Renewing the Social Contract

Even though the provinces have jurisdiction over health care delivery, the Canada Health Act sets the terms by which this happens. It provides universal primary health care to all Canadians, and ensures that this care is comparable across the country. The ability of provinces to deliver on this mandate depends on health funding transfers from Ottawa. These transfers have not kept pace with the rapidly changing demographics and the emerging crises of mental illness and addiction. At the same time, private health clinics, including blood services, represent a creeping two-tiered system, eroding the universal primary health care model.

The Green Party is committed to the principles and requirements of the Canada Health Act and to extending that model to other aspects of health care. Respecting these principles, we support innovation in the delivery of these services to better meet the changing needs of Canadians. We will work to ensure that every Canadian has a family doctor and that primary care is centred on the patient and is sensitive to issues of social justice, equity and cultural appropriateness.

The federal government can and should lead the way in demonstrating a better model of health care. Greens recognize the unique challenges faced by defined populations like First Nations people on reserve and Inuit, members of the Canadian Forces, veterans, incarcerated persons and certain refugee claimants. It is important that these challenges are addressed at a federal level and that vulnerable populations receive equal access to care.

The Green Party supports the recommendations of the Parliamentary Committee on Health to expand the Canada Health Act to include prescription drugs dispensed outside of a hospital. Universal Pharmacare is the best way to accomplish both life-saving and cost-cutting goals.

“Climate change is the greatest threat to human health in the 21st century.” - Pegeen Walsh, Ontario Public Health Association Executive Director, August 2019

As we move into the “era of consequences” of climate change, new health imperatives are emerging. The World Health Organization has stated that “Climate change is the greatest challenge of the 21st century, threatening all aspects of the society in which we live.” ^[26] Public health associations have raised the alarm that climate-related illnesses are growing and need urgent attention. According to a report by the Canadian Paediatric Society and the Ontario Public Health Association, climate change is exacerbating a number of child health issues including “heat sickness, poor air quality, water contamination, and the mental health impacts of natural hazards, extreme weather, and displacement”. ^[27]

So far, this issue is flying way under the radar of many health professionals and government health departments. A Green government will change that.

• Restore the federal/provincial Health Accord, basing health transfers on demographics and real health care needs in each province, replacing the current formula based on GDP growth introduced by the Harper government and retained by the Liberals.
• Expand the single-payer Medicare model to include Pharmacare for everyone as well as free dental care for low-income Canadians.
• Create a bulk drug purchasing agency and reduce drug patent protection periods.
• Negotiate the Canada Health Accord to prioritize expansion of mental health and rehabilitation services, reduction in wait times, access to safe abortion services and access to gender-affirming health services such as hormones, blockers, and surgery (See Section VI Advancing the Just Society: Advancing LGBTQI2+ Rights)
• Uphold Jordan’s Principle in full, ensuring Indigenous People receive the health care they need without being delayed by bureaucratic disagreements over jurisdiction.
• Implement Calls to Action 18-24 from the Truth and Reconciliation Commission, improving health care for Indigenous Peoples. ^[28]
• Support First Nations, Métis and Inuit in (re)building traditional knowledge systems around healing and wellness, including the formal inclusion of traditional healing within mental wellness and home and community care programs. This process must be led by First Nations, Métis and Inuit organizations. ^[29]
• Reorient Health Canada’s mandate towards mental health and addictions, health promotion and disease prevention, and the health risks of climate change.
• Encourage medical associations to train health-care professionals to understand and engage with climate change related health threats
• Address the opioid crisis as a health-care issue, not a criminal issue, by declaring a national health emergency. Recognize that fentanyl contamination is why deaths are more accurately described as poisonings than overdoses. Drug possession should be decriminalized, ensuring people have access to a screened supply and the medical support they need to combat their addictions. Increase funding to community-based organizations to test drugs and make Naloxone kits widely available to treat overdoses. ^[30]
• Establish a national mental health strategy and a suicide prevention strategy to address the growing anxieties plaguing Canadians regarding inequality and affordability, the growing precariousness of work and housing, the climate crisis, social isolation, resurgent racial and ethno-nationalism and other harms and risks.
• Protect our public blood system by prohibiting for-profit blood collection services and removing barriers to blood donations not based on science.

“I am now convinced that the simplest approach will prove to be the most effective − the solution to poverty is to abolish it directly by a now widely discussed measure: the guaranteed income.” – Martin Luther King Jr., Where Do We Go From Here: Chaos or Community? 1967

The most recent Canadian Income Survey reveals that 9.5 per cent of Canada’s population − about 3.4 million people – lives below the poverty line. ^[31] Poverty rates are even higher within marginalized and vulnerable groups, such as people living with disabilities, single mothers and seniors. ^[32] In a wealthy country like Canada, this is unacceptable.

Of all Canada’s social problems, child poverty may be the most shameful. In 1989, the old-line political parties voted unanimously to end child poverty by the year 2000. Despite recent improvements, far too many Canadian children still grow up in poverty. Child poverty rates are especially high among Indigenous Peoples, single-parent households headed by women, and new Canadians. Canada now ranks a dismal 25th out of 38 countries in the Organisation for Economic Co-Operation and Development in terms of relative child poverty rates. ^[33]

In 2018 the government of Canada developed its first poverty reduction strategy, Opportunity For All, which has adopted the Market Basket Measure (MBM) as Canada’s official poverty line. The MBM is a measurement tool that considers what an average basket of goods costs for a Canadian and can vary regionally. When compared against median income and wages it gives a general sense of the affordability pressures that families face in different parts of Canada. Using existing income supplements like the Old Age Security and the Child Tax Benefit, the Liberal government boasts that it has lifted several hundred thousand Canadians out of poverty by nudging them from a few hundred dollars under the poverty line to a few hundred over it. While hundreds more dollars a year can definitely help individuals and families, this current effort can and should go much further.

We can eliminate child poverty in Canada. We must start by recommitting to a vision of Canada as a just society built around a progressive, fair, and compassionate social safety network. Unlike the old-line parties, the Green Party believes reducing child poverty is not just about expanding the middle class; we must undertake real structural change to tackle the root causes of poverty. Poverty is a systemic problem that arises from low wages and insufficient income assistance, a precarious job market, a shortage of affordable housing and quality child care, and cuts in social programs. It is also tied directly to issues of bias and discrimination on the basis of gender, race, sexual orientation, and citizenship, as well as the ongoing legacy of colonization. Eliminating poverty requires systemic action on all these fronts with safe secure housing as a fundamental human right at its core.

Greens believe reducing child poverty starts with a stronger commitment to guaranteeing that all families have the ability to provide for their children. Research has demonstrated that programs providing a universal basic income reduce expenditure on health care – since poverty is the single largest determinant of ill health – and the justice system, and increase school retention. Such programs are affordable, but the savings and costs of implementation are experienced in different orders of government. To proceed will require cooperation of each province, territory and Indigenous community through a vehicle such as the Council of Canadian Governments.

Support for Incomes and Workers

• Establish a universal Guaranteed Livable Income (GLI) program to replace the current array of income supports, such as disability payments, social assistance and income supplements for seniors. Building on the MBM, payment would be set at a “livable” level for different regions of the country. The negotiation to implement a livable income across the country would take place through the Council of Canadian Governments. Unlike existing income support programs, additional income would not be clawed back. Those earning above a certain total income would pay the GLI back in taxes. ^[34]
• Establish the federal minimum wage of $15 per hour. Canada once had a national wage standard but it was removed by a previous Liberal government and in that time regressive wage policies – like training wages well below minimum wage – have been introduced in various provinces. Reinstating a federal minimum wage will create a wages floor for every Canadian no matter where they live or work.
• Work with the Council of Canadian Governments and Statistics Canada to set municipal minimum wages in accordance with the differential costs of living across the country (See Section VII Good Governance: Intergovernmental Collaboration)
• Design and implement a national mental health strategy to address the link between mental wellness and work productivity (See Section V. Renewing the Social Contract: Health Care)
• Support Private Member’s Bill C-344, An Act to amend the Department of Public Works and Government Services Act, which would require successful bidders on federal infrastructure contracts to maximize the spin-off community benefits of such contracts. This will strengthen opportunities for Indigenous, Métis and Inuit-owned businesses, social enterprise, co-operatives and diverse suppliers in communities or nearby where federally funded infrastructure is being built.
• Enhance use of Community Benefits Agreements to increase economic inclusion and opportunity for marginalized communities of colour.

Greens believe it is time to put the interests of our children at the centre of decision-making. If a policy works for our children, it works for our society. Greens will appoint a federal Children’s Advocate to ensure that children’s rights are protected. Far too many children are in care. Far too many children are in poverty. And far too many of those children are Indigenous. Every Canadian child deserves equal services, from early childhood education to adulthood.

Meanwhile, families need child care. Universal child care is fundamental for women’s equality –the “ramp to equality in the workplace for women.”

Canada needs a plan – a road map to affordable child care for all children. A Green government will collaborate with provinces/territories, local communities, Indigenous communities and the child-care sector to ensure that a comprehensive short-, medium- and long-term policy road map – based on the principles of universality, affordability, quality, inclusivity and equity – finally becomes a reality.

Canada must dedicate additional resources to making a universal, affordable, early learning and child-care (ELCC) system a reality. It cannot occur without public funding. Canada needs an ELCC system that contributes to a green Canada. Thus, a Green Party government's child care plan will provide the early educator jobs that sustain local communities. It will also recognize that sparsely and unevenly available child-care services force parents to take out-of-their-way routes to child care and work, often by car. Green Party plans for child care take into account not only parents' convenience but also climate goals. Location of child care must reflect the diversity of family needs and be placed along existing public transit routes, including neighbourhood schools, other local buildings, workplaces and transportation hubs.

The best evidence suggests that ELCC is best situated within the context of other policies that support families and children. A Green Party government will follow the example of Quebec and other countries, improving and strengthening maternity/parental leave by making it more inclusive, more flexible and better paid.

Well-designed ELCC is also fundamental to meeting broader equity and social justice goals, for fighting poverty, as a foundation for children's life-long learning, and as part of the backbone of a thriving society. Quality child care yields high social and economic returns in the short and long term by:

• Supporting women’s workforce participation, education and training.
• Strengthening children’s health, development and well-being in the early years to provide a strong foundation for learning and living in later years.
• Strengthening inclusion and respect for diversity for children with disabilities, diverse ethnic and racial groups, newcomers and disadvantaged Canadians.
• Countering Canada’s slide towards being a more unequal society.

A Green Party government will immediately begin to ramp up federal child care funding to achieve the international benchmark of at least one per cent of GDP annually, adding an additional $1 billion each year until this benchmark is reached with a mature ELCC system. We will eliminate GST on all construction costs related to child-care spaces.

Universal access to quality post-secondary education and skills training is a right, not a privilege. Our society is stronger when the citizenry is informed, critical and well educated. Moreover, post-secondary education is part of Canada’s treaty obligations to Indigenous Peoples and a key focus for reconciliation.

We need to re-evaluate our approach to funding post-secondary education and skills training. The current model is in danger of collapse. Too many universities are caught in a spiral of fund-raising to provide education of diminishing quality. Dramatic funding cuts dating back to the 1990s mean universities have come to depend on part-time contract instructors, higher tuition fees and fundraising to balance the books. The result is precarious employment for many highly educated academics, crushing debt loads for graduates as they begin their adult lives, and lost opportunities for many who simply forego higher education.

The answer is simple. The federal government needs to reinvest in the system. The Green budget will allocate $10 billion to post-secondary and trade school supports.

• Make college and university tuition free for all Canadian students. This would be financed by redirecting existing spending on bursaries, tuition tax credits, saved costs of administering the student loan system, and the hundreds of millions of dollars of student loan defaults written off every year. Tuition scholarships provided by colleges and universities can be redirected to offset other student costs.
• Tie funding in federal-provincial transfers to universities, providing more to universities and colleges with a measurable focus on student-professor contact, mentorship, policies of inclusion and tenure track hires.
• Remove the two per cent cap on increases in education funding for Indigenous students and ensure all Indigenous youth have access to post-secondary education.
• Forgive the portion of existing student debt that is held by the federal government.

Seniors comprise a growing proportion of Canada’s total population, a majority of whom are women. They built the society we now enjoy, have a wealth of experience and continue to contribute to the economic and social life of our communities and country.

An essential duty of the social contract between government and citizens is to make sure people can live fulfilling and dignified lives in their senior years. Green Party pledges such as the Guaranteed Livable Income, Pharmacare, public transportation, home retrofits and affordable housing all contribute to seniors’ quality of life.

A Green government will also develop a National Seniors Strategy with the following priorities:

• Ensure the Canada Pension Plan (CPP) remains robust and adaptive to changing needs and circumstances by increasing over time the target income replacement rate from 25 per cent to 50 per cent of income received during working years.
• Regulate the CPP Investment Board to require divestment of coal, oil and gas shares and ensure that all investments are ethical and promote environmental sustainability.
• Support innovative home-sharing plans and other measures to allow people to stay in their own homes as long as possible. Create more long-term care beds in neighbourhood facilities.
• Protect private pensions by amending the Bankruptcy and Insolvency Act and Companies’ Creditors Arrangement Act to establish the preeminence of pensioners and the pension plan in the creditor hierarchy during company insolvency proceedings.
• In collaboration with health professionals and provincial/territorial governments, develop and fund a national dementia strategy. Within 25 years, the number of Canadians living with a form of dementia could reach 1.3 million, imposing the highest economic, social, and health costs of all diseases. The strategy would support research, improve quality of life for patients and care givers, and educate the public to increase awareness and reduce stigma.
• Amend the Medical Assistance in Dying legislation to ensure that everyone has the choice of dying with dignity. This includes allowing advance directives and guaranteeing the right to draw up a “living will” that gives individuals the power to limit or refuse medical intervention and treatment.

The Green Party values the work and sacrifices of all Canadian Forces and RCMP veterans and active personnel and will ensure that veterans and their families are well cared for. The fact that suicide rates among veterans are climbing is a clear indication that they are not getting the services and supports they need. A Green government will step up to provide long overdue comprehensive services for veterans.

• Provide support for all veterans including disabled veterans that allows them to live in dignity. Ensure that services to veterans and their family members are fully integrated and funded.
• Launch a national re-examination of veterans’ issues in December 2019 based on good-faith engagement with military families and veterans, including issues relating to pensions and benefits. The goal is to identify necessary reforms and changes to programs to better meet veterans’ needs.
• In the meantime, restore periodic payments to veterans at pre-2006 levels.
• Repeal the section of the Superannuation Act the denies pensions to surviving spouses of certain workers, including RCMP and veterans, who married after 60.
• Work with veterans’ organizations to review and update the Veterans Charter and the processes, structure and mandate of the Veterans Review and Appeal Board to ensure all veterans are treated fairly and with respect.
• Ensure that all veterans have access to health care, mental health support and treatments. Military personnel with PTSD must be treated as highly valued people whose health needs to be restored, rather than as liabilities who need to be removed.