November’s meeting between provincial health ministers and their federal counterpart ended with particular acrimony. While the dispute between the two levels of government over funding is age-old, the huffiness with which the two sides parted company was exceptionally caustic: Federal Health Minister Jean-Yves Duclos said the provinces were interested in “one thing and one thing only: money.” The host of the meeting, B.C. Health Minister Adrian Dix, dismissed a federal offer of more money but with strings attached as moving the discussion “a sound-bite further ahead.”
But the two sides have decided to have another go at it next month. The Globe’s Ottawa bureau chief Robert Fife reported this past weekend that they are inching closer to a deal, one that for 10 years would provide increases in federal health transfers and also allow for bilateral agreements with individual provinces in areas such as long-term care.
Perhaps the passage of 11 weeks has helped cool tempers, allowing negotiations to begin once again. The looming federal budget, to be tabled in March or early April, has provided some urgency. But it is also likely that the gut-wrenching stories of Canadians suffering and dying in the morass of a buckling health care system – including a Globe investigation that has found growing waiting times for cancer care in B.C. and a series of abrupt changes at Alberta Health Services – have helped sharpen resolve.
As The Globe reported, a deal between the two sides would involve billions in new money that provinces and territories have been requesting. In exchange, they will have to agree to national accountability measures and reforms to improve their health-care systems. Quebec and Ontario initially objected to Ottawa’s key demands, but last week agreed to accept the conditions, including the creation of a national health data system.
“They’re getting serious. That’s great news,” Mr. Dix said in an interview with Justine Hunter in Victoria. “The federal government is now talking about precise and specific proposals to fund health care in Canada.”
But then Mr. Dix went on to repeat the provinces’ long-standing complaint about federal participation in health care, one which the federal government hotly disputes.
“Their share has been declining and was set to decline again quite dramatically, if they had waited through this budget round,” Mr. Dix told Justine.
In an editorial in December, The Globe called out the provinces for misleading Canadians about the degree of Ottawa’s underfunding. While federal cash transfers now account for a smaller share of national spending, the actual cash transferred isn’t the only way the federal government participates. The provinces benefit from Ottawa’s decision to give provinces more room to levy personal and corporate taxes. Those tax points pull Ottawa’s contribution to 33 per cent of health-care spending, compared with the province’s claim that Ottawa funds just 22 per cent.
Federal ministers gathering in Hamilton this week had a new health-care deal as a key agenda item. Intergovernmental Affairs Minister Dominic LeBlanc told reporters Tuesday that “we’re looking forward to meeting with the premiers,” adding it would happen “soon.”
Cabinet members have expressed ever more optimism about the prospects for reaching a health care deal. Bilateral deals will allow each province to address regional issues. B.C. wants additional help with the cost of home and community care, as well as mental health and addictions initiatives.
No doubt, the friction will remain. But as The Globe’s editorial board noted last December: “Canadians waiting for hours in emergency rooms and waiting years for family doctors don’t much care about which level of government is able to claim the upper hand in the funding debate.”
This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief James Keller. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.