What to watch for as Canada's premiers meet in Victoria – CBC News

It’s been three years since what used to be a staple of the political calendar — the annual summer premiers’ gathering — was held in person.

As the Council of the Federation reconvenes, Canada’s premiers are packing a lot of familiar baggage, particularly when it comes to their demands of the federal government.

After meeting frequently — sometimes weekly or biweekly — earlier in the pandemic, the premiers now feel “ghosted” by Ottawa, B.C. Premier John Horgan, the chair and host of this year’s gathering, told CBC Radio’s The House on the weekend.

It’s unclear what might be delivered between now and Tuesday night, since only one side of the federal-provincial table is gathering in Victoria. Nevertheless, here’s what’s on premiers’ minds.

Health care

It was already the biggest expenditure in premiers’ budgets and an oft-cited top priority for voters. Then COVID-19 put unprecedented stress on health infrastructure that advocates warned wasn’t up to code even before the pandemic.

“When you look at our health-care system compared to other, comparable countries, it’s been deteriorating in terms of the quality of care and the timeliness of care over a long period of time,” Canadian Medical Association president Katharine Smart told CBC’s The Current last week. “That’s not only about dollars. That’s about failing to modernize the system.”

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In many ways, Canada’s health-care system has not been modernized since the 1960s, says Canadian Medical Association president Dr. Katharine Smart. She’s urging Canada’s premiers to address these ‘structural issues’ at their annual meeting in Victoria this week.

Still, it’s the dollars premiers were talking about before travelling to Victoria. They reminded Canadians, yet again, that the federal share of health-care spending (22 per cent, they calculate) is nowhere near where it used to be (35 per cent) or needs to be (as much as the 50 per cent it once was, as Alberta’s Jason Kenney and Manitoba’s Heather Stefanson have told us).

So they’re asking Ottawa, yet again, to sit down and negotiate larger Canada Health Transfer payments.

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Canada’s premiers are set to meet this week for the first time in person since 2019. Health care is expected to be one of the top items on the agenda, with hospitals in parts of the country struggling with major staffing shortages.

It’s not that Justin Trudeau’s Liberal government doesn’t agree that more health-care funding is necessary, although officials take issue with the 22 per cent calculation, arguing the premiers’ math ignores their revenue from federal tax points transferred to the provinces since 1997.

While both sides call for a more “adult conversation” on health-care funding in place of a “sterile” debate on percentages that now resembles a stalemate, the premiers’ request last fall for an urgent first ministers’ meeting on health care was rebuffed.

Why? Provincial elections in Ontario (this spring) and soon, Quebec (this fall), apparently made for difficult political timing in Ottawa’s eyes, even though last winter’s supply and confidence agreement with the federal NDP has presumably given Trudeau’s Liberals more space to work something out without fear of a writ period of their own.

As chair, Horgan (a New Democrat) along with Newfoundland and Labrador Premier Andrew Furey (a Liberal) and Saskatchewan Premier Scott Moe (representing more conservative premiers), have been trying to engage Trudeau in what they say is a non-partisan way. But it hasn’t worked.

“As the kids say, we’ve been ghosted by the federal government,” Horgan said. “I know the prime minister is committed to this, but it’s a matter of timing and tick-tock goes the clock, as far as I’m concerned.”

Federal Health Minister Jean-Yves Duclos announced $2 billion to help with surgical backlogs last March. But last spring’s federal budget didn’t have a large, permanent and non-specific boost to health transfers on its short-term horizon.

In Ottawa’s defence, some provinces have sparked skepticism that additional federal health transfers would be used for their intended purposes. Last month, Alberta’s auditor general found it couldn’t properly account for how billions in COVID funding was spent. Ontario’s Financial Accountability Office reported last fall that Doug Ford’s government didn’t immediately spend billions transferred for urgent COVID needs. New Brunswick used federal COVID transfers to pad its provincial surplus.

Horgan seems to understand that repeating another request for unconditional transfers would be a non-starter.

“This is not about blank cheques, this is not about no-strings-attached,” he told The House. “We need to work on what those accountability mechanisms will be.”

Beyond funding, it’s unclear whether any other kinds of health-care innovations are on the agenda in Victoria.

Smart, for example, has argued for national, not provincial, licensing for health-care professionals, to improve interprovincial mobility for a workforce desperately in demand and making it easier to scale up virtual health-care delivery across jurisdictions. Premiers like Horgan aren’t keen, arguing that their provincial budgets funded the training of these professionals and they can’t risk losing them if licensing barriers are removed.

Pharmacare

Prescription drug expenditures are a major component of health-care costs, but they’ve been broken off into a separate political conversation.

At past summer premiers’ meetings, agreements were hammered out to collaborate on bulk purchasing of medicines to wrestle these costs down. That work continues.

But more recently, pharmacare has become a federal file, with the Trudeau government first appointing a former Ontario health minister to study how a national drug plan could be implemented and the federal NDP demanding serious progress toward this goal as a condition for its ongoing support in the House of Commons.

If a federal universal drug insurance plan ever came to fruition, it could not only allow for more equal coverage for Canadians no matter where they live, but also let provinces that already provide a lot of provincial drug coverage to reallocate that money in their respective health budgets. So why aren’t all the premiers leaning in?

Similar to the $10-a-day federal child-care proposal, it could help each jurisdiction, but differently, based on what they already offer. Because of these potential redundancies, implementing what may seem like a simple idea becomes complex.

Interprovincial trade barriers

This past Canada Day marked five years since the country’s interprovincial “free trade” deal took effect. So why do business groups still complain about interprovincial barriers costing Canada billions in lost productivity and economic growth?

In its recent report card, the Canadian Federation of Independent Businesses found a lot of work remains, with many “F” grades awarded for a lack of progress on specific barriers, like mutual recognition of credentials or the harmonization of business regulations and registrations.

Past summer premiers’ meetings have featured specific headline-grabbing but incremental announcements about “freeing the beer” or “freeing the grapes” (wine), notwithstanding a 2018 Supreme Court decision that allows provinces to continue to restrict interprovincial alcohol trade.

Some premiers have liberalized a lot, and others might be willing to liberalize more, but there’s never been unanimity around the table, particularly among premiers who represent remote Northern communities with high rates of alcohol-related health and social challenges.

Sovereignty, Part 1: immigration

In a scrum with reporters last week, Scott Moe openly mused about the need for Saskatchewan to “use up the full scope of autonomy that we have” and follow Quebec’s lead in seeking more powers to regulate immigration. Moe argued that he needs more newcomers to pursue the economic growth agenda he wants for his province in this tight labour market.

By week’s end, Ontario Premier Doug Ford was also talking about “historic labour shortages,” with his labour minister saying thousands of jobs go unfilled and that it’s urgent for the business community to add more skilled workers in particular. Federal immigration allocations are inadequate, Ontario is arguing, so it needs to be free to do something about it.

Could Quebec Premier François Legault offer some tips in Victoria for seeking more independence? Maybe, but the federal government may be reluctant to enable it. Less restrictive immigration policies could exacerbate inequities: it could be hard for less-popular regions to attract skilled workers and investors if wealthier provinces fling open their doors.

Sovereignty, Part 2: energy

Moe also told reporters he wants to focus on energy security this week.

The war in Ukraine has disrupted global markets and created new demand for not only Canadian oil and gas exports, but uranium and other critical minerals.

Framing this economic opportunity in “energy security” terms also counters the federal government’s climate change objective of gradually weaning Canada off its dependence on fossil fuel exports and keeping its international commitments to cut carbon emissions.

The Alberta government issued a press release Thursday touting how all nine provinces have signed on as intervenors in the upcoming Supreme Court case on the constitutionality of C-69, which Jason Kenney’s government has dubbed the “No More Pipelines Act” for what it says are changes to the federal impact assessment process that threaten the future of Alberta’s economy.

Just like the recent provincial challenge to the federal carbon tax, the Alberta Court of Appeal found C-69 unconstitutional, but legal experts aren’t sure the Supreme Court will agree. In the meantime, this latest legal fight appears to have united the premiers on the need to push back.

New faces, lame ducks and powerful incumbents

This year’s talks will feature new faces, like Nova Scotia’s Tim Houston and Manitoba’s Stefanson. The former is coming up on his first anniversary in office, and the latter will find out next year if voters want to keep her party in power.

Doug Ford may return to the table with some swagger after winning another majority in Ontario last month. Legault, who posed with Ford for the cameras on Sunday night, is tracking toward a potentially even more resounding re-election this fall.

This week will be a swan song for not only chair Horgan, who has announced he won’t run again, but fellow lame-duck Premier Kenney, whose party showed him the door in May.

After a period of suits-only visuals, the premiers’ annual photo call will include a couple of women again: not only Stefanson, but Caroline Cochrane from the Northwest Territories.

Talks begin Monday morning as they have in the past — hearing from representatives of Canada’s national Indigenous organizations.

The Assembly of First Nations will be represented by its B.C. regional chief, Terry Teegee, while Elmer St. Pierre, national chief of the Congress of Aboriginal Peoples, will also attend. Inuit Tapiriit Kanatami will not be present this year, but Métis National Council President Cassidy Caron will attend, as well as a regional representative of the Native Women’s Association of Canada.

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