Canadians have been talking about health care spending for what seems like an eternity, and as such, it is an eye-glazing topic for most folks.
Perhaps this is because a sense of fatalism has set in; no one can see a way in which we can make the system better with so many other spending demands and the competing appeals for lower taxation.
Now, however, might be a good time to un-glaze those eyeballs and pay attention to a battle brewing between Justin Trudeau and the provinces. The outcome will have meaningful consequences for two important areas: mental health services and home care.
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Ottawa provides transfer payments to the provinces for health care (among other things), with the relatively rich provinces subsidizing the poorer ones. The Constitution limits the federal government’s ability to dictate how the provinces spend this money – and nowhere is this fact played out with more acrimony than in health care.
The current federal transfer payment offer contains a controversial provision: a top-up that must be spent on mental health services and home care. So far, only three provincial governments – all in Atlantic Canada – have accepted this arrangement. The others, B.C. included, are holding out for a better deal.
These are two vastly under-funded areas – even though everybody knows that increased funding for them would decrease the load on hospitals and the medical system in general. This is particularly true in the area of mental health.
The Canadian Mental Health Commission in 2012 recommended that nine per cent of health care spending be put towards mental health. None of the provinces have achieved that target, and the results are evident for all to see.
Hospitals are over-burdened by patients who, given better outpatient and home care support, would have avoided hospital stays in the first place (that is, if there were available beds, which is rarely the case). And it is the cost of hospital services that puts significant pressure on health care budgets.
But direct costs to the health care system are just the beginning. Communities suffer when folks living with mental illness do not get the assessment, treatment, and support they need in a timely manner.
Here on the Coast, the Arrowhead Clubhouse is a prime example of what happens when the regional health authority (Vancouver Coastal Health) can’t support the needs of adults living with a mental illness.
Arrowhead has roughly 140 members – a number that grows weekly. Of these, about 40 attend the clubhouse daily and depend on its doors being open for peer support, fellowship, help with everything from transit passes to tax returns, and referrals to medical and legal help.
Arrowhead plays a vital role in keeping vulnerable patients safe, supported, and off the streets. Ask anyone in the medical or law enforcement system, and they’ll say that without the clubhouse, these systems would be over-burdened.
Yet not a dime of funding for Arrowhead comes from Vancouver Coastal Health. There simply isn’t the money. As a result, if the constant search for alternate funding does not pan out, then Arrowhead will revert to a four-day week. And that would be devastating.
If we wish to improve mental health services and home care, then members of the community and our MP, Pam Goldsmith-Jones, must urge the B.C. Government to drop the politics and take the federal funding offer currently on the table.