Canada’s premiers are stepping up political pressure in their efforts to get Ottawa to increase federal health transfers to provinces and territories.
Premiers have launched a new publicity campaign through the Council of the Federation, which includes all 13 provincial and territorial premiers, aimed at increasing public pressure on Prime Minister Justin Trudeau to meet with them and negotiate a higher federal contribution to health care costs.
“As federal health care disappears, so do our doctors,” reads an ad, underscoring the provinces’ position that federal health funding levels “continue to decline.”
Canadian premiers call for increased health care funding from Ottawa
“Provinces and territories are doing their part, but we need the federal government to restore health care funding now to keep our systems strong,” the ad continues.
The campaign, which launched on Monday and includes ads online, in print, on the radio and on billboards, comes as provinces face their own calls for urgent action in the face of significant pressures exerted on health systems across the country.
An exodus of health care workers, especially nurses, from the public system, nationwide shortages of family doctors, continued waves of COVID-19, and influxes of patients in need of mental, home or long-term health care. duration are all factors that have led to emergency room closures, health worker burnout and calls to deal with a health care “crisis”.
The delivery of health care is a provincial responsibility, but the Council of the Federation, made up of Canada’s 13 prime ministers, is using its new advertising campaign to launch the health care hot potato in Ottawa, affirming the long-term viability of Canada’s health care systems “cannot be sustained as long as the federal government’s share of health care funding continues to decline.
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“To ensure the tests, procedures and other health services Canadians need across the country – when they need them – they should no longer have to wait for federal action,” said Manitoba Premier Heather Stefanson, in a statement. Stefanson is currently Chairman of the Council of the Federation.
Premiers have demanded a $28 billion increase to the Canada Health Transfer, which they say will increase the federal contribution to health care costs from the current 22% to 35%.
Ottawa argues that the premiers’ figures do not represent the full extent of the federal government’s total investment in health care, because provincial tax points and other specific bilateral agreements on mental health and home care is not taken into account.
“If you look at the numbers and do the math correctly, the actual percentage of federally funded public health spending is around 35%, we’re already there,” Health Minister Jean-Yves said. Duclos to journalists during a press conference. conference in Manitoba last month.
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He said arguing over percentages is a “futile debate”.
“The most important debate is the important fight for (healthcare) workers…it’s the outcomes for healthcare workers that matter because when we do that, we get the right outcomes for patients,” did he declare.
Additionally, Trudeau said he wants to see more “tangible results” from the $45.2 billion that provinces and territories will already receive this year for health care before discussing any increases to the Canada Health Transfer. health.
In the past, “huge investments” by provincial and federal governments have not always brought about the needed improvements, Trudeau told reporters in July.
But that hasn’t stopped the Premiers from calling for a “First Ministers’ Agreement on Sustainable Health Care Funding” as part of their publicity campaign.
While it’s no surprise to see premiers trying to unload some political heat on Ottawa on an issue that has become a major pressure point, the campaign is somewhat “dishonest” in that it oversimplifies a complex issue, says Katherine Fierlbeck, professor of political science at McCulloch. at Dalhousie University and chair of the department.
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“It’s just not about pumping more money into the system,” she said. “It’s how the money is used.”
If, for example, Ottawa gives more funding to the provinces and they use it to increase the salaries of doctors and nurses, they will end up competing for the same shrinking pool of health care workers, said Fierlbeck.
It also does not address Ottawa’s concerns that an increase to the Canada Health Transfer would not include specific targets or performance measurement tools to ensure the money is spent where it is most needed, she added.
Provinces often balk when Ottawa tries to tie strings in health care funding, leading to political stalemates like the one currently at play between the provinces and the federal government over health care funding.
That’s why it might be time to think about putting in place a different mechanism to ensure greater accountability over healthcare spending and take politics out of the equation, says Haizhen Mou, health policy expert and professor at the Johnson Shoyama Graduate School of Public Policy at the University of Saskatchewan.
She mentioned the Australian Commonwealth Grants Commission, an independent body that advises the Australian government on how federal funding should be distributed to ensure equitable access to services.
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Ottawa wants to see “tangible results” from the provinces on health care, but has been vague about who would measure those results and how they would be evaluated.
If Canada had its own independent body to collect data from the provinces, measure the performance of provincial and territorial health systems, and advise governments on the best distribution of health care spending, it could ease tensions between Ottawa and the provinces. who object to Ottawa telling them how to run their affairs, says Mou.
“This type of governance body can probably provide a better mechanism for managing the fiscal relationship (between Ottawa and the provinces),” she said.
“If we have performance metrics, we should probably let a third-party type organization design the metric, monitor it, and provide some sort of neutral judgment on whether a promise meets a condition. “
Colleen Flood, research chair in health law and policy at the University of Ottawa, says Canada has a “fragmented accountability” system that only gives voters the chance to vote against a government that fails. they are not satisfied with their health system or the way it is managed.
She echoed the memorandum of understanding by saying that an independent office could provide Canadians with another accountability mechanism, but she suggested that a Canadian Patient Ombudsman could play that role.
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“It does not directly solve the problem, but perhaps a constant spotlight on the problems that Canadians are experiencing will help to reverse the situation, to ensure greater accountability on the part of the provinces for their management of the health system, and also reveal where they definitely need more funding,” Flood said.
Meanwhile, talks between the federal and provincial governments on health funding have continued over the past few months.
In February, Canada’s health ministers met and identified several health workforce priorities, including accelerating pathways for internationally trained health professionals, improving and leveraging data on health personnel, staff training and support, and mental health support, Health Canada said in a statement Tuesday to Global News. .
These priorities were reiterated at another meeting in August, with a commitment to update on progress at their next in-person meeting with Duclos in two weeks in Vancouver.