The federal and provincial governments appear deadlocked in their negotiations on the future of health care in Canada, and Prime Minister Justin Trudeau’s latest comments suggest he will not be the one to blink first.
The stalemate is happening while children’s hospitals across the country are inundated with kids suffering from respiratory diseases. In some cases, hospitals have been overwhelmed by the calamitous combination of record numbers of sick patients and critically low numbers of staff to treat them.
The problem goes back to more than a year ago, when provinces first demanded a sit-down with the prime minister to talk about long-term and sustainable funding increases after pandemic strain left them with large backlogs and a burnt-out workforce.
They want to see Ottawa cover 35 percent of health-care costs across the country, up from the current 22 percent, by increasing the Canada Health Transfer.
Reform is already underway in most provinces, but the federal government does not seem willing to join them at the table yet, British Columbia Health Minister Adrian Dix said in an interview Tuesday.
“I would think that the federal government would want to be part of that and to contribute its share, and that’s what we’re asking,” Dix said.
Health Minister Jean-Yves Duclos made an overture to the provinces last month, offering an increase to the federal health transfer in exchange for improved data sharing across the country.
But the meeting ended without progress. Dix said Duclos came to the table with no specifics, and conversations about the health transfer have continued to be elusive with the Liberals.
“It’s always a new moving excuse, a new line in the sand that drifts away after the tide comes in,” he said.
Imposing performance measures on the provinces that affect their access to the Canada Health Transfer is more or less unheard of, said Haizhen Mou, a professor at the University of Saskatchewan who studies health policy.
It’s understandable that provincial leaders don’t want to change that precedent, she said in an interview Tuesday.
“I don’t think the federal government has the right to impose such performance indicators on the broad kind of health transfer,” she said, but added that she understands why the Liberals don’t want to continue to put money toward a system that’s not working.
A more politically palatable situation might be to offer targeted funds for specific priorities and sign individual agreements with each province, she said, rather than treating them all the same way.
In 2016, the provinces were united as they pushed for an unconditional increase to the health transfer, “but in the end they broke apart, the alliance broke,” Mou said.
That year, the government first signed a bilateral agreement with New Brunswick and other provinces then followed suit individually. Mou said she thinks it’s only a matter of time before that happens again.
“I’m not sure how long they can hold out, because the revenue, the power of the fiscal capacity, is still in the federal government’s hands,” she said.
Health-care advocates, including nurses and doctors’ associations, have echoed Trudeau’s call for a plan to transform Canada’s broken system and to do it quickly.
“Patient care is suffering while health-care working conditions for nurses and other health workers deteriorate,” said Canadian Federation of Nurses Unions president Linda Silas, after talks between health ministers ended last month.
“It is absolutely critical that we put aside politicking and get down to productive discussions around concrete solutions to the health-care staffing crisis.”
“We’re absolutely willing to invest much more in health care, but there has to be clear commitments and results that are going to change things for Canadians,” he said.
For now, each side appears to believe that the ball is in the other’s court.