The premiers have accepted Ottawa's offer on health-care. They said it wasn't enough -- and it isn't -- but they took the money. Michael Harris writes:
If Canada’s premiers are feeling Christmas morning disappointment with Ottawa’s financial package intended to save the public health-care system, they aren’t resorting to the usual antics when their demands aren’t met.
The chair of the premiers’ council, Manitoba Premier Heather Stefanson, noted the significant shortfall in requested funding. Quebec Premier François Legault griped that Ottawa’s package was not a long-term solution to the problems besetting the health system.
But not a single premier came out swinging against Ottawa’s offer, not a single one turned it down — at least not yet.
The premiers had asked for $28 billion a year to be added to the Canada Health Transfer. They got $46.2 billion spread over 10 years, with just under half of that coming in the form of a boost to the Canada Health Transfer.
Another $25 billion will be doled out through bilateral deals with individual provinces and territories, with strings attached. Ottawa would like the funding to be invested in areas such as primary care and mental health.
The bilateral deals give Ottawa significant leverage in its dealing with the provinces and territories. With each side deal it is able to consummate, a unified opposition to Ottawa’s offer will be weakened. Think of it as divide and concur.
But the real hallmark of this agreement is data:
What really puts Ottawa in the driver’s seat with this offer, should the premiers accept it, is the level of oversight the federal government will exercise. Through the Canadian Institute for Health Information, the provinces and territories will be required to share data that Ottawa will use to assess whether the new funding, such as it is, actually produces better outcomes for Canadians.
If surgical wait times don’t improve, if more doctors and nurses aren’t recruited, if more Canadians don’t end up with access to family doctors, new funding could dry up — though there are no explicit penalty clauses in the federal proposal. But why else measure performance outcomes, if failing grades don’t come with consequences?
So why are the premiers not raising Cain?
It comes down to this. Health care is now an existential issue for every political party. With record numbers of Canadians without a family doctor, with a shocking number of patients dying in ERs and a COVID-weary medical profession barely on its feet in overwhelmed hospitals, health care in this country is not merely in trouble, there is a clear and present danger of a collapse.
That’s why federal Health Minister Jean-Yves Duclos said the system doesn’t work anymore. That’s why no politician wants to be seen as haggling over the details of a fix, when so many Canadians are suffering, and without timely access to medical care. In Nova Scotia alone, 558 ER patients died in 2022, up 10 per cent from the previous year.
That’s why Ontario Premier Doug Ford is apparently prepared to embrace Trudeau’s insufficient financial lifeline, characterizing it as a “down payment” on better future funding from Ottawa.
Everyone seems to be on board:
That’s why Conservative Leader Pierre Poilievre, whose reflexive reaction to anything Trudeau does is shock and outrage, says he will not only honour the Liberal deal if he is elected prime minister, he will give even more money to the premiers. Even Poilievre understands that at a visceral level, Canadian identity rests on public health care, not hockey. Too bad he didn’t bother to tell Canadians just how much more he would be willing to spend if he ran the show.
Everyone it seems except Jagmeet Singh:
Singh, who entered into a supply and confidence deal with the Liberals that could keep Trudeau’s minority in power until 2025, has accused the prime minister of endangering Canada’s public health-care system in the most fundamental way.
“Most concerning is that, according to the premiers, Prime Minister Trudeau did not raise a single concern with provincial plans to build more for-profit, private health care. When he had the chance to stand up for Canada’s public health-care system, he stood down,” Singh said in a statement.
Even though Trudeau has repeatedly said that health care in all provinces and territories must comply with the Canada Health Act, Singh thinks Trudeau has missed the point. Rather than easing staffing problems in hospitals by having some procedures done in private clinics, the NDP believes that approach will only make matters worse.
So, what happens next? Hard to say. But keep your eye on those side deals with the provinces.
Image: CTV
8 comments:
“Private health care will cannibalize ERs and ORs…. We must move towards more public delivery, not further away,” the NDP leader tweeted.
Is Singh the only one that gets it. Many of the more sober population recognise this as a foregone conclusion.We already saw reports of knee surgeries costing $28,000 in Quebec for those willing and able to jump the line and pay for it themselves. For Freeland to "parrot"the fight against climate change as a primary funding challenge and a contributing factor in the lack of healthcare funding shows how lame this government is. We cannot afford to allow the burning down of our healthcare house aa Trudeau fiddles with his legacy.
Disaster Capitalism has health-care in its sights, zoombats.
Trudeau dodged Singh's concern about the provinces building out private healthcare. The Canada Health Act doesn't prohibit private healthcare; it just requires the provinces to pay for listed services. All the provinces have to do is follow Ford's lead in delisting health services to allow private medicine to grow.
Here's how the Fraser Institute, champion of privatization, sees it:
Ontario’s delisting of medical procedures indicates the province is asserting its ability to define what is (and isn’t) “medically necessary.” Importantly, once a procedure is no longer considered medically necessary, CHA restrictions on private insurance and delivery of care may no longer be relevant. In other words, delisting may allow patients (sick of long wait times) to pay for these treatments, save the province health-care dollars, and show other governments how they too can open the door to private-sector involvement.
The Libs are fine with privatization and the provinces know it. They all just prefer to proceed by stealth because they know the public is dead set against it.
Cap
That's exactly the problem, Cap. It's a shell game.
It probably could have been a better deal but finally the Feds are enforcing some discipline on the provinces. We may even see the provinces investing in health care rather than using it to pay down a deficit or who knows what.
Personally I'd have liked to see claw-back provisions but this is a start.
The provinces like money without strings attached, jrk. But the feds want to see uniform quality across the board.
The provinces received a four-fold increase over the last twenty years but only spent three times as much. Where's the money? In gimmicks like vehicle registration rebates and tax breaks for the rich.
Seems to be a mirror image of the private companies investing their huge (pandemic-windfall) profits and gov't support into (not wages and new investments but rather) share buybacks.
If this deal can give the feds a propaganda-resistant tool to expose the provinces (or better yet keep them honest) than I am all for it.
That seems to be the intent, PoV. We'll see if it works.
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