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The Honourable Jim Flaherty, Minister of Finance, today announced a major new investment in health care. The new investment in health care will see funding grow to record levels from $30 billion per year in 2013-14 to $38 billion per year in 2018-19, for a total investment of $178 billion in health care over the five-year period.

The Government also confirmed the Canada Social Transfer (CST) will continue to grow at its current rate of 3 per cent annually in 2014-15 and beyond, Equalization will continue to grow in line with gross domestic product, and Territorial Formula Financing (TFF) will continue to grow based on its current formula.

The CHT and CST will be reviewed again in 2024.

Maria’s story isn’t unusual. The vast majority of Canada’s seniors, 92%, live in private households. About one quarter of people 65 and older live alone. With increasing life expectancies, a greater number of people are living with several chronic and progressive medical conditions. Close to 15% of Canadians aged 65 and older also live with at least some cognitive impairment – difficulties with their memory or completing daily activities such as banking and cooking.

Within Canadian hospitals, Best Possible Medication Histories (BPMHs) are increasingly becoming the standard of care. The process of creating BPMHs, primarily led by hospital pharmacists, help reconcile patients’ medications. Hospital pharmacists engage in an intensive process to interview patients, review all medications from home, and contact all pharmacies patients use in order to develop definitive prescription lists. If there are discrepancies between the medications a patient takes and a list their pharmacies provide, the hospital pharmacist often offers recommendations to physicians about how to manage those inconsistencies.

Home care organizations are also beginning to explore different ways to harness the expertise of different health professionals. Pharmacists, for example, have a knowledge base about medications that goes beyond their traditional roles of filling prescriptions and providing basic patient education. They can play critical roles within the community to reconcile medications and offer strategies to minimize “pill burden.”

Renegotiating the Canada Health Transfer – the mechanism Ottawa uses to transfer health-care dollars to the provinces – is a golden opportunity to send a message: The days of blindly shovelling money into health care are over.

The Canada Health Act

there is virtually no enforcement

The health-care crisis facing Canada today (along with its accordant costs) in many ways parallels the challenges facing Canada in the early 1990s regarding welfare dependency. The successful welfare reforms that gave the provinces the autonomy to innovate provide a model for reforming Canada's health care.

The 1995 federal budget restructured (and reduced) federal transfers to the provinces for social programs

The results were stunning. The number of Canadians receiving welfare declined from a peak of 3.1 million in 1994 to 1.7 million in 2009, up slightly from 1.6 million in 2008. As a percentage of the population, welfare recipients declined from a peak of 10.7% in 1994 to 5.1% in 2009.

unprecedented, one-sided meetings

the majority of provincial and territorial leaders said the deal amounted to a take-it-or-leave-it offer that was slapped on the table without any chance of discussion

"We were expecting to discuss how we were going to discuss federal transfers,"

The gradual levelling off in growth ofhealth transfers is probably the best possible deal the provinces and territories – and Ottawa for that matter – could hope for. At least in base political terms.

But shrewd tactics and political palatability are not the same thing as good public policy. At a time when medicare needs leadership and vision, the new accord continues the lamentable tradition of thoughtlessly shovelling money at the status quo.

Jim Flaherty’s offer was this: Continuing the 6-per-cent annual increase in the Canada Health Transfer and 3-per-cent per annum hike in the Canada Social Transfer until the 2016-17 fiscal year; after that, until at least 2024, increases in the CHT will be tied to economic growth, while the CST will continue at 3 per cent.

Total Transfer Protection (TTP) provided in 2010-11 ($525 million), 2011-12 ($952 million) and 2012-13 ($680 million) ensuring that a province’s total major transfers in one of these years are no lower than in the prior year. For the purpose of calculating TTP, total major transfers comprise Equalization, CHT, CST and prior year TTP.