The federal government will propose a decade-long plan to fund and reform the health-care system when Prime Minister Justin Trudeau meets with the premiers in Ottawa on Tuesday, according to sources with knowledge of the plan.
The federal proposal will see new money flow as soon as the next budget. It will include a top-up to the planned across-the-board increase to the Canada Health Transfer (CHT) and substantial funding for bilateral agreements with provinces and territories to deal with their specific needs.
Sources say the proposed CHT increases, and the bilateral health deals, will each run for a period of 10 years.
Health-care funding has always been a contentious topic between the provinces and the federal government. The pandemic’s effects on an already strained system have made the need for a new funding agreement more urgent.
On Tuesday, Canada’s premiers will meet in Ottawa with Prime Minister Trudeau to pursue plans to deal with both long- and short-term challenges facing the delivery of health care in Canada.
On Monday, Trudeau said he was looking forward to sitting down with the premiers for what he described as a “working conversation” on how both levels of government can improve “outcomes for Canadians.”
“We will be there putting more money on the table but it’s also important to make sure the focus is on results and outcomes for Canadians,” he said.
Trudeau said his government would work with the provinces over the “coming weeks” to hammer out the details of the new funding agreement and expressed confidence that Canada can afford to boost health-care funding.
“There will be increases to the funding that we’re sending to the provinces for health care,” Trudeau said. He would not say how large that boost will be.
Premiers react to the proposal
Manitoba Premier Heather Stefanson, chair of the Council of the Federation, said premiers are looking for a “long-term, sustainable funding model” from the federal government.
Stefanson said she won’t comment on details media have reported about Ottawa’s proposal, but will instead wait until she sees the full details tomorrow.
“It’s very difficult to make a comment on something that we haven’t seen,” Stefanson told a news conference Monday.
“I would have like to have seen the proposal ahead of time, there’s no question … If we had had it ahead of time, we probably could have had a more fulsome discussion tomorrow.”
Prince Edward Island Premier Dennis King talks about the state of health care in his province and his expectations for Tuesday’s meeting between Prime Minister Justin Trudeau and premiers.
Saskatchewan Premier Scott Moe said he wants any funding deal to be permanent.
“It should not only be for 10 years but ultimately be wrapped into permanent funding, into the Canada Health Transfer, either today or eventually,” he said.
New Brunswick Premier Blaine Higgs agreed that at least part of the funding boost should be made permanent.
“We’re hoping there will be a portion of it that will be a continuous program,” he said.
Higgs added that he doesn’t mind if healthcare funds from the federal government come with strings attached — such as requirements that the money is spent in certain areas — as long as those conditions align with his government’s health-care priorities.
“I am interested to see what the quantum looks like, what the time frames look like and how that fits for us in Newfoundland and Labrador, specifically with respect to modernizing our system,” said N.L. Premier Andrew Furey.
Quebec Premier François Legault also said he won’t accept conditions that don’t fit into his government’s plans to improve health care in Quebec.
“We know how to invest the money. We don’t need the federal government to tell us how to invest the money,” Legault said.
Yukon Premier Ranj Pillai said he’ll wait to see the full details of the proposal before commenting.
“I think it’s just a ‘wait-and-see’ until tomorrow. I think everybody is optimistic that they’re going to table something that’s going to be strong,” he said.
Sticking points
One major sticking point in the negotiations has been the baseline for health-care funding in Canada. The provinces have been asking the federal government to increase the CHT’s share of total public health spending from 22 per cent to 35 per cent.
The federal government has said it will offer more money but rejects the claim that it only pays 22 per cent of the cost of health care. Ottawa has argued that the tax points transferred to provinces in 1977 bring the federal share closer to 38 per cent.
The second major sticking point has been about placing conditions on any increased funding. The federal government says it wants additional funding to be targeted at specific areas.
The provinces have pushed back by insisting the provision of health care is a provincial responsibility. But Quebec and Ontario recently have shown some willingness to meet the federal government half-way.
NDP also wants condition on CHT increase
Earlier Monday, NDP Leader Jagmeet Singh called on Prime Minister Justin Trudeau to make any health-care funding agreement with the provinces conditional on the provinces agreeing not to direct additional resources toward for-profit private health-care providers.
“The prime minister was very strong on this. He said there are going to be conditions. I absolutely agree there should be conditions,” Singh said Monday. “Those conditions should be public money should solve the problem.
“Public money shouldn’t go toward a for-profit clinic being able to have more profit. Our public money should go toward solving the actual problem that we’re up against, which is a shortage of health-care workers.”
Last month, Ontario Premier Doug Ford announced his province would significantly expand the number of medical procedures that can be performed at privately run clinics in Ontario.
The expansion will start with diagnostic clinics performing 14,000 cataract operations a year before the program is expanded to allow clinics to offer MRI and CT imaging, colonoscopies and endoscopies.
Ford said these procedures will be covered by OHIP, the provincial health plan, and stressed that patients will “never use their credit cards” at the clinics.
Singh criticized the move and Trudeau’s description of the expansion as “innovation,” saying that public money should be used to bring more services into the public envelope.
Dr. Alika Lafontaine, president of the Canadian Medical Association (CMA), said he’d like to see Ottawa include a condition in the proposed deal requiring that any federal funding boost be spent on health care.
“The idea that Canada Health Transfers end up going just to a general revenue fund, to be spent any way that a province or territory wants to spend it — it doesn’t make a lot of sense,” Lafontaine told Power & Politics guest host Catherine Cullen in an interview Monday.
“The idea that Canada Health Transfers end up going just to a general revenue fund to be spent any way that a province or territory wants to spend it — it doesn’t make a lot of sense,” said Canadian Medical Association president Dr. Alika Lafontaine.
Lafontaine said the CMA is more interested in where the increased funding will be spent than in the actual sum.
“What we’ve done in previous years is pour more money into a system that produces outcomes that really aren’t what we need,” he said.
“My big concern is that we might be doing that again if we don’t determine what we’re going to do different.”
Assembly of First Nations (AFN) National Chief RoseAnne Archibald criticized Trudeau for not inviting Indigenous representation to the meeting, and called on the prime minister to extend an invitation.
“First Nations inclusion into the first ministers’ meeting is critical,” Archibald said in a news release Monday. “We’ll not be ‘advocated for’ while we wait outside of rooms where we belong.”
