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One week after talks between federal, provincial and territorial health ministers collapsed, the excuses keep trickling out, each one more lame than the next.

Manitoba Premier Heather Stefanson, chair of the Council of the Federation (the group representing all 13 premiers), said they were caught off-guard by a federal offer, with conditions, of more money for health care. Yet, for the past year, all the premiers have been doing is asking for more money, specifically a $28-billion-a-year increase to the Canada Health Transfer.

Federal Health Minister Jean-Yves Duclos, for his part, continues to insist a deal was imminent, and the premiers are to blame for the breakdown. This, despite the fact that Ottawa steadfastly refuses to say how much money it’s offering and under what specific conditions.

Meanwhile, the health system itself continues to collapse, most visibly with pediatric hospitals overwhelmed by simultaneous outbreaks of respiratory illnesses.

What is clear is that our leaders need to stop squabbling like five-year-olds, get off their tuchuses and start giving the health emergency in this country the attention it deserves.

Canadians simply cannot abide the playing of political games while their access to health care fritters away and children’s lives are put at risk.

“Canadians want to see us working together,” Ms. Stefanson said repeatedly during a whirlwind round of media appearances.

At the same time, she made her own announcement: that Manitoba would spend $200-million to hire 2,000 more health professionals.

On the surface, this is good news. But it also exemplifies one of the fundamental problems in Canadian health care – every jurisdiction announcing its own initiatives without any collective national planning or co-ordination.

The staffing crisis is, without a doubt, the biggest challenge in health care today. But it will never be solved by provinces and territories going it alone, mostly trying to poach workers from each other.

The deal the provinces and territories left on the table at their Vancouver meeting last week included two key initiatives: developing a national health data system with particular emphasis on tracking health workers, and expanding and standardizing the use of common health data indicators (like wait times), to see if investments are bearing fruit. There were also other measures, including the national licensure of physicians and nurses, and streamlining accreditation for international medical graduates.

This would have been a bit of progress to build on. Instead, we saw the two sides dig in their heels on their respective positions: the premiers demanding money with no strings attached, and Ottawa insisting there be a commitment to results before putting money on the table.

Only one of those positions is defensible – the federal one.

The premiers are demanding an inflated status quo. Yet, the current way of doing things is clearly not working.

Their cries of poverty are also disingenuous, coming at a time of surpluses, tax cuts and sending billions of dollars to individuals under the guise of “inflation support.”

What Canadians want is for governments to throw the publicly-funded health system a lifeline before it crumbles further. That’s the leadership we need right now.

Health accords have never tackled fundamental reform, except glancingly, and that is long overdue.

Ottawa can and should invest more money in health care. But it has an obligation to do more than simply open up the federal wallet. It needs to kickstart some serious restructuring.

Mr. Duclos and his boss, Prime Minister Justin Trudeau, need to stop being coy and state plainly how much money they are willing to put on the table, as well as the results they expect in return.

Similarly, the premiers need to make their own proposal, or counter-proposal, and it needs to be more substantive than just “give us more money without conditions.” That kind of trust has not been earned.

A First Ministers meeting dedicated to resolving the crisis in health care could be powerfully symbolic, and game-changing.

But it can’t be a mugging of the PM by the premiers, as happened previously. The 2004 Health Accord, which allotted $41.3-billion to the provinces over 10 years, plus a 6-per-cent annual escalator, was billed as the “fix for a generation” but produced few measurable results.

Nor should we have a unilateral imposition of terms, as the government under Stephen Harper did when it cut the annual increase of the Canada Health Transfer to 3 per cent.

We can’t afford those kinds of political debacles again.

Rather, federal-provincial-territorial talks need to result in a meaningful contract to reform the health system, including measurable goals, timetables, public reporting of outcomes and, at its heart, some long-overdue respect for the tax-paying public.

The silence of politicians is deafening, and their inaction even more troubling.

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