I will continue to work with my provincial and territorial colleagues to make sure that Canada's health system is more sustainable, and to improve accountability and deliver better services to Canadians.” - Feb 2012

1. Federal Funding and Aftermath

Ongoing Federal Engagement:• Internationally Educated Health Professionals

Initiative ($2.6M)• Personalized health care ($67.5M)• National Diabetes Strategy ($6M)• Home care planning and evaluation tool ($150K)

2. Provincial/Pan-Canadian Response

Ministers of Health – “… agreed that continued stable, predictable funding is crucial to supporting better care and outcomes...” - Nov, 2012

Council of the Federation – Health Care Innovation Working Group & Working Group on Fiscal Arrangements. - Jan, 2012

3. Federal Politics

Senate – Committee on Social Affairs, Science and Technology: Examining the progress in implementing the 2004 10-Year Plan to Strengthen Health Care

HESA – Study: Health Promotion and Disease Prevention

3. Federal Politics

Finance – Pre-budget consultations, 2011

Report: Staying focused on Canadian Jobs and Growth – Dec, 2011

Expectations:

- Budget likely end of March- $4-8 billion in cuts

3. Federal Politics

NDP Health Critic, Libby Davies (meeting requested): “the federal government has a key role to play in providing proper leadership.” – Feb, 2012

NDP leadership a key issue…

Liberal Health Critic, Hon. Hedy Fry (meeting requested): “Evidence tells us that there’s the need for transformative change in the system.” – Jan, 2012

4. What are Canadians saying?

Ipsos: • Feds have strong role to play in healthcare • Obesity biggest health issue for children & youth

Environics: • Feds should be an equal partner in HC discussions• Strong attachment to public funding• Efficiency more critical than funds

5. Canada’s Health System: A Brief Profile

Health Expenditure Continues to Rise

15

Average Annual Growth Rates

Actual Spending Inflation-Adjusted

Spending1980s 10.8% 4.2%1990s 4.5% 2.5%2000–2009 7.1% 4.3%

SourceNational Health Expenditure Database, CIHI.

What Are We Spending On?

Hospitals29.1%

Drugs16.2%

Physicians13.6%

Other Professionals

10.5%

Other Health Spending

6.3%

Public Health6.3%

Administration3.2%

Capital4.8%

Other Institutions10.0%

16

Note2009 actual data.SourceNational Health Expenditure Database, CIHI.

2011 Health Spending Forecasts

• Spending on health care by governments and Canadians is projected to be– $200.5 billion, a 4.0% increase– 11.6% of GDP (versus 11.9% in 2010)– $5,811 per person– 0.6% above inflation and population growth in

2011 (lowest rate in 15 years)

17

Health Care Spending Outpacing Inflation and Population Growth

18

NoteAAG = average annual growth.SourcesNational Health Expenditure Database, CIHI; Statistics Canada.

More Health Professionals

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2004 2008Percentage

ChangePopulation

Increase

Number of Physicians

60,612 65,4408.0%

4.2%Number of Regulated Nurses

315,135 341,4318.3%

6. Canadian Challenges…

Aboriginal Health and its determinants• First Nations face “cardiovascular crisis”• Diabetes prevalence 1.5 to 3 times Canadian rate• Housing crises (Attawapiskat)• Boil water advisories in I in 5 First Nations• Suicide rates for Inuit = 11 times Canadian avg

6. Canadian challenges…Canada’s aging population:• 2011 census: 14.4 of Canadians over 65• Seniors = 40% of hospital services use• 45% of all P/T government health spending

BUT…• More than age, multiple chronic conditions are

associated with high use of the health care system• Prevention, PHC, community care = fewer

admissions

Rates of Hospitalization for Ambulatory Care Sensitive Conditions, Canada, 2009–2010

7. Ontario update

• Excellent Care for All, 2010• Drummond Report

– 105 recommendations specific to health

• Action Plan for Health Care• CEO pay & OHA• OMA negotiations• OMA and salt

8. International Perspectives

• Standard & Poor’s warning to G20 nations– Healthcare related credit downgrades within 3 years

• OECD: Canada doing well…– Some cancer survival rates– Avoidable hospitalization for asthma

• OECD: Canada doing less well…– Wait times (highest of 11 countries)– Certain in-hospital adverse events– Income inequality (rising since mid-90s)

9. So what? Now what?

• Federal leadership?– Meeting with Minister of Health requested

• Council of the Federation: New player• NDP and Liberal leadership

– Meetings with health critics held fall, 2011– Follow up meetings requested

• Senate Report due “soon”• Budget• CHA’s strategic plan

17 York StreetOttawa, Ontario K1N 9J6Tel: (613) 241-8005Fax: (613) 241-5055

www.cha.ca

Presenter’s info:Keith DennyTel: (613) 241-8005E-mail: kdenny@cha.ca

www.cha.ca