Niagara-on-the Lake, Ont. — Canada's premiers are expected to unveil a proposal today to change and enrich health care in Canada with national goals, while ensuring that provinces can deliver services in different ways, unencumbered by federal conditions.
The premiers emerged from a day-long meeting yesterday with a plan to take to their three-day televised meeting in September with Prime Minister Paul Martin, whom they see as having little choice but to accept their program for change.
Along with the proposal, which covers eight areas, they will request that Mr. Martin deliver on his promise of $9-billion over five years in additional federal funds.
The goal is to create a national health-care system that will be financially viable for at least five years, improve services and noticeably reduce waiting times.
Ontario Premier Dalton McGuinty speaks to a premier during a meeting of the Council of the Federation Youth Forum with the Provincial premiers at the end of the second day of the Canadian Premiers meeting on health care at a Niagara-On-The-Lake resort on Thursday. (J.P. Moczulski/The Globe and Mail)
But it still could go off the rails, said Ontario Premier Dalton McGuinty, chairman of the meeting.
“Obviously there is going to be a bit of a tug of war in terms of conditions that might be attached to new federal dollars,” he said.
On the other hand, Mr. McGuinty said that Mr. Martin is unlikely to play hardball.
“We've got a Prime Minister who has just come through an election by the skin of his teeth and who is very much committed to getting a health-care deal,” he said.
The provinces are determined to retain control over how the $9-billion in new money, as well as the current federal health-care funding of $16-billion a year, is spent.
British Columbia Premier Gordon Campbell noted that while $9-billion may sound impressive, total health-care spending will be $500-billion over the next five years.
“Provinces will be investing half-a-trillion dollars in health care. ... And that's just if we carry on with where we are right now,” he said at the premiers meeting in Niagara-on-the-Lake.
Mr. Campbell also said the idea of a one-size-fits-all health-care system with identical services in every province is unrealistic. “One size hardly ever fits all, to my knowledge.”
He rejected the idea of the federal government telling the provinces how the money should be spent.
“The provinces have to be accountable to taxpayers. We are. We put out reports every year on what we are doing with their health dollars.”
Quebec Premier Jean Charest stressed his political need to protect his province's traditional areas of jurisdiction, particularly because he is a federalist with powerful sovereigntist opponents.
He insisted that he would not accept federal standards in return for more money and cited Mr. Martin's pledge during the election campaign not to impose “national norms.”
Provinces should be allowed to pay private firms to deliver public health care if that is more cost-effective, he said. “I believe in a publicly funded health-care system within which the private sector plays a role,”
He also stressed that federal increases in health-care spending should not be accompanied by cuts to equalization payments sent to eight provinces to keep their services comparable to those in Ontario and Alberta.
He noted that Mr. Martin has promised to meet with the premiers on equalization payments before his government delivers its budget in the winter.
Earlier yesterday, Mr. Martin appeared to dampen expectations that the federal government would accept the premiers' proposal without conditions.
“We all have our responsibilities,” he said while on a visit to Bromont, Que.
“There's no doubt that the provinces have to deliver services, but the fact is, we have an extensive input in terms of aboriginal health, as an example, or on the whole question of provision of information.
“Our funding is important but we all want to make sure that in fact that funding goes in the areas where it's going to do the most good.”
While money was at the centre of all discussions, there was no agreement on exactly how much more money Ottawa should be contributing.
Joe Handley, Premier of Northwest Territories, said that among the 13 premiers,
“There's pretty much agreement that the federal government should restore the funding back to where it was, which brings it to the 25-per-cent [of total health-care costs] level.
“Exactly what that means still has to be worked out in detail,” he added.
With a report from Tu Thanh Ha
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