It’s only a matter of time now before New Brunswick abandons its silly holdout with the federal government over a national child care plan.
And then Ontario, the only other province still refusing to accept Ottawa’s generosity, will quickly follow suit. Prime Minister Justin Trudeau will then declare victory in his showdown with the provinces over the manner in which his government is rolling out a national child care program.
With strings attached for everyone but Quebec.
It’s been amusing to watch all the bluster and bold talk about never giving in to such federal bribery fade away amid public criticism that the hold out provinces were leaving billions on the table in the name of political stubbornness. Many of the premiers said flatly they didn’t like being told what to do with money they insist is rightfully theirs. And then eventually agreed to do just that.
Well, if you’ve enjoyed the childish child care fight, you’ll love the one that’s coming next over health care funding.
The premiers, through the Council of the Federation (COF), are calling on Mr. Trudeau to join them in the new year to hammer out a new funding deal. The provinces and territories are demanding Ottawa increase its contribution to health care costs to 35 per cent from the 22 per cent it sits at now. The feds have signalled that they are ready to up their support but don’t necessarily agree their contribution is only 22 per cent.
The Liberals are also insisting that the money they are prepared to part with – something in the neighbourhood of $24-billion annually to begin with – must come with terms. Specifically, they want to know it is going into areas they deem critical, like eliminating wait lists, hiring more doctors and nurses, fixing long-term care and beefing up mental health services.
Needless to say, we’re at something of an impasse. The provinces see Ottawa handing Quebec $6-billion for child care but without conditions and wonder why they are getting treated differently. It’s almost like some of these premiers are new to this place called Canada.
B.C. Premier John Horgan is chair of COF and is making it his mission to try and get a new deal done. Now the most senior-ranking premier around the table, Mr. Horgan admits the challenge ahead is significant but not insurmountable.
“So much of this discussion is undermined by language,” the Premier told me. “For the provinces to be characterized as greedy by Ottawa is wrong and for us to say Ottawa is too controlling is wrong. It’s not about building empires here. It’s not about control. It’s about doing what’s best for our citizens.”
Which sounds wonderful, but health care funding has always been about control. The provinces believe they know best when it comes to spending money on health care. The federal government insists there needs to be national standards when it comes to some of the areas previously mentioned like long-term care.
Much of this, of course, is partisan posturing. Eventually, that will have to take a back seat to finding a deal, in much the same way Ontario Premier Doug Ford is finally putting petty politicking behind him to get a daycare deal done.
Mr. Horgan’s challenge will be finding a way to build accountability and transparency into any new funding deal. Ottawa can likely back off any “strings attached” language as long as there is accountability and transparency built into the system. Mr. Trudeau doesn’t want to give Alberta’s Jason Kenney a big fat health care cheque only to see him announce a tax break for the rich the next day with his new-found money.
So there has to be an agreed upon data set that can be used as a baseline for measuring success in reducing things like wait lists. Ottawa will want to see tangible proof that the money it’s sending the provinces to deal with these types of issues is having a material effect. That seems fair. This is going to necessitate a lot more sharing of provincial health care data to be achieved.
As it turns out, this was a recommendation made this week by an expert panel looking into the reasons why Canada’s response to the pandemic was so poor in some areas.
There isn’t much disagreement that the areas Ottawa have identified are, to varying degrees, health care priorities across the country. What the federal government wants is measurable achievement – something we all want.
Canada’s health care system is one of the defining features of this country. It’s worth fighting for but not worth fighting over. Ottawa and the provinces need to get a deal done.
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Gary Mason