NS Liberals enter health talks armed with a pea shooter

It came as no surprise but it was nevertheless sad to see that the McNeil Liberals have run up the white flag on federal health transfers. In an interview on Thursday Stephen McNeil reportedly said that his government won’t prolong the debate over the former Harper government’s policy changes that have left Nova Scotia health funding worse off by tens of millions every year.

McNeil, just back from an Ottawa meeting with Justin Trudeau, was presumably interviewed in the customary post-cabinet scrum. But a media scan indicates that only the Chronicle-Herald reported his comments. Perhaps his words went no further because aside from saying the debate is over, the rest of McNeil’s remarks – at least as reported by the Herald – were pretty much incomprehensible. McNeil appears to have said that Nova Scotia is asking: “is there any way that we can now look at will come into the system in a new and innovative way to be able to make sure that those with an aging population get the benefit of that?”

That stuff about aging population sounds like a reiteration of the position the Atlantic Premiers adopted several years ago when they decided they would get nowhere by protesting the Conservative government’s health funding changes that are costing Nova Scotia $25-$30 million per year in health transfers and tens of millions more in equalization. Instead of crying over spilt milk, the Atlantic Premiers, along with those from Quebec and British Columbia, argued that any new funding arrangement should take demographics into account and provide more bucks to provinces with older populations. Of course, that common front was before Sunny Ways, back when there was a big mean Conservative government in Ottawa.

If demographic consideration was the position McNeil, was trying to convey it was undercut later in the article when Health Minister Leo Glavine talked about the Atlantic ministers of health pushing a common request – support for chronic disease management – when federal and provincial health ministers meet in Vancouver late this week. Glavine went on to say that arguing about the funding model isn’t a productive use of time. “We’ll just get into a back and forth with some of the other provinces who just don’t really have that (aging demographic like Nova Scotia.)”

So there it is. The Premier implies the province will try to make the demographic case, the health minister suggests we won’t because some other provinces (such as Ontario and Saskatchewan) don’t agree. Obviously, the Premier and the health minister need to sing from the same songbook. It would be preferable that the song be about reversing some of Harper’s negative changes to the federal transfer formula over the past ten years, and his 2011 decision to limit the growth in transfers to 3% a year beginning in 2017.

Atlantic Canadians voted overwhelmingly against the Conservatives three months ago and it’s just possible some of that vote was a protest against the Conservative position on health transfers. It’s a betrayal for the Liberal government in Nova Scotia to refuse the fight now that there is a Liberal government in Ottawa. Health transfers come from the federal purse. The Trudeau government doesn’t need the approval of provinces to right a wrong committed by its predecessor. In the interests of Nova Scotians who need an adequately-funded health care system, the McNeil Liberals shouldn’t be so quick to let the feds off the hook.

At the very least, the provincial government should be strongly pushing the demographic issue. On the same day that McNeil and Glavine were contradicting one another, the Nova Scotia Nurses Union (NSNU) released a report on what it sees as a crisis in long term care in Nova Scotia. The union acknowledged that this was somewhat old news, but added a couple of fresh angles. One tidbit, backed up by a CBC investigative report http://www.cbc.ca/news/canada/nova-scotia/nurses-union-registered-documents-1.3404482 suggested that overall staffing levels of nurses and continuing care assistants is not only below the optimum suggested by experts but is less than what the Department of Health and Wellness is paying to homes.

And while the NDP has been in the news over the last couple of years about the increase in waiting lists and wait times since the Liberals froze construction of new beds, it was news (at least to me) that the average age of people now in long term care homes is significantly above the national average. According to the NSNU report, while only 55% of Canadians in long term care are over 85 years of age, 73% of Nova Scotians are, with their greater needs adding to the burnout-inducing workload of nurses.

None of this made much of an impression on Minister Glavine. According to a Canadian Press account, the less than affable MLA from King’s West “bristled” at the suggestion there is any crisis in long term care. This reaction was consistent with a document put out last July by Glavine’s department, and consistent with the McNeil government’s whole austerity schtick. The doc, Continuing Care A Path to 2017 Review, Refocus, Renewal, began by telling Nova Scotians that we have one of the best funded long term care systems in the country, with a ratio of long-term care beds to population that is one of the highest is Canada. Seniors who chose to read the report while whiling away some of the 333 days of waiting for a nursing home placement were no doubt be delighted with that good news.

The report does not provide a source or time frame for those claims (good data on long-term care costs is hard to find) nor does it mention that Nova Scotians in long-term care pay among the highest rates in the country. (And then, of course, we are old, as the Liberals love to repeat in a different context). Even if the department’s claims are accurate, the wisdom of trying to deny a well-documented crisis (the Herald did an excellent series on it two years ago) by saying how good things are is probably a bad idea at any time.

This “everything is hunk-dory” approach is particularly misguided on the eve of a meeting of health ministers. There is is some federal money on the table for health care. If Liberal campaign promises are to believed, they will increase health spending (above the Harper-imposed 2017 cap) by $3 billion during their mandate and direct it to home care. There can be no better place to chisel away the per-capita mold than home care, where the demographic factor is obvious.

If Glavine could take off his blinkers and try to make the argument, he could call on the authority of the Canadian Medical Association. As I wrote last Oct. 4, a CMA report, done for the association by the Conference Board of Canada –Federal Policy Action to Support the Health Care Needs of Canada’s Aging Population – called for a “demographic top-up,” starting with $1.6 billion next year to be distributed based on the impact of an aging population on health costs in each province and territory. An overall 1.1% increase in health spending, paid for by the feds, would go disproportionately to provinces whose older populations were driving up health costs. As I wrote at the time, “Increases would range from just 0.1% of health spending in Saskatchewan to a high of 1.6% in New Brunswick and 1.5% in Prince Edward Island. British Columbia’s increase would be 1.4%, and Nova Scotia’s 1.3%, which would be worth almost $54 million to the province next year.”

The Nova Scotia government, through Glavine, should be using the CMA report at this week’s meeting to bolster past arguments for a health funding formula that takes our aging population into account. The Liberals shouldn’t repeat the error they committed with the film industry, letting public policy be shaped by their penchant for austerity and some random statistics from the bureaucracy.

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About Richard Starr

RICHARD STARR has had careers as a journalist, public servant, broadcaster, political staffer and freelance policy adviser. He is author of numerous newspaper and magazine articles, appearing in everything from Atlantic Insight to Atlantic Progress. A lifelong student of Maritime history, Starr is married to playwright and former MP Wendy Lill. They live in Dartmouth.
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