Provinces, Ottawa spar over health transfers
Ontario warns cuts will lead to ‘declining partnership’
Provincial and territorial health ministers are imploring Ottawa not to diminish its role as a funding partner in health care any further.
Ontario Health Minister Eric Hoskins, who cochaired a meeting of his counterparts from across the country on Tuesday, said funding from Ottawa will be “inadequate” if the federal government proceeds with its plans to cut the annual increase in health transfers next year.
“(It) will result in a declining partnership,” he told a news conference at the King Edward Hotel in Toronto.
“What we are asking as provinces and territories is that the federal government . . . not withdraw further, that we want them to sustain the level of partnership that traditionally has been there,” he said.
Canadians have seen that partnership “very seriously erode” since medicare was created about a halfcentury ago, when the federal government footed half the bill, Hoskins said.
Today, Ottawa is paying only 20 per cent of the tab, a share that will decrease further if Ottawa next year cuts the annual increase in the Canada Health Transfer to 3 per cent from 6 per cent.
Federal Health Minister Jane Philpott, who co-chaired Tuesday’s talks, tried to steer the conversation away from money and toward system improvement, innovation and accountability.
She repeatedly pointed out that Canada spends more on health care than many other developed countries that have superior health systems. She expressed disappointment that planned system improvements that Ottawa funded in the 2004 health accord did not materialize.
Philpott indicated that she wants new funds to be targeted to such areas as mental health and system innovation. She also reiterated an earlier commitment to provide $3 billion for home care, including palliative care.
Health Minister Eric Hoskins said Ontario stands to lose $400 million next year if the increase in health transfers from Ottawa is cut in half
“I have made it clear to them that we would love, for instance, to invest in innovation,” she said. “I want to know how they want to use those investments in innovation. I have told them that I am very interested in mental-health care.”
Hoskins said his provincial and federal counterparts are on board with that, but that they need a boost in the annual increase in health funding as well just to maintain the status quo.
“You can transform and we have to transform, but you have to do that in a way which respects and understands that you need to sustain the existing system,” he said.
Hoskins cited a Conference Board of Canada report that found that a spending increase of 4.4 per cent is needed “just to keep the lights on, just to keep the existing services working” because of pressures from a growing and aging population.
Quebec Health Minister Gaétan Barrette said Ottawa’s current plans for health spending will amount to $60 billion less over the next decade for the provinces and territories.
“It says to Canadians, ‘We will not provide up to the level of $60 billion.’ That’s what’s at stake,” he said.
The 2004 health accord — which includes annual funding hikes of 6 per cent — expires next spring. The former Conservative government decided unilaterally that annual health spending will increase at a lower rate of 3 per cent after that.
The provincial and territorial ministers are hoping Prime Minister Justin Trudeau will reconsider that when the first ministers meet this year.
Hoskins said a 50-per-cent cut in the annual funding increase will translate to $1 billion less for the provinces and territories next year. Ontario alone stands to lose $400 million. Philpott apologized about confusion over comments she made earlier on accountability for funds.
Some provincial and territorial ministers expressed anger over an insinuation that health transfers were not being spent on health.
Philpott said that was not what she meant.
“I apologize if people misunderstood,” she said. “There is certainly no intention to make accusations.”
Philpott said the Canada Health Transfer, which stands at $36 billion, will increase by about $19 billion over the next five years.
“It’s really important for Canadians to know that we are going to continue to contribute to the Canada Heath Transfer,” the federal minister said.
Philpott said that over the past five years, $9 of every new $10 spent on health in Canada came from the Canada Health Transfer.
“We are contributing he largest part to spending.”
In addition to the Canada Health Transfer, extra funds will be provided for targeted priorities with strings attached to ensure transformation goals are met, she said.
“This is Canadians’ money . . . We want to find a way that we can work together so that as we agree to make new investments, that we have already got a sense of plan,” Philpott said.
In elaborating on why Ottawa should fund new, more efficient ways of providing health care while at the same time provide sufficient funding for the current health system, Hoskins offered the example of dialysis for kidney failure. The ministers discussed how it would make more sense to monitor blood pressure to prevent kidney failure and thereby lessen the need for dialysis, he noted.
“That’s great and we are all working toward that end, but you still have to provide dialysis today because that individual who needs it will be dead in three weeks without it,” Hoskins said.