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February 8, 2002 The Honourable Roy Romanow, Q. C. Commissioner Commission on the Future of Health Care in Canada P.O. Box 160, Station Main Saskatoon, SK S7K 3K4 Dear Mr. Romanow, On behalf of the Association for Healthcare Philanthropy Canada (AHP Canada), I would like to thank you for the opportunity to present our views on the future of health care in Canada. These are challenging times in health care, and the work of your Commission is critical in demonstrating leadership and providing suggestions and a framework to restore the public's confidence in both its health system and the sustainability of that system for future generations of Canadians. On behalf of our Association and the thousands of volunteers we represent, I would also like to thank you for accepting our invitation to be a keynote speaker for the 2002 AHP Canada Conference in Banff on April 29. We look forward to hearing your views and insights gleaned from the many meetings with groups from all across Canada – groups, like ours, who care deeply about the future of our cherished health system. I am also grateful to you for agreeing to meet with the Board of Directors, President and CEO of AHP International and the volunteer Board Chair for our Association following your address. This conference will serve as a forum for us to present a more formal paper and to provide additional feedback to the Commission and to join with others to address the ideas and concepts in your most recently released discussion paper. We believe there will continue to be an increased need for philanthropy within a system that is financially strained, and we look forward to hearing your views on how we can continue to build a culture of philanthropy in our communities to support health service delivery and healthy communities and citizens. Largely centered in hospitals, AHP Canada represents approximately 400 members across Canada working in the field of fundraising for not-for-profit health care organizations. This annual educational conference is well attended by volunteers who work with us to advance philanthropy in our institutions and foundations on behalf of the communities we serve. It is our view that the role of volunteers in the system must be recognized and strengthened, and we look forward to sharing our perspectives on how the Commission may address these most valuable contributors to our system. This letter serves as an overview of AHP Canada's views on the four areas identified by the Commission: Values, Sustainability, Continuous Change and Cooperative Relations. Canadian Values: While Canadians cherish their health care system, they strongly support an open, honest debate of its various strengths and weaknesses. Liking the system does not mean they support the status quo, therefore all alternatives must be on the table if the Commission is to be taken seriously by the public. A single tier system is desirable, but the Commission should not foreclose on its duty to examine any alternative that can improve availability of services, access to services and quality service delivery. We have a very good system, but we do not have a monopoly on ideas and methods to improve our system. We also believe strongly that any recommendations to make changes or reform the system should consider and reflect the enormous contributions that are made daily by volunteers in the system. Their contributions should serve as a foundation and building block for any reforms contemplated by the Commission. We also believe that the Commission provides a natural and necessary opportunity to explore creative approaches to improve our valued health system. Some of these include:
Sustainability Options for raising additional revenues for the health care system varies: income tax, private insurance, user fees, premiums and partnerships. The philanthropic sector is called upon increasingly to fund operational needs such as equipment, facilities and technology, and value added patient and family educational and support programs. Similar to the educational sector, we believe that a federal/provincial matching programs for healthcare philanthropy may provide additional incentives for effective fund raising programs and incentive for donors who invest in their communities. The main cost-drivers of the system are related to advanced therapeutics, drug and medication costs, technology and servicing a population that is living longer and has a growing number of elderly people. This is an area where private funding mechanisms may be instrumental in making the difference, given the natural partnerships between government, community and individuals. We can work together to create meaningful partnerships and opportunities for positive change. The limitations on revenues and the growing costs to provide quality care – given the costs associated with new technologies and caring for a growing, aging population – makes the question of sustainability one that must be answered, and one that we feel can only be answered with some fresh, creative thinking. Continuous Change The federal government has often hindered provincial politicians from examining the tenets of medicare and the Canada Health Act. An environment that embraces controversial debate and exploration of concepts that will lead to increased transparency on service costs, open forums to facilitate public consultations and improves accountability for the use of public funds are recommended processes for managing change. We would recommend an ongoing role for the Commission after 2003 so that it could provide leadership and ideas on a national level and fill the current gap that exists federally. In addition, we recommend that the Commission examine the role of the individual in health care, one that promotes wellness and healthy lifestyles, and creates incentives for individuals to take more responsibility for their health. Cooperative Relations In reviewing cooperative relationships, we would recommend that there be consideration for realignment of jurisdictional roles and responsibilities to reflect current and future fiscal realities and demographic and public policy trends. We believe that the federal government should provide more funding and leadership in health care. We are hopeful that the Commission can play a role in bridging the divide between the federal and provincial government and, from your consultation and research papers, make recommendations on how they may work together to discuss national health issues rather than scoring points at each other's expense. Issues for AHP Canada Health care is not solely a responsibility of government(s). Our health care system is a community asset and that community includes hospital and health related institutions, foundations, volunteers, auxiliaries and the donor communities who invest in health care through philanthropic programs. We would welcome the opportunity to be a "Partner Organization" during your consultation phase to address the role of philanthropy in the health care system. According to a recent article published in a Ketchum Canada newsletter, charitable donations from all sources in Canada totaled $6.56 billion in 1999. Of this amount, 74 percent, totaling $4.85 billion, came from individual Canadians, 14 percent from corporations and 12 per cent from foundations. In 1999, Canadians gave approximately $1.25 billion to health charities. We believe that we are a significant contributor to sustaining the health care system through our philanthropic work. Our organizations are facing ongoing challenges in the following areas and these are significant areas of fundraising for health charities:
We applaud the work of the Commission. We believe that it will be the driving force behind the articulation of concepts that will address the issues impacting the sustainability, accessibility and quality in our system. Your work should be the catalyst to bring these challenging public policy issues forward to help shape the future of Canada's health system for generations to come. Our role in the system provides an invaluable resource for the Commission, and we thank you in advance for the opportunity to meet with you in April and for taking the views of the AHP into account in making your recommendations. I have included a list detailing the membership of our Board for your reference. It is our intent to bring to your most valuable work a national perspective. Sincerely, Pearl Veenema CFRE CHE Chair, AHP Canada conferences | membership | fund | education | roundtables | bursaries |
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