Atlantic premiers want a new deal on health-care funding with the federal government that would see additional dollars go to jurisdictions, such as theirs, whose populations are disproportionately elderly.
Although Quebec and British Columbia are supportive, Ontario is not completely onside.
The four Atlantic premiers are meeting Monday in Annapolis Royal, N.S., and the health-transfer issue is expected to be on the table, as talks are starting to ramp up between the provinces and the federal government over a promised health accord and how much each province will receive through the Canada Health Transfer – the largest of all federal transfers to the provinces. In 2016-17, the federal government will transfer $70.9-billion to the provinces and territories through its major transfer programs, of which $36-billion is the Canada Health Transfer.
"What we're looking for as new health-care dollars become available is that we move toward the demographic challenge that is being faced by a number of provinces – it's more acute here in Atlantic Canada – and the fact that we deal with the challenges that come with aging when it comes to our health-care system," said Nova Scotia Premier Stephen McNeil.
He says a new funding formula needs to reflect that. "Whether it is entirely about that or portions of it are about that is important to Atlantic Canada," he said. Health-care costs represent 41 per cent of the Nova Scotia provincial budget.
In Canada, Newfoundland and Labrador, Prince Edward Island, Nova Scotia and New Brunswick have the highest percentage of the population over the age of 65 – with Nova Scotia at the highest with 16.6 per cent in 2011, according to Statistics Canada. Across Canada, the percentage is 14.8 per cent.
It is expected that health ministers will be meeting with Federal Minister Jane Philpott later in the year with an eye to getting an accord some time next year. Ms. Philpott is aware of the provincial push for a funding formula tied to aging populations, according to her spokesman.
In PEI, 36 per cent of its budget is devoted to health care. Said Premier Wade MacLauchlan: "One issue that stands out, not just in our region, British Columbia and others are speaking about this, is to have a funding formula that is more attuned to the provinces with an older population. That is really where the cost is."
Negotiating an accord and the transfers tied to an aging population is his No.1 priority, he said.
The previous Conservative government changed the funding formula to an equal per-capita basis in 2014-15. This change in distribution benefited Alberta – other provinces saw their transfers decrease.
Earlier this year, the Canadian Medical Association noted in its prebudget submission to the federal Finance Minister that seniors make up one-sixth of the population but use about half of health-care spending. This will increase to 62 per cent of provincial/territorial health budgets by 2036, according to the CMA brief.
The CMA is suggesting a "demographic-based top-up" that would cost the federal government an extra $1.6-billion in 2016, growing to $1.8-billion by 2020. Under this formula, Nova Scotia would receive an extra $53.6-million and PEI would qualify for an additional $9.1-million. But the other provinces would not be left out – Ontario would qualify for an additional $652-million in 2016 and Alberta would receive $118.5-million more.
"If you accept that there is some role for the federal government to play to achieve some sort of equity across the country, then this per-capita transfer of the federal contribution, regardless of how much it is, clearly doesn't seem to be a very good way to do it because we know there are some provinces that have much greater needs based on an older population," said Dr. Chris Simpson, the past chairman of the CMA.
The existing health accord runs out in 2017. Justin Trudeau's government has promised to renegotiate with the provinces, after the Harper government basically got out of the health-care business in 2011, giving provinces a take-it-or-leave-it deal.
In a statement to The Globe and Mail Friday, Ontario Health Minister Eric Hoskins, who is the chair of the Provincial-Territorial Health Ministers' Table, said that he spoke recently with Dr. Philpott about the health accord. "Restoring an equitable level of federal funding towards health care is an important part of our discussion," he wrote. "As part of this conversation, it is also important that we continue to discuss the need to build a national plan that ensures all Canadians have access to lifesaving medications when they need it."