Trudeau proposes more than $100-billion in health care funding over 10 years

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Prime Minister Justin Trudeau will table a funding offer considerably higher than $100-billion to help fix the country’s struggling health care system when he sits down with provincial premiers and territorial leaders Tuesday, according to a senior federal source.

The 10-year funding proposal from Ottawa will include tens of billions of dollars of new money as well as earlier planned increases to the Canada Health Transfer [CHT], the source said. The provinces are already scheduled to get a 9.5-per-cent increase in health care transfers this year, amounting to $49.4-billion from the $45.2-billion in projected payments in the 2022-23 fiscal year.

A large sum of the new money will be set aside for separate bilateral deals that will target key areas such as primary care, according to the federal source. The Globe and Mail is not identifying the source, who was not authorized to discuss the federal offer.

Mr. Trudeau has said the first ministers meeting will not be a signing ceremony as negotiations will need to continue on bilateral agreements. Intergovernmental Affairs Minister Dominic LeBlanc has previously said that he expects all of the deals to be completed before this spring’s federal budget. Mr. LeBlanc and Health Minister Jean-Yves Duclos have played key roles in the health care negotiations.

Trudeau is meeting with Canada’s premiers to reach a new health care funding deal. Here’s what to know

The Prime Minister has not shared the overall funding number with the premiers ahead of Tuesday’s gathering. But he told the House of Commons on Monday that federal funding is focused on improving the results and outcomes in Canada’s health care systems.

“We know that is what Canadians expect. Whether it is more family doctors, ending the backlogs on mental health services or stopping the overwhelming of our ERs, we will be there to invest with the provinces and ensure results for Canadians,” Mr. Trudeau said.

Earlier, the Prime Minister told reporters that the bilateral agreements are needed to address specific needs of each province and territory, such as primary care, long-term care facilities, mental health and home care.

“That’s the way of ensuring that we’re respecting provincial jurisdiction on health care while making sure that the federal government is there,” he said.

In return for billions of new federal money, Mr. Trudeau wants a commitment from his counterparts that none of the funds will go to non-health care spending and that the provinces and territories will not reduce their contributions to medicare.

“I can agree to that,” Newfoundland and Labrador Premier Andrew Furey told CTV. “No doubt about that.”

Similarly, B.C. Premier David Eby said provincial spending on health would continue to rise under his government.

However, Manitoba Premier Heather Stefanson, who also chairs the council of premiers, was careful not to draw a red line on what her colleagues might find unacceptable in the federal offer.

“It’s very difficult to make a comment on something that we haven’t seen,” she said, while noting that her province has many other budgetary pressures including in education and social services. “We want to ensure that we have enough money for those as well.”

Quebec Premier François Legault said he doesn’t want to see “strings attached” to any federal funding but also conceded that he is okay with Ottawa’s demand that the provinces and territories agree to a national data-collection system.

“I have no problem giving him [Trudeau] that,” Mr. Legault told reporters on his way into an evening meeting of the premiers.

A provincial source said the Quebec government is hoping to be able to negotiate more new federal money through the main health transfer but Mr. Legault told reporters on Monday he is open to bilateral deals in areas that are priorities for Quebec. The Globe is not identifying the source because they were not authorized to discuss the matter.

Nonetheless, Mr. Leagult said the premiers “are going to form a united front.”

The Trudeau government is planning a full rollout of its funding proposal including a technical briefing for journalists. The Prime Minister will hold a separate news conference after the meeting with the premiers wraps up in the late afternoon.

The federal proposal is a response to demands from the provinces to dramatically raise the federal share of health care budgets, in an attempt to shore up provincial medicare systems plagued by the effects of the pandemic, rising costs, staff shortages and backlogs in surgeries and diagnostics.

Ontario, for example, will receive about $73-billion over 10 years in health transfers and money for specific Ontario health care needs as part of a bilateral agreement, according to a provincial source. About $30-billion of that sum would be new money, amounting to $3-billion annually of increased funding over 10 years. The Globe is not naming the source because they were not permitted to speak publicly on the issue.

For more than two years, the premiers have been pressing for an immediate, no-strings attached increase to the CHT to bring the federal share of health care funding to 35 per cent. That would have meant a $28-billion hike but provincial sources concede that they don’t expect Ottawa to meet that request.

Ahead of the meeting with the Prime Minister, the premiers met for several hours Monday evening and will gather again in the morning.

A key issue for the premiers is how Ottawa will divide the new spending and how much of it will be funnelled through the bilateral deals that will come with more accountability measures. The Trudeau government has said they will not force spending deals in areas that are not already provincial priorities.

Federal officials have been spending more time in talks with some provinces such as Ontario, over others such as Alberta and Saskatchewan. But provincial sources said they don’t view it as an attempt by the Prime Minister to split the premiers’ front. Instead, they say it’s understandable that Mr. Trudeau would focus on Ontario, the most populous province, where the Liberals share voters with Premier Doug Ford, a Progressive Conservative.

Among the federal opposition parties, there is a stark divide on the approach that Mr. Trudeau should take with the premiers. NDP Leader Jagmeet Singh wants the government to increase health care money even higher than what the premiers are asking so that Ottawa covers 50 per cent of health costs.

Bloc Québécois Leader Yves-François Blanchet said Mr. Trudeau should agree to the increase to a 35-per-cent cost share asked by the premiers.

The Conservatives are the only party that has not outlined what it believes should happen to federal health transfers, including whether there should be new money.

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