Canada’s Medicare System: It’s all about equality for Canadians with disabilities

The preservation and strengthening of Canada’s Medicare system is very much an equality issue for people with disabilities. One of the most important roles of the public sector is to promote equality. And there is no one-single public government policy instrument in Newfoundland and Labrador that promotes equality for the disabled community. Whether born or onset disability, departments, agencies and even ministries tether our disabled to inaccessible programs and services.

Statistics readily show us that it’s the most vulnerable citizens of our society – people with disabilities and seniors – who benefit the most from our Medicare system. After all, they are the less likely to have the financial resources to access the growing for-profit element of health care in Canada.

The growing gaps and privatization of our Medicare system, however, means less access to health support services for seniors and people with disabilities and represents a step backwards for in their struggle for equality. This is seen most within the community and continuing care sectors of our health system. The irony of this situation is that preservation and expansion of this sector of our public health system not only promotes equality, it makes good economic sense.

The problem with respect to inadequate access to health support services in the community has existed for decades but reached a crisis point in the mid-1990’s when province began to restructure health care. The health care buzz words of ‘closer to home’ health care and the ‘continuing care model’ of health care were to be heard in every jurisdiction across the province giving rise to the closure of hospitals and the elimination of hundreds of acute care beds in the last decade. Unfortunately when it came to implementing a community-based health care model, our politicians failed to provide an adequate infrastructure and resources to community care – the less expensive preventative side of our health care system. The result has created an overburden Medicare system that provides less equal access for persons with disabilities and seniors.

Newfoundlands’s ability to promote equality should be measured by the degree to which our most vulnerable citizens can fully participate in all aspects of society. An important vehicle to achieve this is through the provision of a range of public services that supports the integration and participation of our disadvantaged citizens. Most of these services support and form a community-based health care system.

Canada’s ability to promote equality should be measured by the degree to which our most vulnerable citizens can fully participate in all aspects of society. An important vehicle to achieve this is through the provision of a range of public services that supports the integration and participation of our disadvantaged citizens. Most of these services support and form a community-based health care system.

Around the time that health care was being restructured across Newfoundland towards a community-based model of health care, our federal government, through their war of the deficit, cut back on its funding of health care and eliminated its funding for the many support services that support a community-based health care system. The biggest single factor in this regard was the 1995 federal budget of former Finance Minister Paul Martin, which reduced federal funding for health care and eliminated an important public policy instrument that promoted greater equality in Canada – the Canada Assistance Plan (CAP). CAP would have also gone a long way in providing financial resources to support a community care model of health within Canada.

CAP was a federal/provincial fiscal arrangement dating back to 1966 whereby the federal government provided provincial governments with fifty cents for every dollar they spent on community-based health and social services. These federal ‘50¢ dollars‘ provided provincial governments with a significant incentive to expand services and programs to allow our more vulnerable citizens like people with disabilities to fully participate in the lives of their communities. The elimination of CAP has affected the lives of persons with disabilities disproportionately to other Canadians since the national standards of CAP ensured that they had access to many of the vital services that relied on for independent living in their communities.

Since the elimination of CAP, provincial governments have failed to provide adequate funding for the necessary support services to sustain a community-based health care system. Although spending on community-based services has increased, most of that spending has come from private sources such as the Janeway Telethons, Dream Homes, Daffodil Place, Health Care Foundations etc.. The increased demand for health support services has greatly outstripped the increases in public spending.

Amidst high taxes, the generosity of the corporate world and consumers in this province has helped to ease the need for community services, unfortunately it's not enough. We have not even begun to grapple with the more devastated issues in health care for the disabled and senior community, home care, equipment, housing, drugs, human rights and much more.

It’s estimated that more than twenty thousand persons with disabilities need help with one or more everyday activities but over two thirds of those persons are not getting the help they need. There are many examples where provincial governments across the country have slashed, privatized, and/or downsized a range of services that would have greatly supported people with disabilities in overcoming barriers to participating fully in daily living, including economic and social activities.

The support services funded under CAP included such programs as home care, homemaker services, attendant care and respite care. CAP also contributed to the costs of medical and assertive devices that allowed seniors and people with disabilities to be integrated and fully participate in society. These inexpensive people-oriented services not only improved their quality of life. They helped keep them out of long -term care institutions and/or hospitals. Without CAP funding and no recognition under the Canada Health Act, these services now lack stability and can be changed or eliminated at the drop of a hat. As a result, the real-life needs of many people with disabilities are being eliminated.

This instability in funding for these vital support services has greatly attracted ‘for-profit’ interests and thus spread the growth a two-tier health care. The growth of ‘for profit’ private services in community health will always hit hardest at those with the lowest incomes resulting in less access to health care services for them compared to those who can afford to pay directly for health care. People with disabilities are disproportionately poor, and as a result their access to health services will decrease as a result of increased fees and privatization.

For people with disabilities, the goals of Canada’s Medicare system should be to assure equality of opportunity, full participation, independent living, and economic self sufficiency. A health care system that is increasingly relies on private financing results in the opposite – it creates unequal access. In fact, private sector involvement in our health care system only forces people with disabilities to rely more on the old ‘charity’ model of care – a model that emphasizes dependence, segregation and transfers the costs of disabilities away from the state and towards families and charitable organizations. The disability rights community strongly objects to this model as a throwback to the old British Poor Laws of the 1600’s.

Newfoundlands Medicare system needs to be revamped and strengthened through the development of provincial standards to ensure that it doesn’t continue to discriminate against people with disabilities. There are many essential health support services that are unavailable or unaffordable to thousands of NL'er with disabilities. While these necessary supports are diverse, the most widespread and acute needs relate to three areas:

• personal support services of all kinds (such as self-directed attendant care, home support services, sign language interpretation, communication supports, and support workers);
• assistive devices and supplies (such as mobility aids, hearing aids and other communication aids, incontinence supplies, home oxygen, etc.; and
• prescription drugs and related health needs (such as special diets)
• Health support services provided on an equal basis to all regardless of their residential or living arrangements. In particular, persons living independently or with families and other caregivers in the community should be eligible on an equal basis with persons living in residences and institutions.
• Health support services provided based on national standards applicable to Provinces and Territories, and be portable across jurisdictions.

These principles are essential for cementing the link between equality, full participation and health care. By incorporating home care, other health support services and Pharmacare into the Medicare system, the provincial government would go along way to promote better health outcomes, greater equality and independence for NL'ers with disabilities, and ensure our public universal health care system is strengthen, sustainable and equitable.

Brudder

Equal Access For The Disabled NL'er

Traditionally, disability issues have essentially been addressed as acts of charity. Persons with disabilities have suffered from a relative “invisibility”, and tended to be viewed as “objects” of protection, treatment and assistance rather than subjects of rights. Equal access to basic rights and fundamental freedoms including access to health care, employment, education, participation in cultural activities, that most people take for granted, have been denied to them.

Over the past two decades, a dramatic shift in perspective has taken place, and persons with disabilities have started to be viewed as holders of rights all over North America, However Newfoundland and Labrador still remains a distant shadow in that regard.

The United Nations High Commission for Human Rights propagates the “Rights-based approach to disability” which essentially means viewing persons with disabilities as subjects of law. Its final aim is to empower disabled persons, and to ensure their active participation in political, economic, social, and cultural life in a way that is respectful and accommodating of their difference.

The Biwako Millennium Framework developed to supplement the UN Millennium Development Goals, states that a rights-based approach should be taken to advance disability issues. The civil, cultural, economic, political and social rights of persons with disabilities should be addressed and protected.

• Non-discrimination: the Dignity of each individual, who is deemed to be of inestimable value because of his/her inherent self-worth, and not because she is economically or otherwise “useful”
• Autonomy and participation: the concept of Autonomy or self-determination, which is based on the presumption of a capacity for self-directed action and behaviour, and requires that the person be placed at the centre of all decisions affecting him/her; Equality of opportunity: the inherent Equality of all regardless of difference;
• Inclusion: and the ethic of Solidarity, which requires society to sustain the freedom of the person with appropriate social supports.

The Biwako Millennium Framework (BMF) recognizes that to uphold the rights-based approach to disability the following core issues be addressed–

• Prevention of causes of disability,
• Early identification and intervention of children with disabilities,
• Reaching out to persons with disabilities in rural areas,
• Raising awareness and advocacy for the inclusion of persons with disabilities in all activities in the community, including social, cultural and religious activities.
• Education, training and employment needs to be met.
• It is essential that persons with disabilities exercise choice and control over initiatives for community-based rehabilitation.

Food for thought!

Brudder

Thousands in N.L. 'suffer hideously,' palliative care report finds

How does one even begin to digest the truth and reality found in this report, especially given that this report remained hidden for nearly a year!

"Throughout Newfoundland and Labrador many of the most vulnerable, terminally ill and those with life-limiting illnesses continue to suffer hideously," says a needs assessment report completed last fall for the Dr. H. Bliss Murphy Cancer Centre in St. John's. CBC News obtained a copy of the report, which has not yet been publicly released.

"They struggle daily for medications and services and such as medical care, home care, nursing and medical care. They struggle through the bureaucratic roller-coaster of endless paperwork for admission to acute care, respite care, palliative care and long-term care facilities … because of the lack of these same basic services in their individual communities."

"Palliative care is currently a specialized service available to less than 10 per cent of the people who die in Newfoundland and Labrador."

Very scary, very sad and very demoralizing. On October 27, 2008 I had written a post very much related to this topic. At the time I was somewhat shy about posting it, because maybe the suggestions were more than could be easily proven. My thoughts then somehow seem more likely to have merit than not, and as a result of this report we ought to be taking what we are told by health care officials, less for granted.

In victory or shame of defeat, I am ready to go the extra mile to discover the dirt. Are you with me?


Brudder

National Hunger Awareness Day - What Should This Day Represent - Who Should Be Watching?

This is National Hunger Awareness Day. The General Manager of the Community Food Sharing Association, Eg Walters, indicates there are still a lot of people using food banks. Walters says locally they are seeing an increase of 25 to 30 % increase in some locations and more frequent visits.

According to the Food Sharing Association it cost $168.14 a week for basic food, to feed a family of four. Feed them what is the question? Canada's food guide would certainly disagree with this promotion, so in reality, FSA and Stats Canada are saying, as long as it's edible, it's food!

I took the liberty to draft a very harsh, relatively modest week long menu, with current supermarket prices, and where possible I used discount stores such as Pipers and Dolla-Rama to buy yet cheaper product and quality. The attached menu below does not include snacks, treats, lunch items, fresh fruit or vegetables, very little real nutrition in fact. This list does not support household and personal care items, over counter medicines or dairy. I believe you will be quite awed by the findings.

Relative to all of this is just how little income support payments are at $666.00 per month, and they are provided for food, utilities and clothing. Simply put, it's undoable and it has to change!
This day comes along with the reports from both child youth services and and child youth advocate about the digressive state that children live in.

Poverty has man forms and colors, I personally do not see a greater physical or emotional abuse than that of having a child go hungry! Poverty shapes both families and the way they live. Families without financial resources strong enough to provide even the most basic of needs, often take on many faces, sometimes these faces can affect the way children and parents interact with each other.

Children at most ages do not understand the concept of financial restraint, and whether it's a cell phone, new $100 shoes or splash cash, if they want it, they expect to have it. Socially under developed children do not in most cases build on stereotypes, and will associate with other children from various financial abilities. Thus, when a lesser fortunate child's best friend can afford a blackberry, then it its expected he/she can have one too. Children learn quickly to be bitter, vindictive, and even threatening toward their parents when they do not get what they want. Often eating healthy or eating at all depends how often a child's wish is granted.

Food For A Week

Resource: Canada's Food Guide

Take a look, please offer your comments.


Brudder