accountability? why not?

[Guest Namgalsip]

Hey all,

 

Maybe someone can share their thoughts with me. I was wondering why provinces are having so much difficulty with Romanow's request for accountability? I'd think it's a good thing that we can finally find out where all our money is going.

 

It seems to me that Canada's health care has soooo much more money than most countries in the world and yet our system struggles. I personally think it's more a matter of how the money is spent rather than the lack of it.

 

Maybe I'm missing something.

 

Nams

[Guest tirisa]

I agree... I think that the provinces should be accountable to the feds for the money that they've received from the feds, to prevent more toasters and lawn mowers to be purshased with diagnostic equipment funds. However, I think the reason why provinces don't want to do it is two-fold. 1. Being accountable means more bureaucracy... having to put systems into place to keep track of where the money has gone is, and hiring many many people to track it, is a pretty huge process. 2. The provinces HATE having to "report" back to the feds for their spending habits, since it implies that the provinces can't truly control what happens to the money. No more lawn mowers and toasters for the hospitals. Anyway, I think those are the main reasons, as I see it. Other points of view would be extremely welcome and helpful in better understanding this situation.

 

Cheers,

T

[Guest DHP62]

I think a major reason provinces don't want strings attached by the federal government goes as follows: provinces feel they are closer connected to their own population then the federal government and can therefore allocate money more appropriately to serve the needs of their province's population. Health needs vary widly across the nation, from province to province. Therefore, provincial governments feel they are better suited to determine where money should be spent, rather than being told by the federal government under generalized rules that are not specifically suited to that province's populations need.

 

As for having to report back to the federal govenment, the CHA made health care a provincial jurisdiction, end of story. So really, the federal government is going back on its own legislation by asking provinces to report back to them. I don't think provinces would mind being accountable to their own province's population, but there is a certain bitterness behind having to be accountable to the federal government, who have time and time again screwed the provinces over. I for one would not want to report to a boss that treated me poorly and previously told me to work independently.

 

Sorry, that's very anti-federal, but I'm just assuming the role of the provincial governments.

[Guest cheech10]

Actually, the BNA Act and later the Constitution Act made Health Care a provincial responsibility, not the CHA. The federal government offered to pay a portion of the provincial health costs as long as they met 4 (and later 5) broad principles in the provincial insurance plans. The provinces resent what they see as a further intrusion into their affairs at a time when the feds are paying a smaller portion than ever before. All provinces want to maintain their independence, and don't want to abide by any rules other than those outlined in the CHA.

[Guest DHP62]

good call cheech, I forgot it was the BNA. All those acts get confusing...although I need to know them for a midterm coming up...yikes! Thanks for the clarification.

 

And yes, I agree that provinces see monitoring and accountability as an intrusion on their jurisdiction.

[Guest shutterbug]

From a health information perspective...it would be extremely extremely difficult and costly to develop a system to (reliably) report the information that the feds want.

 

Most likely the info would come from existing data sources with no plans to standardise reporting practices across the board...this is what was done when the PIRC (I forget what it stands for) indicators were mandated...:rolleyes in the end the information was totally useless and wasn't even used in resource allocation planing.

[Guest Namgalsip]

Accountability dosn't necessarily have to be to the federal gov. Here's a quote from a globe and mail article

 

"The Commission on the Future of Health Care in Canada recommends that a national (not federal) body be created that would focus on accountability; the Health Council of Canada would act as an impartial mechanism for collecting information, proffering strategic advice and seeking input and advice from the public.

 

Do we have too many hospital beds? Not enough doctors? Should we spend more money on drugs to keep people out of hospital? Hire more nutritionists so we need fewer heart surgeons?

 

We do not know the answers to these and many other questions, because we do not have the numbers or the research. In our debates about allocations to the health system, there is much rhetoric but few facts.

 

The health council — or something like it — is necessary because in the age of genetics we remain in the health-information Stone Age. For all the money we spend on health, we have little clue about the results. We do not have the data we need regarding health outcomes."

 

I still don't see anything wrong with this.