The Theater of Health

Ottawa has launched the ball of the great Canadian vaudeville: the endless negotiations on the financing of health.

The Minister of Health will be credited for setting aside Ottawa’s usual condescension to the provinces. By listing his priorities, Jean-Yves Duclos recognized that it is up to them to manage the network.

Everyone expected a virulent reaction from the Legault government. She was rather polite.

Premature defeat of a government with a facade of nationalism or recognition of a reality from which Quebec will not escape?

There is the question.

The worm in the apple

As soon as he is out of his covid convalescence, François Legault will raise his voice.

He will brandish the common front of the provinces against Ottawa, the constitutional right of the provinces to manage the health network alone. It will be shattering, where his minister Sonia Lebel was a diplomat.

That’s the game. He claims, she negotiates.

But the provincial common front on health has always been more fragile than it seems.

When Minister Duclos affirms that citizens are not interested in the tug of war, he is right. Only Quebec acts as a Gallic village on this question.

Jean Charest had pulled off the masterstroke in 2004 of exempting Quebec from Ottawa’s conditions under asymmetrical federalism.

The problem is that over time, the billions from the government of Paul Martin, renewed by Stephen Harper, have essentially been used to finance salary increases for doctors in Quebec. Finally, from a strictly accounting point of view.

This reality has not gone unnoticed by the federal government. Worse, it has essentially squandered the gains of the hard-won asymmetry.

So much so that in 2016, it only took a few months for the Trudeau government to divide the provinces, to put financing conditions across their throats. And, whatever the main interested party says, even Gaétan Barrette had finally given in.

So for the loud cries against the targeted agreements of the federal villain, we will come back. The precedent has already been set.

Do better

Although the PLC-NDP pact at the beginning of the week gives reason to fear the worst with regard to the centralizing aspirations of the federal government, rarely has Quebec had the chance to negotiate in such a favorable climate.

Jean-Yves Duclos, Health, is certainly the least dogmatic of Liberal ministers. And Chrystia Freeland, in Finance, on child care and during the pandemic, has demonstrated that she knows how to negotiate effectively.

Above all, even in Ottawa, we have understood an essential lesson: without a substantial and well-funded reform of the health care system, it is doomed to collapse under its own weight.

It will therefore be up to the Legault government to prove that its overhaul of the health care system is likely to succeed where others have failed.

Unfair to put the burden of proof on the shoulders of Christian Dubé? Absolutely, but that’s the reality of federal-provincial relations.

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