Premiers intensify campaign for increase to Canada Health Transfer

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The premiers are united in their push for more health care funding from the federal government and are using the pandemic as a means to bolster their argument that the system needs a massive cash infusion.

The 13 provincial and territorial premiers in the Council of the Federation (COF) will hold a meeting next Friday, and the discussion will focus on the transfer that Ottawa provides for health care.

Provinces have long called for an increase to the Canada Health Transfer (CHT), but Prime Minister Justin Trudeau has said the discussion should wait until the pandemic is over.

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The premiers are not prepared to wait and believe that the pandemic has underscored how Canadian health care systems are overwhelmed and on the brink. Throughout COVID-19, physicians have pointed to intensive-care units that have been inundated with patients, delayed surgeries and health care staff pushed to the limit.

A provincial source told The Globe and Mail on Wednesday that there was a strong consensus among all premiers on a conference call last week on getting the Prime Minister to commit to a discussion on increasing funding. The Globe is not identifying the individual because they are not authorized to speak publicly about the matter.

B.C. Premier John Horgan, who is COF chair, said in a statement to The Globe that premiers will come together next week to continue work on the “critical” issue of the CHT.

“The pandemic has highlighted how the delivery of health care services differ from region to region,” Mr. Horgan said. “What we all have in common, however, is the need for better funding to address the needs of residents, whether we are in a pandemic or not.”

Mr. Horgan said provincial, territorial and federal governments have an opportunity to take an “important step” on the CHT and that Mr. Trudeau has been “a reliable partner throughout this pandemic.”

Ontario Premier Doug Ford said Wednesday that next week’s COF meeting “will be another important opportunity for all premiers to stand united in reiterating our call for the federal government to increase its share of health care spending.”

“The pandemic has underscored many challenges facing our country’s health care system and it’s time for the federal government to finally start taking this request from the provinces seriously,” Mr. Ford said in a statement to The Globe.

For their part, the Trudeau Liberals have not been keen to discuss long-term funding right now. When asked about the issue on Monday, Mr. Trudeau told a news conference that he has repeatedly said that Ottawa will “be there to invest more into the future in the Canada Health Transfer.”

But he reiterated that “while we are in the middle of fighting this acute crisis,” in reference to the pandemic, that the federal government would offer supports that are “immediately required.” In April, Mr. Trudeau promised to approve long-term increases to provincial health transfers once the pandemic came to an end.

Mr. Trudeau said Monday that the federal government has spent the past two years engaging directly with provinces and territories on funding for health in addition to the CHT, which is worth $43.1-billion this year. He cited that $63-billion has been provided for health-related expenses, such as paying for vaccines and treatments.

“We have been there to respond to this crisis in our health care system,” he said. “I think one of the things we’ve seen across the country is Canadians expect their health care systems to be able to give them the support necessary, whether it’s during a pandemic or outside of the pandemic.”

The current funding formula for the CHT, which began in 2017-18, is for it to grow in line with a three-year moving average of nominal gross domestic product, with a guaranteed increase of at least 3 per cent a year. In December, 2011, the former Conservative government announced that CHT cash levels would grow at 6 per cent annually until 2016-17.

Premiers argue that Ottawa should increase its contribution to the CHT to 35 per cent from 22 per cent, which would amount to about $28-billion more this year.

Jane Philpott, the dean of the Faculty of Health Sciences and director of the School of Medicine at Queen’s University, said in an interview that there was a time in the 1970s when the federal government did pay a higher portion of health care costs.

There was a negotiation at the time for Ottawa’s cash transfer to be less in exchange for the provinces to have the ability to collect more of their own tax revenues, she added.

Dr. Philpott said she believes there may be some advantages for the federal government to take on a larger share of the costs, such as to play a larger role in the strategic approach of health care. But she said she has always advocated, and did so back in discussions with provincial governments as federal health minister in 2016, that there is a need for spending to be done in a smarter way.

“We know very well that Canada doesn’t get the same kind of health outcomes as some other countries that get essentially better value for money,” she said.

In terms of an increase to the CHT, provinces have found support in political parties at the federal level.

New Democratic Party health critic Don Davies has said there is a need for stable and predictable health care funding for the long term that could be achieved through an increase to the CHT.

The federal Conservatives promised during the past election campaign that if they were to form government they would meet with premiers within the first 100 days to propose a new health agreement to boost the annual rate of increase to the CHT to at least 6 per cent. The party said this would amount to $60-billion being spent on the health care system over the next decade.

In September, Bloc Québécois Leader Yves-François Blanchet said federal health transfers to the provinces are the most urgent political issue facing the country and called on Mr. Trudeau to convene a health summit with the premiers as soon as possible.

With a report from The Canadian Press

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