Federal Election 2015 Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future

Transcription

1 Federal Election 2015 Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future

2 The Canadian Cancer Society Powered by 140,000 volunteers and a network of nationwide staff, and supported by millions of Canadians, the Canadian Cancer Society is Canada s largest national health charity. Over the years, we have invested more than $1.3 billion in Canadian science, which has resulted in fewer people developing cancer and more people surviving it and living longer, healthier lives. Throughout our 77-year history, the Society has been a champion of healthcare improvements and innovation. We are dedicated to finding new and better ways to protect the health of Canadians, shrink cancer rates and reduce cancer s toll on our country. We are building on our legacy, and we are ready to work in partnership with the Government of Canada on behalf of all Canadians to make the recommendations in this document a reality. Stock photos: Getty Images Licensed material is for illustrative purposes only; persons depicted are models.

3 Executive summary Two of every 5 Canadians will develop cancer during their lifetimes. About 25% of us will die from the disease, making it our leading cause of death. Cancer cases are projected to climb 40% over the next 15 years as our population grows and ages, according to the recently published 2015 Canadian Cancer Statistics. This will create a potentially devastating burden on families, healthcare providers and our country s economy. Cancer already costs Canadians more than $17 billion per year. Without a strong national response, there is a risk that the rising number of cancer cases will overwhelm our healthcare system, compromising the quality of care available to patients today and crowding out the investments required to better prevent and treat the disease tomorrow. While most new cases will occur among people 50 years of age or older, the decisions we make now will directly affect all Canadians. If we are unable to make the necessary long-term investments in research, training and public education because we have allowed the cost of meeting acute care needs to spiral out of control then the future health and well-being of all Canadians, including our children and grandchildren, will suffer. The federal government has made some important commitments in the last few years restricting sales of some flavoured tobacco products, expanding support for family caregivers, funding the Canadian Partnership Against Cancer but their effectiveness has been weakened by contradictions and missed opportunities. This is a symptom of the declining priority given to health issues generally in Ottawa over the past decade. In the upcoming federal election campaign, all party leaders have the opportunity and obligation to show leadership and move the national health debate forward. Cancer is too large and complex a problem to solve in isolation from a larger health agenda. Success requires a new era of federal health leadership and accountability. We won t get there in a single day, week or year, but the journey must begin now. The recommendations that follow for a stronger tobacco control strategy, guaranteed access to palliative care and smart long-term federal research investments are steps all federal party leaders must support. Together these actions will help stop more cancers before they start, provide badly needed support to patients and their families and establish a practical foundation for making longer-term progress. longer-term progress. Summary of recommendations 1. Tobacco control: reduce tobacco use by adopting plain packaging rules and replacing the Federal Tobacco Control Strategy with a comprehensive and properly funded plan. 2. Palliative care: guarantee in federal legislation the right of all Canadians to affordable, high-quality palliative care. 3. Research: commit to long-term investments in health research that keep up with rising costs and population growth and are delivered through simple, streamlined funding programs that maximize the impact of every dollar. 2 Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future Canadian Cancer Society

4 Federal Election 2015 Canadian Cancer Society Platform Our cancer challenge Every single hour about 22 Canadians hear the words I m sorry, you have cancer, joining the more than 810,000 people across the country already living with the disease. One of every 4 of us can expect to die from cancer, making it Canada s leading cause of death. The number of cancer cases is projected to increase by 40% over the next 15 years as our population continues to grow and age, according to the recently published 2015 Canadian Cancer Statistics. Without a strong national response, this growing challenge will result in a potentially devastating burden on our healthcare system. There is a very real risk that the dramatic increase in cancer cases will overwhelm families, healthcare providers and our economy. Beyond its terrible physical and emotional toll, cancer has a crushing financial impact. Cancer costs Canadians $17.4 billion per year, according to a 2004 Statistics Canada report. Tens of thousands of cancer patients are struggling to pay for medication, find affordable homecare and continue earning enough income while they undergo chemotherapy or radiation treatment. While the vast majority of new cancer diagnoses will affect people 50 years of age or older, the stakes are high for all Canadians. The future health and well-being of younger Canadians will be directly affected by the decisions we make now. Their odds of developing cancer during their lifetimes, and their hope of recovering from it, will depend on what we do to better treat and prevent the disease. Today we are all beneficiaries of life-saving advances achieved through decades of work by cancer researchers, clinicians, advocates and policy-makers. We must build on their achievements so that all Canadians, including our children and grandchildren, will also benefit from continued progress. If we are unable to make the necessary investments in research, training and public education 4 Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future Canadian Cancer Society

5 because we have allowed the acute care needs of our aging population to spiral out of control then we will have failed. The need for national leadership To succeed we will need strong national leadership. In recent years the federal government has made some helpful commitments, but too often when Ottawa has taken a step forward, it has also stumbled a step back (table 1). Table 1. Federal policy scorecard ( ) Progress Raised federal tobacco taxes by $700 million per year and, in 2011, enhanced warnings on cigarette packages. Brought forward legislation restricting the sale of flavoured tobacco. Stopped opposing international efforts to officially designate asbestos as a hazardous substance. Extended the Compassionate Care benefit for family caregivers from 6 weeks to 6 months. Maintained $50 million annual investment in the Canadian Partnership Against Cancer, which brings researchers, charities and public servants together to fight cancer. Failures and missed opportunities Cut funding for tobacco control by 40%, depriving Health Canada of the resources necessary to stop tobacco sales to minors, enforce other federal tobacco laws and to maintain national tobacco prevention and reduction programs. Took 5 years to close just one of many serious loopholes in its own flavoured tobacco legislation. Offloaded the national responsibility for banning menthol cigarettes onto 13 different provincial and territorial legislatures. Failed to adequately improve its own domestic strategy for reducing asbestos exposure, Canada s leading cause of workplace death. Made no broader commitment to improve access to home and palliative care for tens of thousands of Canadians fighting cancer and other life-threatening illnesses. Failed to build political partnerships among different levels of government. The federal government s effectiveness has been undermined by contradictions and missed opportunities. This is a symptom of a deeper decline in the political priority given to health issues inside Ottawa. Over the past decade, health policy has been pushed to the margins of the national agenda. Canadians real-world health concerns don t receive the same attention or priority they once did. What s left is checkbook federalism: Ottawa takes in and ships out billions of tax dollars for healthcare but without setting clear national objectives for its investments or effectively measuring their impact. While federal health spending has gone up, federal accountability for health has gone down. According to the Minister of Finance, annual federal health transfers to provinces and territories will reach $40 billion by But what concrete improvements will that money buy Canadians? What holes in nationwide health coverage will it repair? How will it improve disease prevention from Victoria to St. John s? The federal government offers few answers. The country needs federal leaders to revive our national health debate if we re going to meet our growing cancer challenge. Cancer touches too many lives, takes too great a toll and is too intertwined with other health issues to be dealt with in isolation from a bigger picture health agenda. We won t get there in a single day, month or year this job is much bigger than that. But during this election campaign, all parties have the opportunity and the obligation to show leadership and move the health debate forward. 6 Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future Canadian Cancer Society

6 Our next federal government must be prepared to take strong sustained action to stop more cancers before they start and repair dangerous holes in our publicly funded health system. It must build on the research, treatment and public policy breakthroughs of the past several decades, which have dramatically improved survival rates and saved hundreds of thousands of lives. What follows are practical, affordable steps that all federal candidates can support. Together these recommendations will make a lasting improvement in the lives of people touched by cancer and contribute to a healthier future for all Canadians. Recommendations 8 Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future Canadian Cancer Society

7 Prevention: Stopping disease before it starts Recommendation 1 Reduce tobacco use by adopting plain packaging rules and replacing the Federal Tobacco Control Strategy with a comprehensive and properly funded plan. 10 Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future Canadian Cancer Society

8 No health issue cries out louder for leadership than disease prevention, and nowhere are the opportunities for progress greater, or the need for action more urgent, than in cancer. There is no more effective way for the federal government to protect and prolong Canadian lives than by improving cancer prevention. By making prevention a priority, the federal government would also reduce the incidences of other widespread chronic ailments that share cancer s key risk factors, including heart and lung disease, strokes and diabetes. We ve learned that about half of cancers can be prevented through a combination of healthy living and reduced exposure to cancer-causing substances. By applying this knowledge, we can stop more cancers before they start, which will lower long-term cancer rates and reduce future health risks for all Canadians, including our children and grandchildren. Reducing cancer risks Many Canadians encounter risk factors at home or in the workplace, often without realizing those risks are even there. The federal government must help Canadians by promoting sun safety and protecting them from asbestos, radon and ultraviolet radiation. As a country, we must also confront the problems of excessive body weight, physical inactivity, alcohol consumption and unhealthy diets, which together are increasing Canadians cancer risks. Tobacco: Public health enemy #1 The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly 6 million people a year. World Health Organization Canada s monumental effort to reduce tobacco use over the past 50 years is among the most important public health achievements in our history. But there is still a great deal of work left to do. Despite the dramatic decline in the percentage of Canadians who smoke, the total number of smokers 5.4 million across the country remains stubbornly high. Smoking remains our number 1 preventable cause of death, leading to about 30% of all cancer fatalities. Making matters worse, an unacceptably high number of young people begin smoking each year. By taking strong, innovative actions against tobacco use in the past, the federal government saved lives at home and enhanced Canada s reputation on the world stage. Now Canada must again become the world s leader in tobacco control, as it once was. The federal government has faltered on several fronts in the last few years. For example, as other governments have taken action to ban menthol cigarettes and adopt plain packaging rules, Ottawa has stood still. Investing in tobacco control One factor undermining the federal role in tobacco control has been declining resources. When it was created almost 15 years ago, Canada s Federal Tobacco Control Strategy was intended to have an annual budget of $110 million, but today s investment is barely one-third that amount. 12 Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future Canadian Cancer Society

9 In the wake of major budget cuts announced in 2012, annual investments in tobacco control by the federal government stand at $38 million equal to just one cent of every dollar collected by the federal government through tobacco taxes. Proper funding is a prerequisite for the comprehensive and sustained tobacco strategy Canada needs. With the right resources, we can target youth tobacco use, a top priority given that most smokers begin as teenagers or pre-teens. The federal government must also: Develop a game changing tobacco control plan to push tobacco use down to its lowest possible level by implementing bold new measures that more aggressively reduce tobacco demand and regulate its supply. Accelerate research on youth smoking trends, e-cigarettes and other topics. Expand programs that prevent smoking and help smokers to stop, including telephone quitlines. Increase enforcement of the ban on tobacco sales to minors and other federal tobacco laws. Launch a mass media, nationwide public awareness and outreach campaign Canada s first in more than a decade. Plain packaging At the heart of our new national tobacco strategy should be a plan to eliminate the most effective tool that tobacco companies are still using to promote their products: the colourful, market-tested designs on cigarette packages themselves. The concept of plain packaging rules is simple. They ensure that cigarette packages no longer function as mini-billboards by eliminating the use of brand-specific colours, logos and graphics on the package itself. Health warnings remain, but packages can no longer convey positive lifestyle messages nor can they be sold in super slim packs (targeting women) or in other special formats. Canada must catch up with the global trend toward plain packaging. First implemented by Australia in 2012, Great Britain and Ireland have also now legislated their own plain packaging rules, which will take full effect in May New regulations are also under advanced consideration in France, Norway, Finland, Sweden and New Zealand. The next federal government must be ready to act when the current Federal Tobacco Control Strategy expires in All political parties must support a more effective and properly funded replacement. In the United States, per capita federal investments in tobacco control are more than 2 times higher than in Canada. 14 Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future Canadian Cancer Society

10 Palliative care: The care you need when you need it most Recommendation 2 Guarantee in federal legislation the right of all Canadians to affordable, high-quality palliative care. 16 Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future Canadian Cancer Society

11 One of the federal government s most important obligations is to ensure that all Canadians have access to affordable, high-quality healthcare. Of the areas where Ottawa has failed to meet this responsibility, palliative care is one of the clearest and most pressing. Palliative care refers to an array of treatments and support services required by people who are facing life-threatening illnesses, including emotional and psychological counselling, specialized pain and symptom management and advanced care planning. Palliative care was initially developed for, and is still largely delivered to, patients with advanced cancer, but there s a growing realization of the broader need for this form of patient-centred care right across healthcare systems. Most Canadians would be shocked to learn about the problems plaguing palliative care across our country today. Given our common belief in a universal, publicly funded health system, we assume that the necessary services are available to all Canadians, especially the sickest and most vulnerable among us. Tragically, this is not the case. Palliative care services vary dramatically across Canada, not only from one province to the next, but among communities in the same region. However, no one knows the exact size and severity of the system s gaps. The lack of reliable nationwide indicators and data collection makes measuring the problem extremely difficult. Often palliative care can be effectively delivered outside of a hospital setting. Receiving care at home is the preference of many patients and often less costly for a publicly funded healthcare system. Unfortunately, for many Canadians this type of care is not available. For some this will mean dying in an emergency room or while lying in a corridor waiting to be assigned a bed, when they could be in their home or elsewhere in their own community, comfortable and at peace, surrounded by loved ones. The financial burden Palliative care is just one example of a service that is not adequately provided by Canada s publicly funded health system. Despite the widespread belief that Canada has universal health coverage, there are a number of areas where essential treatments and services are not covered. These gaps, combined with job and income insecurity, place a suffocating financial burden on many cancer patients. No Canadian should go broke paying for cancer medication, yet access to affordable drugs is unequal and unfair. That must change. From job protection and temporary income support, to specialist care at home when you recover, there are critical gaps to fill. While some excellent support programs and service delivery models exist across the country, we know that many Canadians are falling through the cracks in Canada s patchwork of palliative care services. No single government or political party is to blame for our current situation. Our understanding of the importance of palliative care has steadily increased in recent years, and the roots of our current problems run back decades, through the mandates of different governments. The next government, however, will have no excuse for failing to act. As our population ages and cases of cancer and other chronic diseases increase, the need for early access to high-quality palliative care has never been clearer or more urgent. The first step toward a solution is for the federal government to recognize a fundamental principle: that all Canadians have a right to palliative care. The government must enshrine this right in federal legislation, and guarantee Canadians access to these essential health services, by adopting a new national Palliative Care Act. 18 Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future Canadian Cancer Society

12 Cancer research: The road to hope and progress Recommendation 3 Commit to long-term investments in health research that keep up with rising costs and population growth and are delivered through simple, streamlined funding programs that maximize the impact of every dollar. 20 Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future Photo: Dr Bruno Salena and Dr Yingfu Li, McMaster University Canadian Cancer Society

13 Health science is key to the fight against cancer. Its discoveries can lead to better treatments and prevention strategies and ultimately to cures. What researchers learn in the lab, clinic and out in the community can help stop more cancers before they start and enable more Canadians to survive and thrive after a cancer diagnosis. Cancer research has fueled tremendous progress over the years. Decades of work by dedicated researchers have led to better cancer prevention, detection and treatment. The impact on survival rates has been especially dramatic. Today over 60% of Canadians diagnosed with cancer will survive at least 5 years. In the 1940s, survival was about 25%. With 40% more cancer cases expected by 2030, we must continue investing in new research while vigorously applying the vast knowledge of cancer biology that s been accumulated over the past century. Future research findings will be essential to diagnose cancers earlier, treat patients with more precision and less toxicity and help Canadians understand how to lower their risks of developing cancer in the first place. The federal government will play a critical role in future health research. In addition to charitable funding for health research including the Canadian Cancer Society s $40-million annual research investment Canadian researchers rely on public funding, including major investments by Ottawa. The next government must protect and expand health research funding to keep up with rising costs and the changing needs of a growing and aging population. Failure to do so will weaken the Canadian research community, and compromise our ability to understand and respond to our country s future health challenges. It would also diminish our standing globally, costing Canadians research and leadership opportunities that transcend international borders. Ottawa s preference for short-term funding commitments leads to inefficiencies. On-again, off-again funding cycles force researchers to spend more time ramping up and shutting down projects and less time running them. The repeated search for funding support, qualified staff and appropriate facilities can all end up costing time, money and progress. Finally, the tendency to create a multitude of separately delivered programs, each with its own set of eligibility criteria and application procedures, can create an administrative burden for our scientists that is a drag on productivity. Historically low success rates in federal granting competitions is also discouraging researchers, especially young ones, from submitting proposals at all. Federal funding programs are so fundamental, in fact, that their design and delivery can have a decisive influence on how much health researchers achieve and how quickly they can achieve it. Without clear national objectives and the commitment to provide long-term, dedicated funding, there is a growing risk that the most fundamental health research will be crowded out by a federal innovation agenda skewed toward short-term commercial interests. 22 Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future Canadian Cancer Society

14 Conclusion As our population grows and ages in the years ahead, the number of cancer cases will increase dramatically. The stakes are high for all Canadians: without a strong national response, our healthcare system will be overwhelmed and patients, families and our economy will suffer. The sooner we confront this challenge, the better we will do. By taking swift and sustained action, we can properly care for our aging population while building a healthier future for all Canadians, including our children and grandchildren. Success requires a renewed commitment to health by all political parties, leading to a new era of federal leadership and accountability. We will not get there in a single day, week or month, but the journey must begin in this year s federal election campaign. Stronger tobacco control, guaranteed palliative care and smart long-term research investments: these are steps all federal party leaders must support now. Together these actions will help stop more cancers before they start, provide badly needed support to patients and their families and establish a practical foundation for making longer-term progress. As Canada s largest national health charity, the Canadian Cancer Society is ready to help make these recommendations a reality and to continue working with all partners to build a future where Canadians no longer need to fear cancer. Contact: Gabriel Miller Director, National Public Issues Canadian Cancer Society Gabriel.Miller@cancer.ca x Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future

15 Canadian Cancer Society Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future