While the provinces are preparing to return to the charge at the start of the week to demand a recurring and unconditional increase in federal health transfers, to increase them from 22% to 35% of the costs, the federal government rather considers that it is already doing more than its share and says it wants to discuss targeted investments for the future.
Data prepared by officials, obtained by The Canadian Press, indicates that Ottawa in some way contributed 37.8% of government health spending in 2019-20, 44.7% in 2020-21 and 39.8% in 2021-2022.
These figures take into account the value of tax points ceded to the provinces some 40 years ago when part of the federal transfer — currently $45 billion — was replaced by this tax transfer. The operation is valued by Ottawa at $19.0 billion in 2019-2020, $19.9 billion in 2020-2021 and $20.9 billion in 2021-2022.
Ottawa includes COVID-related expenses in its calculation. They would be $500 million (or 0.3%) for the first year analyzed, $19.1 billion (or 8.4%) for the second and $3 billion (or 1.3%) for the third. .
“In their calculation of current federal spending, the provinces are completely ignoring this transfer,” said a federal government source familiar with the matter on the phone, to whom The Canadian Press granted anonymity so that she could speak. express freely.
“When we do the calculation by including the tax transfer that the provinces exclude from their calculation, we are already well beyond the 35% claimed. That’s if we want to persist on the numbers, ”she continues.
In an email, the office of the federal Minister of Health, Jean-Yves Duclos, indicates that Canadians do not want a “sterile tax debate” and rather want “care”.
The minister’s team stresses that Ottawa has demonstrated that it is ready to do its part to ensure the viability and accessibility of the health care system. She cites the billions invested through bilateral agreements on long-term care, mental health and home care, in addition to those announced in March that would go to reducing waiting lists for surgery.
“Since the start of the pandemic, our government has invested more than $72 billion to protect the health of Canadians,” it also notes.
Collaboration or confrontation
Ottawa says it does not want a squabble with the provinces, Minister Duclos said in March in a long speech that aimed to set out his “vision of the future of federal-provincial collaboration” in health care. health in the country.
Mr. Duclos said he was looking for “partners” to work on five “priorities” on which there seems to be consensus: delays in treatment, diagnosis and surgery and health care workers; access to primary care; long-term care and home care; mental health and addiction; and health data and virtual care.
Ottawa no longer wants to simply write checks that the provinces spend as they see fit, which would be the equivalent of “throwing more money at the problem,” our source says. Rather, the government wants to be assured that the “additional investments” will lead to “concrete results” in the lives of patients.
But Ottawa may well find Quebec on its way, warned in recent months Prime Minister François Legault, who had difficulty understanding what the Trudeau government is getting involved in when health is an exclusively provincial jurisdiction.
Expectations from the federal government are low on the eve of the two-day meeting of the Council of the Federation. The event, to be held Monday and Tuesday in Victoria, British Columbia, will bring together the premiers of the provinces and territories in person.
We note in broad strokes in Ottawa that Quebec is on the verge of calling an election, while it is one of the provinces most resistant to what could be perceived as an intrusion by the federal government in its areas of jurisdiction, which makes it difficult to negotiate on such a thorny subject.
At their meeting, the premiers plan to discuss “primarily” health care, and in particular the “urgent need to close the funding gap.”
Such a conversation with the federal government “cannot wait any longer,” BC Premier and meeting host John Horgan said in a statement.
The increase in federal health transfers, on a recurring and unconditional basis, remains the “priority” of the Quebec government, argued Ewan Sauves, the press secretary for Premier François Legault.
“The federal government has always said that it would be ready to have the discussion once the worst of the health crisis is behind us. Here we are. It is high time now for him to do his fair share of raising his transfers to 35%,” he wrote in an email.
Premiers will also discuss the rising cost of living and economic recovery.