When it comes to federal health transfers, the time has come for our politicians to stop bickering like children.
Posted at 5:00 a.m.
“What Canadians want us to do is sit down like adults and find a way to resurrect our public health care system,” British Columbia Premier John Horgan said Monday in the framework of a meeting of the Council of the Federation, which he chairs.
Words full of common sense.
The Earth is calling Ottawa: negotiations must be conducted as soon as possible on the financing of health care. It is about their access and their quality, from one end of the country to the other.
Over the past two years, the pandemic has served as a pretext for the federal government to postpone discussion of increased transfers to the provinces.
It used to be a good alibi… but it’s not anymore.
Ottawa has given the provinces a serious boost by injecting colossal sums to enable them to stay the course in the storm. We’re not going to deny it. But these are one-time investments, not recurring sums.
The federal government has put a balm on the wounds of the provinces. He must, as of now, offer them long-term treatment.
We shouldn’t have to argue this for very long. It’s a matter of arithmetic. The provinces’ health expenditures are increasing much faster than their revenues.
For 20 years, they have generally increased by 5 to 6% per year. However, the annual increase in health transfers from the federal government is 3%.
And that spending is certainly not going to stabilize over the next few years. The pandemic has reminded us of the urgent need to invest in improving the resilience of our health systems.
Let’s take a very specific example: there are now more than 9,000 more beneficiary attendants in CHSLDs in Quebec. That represents additional, recurring expenses of $800 million a year. A substantial sum.
Let’s not forget either that the aging of the population in Quebec will continue to increase the necessary investments in health care, as well as the high cost of new technologies and drugs.
The provinces claim that the sums allocated by Ottawa currently make it possible to absorb 21% of their health expenditure and that they would like this share to reach 35%.
That is why they are asking Ottawa for $28 billion more annually. An astronomical amount, yes, but let’s not forget that this is a trading position.
In Ottawa, it has been replied several times since Monday that the calculations of the provinces are wrong because they do not take into account the way in which the federal contribution was modified in 1977. Part of the sums traditionally paid for health had then been offered to the provinces in the form of tax points.
According to calculations by economics professor Trevor Tombe of the University of Calgary, the value of this sum in 2022 would reach some $20 billion. If we add it to the funding granted annually by the Canada Health Transfer, which amounts to $45 billion this year, the share of provincial expenditure assumed by Ottawa would therefore be around 32%.
Theoretically, this debate is not without interest.
The problem is that this bickering will solve nothing and will not improve the lot of users of the health system.
Nor does it change the fact that the provinces need Ottawa to inject substantial amounts into health care. Otherwise, they will have to reduce the amounts currently allocated to other state missions (such as education and infrastructure maintenance).
However, in the face of repeated appeals from the provinces who wish to negotiate in good faith, the Canadian Prime Minister and his ministers concerned procrastinate and refuse to collaborate. However, this does not prevent them from considering new expenses, such as a drug insurance and dental care program, instead of ensuring that the health system is properly funded.
Justin Trudeau has been Prime Minister long enough to know that being dragged out on such an important issue is not proof of leadership.