Canada’s provinces and territories have rejected a proposed increase in federal health care funding, in part because Ottawa tied the offer to the creation of national human resources and data collection programs. The impasse emerged at a meeting of Canada’s health ministers in Vancouver on Tuesday, blocking progress on cooperation between governments at a time when health care services across the country are in crisis due to understaffing, ongoing waves of COVID-19 infections and other problems. Federal Health Minister Jean-Yves Duclos had said Monday that Ottawa was prepared to increase health care funding to the provinces by an unspecified amount if they commit to a national health data system as an accountability measure. Tuesday’s agenda included two “decision items” that ministers were asked to approve: a pan-Canadian health-human resources action plan and a pan-Canadian health data strategy. But by midday, with meetings still underway, Canada’s prime ministers issued a joint statement saying no progress had been made with the federal government. In response, Mr. Duclos withdrew from a joint press conference and refused to sign a joint communiqué. At the end of the meeting, Mr. Duclos told reporters that the federal, provincial and territorial governments had been working cooperatively on the two issues for months and that his counterparts had not raised specific objections until a few days earlier, when they received “marching orders from their prime ministers to make no further progress”. “Prime ministers are forcing my colleagues to talk about one thing and one thing only: money,” Mr Duclos said. “All the prime ministers keep saying is that they want an unconditional increase in the Canada Health Transfer sent to their health ministers,” he added, referring to the program that accounts for the largest share of federal health funding for lower governments. “This is not a plan. that’s the old way of doing things.” “If anyone still doubts that, the current crisis is irrefutable proof that the old way doesn’t work. We have to do things differently.” British Columbia’s health minister and meeting co-chair, Adrian Dix, told a news conference that Mr. Duclos’ offer took the parties “a very good step forward” but that demands from provinces and territories for increased health funding care were not satisfied. “We’re moving on to important files. But this issue of transferring health to Canada is fundamental,” Mr. Dix said. He invited Prime Minister Justin Trudeau to meet with premiers on the issue. At a press conference on Tuesday, Mr. Trudeau took issue with what he described as provincial governments planning tax breaks while arguing that more federal money is needed for health care. He was speaking in New Brunswick, which announced plans to lower tax rates for residents earning more than $45,000 a year in taxable income. The prime minister said Canadians should ask questions when their provincial governments demand more money from federal health care “while, at the same time, they turn around and give tax breaks to the richest.” “We’re going to be there with more money, but we’re going to make sure the money actually delivers the kinds of results that people here in New Brunswick and across the country really deserve,” he said. Premiers have repeatedly argued in the past that health care funding started out as a 50-50 split between the federal government and the provinces and territories, but that Ottawa’s share has been reduced to 22 per cent. They are asking for an increase to 33 percent or an additional $28 billion in funding annually, with no strings attached. The federal government countered by arguing that, when the tax point transfer is taken into account, the share of provincial and territorial spending covered by the Canada Health transfer averages 33 per cent today, which is similar to the historical average. Several organizations, including the Canadian Medical Association, have called on the federal government to include nationwide licensing as part of the health-human resources aspect of its proposal. Such a change would eliminate the need for doctors to seek new licenses when moving between provinces, allowing them to work where they want and are needed most. “I live in northern Alberta and am 2.5 hours away from Fort St. John,” said CMA President Alika Lafontaine. “I would love to go there for a couple of days with a group of surgeons to provide care for BC patients, but I don’t because it will take me nine to 12 months to register for a BC license, and that’s despite the fact that I practice for more than 10 years”. He added that many issues in Canadian health care are interrelated and that action on one element would prompt action on others. “If we change one thing, we actually change everything,” he said. “If we figure out nationwide licensing, for example, we open up the opportunity for underserved providers to provide virtual care across the country.” With a report by Ian Bailey
