Sunday, December 10, 2006

Jurisdiction Over Autism

The primary argument used by opponents of amending the Canada Health Act to include treatment for autism is that health issues are matters within provincial jurisdiction. The Conservative government, the Bloc and some "representatives" of the Autism Society Canada
[I use the term "representatives" loosely. ] argue that because health care is a matter within provincial jurisdiction the federal Canada Health Act should not be amended to include autism. This superficial argument would, if taken literally, require the repeal and abolition of the Canada Health Act. It would also require that we ignore the whole concept of cooperative federalism which has seen the development of federal-provincial sharing of resources and information to tackle issues which could overwhelm governments acting alone and strictly within their constitutional jurisdiction. Autism is exactly the type of problem which is too much for some jurisdictions to handle effectively and which requires federal financial support. Families are literally moving to rich Alberta, from across Canada, to seek treatment available to age 18 for their autistic children. In the face of this national situation the jurisdiction argument crumbles.

The development of cooperative federalism means that the federal government could make funds available to assist treatment of autistic Canadians without regard for their place of residence. Right now the federal government and the provinces are haggling over the receipt of federal monies to reduce wait times under provincial health care jurisdiction. There is no reason treatment of autism could not be required as a condition of receiving federal health care dollars under the Canada Health Act.

Clement says provinces still need convincing on wait-time guarantees

Sat Dec 9, 4:15 PM

By Chris Morris

MONCTON, N.B. (CP) - Federal Health Minister Tony Clement admitted Saturday that some of his provincial and territorial colleagues still need convincing on the issue of guaranteeing wait times for medical care, but he said he's confident it can be achieved.

Clement said a federal-provincial health ministers meeting in Moncton, N.B., underscored the fact that although money is a major sticking point, all jurisdictions agree on the need for timely access to quality health care for their citizens.

"It's not as if we're on Venus and they (the provinces and territories) are on Mars," said Clement as the two-day health ministers meeting concluded.

"We're all talking about making the system better. The provinces are doing a lot of work right now to reduce wait times. The issue is if we are going to go ahead with wait-time guarantees, how exactly would that work? What are the implications? We won't know the answers until we try some things out."

Clement wants the provinces to move forward with pilot projects on wait-time guarantees, but he said some of them still need convincing.

The federal Conservative government promised the guarantees, which are supposed to ensure patients can go to another jurisdiction at the government's expense if timely care is not available at home.

Clement said the federal government is moving ahead in health areas where it has jurisdiction, but the guarantees are supposed to be available to all Canadians.

"I suggested we are willing to work with provinces to run pilot projects to get information," he said.

"Right now we are operating in a vacuum. We have many questions but few answers because of our lack of experience in running wait-time guarantee programs."

New Brunswick Health Minister Mike Murphy, chair of the conference, said the issue is money.

"Mr. Clement is very clear as to his agenda and we'd like to partake in many of those things on his agenda but proper financing is in order," Murphy said.

The New Brunswick minister said some argue money from the 2004 health-care accord, which was supposed to fix medicare for a generation, is simply allowing the provinces and territories to keep pace with the inflationary cost of health care.

A recent report from the Canadian Wait Time Alliance says it is impossible to track the impact of the $41-billion health-care accord because the provinces aren't posting sufficient data.

Experts who worked on the report said it's regrettable that the provinces use inconsistent methodology to report results, making it impossible to identify leaders or laggards.

Two provinces - Prince Edward Island and Newfoundland - have not set up wait-time websites.

Prince Edward Island Health Minister Chester Gillan said the province is working on improving access.

"We're looking at any and all innvoative ways to get to the benchmarks," Gillan said.

However, critics maintain that benchmarks without guarantees are just empty promises.

Clement said a major federal and provincial meeting on wait-time guarantees will be held in February in Toronto.

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