Western Canada: Ottawa offers provinces billions for health care but still falls short of demands

Good morning. It’s James Keller in Calgary.

The federal government and the provinces have been far apart in negotiations for increased health care funding.

First, there was the issue of money. The provinces demanded an additional $28-billion a year. Premiers argued that Ottawa had fallen far behind in its obligation to fund the country’s costly public health care system, which began as a 50-50 split, but the burden has since shifted significantly to the provinces.

The premiers also demanded that the new money be offered up with no strings attached, and specifically balked at the federal government’s insistence of data tracking and other accountability measures. Alberta was particularly vocal in opposing any conditions, along with Quebec and Ontario.

With Prime Minister Justin Trudeau’s offer unveiled this week, it’s not clear what the provinces got for holding out.

Mr. Trudeau’s government is offering $46.2-billion in new health care funding over 10 years, which amounts to less than $5-billion extra each year. That level of funding is essentially what the Liberals campaigned on in the 2021 election, when the party pledged $21.9-billion in new funding over five years.

And there are strings. The increase to health transfers will come with the condition that provinces and territories improve how health information is collected, shared and reported to ensure more transparency.

Alberta Premier Danielle Smith called the funding offer a start but said it is not enough. Still, she said she remains committed to reaching a deal with the federal government that leads to better outcomes for patients.

The new federal money includes $25-billion for separate bilateral deals that will be negotiated individually with each province and territory. Those agreements will target areas such as primary health care, staff shortages and surgery backlogs, mental health care and substance use, and health system modernization.

The premiers acknowledged that they did not get even close to what they had been asking for, but appeared resigned to accept the funding offer.

Manitoba Premier Heather Stefanson, chair of the council of the federation, said the premiers are disappointed that the offer fell short of their demands and need time to examine it.

B.C. Premier David Eby said the public wants to see the two levels of government working together to improve the health care system, but he called Ottawa’s proposal “fiscally limited.”

Ontario Premier Doug Ford said he welcomes any new funding, while Quebec Premier François Legault said the funding presented by Mr. Trudeau was pretty much Ottawa’s final offer, which no premier said they would reject.

Ms. Smith also had a one-on-one meeting with Mr. Trudeau, two weeks after the Premier pitched one to discuss her complaints about the federal government’s approach to the oil and gas industry.

Before the meeting, Ms. Smith shook hands with the Prime Minister and told reporters that she looked forward to find areas of common interest, but said she would be pressing her concerns with Ottawa’s environmental policies. The Premier wants the federal government to drop the phrase “just transition” from its plan to promote green jobs.

“The Just Transition legislation gives the impression that the energy sector is going to be phased out. It’s not going to be phased out,” she said before the meeting.

Ottawa has yet to table such legislation and has accused Ms. Smith and her government of misrepresenting the contents of a briefing document about the issue.

This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief James Keller. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.