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Liberal Leader Justin Trudeau makes a campaign stop in Markham, Ont., on Aug. 17, 2021. He is joined by Liberal candidate for Markham-Unionville, Paul Chiang and wife Monica, and Liberal candidate for University-Rosedale, Chrystia Freeland.Sean Kilpatrick/The Canadian Press

A video Liberal Chrystia Freeland posted to Twitter about Conservative Leader Erin O’Toole’s stand on privatized health care has been labelled “manipulated media” by the social media giant, but Liberal Leader Justin Trudeau is standing by the post.

The debate over Canada’s health care system dominated the start of the second week of the campaign for the Sept. 20 federal election, with the Liberals repeating a promise to give money to the provinces to facilitate the hiring of family doctors and the Conservatives calling for the Commissioner of Canada Elections to investigate the Liberal video. Mr. O’Toole also was asked on Monday to clarify his past comments about health care privatization.

The video was posted to Twitter on Sunday on the account of Ms. Freeland, who is deputy prime minister and is seeking re-election in the Toronto riding of University-Rosedale. It splices together comments on privatized health care that Mr. O’Toole made in July, 2020, while he was running for the Conservative leadership.

In one clip, asked if he would allow provinces to experiment with health care reform, including private, “for-profit” and non-profit options inside universal health coverage, Mr. O’Toole says, “Yes.”

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He goes on to talk about “public-private synergies,” but the Liberal video does not include his remark that “universal access remains paramount.”

“We have to find public-private synergies and make sure that universal access remains paramount,” Mr. O’Toole says in the unedited version.

Twitter later labelled Ms. Freeland’s video as “manipulated media.” According to its policy, users may not “deceptively promote synthetic or manipulated media that are likely to cause harm.”

“The Tweets in question have both been labelled in line with our global synthetic and manipulated policy,” Twitter Canada said in a statement to The Globe and Mail. The social media site said it assigns the label “to help people understand their authenticity and to provide additional context.” Twitter Canada did not specify how the determination was made.

Attempts to reach Ms. Freeland for comment were unsuccessful.

But Liberal Party spokesman Alex Lawrence referred to comments Mr. Freeland made on CJOB radio in Winnipeg on Monday when she was asked about the tweets.

“The original tweet very clearly contained a link to the full answer that Mr. O’Toole gave during the Conservative leadership race to a question about whether he supports private, for-profit health care. His clear answer was an unequivocal yes,” Ms. Freeland told the radio station.

Mr. Trudeau on Monday stood by the video, saying Mr. O’Toole’s response to the question was also posted online in full under Ms. Freeland’s account.

“What’s really important here is that in the middle of a pandemic, Erin O’Toole came out unequivocally in support of private health care in terms of for-profit health care,” Mr. Trudeau said. “We posted the entire interview … and I encourage all Canadians to take a look to see what Erin O’Toole has to say about what he sees in the future of health care.”

In a letter to Commissioner of Canada Elections Yves Côté on Monday, Conservative Party lawyer Arthur Hamilton called for an investigation and said the agency should have the video removed from any platform where it has been published. Mr. Côté's office confirmed on Monday it had received the complaint, but spokeswoman Myriam Croussette said due to confidentiality requirements, she could not say whether Mr. Côté would investigate.

The Liberals tried to regulate content on social media sites through the controversial Bill C-10, which passed in the House of Commons in June. However, it was stalled in the Senate and did not become law before Mr. Trudeau called the election.

Earlier in the campaign, Twitter removed a Conservative video that superimposed Mr. Trudeau’s face onto a girl’s body in a scene from the film Willy Wonka and the Chocolate Factory. The social media company cited copyright concerns for that decision.

On Monday, Mr. O’Toole avoided directly answering questions on whether he still thinks more privatization is needed.

“I 100 per cent support our public and universal health care system,” Mr. O’Toole said. “All provinces are going to be going through how they need to improve, how they need to address long-term care, I think Ottawa needs to be a partner, not a paternalistic-Ottawa-knows-best player.”

The Conservative Leader pointed out that his party has promised it would increase transfer payments to provinces a minimum of six per cent per year from its current floor of three per cent. That is much higher than the commitments from the Liberals.

In the 2020 video, Mr. O’Toole also praises a Saskatchewan policy that allows for-profit clinics to charge for MRI scans if they provide an equal number of free scans to people on the public waiting list. The Liberal government said it breached the Canada Health Act and meant Ottawa could withhold some of the province’s federal transfers for health.

Mr. O’Toole in the video called the Saskatchewan policy a “brilliant move” and said it reduced waits, but data from the Canadian Institute for Health Information show wait times went down slightly before going up in 2019 and 2020.

One of the Saskatchewan clinics charges $950 for the first MRI, according to its website. A Liberal spokesperson said on Monday that if the party is re-elected, the amount of federal cash the province will get in health transfers will be affected. “If the patient charges in Saskatchewan are not eliminated, a clawback will occur,” the spokesperson, Thierry Bélair, said in an e-mail.

In Halifax on Monday, Mr. Trudeau announced that a re-elected Liberal government would give the provinces $6-billion immediately to reduce health care waiting lists, and $3-billion over four years for 7,500 new family doctors, nurses and nurse practitioners. The party also promised $400-million over four years for virtual health care services.

In their 2019 platform, the Liberals also said they would spend $6-billion to ensure every Canadian has access to a family doctor or primary health team. That pledge was not mentioned in the 2021 budget. However, the Liberals did approve more than $4-billion in one-time transfers to the provinces for health care spending related to COVID-19.

Mr. Trudeau was also asked about the rate of increase for federal health transfers, but did not offer specifics.

Since the beginning of the pandemic, the premiers have called on Mr. Trudeau’s government to approve a major increase in the Canada Health Transfer, which is worth $43.1-billion this year. The current formula requires the transfer to increase each year in line with economic growth, with a guaranteed hike of at least 3 per cent.

Provinces have said those increases are not in line with rising costs in health care, especially with shifting demographics leading to a higher number of older Canadians who require services. The provinces have also pointed to studies by the Parliamentary Budget Officer that say federal finances remain sustainable and provincial budgets, on average, do not.

NDP Leader Jagmeet Singh on Monday called Mr. Trudeau’s announcement a recycled “empty health care promise.”

Mr. Singh, speaking in Montreal, where he promised an NDP government would end subsidies to oil and gas companies, called the Liberal video “really troubling” and said the government should do more to combat misinformation and hate speech online.

“We’ve got the Liberal Party putting out misinformation, spreading it online, to the point that Twitter had to flag it,” Mr. Singh said. “It is really disconcerting … that the current party in power is engaging in exactly what we need to be ending.”

With reports from Bill Curry and Menaka Raman-Wilms in Ottawa

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