Medicare needs to go up next level, says former top civil servant

Nigel Armstrong
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Mary Boyd, chair of the P.E.I. Health Coalition welcomes Alex Himelfarb to a celebration lobster dinner at Trinity church in Charlottetown Thursday, Aug. 28. Himelfarb, once Canada's highest ranking civil servant, is on the Island as a guest of the Canadian Health Coalition to lobby for health issues to the meeting of premiers underway in Charlottetown.

Alex Himelfarb, once the most senior civil servant in Canada, is asking Islanders to lobby for better terms and cooperative negotiation on federal health funding.

Himelfarb, of Ontario, is on the Island as a guest of the Canadian Health Coalition to help lobby on health issues during the meeting of premiers underway in Charlottetown.

He is currently director of the Glendon School of Public and International Affairs at York University. In 1999 he was appointed deputy minister of Canadian Heritage, then Clerk of the Privy Council and secretary to the federal cabinet from 2002 to 2006.

The Canadian Health Coalition is planning a march, beginning at noon Friday, from Trinity church in Charlottetown to the Delta Prince Edward hotel where the premiers are meeting.

Coalition participants met for a welcoming lobster supper at the church Thursday.

"It took courageous leadership to build medicare," Himelfarb said during the dinner. "It withstood some battering, some bruising and some bending but it has never broken.

"It's not everything we want it to be," said Himelfarb. "It's going to take some courageous leadership to get it to the next level, medicare 2.0, if you will.

"There are signals right now that that leadership is not materializing," he said.

Medicare needs to expand to include drug costs under a pharmacare program, and funding agreements for long-term care.

"There is a remarkable consensus among health care experts and health practitioners about what needs be done to bring health care up to the evolution of medicine," he said.

Health care has changed, and so too has the demography of Canada, and so too must health care funding between all levels of government, says Himelfarb.

He said vision statements about the future of care by the nurses union and by the medical association are very similar.

"There is a massive consensus," said Himelfarb. "It's going to take some money and some leadership to do it."

A strong tax system will help, he says.

"We always celebrate the latest tax cut but we don't ask what we are giving up," said Himelfarb. "Taxes are how we pay for the things we do together."

The federal government says it will spend about $40 billion  on health care over the next ten years.

That is potentially about $36 billion less than what it would have spent under similar terms to a negotiated health accord with the provinces that expired this past March, said Himelfarb.

The new unilateral federal health funding formula increases cash transfers by six percent per year, but only until 2017 when increases become tied to the GDP, Himelfarb said.

When the GDP goes down, funding goes down but that is when times are difficult and health demands go up and the ability of provinces to increase funding goes down, said Himelfarb.

"The provinces that have the greatest need have been cut the most," he said.

"Health care funding has to be built up co-operatively with the provinces," said Himalfarb. "It can't be imposed unilaterally."

Organizations: Canadian Health Coalition, Glendon School of Public and International Affairs, York University Canadian Heritage Privy Council Trinity church Delta Prince Edward hotel

Geographic location: Canada, Ontario, Charlottetown

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Recent comments

  • Jack
    August 29, 2014 - 11:12

    Civil Service, NOT SERVANTS

    August 29, 2014 - 10:34

    Why didn't Himalfarbspeak out when he was the most senior civil servant in Canada, when governments would have listened to him? Instead, he remained silent until he got his huge pension and now thinks we should listen to him. I don't have any respect for people who sit quiet when in power and then advocate after they retire. The time for him to speak up was when he held a power position, now he is just another highly pensioned civil servant, possibly feeling a touch of remorse.