Tuesday, January 3, 2012

Feds, schmeds! This is a chance for provinces to shine!

Hi, guys! Anything interesting happen while I was away? What? The federal government unilaterally imposed a healthcare funding plan on the provinces? Ha, ha. Sure they did.

Oh, I see they did.

Like many of the provincial finance ministers, I wasn't thrilled with this strategy, but perhaps for different reasons:

  • Too much money! Transfer payments continue to increase by 6% annually until 2017.  Then, increases are tied to economic growth.  That much dough is a recipe for whittling at the edges of the status quo, not an incentive for radical redesign of healthcare.

  • No airing of dirty laundry! A negotiation process would have been as much about outcomes and accountability as it was about dollars and cents.  We should have had a national, bare-knuckles brawl about the waste, perverse incentives and lack of patient-centredness in our health system. We've been deprived of the chance to let the public have a real say in restructuring healthcare.

  • No master plan! If each province takes its no-strings-attached loot bag and hunkers down in its respective corner, we could end up with widely disparate models of care delivery.  We need a national clearinghouse for improvement ideas and innovation so we can learn from each other's experience.

Wait a minute! Who says we need the federal government's permission to do these things?  This is a golden moment for the provinces.  Mr. Harper is going out of town and giving us the keys to the house.  We can fight over the liquor cabinet, or we can pull together.

Some will see a crisis.  Real leaders will see opportunity.

I hope we start hearing their voices soon.

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