March 31, 2016
Budget 2016: still waiting for the Health-care litmus test
A recent Ipos poll showed that out of a list 15 of the top priority coming into budget 2016, ‘spending more on health care’ was the top priority for Canadians. As global news reported, “A provincial breakdown of the new data showed healthcare was high across the country, with the most support in B.C. (56 per cent) followed by Atlantic Canada (44 per cent), and Alberta (41 per cent). Saskatchewan and Manitoba residents were the lowest with 32 per cent ranking healthcare spending in their top three. Quebec and Ontario residents were comparable on the issue at 39 per cent and 35 per cent.”
Coming into this budget, after a dark decade of underfunding and privatization by the Harper government, health care advocates had high hopes. The Council of Canadians has participated in the CCPA’s alternative federal budget which highlighted, “The health policy commitments of the new federal government include promises to renegotiate the Health Accord, and to increase access to home care, mental health services, and prescription drugs.” It was our hope that robust improvements and investment in some of these areas would be included today (as the bar has been set so low you can trip over it).
Unfortunately, looking at the appendix tables it becomes clear that the government’s budget projections maintain the Harper government’s reduction in health care transfers to the provinces relative to the GDP. Counter intuitively the budget states, “Starting in 2017–18, the CHT will grow in line with a three-year moving average of nominal GDP growth, with funding guaranteed to increase by at least 3.0 per cent per year.” So as opposed to a fixed 6% escalator which was included in the last health accord, health transfers to the provinces will be lower when the economy is doing worse (i.e. the time when people need health care the most). We echo the CLC statement that, “The CLC said they are disappointed by that, but hopeful that continued talks between the Health Ministers will result in new, sustained funding for health care that allows our system to meet the needs,” of Canadians.
In regards to a renegotiated Health Accord, this budget does little to make clear where we are headed. Is this government planning to reflect Canadian’s top priority and invest new money into the public system in the future, or are future budgets going to follow the template of Harper’s budgets with underfunding health services and increasing two-tiered services? It is too early to tell, but we hope the new government follows some of the suggestions the Council of Canadians have made on this topic.
For discussion regarding funding for safe water on reserves, which has a major health impact, I will leave that analysis to the Council of Canadians amazing water campaigner Emma Liu. For nutrition issues CPJ has highlighted that, “the government has also committed to expanding the Nutrition North program by investing $64.5 million over five years to ensure nutritious food reaches northern communities. We hope that the program will also be improved so that it is more effective in reaching this goal.”
In regards to trade the budget stated, “The Government recently completed the final steps of the Canada-European Union Comprehensive Economic and Trade Agreement. Canada and the European Commission are committed to swift ratification so that our citizens can quickly reap the benefits of this high-quality agreement. The Trans-Pacific Partnership (TPP) would offer opportunities to grow Canadian trade with Asia Pacific countries, enhance North American production and improve job quality in Canada.” These deal will have a massive impact on our health care, increase costs and create a policy chill for new initiatives (like a full and comprehensive national pharmacare plan). The Council of Canadians has written extensivelyon this issue in regards to health and new analysis from allies continues to emerge that these are net-negative deals for the health of our nation.
Overall, much of the talk following the budget will no doubt be right wing hyperbole and defrosted talking points regarding ‘reckless spending’ by the Liberals. Unfortunately this has the double effect of limiting important discourse on the budget and making it look more progressive than it is. The $29.4 billion deficit sits at around 1.5% of Canada’s GDP, which is much less than the 3.5% of GDP deficit the Harper government put out in one of their budgets. This budget also comes at a time when interest rates in Canada and around the world are at record lows. Lastly, it is important to put spending into context and check it against government spending as percentage of GDP over time. The first fiscal plan included in the budget ends, “in the year 2020-21, with federal spending at one of the lowest rates in the past 65 years—15.1% of GDP, slightly higher than 2014-15’s all-time low level of 14.2%.”
What is worrying overall, and specifically for health care in Canada, is the continuing trend we are seeing to marginally invest in our social safety programs. Spending on social programs isset to rise to just 14.6% of GDP one year from now (in the 1970s this was around 20%). We are not seeing a turnaround in the downward spiral, but at best a brief flatline before they fall back down to 2015 levels by 2020. This comes at a time when the health of Canadians is getting worse, make no mistake about it. 1 in 7 Canadian children live in poverty (this rate places us 15 out of 17 similar nations). In Canada, 30,000 people are homeless on any given night, with an estimated 50,000 hidden homeless. Roughly 40,000 Canadians die prematurely each year as a result of social inequality (equal to 110 Canadians dying a day). To be fair the new Child Canada Benefit and the improvement to the Guaranteed Income Supplement for seniors are a couple of positives steps the individual level to affect the SDOH, but this shouldn’t be confused with investing in the social programs we all use as a community.
By putting these figures in a historical and contemporary context it shows that while this budget is being framed as for the middle class, it does not rebuild the public social safety nets -like medicare- that Canadians (including the middle class) depend upon. Compounding the matter this comes at a time when the wealth gap between the working class and the rich is growing with the wealthiest 20% now control nearly 70% of all wealth in the country. The top 10% own almost half of all wealth. This income gap has accelerated in the last 10 years, the wealth of the top 10% of Canadians increased by 42%. And what is the result? Poor men and women are, respectively, 67 and 52% more likely to die each year than their wealthy counterparts. Real change would be investing in our social services like public health care and not being afraid to raise the revenues needed (or just start closing things like the $750 million CEO stock option tax loophole this budget kept and the finance minister stated won’t be touched in future budgets).
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