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PoliticsPaul Martin on Health Care

Paul Martin on Health Care

Paul Martin on Health Care

Within minutes of ascending to the Liberal Party leadership on November 17, and in front of thousands of adoring Liberals, Paul Martin declared forcefully that he intends to protect and promote universal health care in Canada. Martin has been consistent in his support for universal health care — even during the tough years of 1993-97, when he was trying to balance the budget. In the 1996 budget speech, he said that "we will remain opposed to the imposition of residency requirements on social assistance recipients who move from one province to another, and we will be steadfast in upholding the principles of Medicare?' Later in the same speech, Martin said, "Why can we not decide together that Medicare 10 years hence will not simply survive, but be the most successful system in the world, with a record of prevention, care and cure that is second to none?"

In some ways, this speech was déjà vu from a different era. In 1946, Paul Martin, Sr. became the federal Minister of Health. He strongly believed in the benefits of national health insurance. The obstacles he faced were stubborn and conservative provincial governments and a preference in Ottawa for other forms of economic action. Martin, Sr. was patient and hunkered down and waited them out while still pushing his vision. In the end, however, it was only under the threat by Martin, Sr. to quit Prime Minister Louis St-Laurent's government (should he not support a new national health insurance plan) that finally ensured endorsement of the idea by Cabinet. In April 1957, Martin, Sr.'s national hospital insurance scheme, The Hospital Insurance and Diagnostics Services Act, introduced in the House of Commons and was unanimously passed.

For Paul Martin, the key to any new health care initiative will be ability to pay. Aides say he will lay out a broad stroke and achieve each health objective in increments. Martin's health formula is to secure a single-payer, publicly-funded, universal health care system. He has committed to working with the provinces to come up with a solid plan to avoid duplication of services between the two levels of government and to ensure a cost-effective and efficient health system.

To that end, Martin has publicly declared his support for many of the health care reform initiatives from Roy Romanow's Royal Commission on the Future of Health Care in Canada, including the creation of a National Health Council (NHC). Martin firmly believes that health care must be universal and available in all regions of the country. At the Grey Cup meeting with the premiers immediately after winning the leadership, Martin restated his support for the NHC. Within a day of the meeting, however, Premier Ralph Klein of Alberta was publicly slamming the concept, saying: When you go to the hospital, the last thing you're going to ask your doctor about is the NHC." Klein believes that the council will meddle too much in his government's handling of the health portfolio, which is "our constitutional responsibility."

Martin disagrees with Klein and in the end, he will get the NHC. "I believe it would be a shame if we allowed the idea of the health council to founder. I am not hung up on whether this is seen more as a federal or provincial initiative. My concern is that we get it done right, so that we give ourselves the capacity to measure how well our health care system is serving Canadians. If there are concerns about the health council's structure, administration or respect for jurisdictional realities, I believe that solutions can be found with a spirit of flexibility and collaboration.”

Martin's insistence on this is based on his desire for efficiency and cost-effectiveness for the health care system. Aides say he was impressed but also worried about how the health care system responded to the SARS crisis. "The on-the-ground medical staff—nurses, doctors and health care workers —did a great job, but there was a real problem on the coordination side in terms of sharing information between hospitals and from province to province," said one aide. So expect Martin to endorse the National Advisory Committee on Severe Acute Respiratory Syndrome (SARS) and Public Health, the Senate Health Committee and the Canadian Medical Association's call for new health emergency legislation to deal with public health crises. The legislation would include the creation of a new Chief Public Health Officer for Canada to coordinate health-related activities between jurisdictions.

Martin has also endorsed additional funding to the provinces for health care. He wants better information on waiting lists, so the success of government initiatives can be better measured and targeted. In an April 2003 address, Martin said: "If there is any way in which you measure whether your health care system is working or not, it's through waiting lists – it's how long it takes to see a general practitioner and then the specialist and the surgeon. And we just don't have that information. Working with the provinces, we can and we must develop objectives for maximum wait times, procedure by procedure, based on good science and management, and the real-life experience of patients." Martin's focus on health care "coordination" emphasizes the importance he places on the issue. He also committed to having annual meetings with the premiers, starting in early 2004.

Martin supports a plan that would allow generic-drug manufacturers to provide affordable AIDS treatment drug to poorer nations in Africa. Martin was very receptive to having U2 rock legend and activist Bono speak at the Liberal leadership convention. Expect changes to the Drug Patent Act to allow cheaper generic drugs to be made available to Africa. Said one aide: "Paul has his mind made up on this – it's really a conscious thing and the right thing to do – and he is 100% committed to it." Martin says that Canadian companies are world leaders in aids research just as other Canadian corporations continue to lead the way in research and development. He maintains that support for R&D will be a pillar for his government.

Martin is also promising a National Home Care Program. He believes that people will get better care at home rather than being warehoused in a hospital. Canadians have been telling him that's what they require – they just need help via incentives from government. For Martin's policy people, it's all about channelling money. Does it go to hospitals or to homes for people to help take care of their own?

It is clear that Martin is committed to more than just tinkering with the health system. He plans significant changes to strengthen it. Martin is sending a strong message to the premiers that he will work with them to make the much-needed improvements to Canada's tattered health care system. Yet if they are not on board, he will abide by the Canada Health Act and use it to ensure that the national goals and objectives he has laid out for health care are implemented. If it sounds like déjà vu, it is. Martin is just following his father's lead, which is a proven formula for success.

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