Health financing: the common front of the provinces holds, for the moment

The provinces hoped on Tuesday that their common front would stand up to Justin Trudeau and had no intention of being pushed around by Ottawa in an effort to quickly reach agreements on health funding. Although the federal Prime Minister may have expressed the wish that his offer – which he will present to them on Tuesday afternoon – will lead to agreements in the weeks and months to come, two of his provincial counterparts have retorted that they would take the time necessary to negotiate.

The premiers of the ten provinces and three territories met in Ottawa on Tuesday morning to prepare their strategy for a long-awaited meeting that they have been demanding from Prime Minister Justin Trudeau for more than two years.

“Mr. Trudeau had two and a half years to present a proposal [quant à la bonification du financement fédéral en santé] “, argued the Premier of Quebec, François Legault, in the morning. “So we’re going to ask for a few days to study it,” he warned, chuckling.

His counterpart Heather Stefanson of Manitoba, who was with him at a press briefing, added that the provinces would in fact only have “two hours” to discuss it with Mr. Trudeau. A reproach that had also been issued by other provinces on Monday.

Justin Trudeau nevertheless said he was optimistic, Tuesday morning, to come to agreements with the provinces fairly quickly. He called the afternoon working meeting a “conversation start”. “We hope to be able to deliver money to the provinces in the weeks, in the months to come, but that will depend on the conversations we are going to have,” he commented on his arrival at the meeting of the Council of Ministers in Parliament. Tuesday morning.

A “substantial” envelope

Several of the premiers of the provinces had also shown themselves disappointed Monday still not to have been informed of the federal offer. Ms. Stefanson even said she was “concerned”. “We probably could have had a more exhaustive discussion [mardi] “, she had commented on the eve of the work meeting, Monday.

Justin Trudeau’s office wanted him to present his offer to his provincial counterparts in person on Tuesday afternoon.

The Premier of Quebec, François Legault, reiterated the provinces’ request: an increase in federal funding so that it represents 35% of their health bill (rather than 22% currently), as well as an indexation of the transfer to 5 % per year (the annual increase is currently linked to economic growth with a floor indexation set at 3%).

Asked whether this request would be negotiable, François Legault replied that the provinces would be open to “a first step in the right direction”. “It would be much better to have a substantial amount, even if it’s not the full amount,” in preparation for the spring budget, he said.

Quebec is also claiming “a substantial amount, unconditionally. If it did not meet these two expectations, we would be disappointed, ”added Mr. Legault.

Other provinces, in the Maritimes in particular, have shown themselves more willing to accept federal funds that would be tied to investment targets in certain health sectors prioritized by Ottawa.

The federal government was planning, according to our information, to ask the provinces not to reduce their own health spending, by receiving larger amounts from Ottawa, and that these not be used to finance the private health sector.

The provincial and territorial premiers had gathered in the “penthouse” of the Delta hotel in the center of the federal capital on Tuesday to prepare for their meeting with their federal counterpart. Heads of government exchanged small talk such as: “I have to participate in Question Period tomorrow, but I miss Question Period today” as the cameramen strained to take the pulse of the room offering a view breathtaking view of Ottawa and Gatineau.

Good humor reigned during the shooting, concealing the fears of dislocation of the common front of the members of the Council of the Federation as soon as the offer of the federal Prime Minister, Justin Trudeau, was presented.

Waiting for the numbers

The Trudeau government’s proposal will be in two parts: an increase in the federal health transfer paid to the provinces each year, then individual envelopes for bilateral agreements with the provinces in the five priority areas set by the federal Liberals (the lack workers, primary health care and family medicine, home and long-term care, mental health and addictions, and virtual health care).

The Trudeau government has promised a “substantial offer”. The increase requested by the provinces, to reach 35% funding, would be equivalent to an injection of $28 billion in the first year. The federal government clearly indicated that its proposal would not be of this height.

The federal transfer amounted to $45.2 billion last year and was to reach $49.4 billion for the year 2023-2024 according to budget forecasts.

Further details will follow.

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