Health Care in a Renewed Federalism

In this paper, Tom Kent argues that confusion and conflict in our fiscal federalism are inhibiting nation-wide economic, social and environmental policies of which Canada has urgent need.  The impending negotiation of new financing arrangements for Medicare can be the occasion for a wide reshaping of federal-provincial relations.

Ottawa should not go on providing an escalating transfer for Medicare as it is.  Instead, assured funding at about the present level should be used to lever two major changes, in policy and in procedure.  One would move resources into promoting health rather than just treating sickness.  The other would secure a comprehensive shift to group practices for the delivery of primary care.

In the same spirit, more federal dollars should be put to direct use for purposes crucial to our success in the globalised economy.  They centre on our most under-developed resource: the abilities of all our youth.  They would combat child poverty, make child care generally available, improve access to post-secondary education, and extend skills training.  Tax reforms to finance these programs would include some income-related recovery of Medicare expenses.

ISBN – 1-55382-518-7