Canada's Health & Care Economy

The New Democratic Party built Canada's public healthcare system, which today stands as one of Canadians' greatest sources of national pride. Canada's "care economy" encompasses our healthcare sector, but also the crucial labour of childcare, disability and elder care.

Caring for Canadians is some of the most essential work in our society today. Together, it makes up the largest employment sector in Canada, and it is low-carbon work that drives our economy and improves our quality of life.

But too many jobs in our health and care sectors are underpaid, understaffed, underappreciated, and facing growing privatization – it's time for a change.

Under an NDP led by Avi Lewis, healthcare and care work will be expanded, better paid, properly valued, and shielded from profit-taking. Here's how:

1. Healthcare: Shift the goalposts to truly universal healthcare, bringing pharmacare, dental, vision, hearing and mental health care under the public system. Ensure access to primary health care teams covering the spectrum of care in every community in the country.
2. Elder and long-term care: Take the profit motive right out of the sector, bringing long-term care into the public and non-profit system; fund a range of local options for aging and supportive care in communities across Canada.
3. Childcare: Double the number of high-quality spaces in the public and non-profit sectors; improve access to culturally-appropriate childcare and use Canada Post to send a free baby box to new parents.

All of these efforts will require many more workers in our understaffed healthcare and carework sectors.

We'll attract more workers to the field by making care work a stable, valued and well-compensated career in Canada. An Avi-led NDP will train and attract more nurses, nurse practitioners, personal support workers, social workers, harm reduction workers, childcare and other essential carework roles by increasing wages and benefits with national standards and expanded public and non-profit sector roles; streamlining recognition of foreign credentials; implementing pan-Canadian licensure as well as residency spots for internationally trained doctors; and following the lead of many European countries by making post-secondary education tuition-free.

Protecting and expanding health care

Healthcare is our defining national institution. The principle that medical care should be based on need, not on one's ability to pay, is something that unites Canadians. It is our party's crowning achievement, one that cannot be taken for granted given the threats that it now faces.

What was once a right-wing dream of expanding privatization is now our reality. More and more provincial premiers are starving our public system and increasing private services – while the federal government lets them get away with it.

Our task, as Tommy Douglas once said, is to save our healthcare system from "subtle strangulation." The federal government needs to start enforcing the Canada Health Act, and rebalance the cost burden between Ottawa and the provinces. The original intent of Medicare was that costs would be shared on a 50-50 basis between the federal and provincial governments: today, the Canada Health Transfer makes up less than a quarter of the share.

We also have a moral responsibility to address the toxic drug crisis at the speed and scale that this emergency demands. It is a slow motion, mass-casualty event that has killed over 50,000 Canadians since 2016. These are preventable deaths, and it's time to respond with a healthcare approach grounded in evidence and compassion so that no one else has to mourn the loss of their loved ones to drug poisoning ever again.

With Avi, a renewed and revitalized NDP will protect and expand our universal healthcare system. The programs that the NDP fought for and won in the last parliament – dental care, and coverage for birth control and diabetes drugs – were important victories that have made a real difference in people's lives. Now it falls to us to build on these successes and bring truly universal health care to Canada.

An Avi-led NDP will:

• Deliver health care that covers you from head to toe. It's time to build a health care system that includes universal coverage for dental, prescription drugs, vision, hearing and mental health care. Not only will it make life more affordable for millions of Canadians, it will allow people to lead healthier lives and prevent trips to the emergency room by making sure that cost is never a barrier to seeing a dentist, a counsellor or filling your prescription. Yes, this will reduce profits for private insurance companies, but it will dramatically lower health care costs for all of us, and the country as a whole.
• Expand team-based primary care across Canada. We will ensure that every family has access to primary care by promoting team-based care, where family doctors and nurse practitioners work together with other health professionals to deliver primary care in local communities. These care teams will develop strong links with social service providers, helping to build healthier communities with a focus on prevention.
• Defend and improve reproductive healthcare. In many parts of Canada, especially rural and remote areas, access to abortion is virtually nonexistent. The federal government must ensure equal access to reproductive healthcare and enforce the Canada Health Act when provinces seek to limit access to this important right.
• Recruit and retain nurses. We will improve patient care and promote the recruitment and retention of nurses in the public system by mandating safe hours of work, incentivizing provinces to adopt nurse-patient ratios and offer paid preceptorships for nursing students so no student is working unpaid in a hospital or long-term care home. We also need streamlined registration pathways for internationally educated nurses and other health professionals. Finally, we will phase out the use of private nursing agencies, which are draining billions of public dollars out of the health system and into private health care profits, weakening the public system's ability to hire and retain full-time staff.
• Address the toxic drug crisis with a national healthcare approach rooted in harm reduction, evidence, and compassion. The toxic drug crisis is a public health emergency that demands coordinated and comprehensive action against rising preventable deaths. The federal government must commit to ensuring and expanding access to life-saving harm reduction services including drug checking, supervised consumption, safer supply programs, and widely available naloxone. Canadians faced with toxic drug supplies deserve federal policy that is guided by human rights, public health principles, and dignity.
• Build a nationwide network of "Crisis Response, Community-led" (CRCL) services to support people in mental health crisis and keep them and the broader community safe. CRCL services (pronounced "circle") involve crisis care delivered by teams of mental health professionals and community members trained in trauma-informed care, crisis intervention and de-escalation strategies. The model has been implemented in several British Columbia municipalities including North & West Vancouver, Victoria, New Westminster, Comox Valley and Prince George, with promising results for people in distress, while freeing up law enforcement officers to contend with violent crime.

Reimagining elder and long-term care

Today, one in five Canadians are over 65, and in the next five years seniors will make up 25% of the Canadian population. Allowing our elders to age with dignity, proper support and in the place and manner of their choosing is a key priority of an Avi-led NDP.

Across Canada, seniors and the people who care for them are advocating for new forms of elder care, from creative experiments in aging in place; non-profit intergenerational housing; culturally-appropriate care for queer, immigrant, Indigenous and other elders, and reimagined long-term care facilities that are beautiful, social, and integrated in their communities. Because there is no one-size–fits-all approach to aging, Avi's NDP will help fund and expand a range of public and non-profit options to help seniors age in their communities.

For many Canadians who require more extensive caregiving, long-term care facilities will remain a necessary and important option – and they must be better. In the first months of the pandemic in Ontario, roughly 4 out of 5 COVID deaths occurred in long-term care facilities – and for-profit nursing homes had four times as many deaths as city-run homes.

Caring for our society's most vulnerable people should not be a place for profit. Following the call of the Canadian Labour Congress, Avi's NDP will advocate to:

• Bring long-term care into the public and non-profit system and regulate it under the Canada Health Act;
• Remove private, for-profit businesses from the sector;
• Require proper staffing and health and safety protections for workers; and
• Permanently raise wages and benefits for long-term care workers to match the value of their essential work.

Avi's NDP will use the federal government's constitutional spending powers to establish a 50/50 cost-sharing program with the provinces and territories, including new investments in both infrastructure and the staffing needed to deliver quality residential, home health and community support services. Core national standards for staffing ratios and other essentials of care will be established through a newly constituted and collaboratively-governed Health Quality Council of Canada.

The cost of the status quo is too high to continue – we need to follow the lead of countries like Sweden and Denmark and ensure that seniors, people with disabilities and other Canadians in need of care can live with dignity, proper support and in the place and manner of their choosing – while being cared for by workers that are well-compensated, respected, and protected in their place of work.

Childcare that works for workers and families

Quality, accessible childcare is a cornerstone of a healthy society, one that promotes gender equality and the wellbeing of children. It also means more economic prosperity: for every dollar spent on childcare, the economy gets $2.80 in return. Investing in childcare is a true win-win that helps families and our country flourish.

$10 a day childcare has made life more affordable for those who are able to access it – but thousands of families are still languishing on waitlists. This is partly the result of a lack of physical spaces and centres. But a more fundamental problem is a workforce crisis caused by meagre wages and benefits for childcare workers.

Right now, the average wage for an early childhood educator is less than $25 an hour. Most ECEs don't have pension plans, and many lack access to workplace health and dental plans. Low pay negatively impacts job satisfaction, and makes it more difficult to recruit and retain qualified workers.

Every child has a right to access early childhood education and care. To make that right meaningful, we must build a system that's universal, affordable, well-funded and staffed by fairly compensated educators delivering high-quality programs.

An Avi-led NDP will:

• Treat childcare workers with the respect they deserve. That means using the spending power of the federal government to ensure that child care workers in every province and territory have better wages and working conditions, benefits and a pension plan. Provinces must develop fair wage grids that reflect these outcomes as a condition of receiving federal funding. This is essential to recruiting and retaining the workers we need to reduce wait times for families.
• Double the number of high-quality child care spaces for kids, while keeping class sizes low and improving staff-to-child ratios. These spaces will be built in the non-profit and public child care system where wages and benefits are higher than the private sector.
• Improve access to culturally-appropriate child care in Indigenous communities. Ensure that Indigenous children are connected with their languages and cultural traditions, by working closely with Indigenous communities both on and off reserve.
• Provide free baby boxes for new parents. Finally, we will follow the lead of countries like Finland and Scotland by sending a free baby box containing essentials through Canada Post to parents of newborns. A baby box contains essential items like a mattress, sheet, blanket, clothes, changing mats and books. It will save young families money, and help kids get the best possible start in life.