Seite - 352 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE352 Whatever answers are ultimately found, the devastation caused by the pandemic has exposed two significant fault lines that must be addressed. The lack of comprehensiveness of the single-payer system is the first and most obvious barrier to equal access to care for long- term care residents, like for those seeking home care, mental health, substance abuse, pharmaceutical, dental, and other crucial services that are excluded from the Canada Health Act.73 The prioritization of hospitals in governments’ pandemic preparedness is a reflection of the privileged status of acute care delivered by physicians and hospitals within the public system.74 William Lahey observes that: [The] compartmentalization of our health care system obscures the nature of the premises and assumptions on which we implic- itly rely when we make choices about … funding… These include a premise that … curing is more important than caring (as well as prevention), that dealing with the episodic illness of the healthy is more important than dealing with chronic illness and disability, and that physical health takes priority over other dimensions of health, including mental health.75 Expansion of the Canada Health Act to include long-term care has been identified as a major step towards resolving underfunding, lack of uniform standards, and other systemic problems within the current “mashup of systems” as the National Institute on Aging has described it.76 Whether through the Canada Health Act or new federal/provincial/ territorial framework legislation, the full integration of long-term care le gouvernement brasse la cage”, Journal de Montréal (13 April 2020), online: <www.journaldemontreal.com/2020/04/13/chsld--deux-organisations-veulent- que-le-gouvernement-brasse-la-cage>; Loriggio, supra note 68. 73. Jackman, “Health Care and Equality”, supra note 41. 74. Lewis, supra note 18; Colleen M Flood, Bryan Thomas & David Rodriguez, “The Role of Law in the Rise and Fall of Canadian Medicare” in Joanna Erdman, Vanessa Gruben & Erin Nelson, eds., Canadian  Health  Law  and  Policy, 5th ed (Toronto: LexisNexis Canada, 2017) 51. 75. William Lahey, “The Legal Framework of Canada’s Health Care System” in Jocelyn Downie, Karen McEwen & William MacInnis, eds, Dental Law in Canada (Markham: Lexis/Nexis Butterworths, 2004) 29 at 79-80. 76. MacCharles, supra note 14; Armstrong, supra note 59; National Union of Public and General  Employees, supra note 19; “Mark Hancock Calls on Trudeau to Fix Long- term Care Now” (21 May 2020), online: Canadian  Union  of  Public  Employees <cupe. ca/mark-hancock-calls-trudeau-fix-long-term-care-now>.