victory-
At every meeting of provincial premiers in recent memory, the demand has always been the same: more funding from the federal government for health care.
But the call of the perennial history of federal-provincial relations year of the year award, held this week in Victoria, BC, was more insistent, with health care systems across the country still reeling from the pandemic.
Provinces are grappling with burnout among frontline health workers, reduced hours at urgent care centers and persistent delays in diagnostic tests and surgeries, despite a special one-time federal transfer of $2 billion earmarked to help solve such problems.
The problem, say prime ministers and territorial leaders, is not just the effects of the COVID crisis, but a systemic underfunding of health care that they insist is getting worse every year as Canada’s population ages and increases the cost of new therapies.
Prime ministers boil down the complexity of funding gaps to a simple number: 22 per cent, that’s the share they estimate the federal government spends on health care costs for each Canadian, a figure that was closer to 50 per cent. cent in the early days of Canada’s publicly funded health care system.
In Victoria, the prime ministers reiterated their call for the Trudeau government to increase the number to 35 per cent, an increase that would add an estimated $28 billion in annual spending. They also demanded that Trudeau urgently call a meeting of prime ministers to reach an agreement.
The federal government was not represented at the Victoria meetings, but at the end of the first day, Intergovernmental Affairs Minister Dominic LeBlanc fired back from Ottawa, accusing the premiers of promoting a false number by not including the tax points that Ottawa transferred to the provinces in its calculations on health care.
LeBlanc also raised an ongoing problem for the federal side: Provinces spend money after receiving federal health aid. LeBlanc was referring to the $500 per person refund checks sent by the Quebec government to Francois Legault and the refund of vehicle license plate fees by Ontario Premier Doug Ford shortly before the provincial election.
How can the provinces cry poverty on the one hand, it is thought, and then reduce their own income with rebates and rebates?
“What is not false is the fact that the Canadian health system is in crisis. We see it in every province,” responded Newfoundland and Labrador Premier Andrew Furey, who is also a practicing physician.
“It’s not untrue when I have to go in and tell a patient they can’t have surgery, that’s not untrue.”
British Columbia Premier John Horgan, host of this year’s premiers meeting, seemed particularly upset by LeBlanc’s comments. For Horgan, the emphasis on provincial systems is both political and personal. He often cites his own experience during throat cancer treatment, and his province is experiencing a severe shortage of primary care physicians, with more than 900,000 residents reporting they do not have a family doctor.
“It’s not about coming up with our alms bowl and saying ‘Please, sir, give us some more,'” Horgan said, evoking “Oliver Twist.”
Horgan also suggested that two key programs the Liberal government is pushing could be put on hold until the health transfer issue is resolved.
“We’re happy to talk about revamped programs like pharmacare or new programs like dental care, but we shouldn’t do that until we have a firm foundation for our entire program,” he said.
While progress on a national drug program has been slow, the Liberals must begin implementing dental care as a condition of a deal with the federal NDP to retain power until 2025. Both programs require negotiations with the provinces to establish.
The two days in Victoria were the first in-person meetings of prime ministers and territorial leaders since 2019. During the pandemic, they were regularly meeting virtually with the prime minister to coordinate their response to COVID-19. But as prime ministers head home, there is no plan to sit down with Trudeau or his ministers, and no specific commitments to increase transfers.
The cooperative spirit that prevailed during COVID now appears to be fading, as the health system still struggles to recover from the biggest crisis it has faced in generations.