The federal and provincial governments appear to be at an impasse in negotiations over the future of health care in Canada, and Prime Minister Justin Trudeau’s latest comments suggest he won’t be the first to blink.
In a year-end interview with The Canadian Press on Monday, Trudeau said he was unwilling to press ahead with health care reform in the future, despite calls from provincial premiers for more federal funding to shore up their ailing health systems.
“It’s not right to just throw more money at a problem and sit back and watch it go unresolved, because we’re not using this opportunity to say, ‘No, no, no, it’s time to improve the system,'” Trudeau said.
The stalemate is unfolding while children’s hospitals across the country are overwhelmed with children with respiratory illnesses. In some cases, hospitals have been overwhelmed with record numbers of sick people and few staff to treat them.
The issue dates back more than a year, when the provinces first asked to sit down with the prime minister to discuss long-term and sustainable funding increases, as the stress of the pandemic left them with a huge backlog of work and an exhausted workforce.
They want to see Ottawa pay for 35 per cent of the nation’s health care costs by increasing the Canada Health Transfer, up from the current 22 per cent.
Trudeau told them those discussions should wait until after the pandemic, but a one-time allocation of $2 billion to tide them over during the Omicron wave.
Now the prime minister says the system needs reform and he won’t give up the money unless the provinces commit to change.
“Canadians are right to look at all the government orders and say, ‘This sucks, you really need to fix this,'” Trudeau said.
Health Minister Jean-Yves Duclos courted the provinces last month, proposing increased federal health transfers in exchange for improved national data sharing.
The meeting ended without progress.
Hai Zhenmou, a professor at the University of Saskatchewan who studies health policy, said implementing performance measures for health transfers in Canadian provinces is almost unheard of.
In an interview Tuesday, she said it’s understandable that provincial leaders don’t want to change that precedent.
“I don’t think the federal government has the authority to impose such performance metrics on broad health transfers,” she said, but added that she understood why the Liberals didn’t want to keep throwing money at a system that wasn’t working.
A more politically acceptable scenario, she said, might be to provide targeted funding for specific priorities and sign individual agreements with each province rather than treating them as a whole.
That’s what the Paul Martin government did to address waiting times in 2005, and what Trudeau did to fund mental health and home care services when faced with a similar situation in 2016.
In 2016, the provinces united to push for an unconditional increase in health transfers, “but in the end they split and the alliance broke,” Mou said.
The government signed a bilateral agreement with New Brunswick, and other provinces followed suit. Mou thinks it’s only a matter of time before this happens again.
“I’m not sure how long they can hold on because revenue, the power of fiscal capacity, is still in the hands of the federal government,” she said.
Health care advocates, including the nurses’ and doctors’ associations, echoed Trudeau’s call for a plan to overhaul Canada’s broken system and implement it quickly.
“Patient care is being compromised while health care working conditions for nurses and other health workers are deteriorating,” Linda Silas, president of the Canadian Federation of Nurses Unions, said after talks between the health ministers concluded last month.
“It’s absolutely critical that we set politics aside and start having productive discussions around concrete solutions to the healthcare staffing crisis.”
Trudeau was asked on Monday how he planned to start talks if he didn’t sit down with the premier, but he seemed to feel it was up to provincial and territorial leaders to decide what to do next.
“We’re absolutely willing to spend more on health care, but there has to be clear commitment and results to make a difference in Canadian lives,” he said.