Ordinarily, provinces only want one thing from the feds –money.
So when the feds offer money in exchange for something, provinces are reluctant to accept.
All that has changed now that Canada is facing a shortage of health care workers and operating rooms.
image: Canada’s premiers
Other than universal health care, Canada has no central control of health delivery. It’s delivered by the provinces and overseen by the feds.
The provinces provide most of the funding for health care whereas the feds only contribute 22 per cent. It used to be greater. At the inception of health care in 1957 the feds paid 35 per cent. In the late 1970s, it dropped to 25 per cent.
The provinces do the heavy lifting while the feds try to initiate county-wide programs like dental care.
It’s a recipe for tension, an awkward and inefficient way to run a universal health system. Medicare would be easier to administer if it wasn’t fractured into fiefdoms. Other countries do a better job.
In Australia, the federal government funds and controls health care, There, the feds control the purse and the programs.
However, the crisis in our health care system has caught everyone’s attention, federally and provincially.
Conditions which the provinces rejected are now being reconsidered. It’s a new era of reciprocity; more of a forced marriage than cooperation.
The new era has left health ministers unfamiliar with the new terrain. First, they were willing to accept federal money last November when provincial health ministers met with their federal counterpart in Vancouver.
Then premiers nixed the deal, presumably because they didn’t like being told what the money would go for.
Now provinces are sensibly reconsidering the federal offer in exchange for some reasonable national goals.
In recent negotiations, Federal Health Minister Jean-Yves Duclos said there has been a “change in tone and direction” from the provinces and territories to accept Ottawa’s demands to modernize data sharing, reduce backlogs in surgeries and diagnostics, retrain and hire more nurses and use medical clinics to handle millions of Canadians without family doctors.
It’s an offer the provinces can’t refuse.
Duclos is using a divide and conquer strategy. Ontario’s premier Ford was the first to break from the pack of provinces. Ford announced that Ontario is willing to accept Ottawa’s key demands, including a national health data system.
In addition to that compromise on Ford’s part, the feds are negotiating special deals with Ontario that would see Ottawa transfer $70-billion to the province over the next decade.
And now Ontario is willing to have transfers for specific programs. Some of this money would be earmarked under a bilateral agreement for home care and building long-term care facilities to reduce the stress on hospitals,
Ford insists that he is not breaking in solidarity with other provinces. He insisted that any bilateral agreement would not come at the expense of other provinces and territories.
Then Quebec Premier François Legault said he also is ready to share data on the province’s health care systems.
Just wait, the rest of the provinces will come to their senses and follow.