In conversations with provincial and federal politicians and officials about the stalled talks about health care funding, one phrase is often repeated: We don’t want to negotiate in public.
An official who was asked what sum their province is really looking for from Ottawa – because the $28-billion-a-year they ask for in public is not in a realistic ballpark – dodged the question, saying don’t want to negotiate in public. Questions about whether provinces could accept some version of federal calls for more timely data on health care outcomes get the same response. A federal source, pressed for details on what Ottawa wants, said the same thing: we’re not going to negotiate in public.
That’s an old chestnut, even an accepted dictum. But after another week where federal and provincial politicians accused each other of stymieing progress in talks, we have to realize that in this case, it is dead wrong.
Ottawa and the provinces should absolutely negotiate health care funding in public. The public is the party whose interests are not being represented.
For one thing, though the public is feeling the brunt of a health care crisis, the provinces and the feds aren’t really negotiating – not yet.
The provinces have asked for megabucks with no conditions. The feds haven’t put forward a figure, but they want the provinces to provide information on how the money would be used, and more public data on health care outcomes.
But details?
“There was no proposal of any kind put on the table,” Manitoba Premier Heather Stefanson said in an interview. She called for the feds to put a proposal on paper. And the Premier is right: They should.
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Yet the premiers haven’t proposed any details, either, other than a massive number. They have asked for Ottawa to transfer an additional sum equivalent to about 1 per cent of Canada’s entire economy every year without much information about how it will be used. No premier in their right mind expects to get it. It’s not a serious proposal.
Each is waiting for the other to move first. That is an old negotiation game. One senior provincial official said anyone who buys or sells a house doesn’t want to negotiate against themselves by revealing too much, and provinces are doing the same thing.
And if this was a negotiation where what matters is who gets the best deal, that would make sense. But that isn’t what matters – at least it is not what matters to citizens.
Whether Ottawa or the provinces pay the costs of health care, it is coming out of the same taxpayer’s pocket. The interests of their residents are in ensuring there is a functional health care system.
Right now, provinces are overwhelmed by two health care problems: their system is already in crisis, and they expect the demand to grow at rapid pace in coming years. The need to reform the system while it is in crisis.
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British Columbia Health Minister Adrian Dix said in an interview that in 10 years, B.C. will have twice as many people over the age of 75, He said that in the five years he has held his post, the province has hired 38,000 health care workers.
“And you know what? We’re going to need 38,000 more in the next five years. And in the five years after that? Oh yeah, 38,000 more,” he said.
Mr. Dix believes Ottawa should step in with money to ensure some stability and help the provinces make health care sustainable – and he’s right. But not when it comes to the massive influx of cash the provinces have been demanding to rid themselves of hard choices for reforms. The feds have no role in managing health care but are justified to ask for better and more timely data, and more public accountability.
And now we need Ottawa and the provinces to put it on paper, pronto. And show the public.
Of course, there is always a danger in that. Ms. Stefanson said it is a bad idea to negotiate through the media. Indeed, that is a well-established axiom because of the danger of politicians playing to the gallery with soundbites that disrupt goodwill at the negotiating table. But Ottawa and the provinces have been doing that dysfunctional dance for a year, anyway.
While each side jockeys over their own concerns, the public’s larger interests have been left out. So it is time for both to put their proposals on paper, in detail, and in public, to let Canadians in on the negotiations.
Campbell Clark