Skip to main content
editorial

This week in Whitehorse, at the annual meeting of the Council of the Federation, the premiers of the provinces and territories seem poised to reach a true, or nearly true, Agreement on Internal Trade that really makes Canada a free-trade zone, long after the first, exception-ridden attempt in 1994.

Let's just hope (or imagine) that the New Brunswick government is only appealing Gérard Comeau's victory, in crossing an interprovincial provincial boundary with some cases of beer, just to make sure this is the final nail in that particular coffin.

The quasi-intractable factors in federal-provincial relations, however, are still health care and health transfers, even in Prime Minister Justin Trudeau's ostensible era of good feelings.

The grip of health-care costs – and the provinces' constitutional jurisdiction over health – is still very much with us.

Next year, the old health accord, under which Ottawa guaranteed a six-per-cent annual increase in transfers to the provinces, year after year, will expire. Instead, transfers are planned to rise at the rate of Canada's economic growth plus inflation, with a guaranteed floor of only three per cent.

It's true that the actual costs of health care are not proportional to the increase of GDP. But endless six-per-cent increases were not sustainable, especially because of the aging population of Canada, and especially in the Atlantic provinces.

Mr. Trudeau and Finance Minister Bill Morneau should be looking for alternatives that do not doom us all to a relentless future of heavier and heavier taxation to pay for health care – even if that means adopting in whole or in part the Conservative formula that has the provinces screaming.

The emphasis on physicians' services and hospitals has been evident ever since 1867. But the aging population needs long-term facilities – themselves another set of capital investments – rather than getting them housed indefinitely in huge bureaucratic hospitals. They also need drugs, far more than the doctors and politicians of the 19th century ever imagined.

Canada's premiers may not be equipped to reconceive the country's political economy, all on their own. But we hope the Council of the Federation can set up the adult conversations that Ottawa and the provinces need to have.

Interact with The Globe