Canadian Women's Health Network's Submission
To The Commission on the Future of Health Care in Canada
Women are concerned with health care services in Canada. We represent the majority of paid health providers, and also provide the bulk of the unpaid caregiving in communities and homes. As well, we are frequent users of health care services, primarily due to our reproductive roles.
Therefore, it is essential that that a gendered analysis is considered in the " work toward making recommendations to ensure the sustainability of a universally accessible, publicly funded health system, that offers quality services to Canadians and strikes an appropriate balance between investments in prevention and health maintenance and those directed to care and treatment. " www.healthcarecommission.ca
Despite media reports to the contrary, we do not believe that our health care system is in crisis. Canadians have much to be proud of. However, there are challenges, for example: the de-listing of services covered, increasing drug and technology costs, increased private spending and declining public funding, and the erosion of federal coordination. New service models are needed to address these challenges.
In this light, a renewed vision of Medicare must include as a minimum:
- Publicly funded and non-profit administered health care system: It has been well documented that publicly administered health care is more efficient, cost-effective and equitable than a privately run system. Medicare is perceived as a pillar of Canada's health care system and as such should be maintained.
- Canada Health Act respected and expanded to include:
- A national Pharmacare Program and mechanisms to manage equitable access to medical technologies and new techniques:
- A national Homecare Program: Women are on the front lines of caregiving and receiving care, and home and community care policies and practices affect them in different ways than men. Caregiving has a greater impact on women's lives, and has been a significant contributing factor to economic inequality between men and women. As such, a national Homecare program would improve the living conditions for both the caregiver and recipient.
- A National program on health promotion and disease prevention: Our current health care system is focused on treatment and intervention. This is very costly and inefficient. A National program would enhance research, capacity development and information dissemination on health promotion and disease prevention policies and programs in Canada.
- Protection of our Health Systems in international trade agreements: The Federal Government should exclude health services from all international trade agreements.
- A strong federal role in coordinating equitable access to health services
This renewed vision must reflect and support the principles of equity, social justice and the precautionary principle. This means a commitment to access based on need not the ability to pay and that when there is uncertainty about a procedure, policy or activity the onus should be on those who wish to carry it out to demonstrate in advance its lack of harm.
This renewed vision should include in its framework:
- New models of engaging the Canadian public in health services and increasing their capacity to make informed decisions about their health and health care. Canadians have continued to articulate a desire for increased access to credible information, i.e. the full spectrum of information on health conditions, treatment options, health outcomes, and healthy public policy; support for self care activities; and mechanisms to participate in health service planning. Although there are some exciting examples, there have not yet been systemic changes that would make this goal reachable.
- Gender-based analysis and women-centred models of care: Experience has shown that gender is rarely considered as a variable in assessing local health needs and that, the health needs of women are rarely considered separately from those of men. Consequently, gender based analysis should be mandated by all those involved in health service research, planning, implementation and evaluation.
- Openness to innovative and alternative methods of care: The health care system should reflect the diverse health practices of Canadians. As more people are discovering complementary approaches to traditional methods, including traditional Chinese medicine, naturopathy, chiropractics and midwifery, the renewed system must consider these approaches.
- Population health: Role of health determinants: Research has clearly demonstrated the impact of the "structural" determinants of health on the well-being of populations. The links between health inequities and economic and social inequities are clear. Thus, governmental programs and policies should require health impact assessments and programs that address structural inequities should be reinforced and expanded.