[Analyse] The outdated stubbornness of health negotiations

Each week, our parliamentary correspondent in Ottawa Marie Vastel analyzes a federal political issue to help you better understand it.

The federal-provincial quarrels on health follow and resemble each other. And the one pitting Justin Trudeau against his counterparts these days is no exception. The provinces are asking for more than Ottawa is willing to give them; the two camps remain on their positions, and the discussions are deadlocked. But after three years of a pandemic and in the midst of a crisis paralyzing the country’s pediatric hospitals, this same refrain no longer goes so well.

The federal Prime Minister is, however, using the pandemic precisely to insist on the fact that he must impose certain objectives on the provincial governments, in exchange for an increase in health transfers. “It wouldn’t be the right thing to do just to throw in more money and sit back and watch the problem go and not fix it, because we didn’t use that moment to say, ‘No. , no, no, it’s time to improve the system,” repeated Mr. Trudeau in an end-of-year interview with The Canadian Press.

Justin Trudeau refuses to meet with provincial premiers until their health ministers have reached an agreement with his. The provinces claim, on the contrary, to sit down between prime ministers to agree directly between bosses. Ottawa says it is ready to pay them more money, but on the condition of agreeing on targets aimed at improving the health system. The provincial premiers refuse and defend their area of ​​jurisdiction. A discourse of the deaf that has persisted for months.

The federal government believed, supported by internal polls, that Canadians are tired of these wars of numbers and private preserves and that what they want above all is change. The citizens, it was believed in Ottawa, would therefore prove them right.

But a Nanos poll revealed this fall that, on the contrary, a majority of Canadians do not support the position of one or the other level of government. They are rather divided, 44% of respondents having affirmed to support the position of the provinces against 43% for that of the federal government. And they are equally divided when it comes to choosing whom to trust for solutions — 27% relied on the provincial government, versus 26% on the federal government, while 38% said neither.

All this against a backdrop of overwhelming findings: 70% reported that their access to health care had become even more difficult since the pandemic.

Despite its own encouraging soundings, the Trudeau government may be sensing this undercurrent. For it thus seems that the door is no longer as closed to the provinces as it was. The tone may remain firm in the public square, but the start of 2023 could be a little more conciliatory.

New year, new attitude?

The provinces are also using the pandemic to stand up to the federal government. They believe that their united front, which held firm in 2020, allowed them to win more money in Ottawa, and this, without conditions. Five of the prime ministers of the time — all of Conservative or right-wing allegiance — are still in office. Including François Legault, who seems to be waiting for his federal counterpart firmly for their meeting on Friday, having again accused him of practicing “centralizing federalism” and of holding a “shocking” speech on health financing.

It is also easy for the provinces to summon Ottawa to manage its own files—such as the issuance of passports or the processing of immigration applications—or even its own bills on official languages ​​(C-13) or firearms fire (C-21), which did not come to fruition before the parliamentary recess.

History, however, tends to repeat itself. Although Justin Trudeau promised in 2015 that a Liberal government would “reengage[ait] in these discussions about [le] health system” with the provinces, he ended up overcoming the provincial common front two years later by reaching an agreement with some of them to then force the hand of others, such as Quebec.

It’s a safe bet that the Atlantic provinces will once again accept the federal funds and their conditions. No one can predict what Doug Ford will do in Ontario.

A deflated threat

New Democrat leader Jagmeet Singh, meanwhile, issued a new threat to his agreement with the Liberal government. Visibly sensing popular impatience, faced with overflowing pediatric emergencies and the dispatch of the Red Cross to an Ottawa children’s hospital, Mr. Singh called on the Prime Minister to meet with his counterparts and recalled that he could withdraw its support at any time.

This is not the first time that he has brandished this warning, which had been the same this summer when the Trudeau government was preparing to announce the first parts of dental insurance for children. What makes the Bloc leader Yves-François Blanchet say that it is only “pre-Christmas bluster”. Mr. Singh also spent the rest of his press briefing, after having hardened his tone, repeating that it would only be a last resort and that he did not want an election in 2023. the by-election in Mississauga-Lakeshore — with all the necessary nuances — did nothing to encourage the NDP to seek an election quickly. Neither do the Conservatives, for that matter.

The arrival of the new year will tell if all these political debates can calm down and who, of Justin Trudeau or his provincial counterparts, will be the first to water down his wine. In the meantime, health care workers will obviously have to continue to ring the alarm bells in vain, and parents, to worry at the first sign of respiratory virus in their children.

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