“Twenty-four months ago, we were working together in an unprecedented way,” BC Premier John Horgan, this year’s Federation Council chair, said in Victoria on Tuesday. “There was an unprecedented partnership and the federal government was there and we applauded that commitment … and now, eight months later, we’re exchanging notes through the media. Where did the love go? Everything was so good and then it wasn’t.” Horgan said Prime Minister Justin Trudeau promised the premiers that, once the public health emergency is over, the two sides will meet to chart the future of health care funding in Canada. No such meeting has been scheduled and his calls for a sit-down meeting have gone unanswered. “I wrote to the prime minister in December, no response,” Horgan said. “We’ve sent a package of principles that we thought would guide a discussion. No response. And now it’s ‘We want you to spend it on specific things.’ “We’re fine with that … but there are differences and nuances depending on where you live.” Horgan said because each province’s health system has different needs, the federal government and the premier must deal with them separately. Premiers say the federal government only covers 22 per cent of health care costs in Canada. They say they want that federal share to rise to 35 percent and stay at that level over time. The federal government, meanwhile, disagrees with the math the provinces use to determine who should pay for what. “It’s time for the federal government to stop talking, stop saying we don’t have a problem with our government-funded national health care system and sit down with the 13 premiers from the provinces and territories,” Horgan said. he said.
Disagreement in basic data
In 1977, the way the federal government finances health care changed. Direct federal funding for hospital and medical services was reduced, and provinces were given the power to collect more income and corporate taxes to directly fund health services.
The federal government says the tax credits given to the provinces cover between nine and 10 percent of the cost of public health care services. Premiers say the Canada Health Transfer (CHT) — the largest federal transfer to the provinces — covers about 22 per cent of the cost.
The federal government says that when the CHT and those tax credits are combined with money Ottawa spends on bilateral agreements on long-term care, home care, mental health and some other services, the portion of health care spending covered by the federal government In 2021-22 it approached 38.5%.
“Right now, federal spending to support public health care is about a third of all spending,” Intergovernmental Affairs Minister Dominic LeBlanc told guest host Paul Hunter on CBC News Network’s Power & Politics on Monday.
“They’re using this bogus figure of 22 per cent because they’re deliberately refusing to acknowledge that $20 billion was generated last year by provinces and territories in tax havens that the Government of Canada withdrew from and then immediately set about generating revenue for themselves. “
Quebec Premier Francois Legault and BC Premier John Horgan answer questions during a press conference on the second day of the summer meeting of Canadian premiers in Victoria, BC, Tuesday, July 12, 2022. (The Canadian Press/ (Chad Hipolito)
Lee Soderstrom, a retired associate professor of economics at McGill University who has studied health care economics in Canada, said the number reported by the federal government is about right.
“Provinces have long already received about 35 per cent of their total health care spending. Furthermore, unlike critics of federal cost-sharing, Ottawa has not reduced its share of provincial health costs,” Soderstrom said in an email to CBC News. .
Horgan said Tuesday that while the federal government may dispute who pays for what, Canadians just want a system that works.
“Regardless of what the right number is, are the tax points as important as they were in the 1990s today, as we look to the future, these are conversations we should be having together, not through the media,” Horgan said.
“That’s why we’re strengthening our unanimity today to ask the federal government to call a meeting. We’re going to get there … we can sit down and solve these problems for Canadians.”
Strings attached
A federal government official who spoke to CBC News said the premiers’ demand for a $28-billion annual increase in the CHT — with no discussion of where the money would be used — won’t fly with Ottawa. LeBlanc reiterated that position again on Monday. He said any increase in federal health care funding must come with conditions and a commitment from provinces to maintain current funding levels and match any increases in federal funding. “Of course there will be strings attached in the sense that we’re not going to increase federal spending to the provinces on health care so they then reduce their own spending. That would be absurd,” LeBlanc told Hunter. Horgan said provincial governments are held accountable for how they spend money through their respective budget processes and every dollar spent by provinces is discussed in regional legislatures. “The so-called strings make it sound like there’s some kind of serfdom going on here,” Horgan said. “We’re co-governors. We’re equal ranks of government. There’s no hierarchy here, we’re the same, and we’re saying we need to collectively sit down and figure out where we go from here.” Federal Health Minister Jean-Yves Duclos told CBC News Network’s Power & Politics that the details of the specific outcomes the federal government would tie to any additional health funding can be worked out between him and provincial health ministers. Horgan and Ontario Premier Doug Ford rejected that proposal and said it would be insulting for Prime Minister Justin Trudeau to refuse to meet with them. “It’s quite disingenuous when you have the minister come out and say, ‘Here are some ideas, and by the way, give them to your health ministers,’” Ford said. “It’s just a request, come to the table… It’s unacceptable. We have to sit down.” Horgan also said he doesn’t see how provinces can continue to have discussions about sharing the costs of a national drug or dental program until the overall funding issue is resolved. “We shouldn’t do this until we have a solid foundation for our entire program,” Horgan said.
Affordable prices and global challenges
The premiers also released a five-page announcement asking the federal government to help them address the cost of living, supply chain and labor challenges facing Canadians. The premiers said they need federal help to eliminate supply chains, fight climate change, improve energy and food security, improve mental health and addictions services, strengthen Arctic sovereignty and address labor shortage. Prime Minister Doug Ford answers a question from the media on the final day of the summer meeting of Canadian prime ministers at the Fairmont Empress in Victoria, BC, on Tuesday, July 12, 2022. (Chad Ippolito/The Canadian Press) Ford said Ontario is facing a once-in-a-generation labor shortage. He said the federal government should help attract economic migrants to fill hundreds of thousands of vacant jobs in his province. “As of this morning, with the numbers I got from our team, we’re 378,000 short,” Ford said. “That’s 378,000 people who could be contributing to our economy and … if we don’t fill those jobs, someone else around the world will.” Ford said one of the biggest obstacles to filling those positions is a cumbersome immigration process that can take up to 26 months to bring an immigrant to Canada and declare them eligible to enter the workforce.
