(Victoria) The song is well known and the premiers of the provinces and territories have come together to sing it together once again. Ottawa must repeatedly and unconditionally increase federal health transfers from 22% to 35% of costs, they claim.
Posted at 7:23 p.m.
Updated at 7:55 p.m.
“We’ve been short of money across the country for a long, long time because we can’t rely on a stable partner,” B.C. Premier and Council of the Federation Speaker John Horgan said Monday. during a press briefing, the first of a meeting that is being held in person for the first time since 2019.
Quebec Premier François Legault, who also took the floor, said that this “unanimous priority” that the premiers have been reiterating for three years is “necessary (and) reasonable”.
“It’s important to have these recurring $28 billion because the priority is to hire nurses, staff, and that, we can’t do that with the non-recurring money we received from the federal government. added Mr. Legault.
Rather, the federal government considers that it is already doing more than its share when it takes into account the value of tax points ceded to the provinces some 40 years ago when replacing part of the federal transfer, ignored by the provinces.
According to calculations prepared by officials, revealed Sunday by The Canadian Press, Ottawa estimates that it contributed in some way to 37.8% of public health spending in 2019-2020, 44.7% in 2020-2021 and 39.8% in 2021-2022.
This data made Prime Minister Horgan jump. “When Canadians hear us having an accounting debate, […] God, people expect us to sit down and sort out how they’re going to get their hip replacement when they need it,” he said.
In turn, Mr. Legault held up his title of “chartered accountant, CPA” and pleaded that “despite the transfer of tax points, in Quebec, for example, 40% of taxes go to Ottawa, 60 % in Quebec, then well, they pay only 22% of health expenses”.
This is without taking into account that the growth in health spending is 5% to 6% per year, he argued, so much so that, according to data from the Quebec Ministry of Finance shared by his cabinet, the share of the federal government in health has fallen, including the transfer of tax points, from 43.3% in 1979 to 33.4% in 40 years.
Conditional priorities?
The office of the federal Minister of Health, Jean-Yves Duclos, has made it known that Canadians do not want a “sterile tax debate”, but rather “care”. He notes in passing that Ottawa has invested more than $72 billion in the fight against the COVID-19 pandemic.
The Trudeau government says it wants to discuss targeted investments for the future. Minister Duclos had also presented a series of five “priorities” during a speech at the end of March, refusing stubbornly to qualify them as “conditions”, a toxic word in the face of provinces that jealously defend their areas of jurisdiction.
Those priorities that seem to have consensus are delays in treatments, diagnoses and surgeries and healthcare workers; access to primary care; long-term care and home care; mental health and addiction; and health data and virtual care.
“It reminds me of the siren song that wants to deflect the boat towards the magic island by saying: “we are waiting for you with what you want”, illustrated the Quebec Minister of Intergovernmental Affairs, Sonia LeBel, in an interview.
Although M.me LeBel recognizes that these are issues of the hour, these may change in the months and years to come. Out of the question “to be trapped in a kind of path where we will say ‘come this way, come this way, these are the priorities of the hour'”.
“It is the responsibility of the provinces and each province has different issues, different health priorities and it is up to us to assume them. The federal government’s responsibility is to be an adequate financial partner. “And by the way, “these are conditions”, she decided.
Settle it once and for all
In a study published last year, the Center for Productivity and Prosperity of HEC Montréal concludes that the solution to this eternal federal-provincial bickering is the outright abolition of health transfers and that, in return, the federal government cedes the tax points needed to fund health care.
“These transfers were born because the federal government did not retrocede the tax points that it took to finance the war effort in the early 1940s”, explains in an interview one of the authors, Jonathan Deslauriers.
According to him, the question will never be resolved as long as the federal government makes transfers to the provinces since they will continue to be subject to the goodwill of Ottawa. “There is nothing that guarantees them that, in 10 years, the government will agree to maintain these transfers and will continue to improve them,” added Mr. Deslauriers.
In Ottawa, however, it is felt that this is not a realistic scenario since the federal government has legal responsibilities and obligations under the Canada Health Actwhich relate in particular to the principles of universality, accessibility, public financing and public administration of the health system.
The Summer Premiers Meeting will continue for a second and final day on Tuesday. The theme of the rising cost of living and economic recovery is also on the agenda.