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opinion

The house of medicare is on fire, and all the Premiers want to do is renegotiate the mortgage?

How short-sighted. And petulant.

Canada’s health ministers just wrapped-up a few days of meetings in Vancouver and the confab ended with no agreement.

That’s because the Premiers big-footed their health ministers by stubbornly demanding more money with no strings attached.

The Council of the Federation (which represents the 13 provincial and territorial premiers) issued a press release even before the meeting ended, declaring it to be a failure. Worse yet, a leaked copy suggests the release was written a week before the meeting.

In other words, failure was pre-ordained.

Clearly this is a negotiating strategy by provincial and territorial leaders. But letting the crisis in health care fulminate in the hope that the feds will blink (and cough up a lot more cash) is playing a dangerous game.

Toying with people’s lives is about cynical as politics can get.

Hospitals, even children’s hospitals, are dangerously overcrowded, from their emergency rooms on up. Surgical backlogs keep growing. Prevention programs like cancer screening are collapsing.

All this and more, principally because health workers – doctors, nurses, technicians, support workers and others – are overwhelmed and leaving in droves. Because the structure of the system is outdated and dysfunctional.

The system’s unravelling will continue unless there is urgent action, especially on the staffing crisis, followed by fundamental reform.

The public has a right to expect solutions from governments. That’s why the first in-person meeting of the 14 federal, provincial and territorial health ministers since 2018 elicited a lot of interest.

The Vancouver meeting started on a high note. Federal Health Minister Jean-Yves Duclos declared that Ottawa was ready to bolster the Canada Health Transfer (the mechanism used to transfer health dollars to the provinces), though he was coy about the amount.

A lot was accomplished in the backrooms, we’re told. Everyone declared they were leaving disappointed but optimistic.

In fact, there was an 18-page agreement outlining a series of concrete measures to help alleviate the health care staffing crisis ready to be signed.

The draft deal included a plan for national licensure of nurses and physicians, streamlining the process for licensing international medical graduates and much better data collection and sharing. All of these things are happening to varying degrees in some provinces and territories, but the plan, sensibly, was to better co-ordinate efforts. That’s why the feds placed so much emphasis on data collection and sharing.

A lot of what was in the deal echoes what health care organizations representing physicians, nurses and hospitals had asked for in their “prescription for hope,” a list of measures they believe can stabilize our strained health care system, so it would have been greeted enthusiastically.

Ottawa was even reaching for the chequebook.

Until the Premiers put the kibosh on progress.

Why? Because they are sticking to their ridiculous all-or-nothing position.

The provinces and territories are demanding an additional $28-billion a year from Ottawa (in addition to the current $45-billion annual transfer with a 3 per cent escalator, and another $19.6-billion in tax points.)

That may (or may not) be a reasonable demand in a country that spent $331-billion on health care last year, including $232-billion in public money. But that’s not how you negotiate.

More problematic is the provinces and territories holding fast to their churlishly dogmatic view that health transfers must come with no strings attached.

The Premiers argue that they are accountable to the public, not the federal government. But Ottawa has duties too, including using their spending power to create a semblance of a national system.

The allergy to accountability is not in the public interest.

Besides, none of what the federal government is asking for, such as allowing freer movement of health workers between jurisdictions and data that is comparable between provinces, is even remotely unreasonable.

The federal minister, Mr. Duclos, said it well: “Before we talk about the means, we need to talk about the ends.”

Demanding more money is not a plan.

The provinces need to outline concrete actions to tackle the current crisis in health care. Then we can talk funding, short-term and long-term, and what additional spending will achieve.

The health system is ablaze. Enough fiddling, already.