Across Ontario federal Conservative candidates have refused to attend most all-candidates debates on health care. This is a new low. Never has any political party simply refused to debate a leading issue for voters.

In correspondence and the media, candidates have excused themselves, saying that “health is a provincial matter.” This has long been Stephen Harper’s position.

But this claim is a profound break with Canadians of all political stripes who believe that public health care helps define our country and that access to health care should be provided to all based on need, not wealth. In the federal election’s partisan political debate that has focused so strongly on the economy and Canadian values, it is hard to imagine any issue than health care that is more deeply rooted in both.

Harper has shown a preference for debates hosted only by particular media outlets, and has focused on what it considers economic issues. But public health care is an economic issue that impacts every Canadian.

Consider, for example, the promised tax cuts compared to user fees to patients if our federal government fails to shore up public health care.

Economists at the Canadian Centre for Policy Alternatives calculate that 60 per cent of income earners will receive only $50 on average from Harper’s income-splitting plan.

Currently at private clinics, patients are being charged $100 to $1,500 per eye or more for cataract surgeries. A single cataract surgery will wipe out the so-called tax breaks for even wealthy Canadians. The federal government can and should act to stop the extra billing of patients which is a violation of the Canada Health Act, but has done virtually nothing for the last decade.

Canadian seniors outnumbered children this month for the first time. With more than 30,000 people on wait lists for long-term care across Canada, if no long-term care plan is developed for our aging population, the cost for a family to pay nursing home fees can run up to $30,000 per year or even more.

In fact, the $50 most of us will get from the income-splitting tax cut can buy only two hours of private home care, unless access to public home care for Canadians is improved.

The bottom line? The proposed tax cuts will be paid for largely by cuts to health care and Old Age Security, and these cuts will cost Canadians far more than we ever see in our tax returns.

Canadians deserve a full debate about these issues.

In 2014, Harper let the Canada Health Accord expire and refused to even meet with the provinces. He also shut down meetings with the provinces and territories on a national drug plan, stymied talks on home-care and long-term care, closed down the Health Council of Canada, and cut health care for refugees and veterans.

Premiers across Canada calculate the cost of Harper’s planned cuts to the health care funding formula to be $36 billion over the next decade. Ontario will be hit hardest, losing $8 billion.

That $36 billion could buy 144 million MRIs for Canadians. It could build more than 100 new hospitals or pay a year’s worth of long-term care for 738,000 seniors.

In fact, the Parliamentary Budget Office calculates that Harper’s funding formula cut will significantly reduce the federal share of health funding. It warns that this plan will download costs to the provinces even though they cannot afford them, leaving little choice but to cut health care. In plain language, Harper’s health care funding formula is a prescription for privatization.

In truth, our federal government has a crucial role to play. It is the steward of the Canada Health Act and a robust medicare system that took generations to build. It is a system that sets national standards; delivers health care to First Nations, the RCMP and armed forces; provides service to veterans and refugees; and has the power to regulate Canadian drug prices, which are now among the highest in the developed world.

The NDP, Liberals and Green Party have all committed in varying degrees to meeting with the provinces, renegotiating the federal funding plan for health care. They have promised some money for long-term care, home care, some movement towards a national drug plan or controlling the cost of drugs.

All of these are a step forward compared to the last 10 years of federal government inaction. But given the financial straitjacket that has been created, the plans are modest at best. One wonders what they might look like if there was a real debate about the future of health care in our country.

Natalie Mehra is executive director of the Ontario Health Coalition.

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