Thank you, Mr. Chair.
On behalf of the Canadian Medical Association and our 83,000 members, thank you for the opportunity to appear as part of your pre-budget consultations. The CMA strongly supports the federal government's commitment to work with provinces and territories toward a new health accord with defined objectives and long-term funding agreements.
To help deliver on this commitment, we've outlined six recommendations for prompt federal action to ensure Canada is prepared to meet the health care needs of its growing and aging population.
First is additional funding to the provinces and territories targeted to support seniors' care by means of a demographic top-up to the Canada health and social transfer. Second is a targeted fund for home and palliative care innovation. Third is infrastructure investments to improve and provide for more long-term care. Fourth is coverage for highly expensive prescription medications. Fifth is more financial support for family caregivers. Sixth is an exemption for group medical structures from the federal proposal to alter access to the small business deduction, which threatens research, teaching, and specialized services.
I would like to briefly expand upon three of these.
First, we know that jurisdictions are struggling to meet the health care needs of our aging population. That is why the CMA is recommending new seniors' care funding be provided to the provinces and territories by means of a demographic top-up to the Canada health and social transfer. This needs-based funding would be delivered in addition to the Canada health and social transfer, which currently disadvantages jurisdictions with older populations. This fair method of distribution ensures there will be no losers, avoids opening up the funding formula, and may be delivered immediately.
Second, the CMA was pleased to hear the federal government commit to providing more and better home and palliative care services. To deliver on this commitment, the CMA is recommending a targeted home and palliative care innovation fund. This fund would encourage innovation in home care and help scale up best practices, the silos of excellence such as the Bruyère Foundation, and address critical shortages. This fund would also support development of a much-needed national strategy for palliative and end-of-life care.
Finally, I would like to take a few moments to discuss the federal proposal to alter access to the small business deduction. The CMA welcomed the finance committee's acknowledgement of the economics of medicine as a small business and your recommendation to maintain the incorporation framework for professionals. Despite the committee's recommendation, however, budget 2016 introduced a proposal to alter access to the small deduction.
The CMA estimates that this change will affect nearly 15,000 physicians incorporated in group medical structures, mostly in teaching hospitals and universities. In doing so, this proposal will hinder medical research, training for the next generation of physicians, and patient access to specialized care.
If the proposed changes are enacted, these partnerships will likely wither and die as the federal government will be incentivizing solo practice over group practice. This concern was reaffirmed by a recent survey of physicians that found that over 60% would dissolve their group structure should this proposal go through, even though most of these group structures are within academic health sciences centres and were not formed for commercial or taxation purposes but rather mandated by provincial negotiations.
To avoid these unintended negative consequences, the CMA is strongly urging the federal government to exempt group medical structures from the application of this proposal. In summary, the CMA is offering six clear and actionable recommendations for the federal government to deliver on its commitment to invest in Canadians and support economic growth.
I welcome any questions you may have. Thank you.