Mr. Chair, members, thank you very much for this opportunity to be before the committee on behalf of the CMA and its 76,000 members. Canadians believe that transforming our health care system to meet 21st century Canada must be among the highest priorities for all levels of government, including the federal government.
I would like to begin by commenting on the health transfer framework announced by the Minister of Finance in December. This announcement provided some predictability for years. However, with the federal government reducing its involvement in several areas affecting health or health care, added costs will end up in the laps of the provinces and territories. So while this budget may enhance the federal government's fiscal prospects, it will do little to help the provinces and the territories.
But there's more to this debate than just funding. We believe that Canadians would be better served if federal health care transfers came with specific guidelines, ensuring that the system provides care of comparable access and quality to Canadians across the country, regardless of their circumstances. We are encouraged that the Minister of Health has indicated that she wants to collaborate with the provinces and territories on developing accountability measures to ensure value for money and better patient care. We look forward to the minister's plan for accountability.
This budget is notable for other missed opportunities. For many years, groups across the political spectrum have called for a pharmaceutical strategy to reduce national disparities. In fact, such a strategy was committed to by governments under the 2004 accord. Minister Kenney referred to this issue indirectly when he said that the recent cancellation of supplemental health benefits for refugee claimants is justified because refugees should not have access to drug coverage that Canadians do not have. Rather than cutting off those desperately vulnerable people, Canada's physicians urge the federal government to work with the provinces and territories to develop a plan that ensures that all Canadians—all Canadians—have a basic level of drug coverage.
Indeed, we now appear to be in a race to the bottom in the way we treat vulnerable groups—for example, by deferring old age security for two years, changing service delivery to veterans and mental health programs for our military, and the EI program.
Significant policy changes have been announced since the budget, with little opportunity for debate and little evidence provided. We note as well the lack of open consultation with Canadians on matters of great importance to their lives. Successful policy requires buy-in, which is best achieved when those interested are able to participate in the policy-making process.
This brings me to a wider concern shared by our members that policy-makers are not paying adequate attention to the social determinants of health, factors such as income and housing that have a major effect on health outcomes. We remind the government that every action that has a negative effect on the social determinants of health will have dramatic physical consequences.
The federal government is the key to change that benefits all Canadians. While there are costs and jurisdictions to consider, the CMA believes that the best way to address this is to make the impact on health a key consideration of every policy decision that is made. The federal government has used this approach in the past as it relates to rural Canadians, for example.
We therefore call for a new requirement for a health impact assessment to be carried out prior to any decision made by cabinet. This would require that, based on evidence, all cabinet decisions take into consideration the possible impacts of health and on health care and whether they contribute to the country's overall health objectives. A similar model is in use in New Zealand and some European countries.
For example, if we took that example in tobacco legislation, we would influence our tobacco strategies. Such an assessment would have a particularly dramatic impact on the effects of poverty. Poverty hinders both human potential and our country's economic growth, and needlessly so, as there are many ways to address it effectively.
The National Council on Welfare, which will disappear as a result of this budget, reported last fall that the amount it would have taken in 2007 for every Canadian to have an income over the poverty line was $12.6 billion, whereas the consequences of poverty that year added up to almost double that amount.