When Prime Minister Justin Trudeau meets with the premiers today, competing priorities could undermine a national approach to fighting the pandemic.
The premiers demanded this meeting to discuss their call for a permanent annual boost of $28 billion to health care transfers.
Sources tell CBC News that Ontario Premier Doug Ford will push the federal government to commit to a funding increase by the spring budget.
While Trudeau has agreed to a conversation on transfers, federal sources say the prime minister wants to keep the focus on the immediate threat posed by the second wave of the coronavirus — and that no formal commitment to a specific funding boost is likely to come out of the meeting.
“We understand that there is an important conversation to be had on health care services and delivery,” said a senior federal official speaking on background. “But there are also some more urgent things that need to be discussed.”
Canadians want ‘change’, says CMA chief
Dr. Ann Collins, president of the Canadian Medical Association (CMA), said the first ministers must deal with the acute problems facing the health system as well as the chronic ones. She said the pandemic exposed cracks in what was already an ailing health care system — plagued by long waits for tests and surgical procedures and gaps in long-term care.
“To come out and give an indication that it’s status quo, that is unacceptable,” she said. “Not only is it unacceptable to the CMA, it’s unacceptable to Canadians. This is what Canadians want to see. They want change, they want assurance that their leaders care about their care, about our health care system.”
Right now, the provinces spend $188 billion on health care and the federal government covers $42 billion, or roughly 22 per cent of total costs. The increase proposed by the premiers would see the federal government cover 35 per cent of health costs.
The premiers have said long-term funding is needed to meet rising health system costs caused by factors that predate the pandemic, such as an aging population and the increasing expense of new medical technologies and drugs.
As competing priorities strain efforts to come to a consensus at the first ministers’ table, so too will federal doubts about how some provinces have handled the second wave, the federal source said.
“We’re not going to be strident and critical of the premiers. Canadians don’t want that,” said the senior official. “But there are some legitimate questions that should be asked of provinces.”
Those questions centre around how certain provinces have or have not used the resources Ottawa has sent them to deal with the pandemic, said the source, adding that there is significant frustration at the federal level over how some provinces have been slow to scale up testing and contact tracing, despite getting billions of dollars in federal cash.
This week, Ontario’s financial accountability officer reported the Ford government is sitting on more than $12 billion in unspent pandemic reserve funding. Rapid tests — which some premiers loudly demanded — sit unused in some provincial warehouses.
One provincial source said the federal government had promised to hammer out the health transfers issue at this meeting and is now trying to “dilute” those talks with vaccine discussions.
“There are many channels for conversations that are happening with senior officials around the vaccine on a daily and hourly basis,” said the source. “But there is only one place and one table where a substantial conversation can happen around sustainable health care funding and fixing Canada’s health care system, and that is around the FMM table.”
Another potential sticking point is jurisdiction. In demanding a surge in federal health funding, the premiers also are insisting that Ottawa send the money with no strings attached.
This is a source of frustration for a federal government that has bankrolled the bulk of the pandemic response — often in areas of provincial jurisdiction — and is pushing for national standards in long-term care.
Conservative Leader Erin O’Toole said there must be more collaboration between the federal and provincial governments and more federal funding without conditions.
“It can’t be Ottawa setting the terms for the provinces,” he said.
NDP Leader Jagmeet Singh said consecutive Liberal and Conservative governments have “starved” the health care system.
“This is wrong and it needs to stop,” he said.
But the federal official said the government’s first focus must be on the pandemic emergency.
“We are not out of the woods yet. We are in far deeper woods when it comes to COVID.”