Premiers accept Ottawa's health-care funding offer, continue to negotiate bilateral agreements

After deliberating for nearly a week, premiers across Canada have accepted new federal health-care funding which would add $46 billion over 10 years to provincial coffers.

Though some appreciated the extra dollars, others believe it fell "far short" of what the provinces and territories said they needed.

"This is not long-term, sustainable funding that will address the health-care challenges that we have across our country," said Manitoba Premier Heather Stefanson on Monday.

The premiers requested an immediate, annual top-up to the Canada Health Transfer (CHT) of $28 billion, plus a minimum 5% yearly increase — equivalent to more than $300 billion in new spending over 10 years. 

In last week's announcement by Prime Minister Justin Trudeau, the premiers received an increase in health-care spending by $196.1 billion over the next decade.

He also offered to top-up the CHT by an additional $2 billion — bringing it to $51.3 billion — while proposing a boost to the annual health transfer increase to 5% a year for five years, up from 3% under the previous cost-sharing agreement.

Despite coming short, the premiers said they wouldn’t leave money on the table to aid their ailing health-care systems.

"It took 2½ years even to be able to sit down and be at the table and have a discussion with the prime minister," said Stefanson, chair of the Council of the Federation. She added that the provinces and territories would accept the offer and prioritize those dollars as they deem best.

Health-care systems across the country have not yet recovered from the pandemic strain. People continue to endure long waiting times while surgery backlogs, staffing shortages, and clogged emergency rooms besiege hospitals.

Roughly one-in-10 Canadians are still waiting for surgery, a diagnostic scan, or an appointment with a specialist.

According to the Fraser Institute and Secondstreet.org, Canadian patients waited longer than ever this year for medical treatment, including critical surgeries, treatments, and procedures. In 2021/22, median wait times for Canadians were 27.4 weeks — the longest ever recorded — up from 25.6 weeks in 2020/21. 

At least 13,581 patients have died waiting for surgeries, procedures, and diagnostic scans this year, compared to 11,581 last year.

Now, Ottawa is negotiating the $25 billion bilateral agreements with each province and territory to allow each premier to prioritize where their share of that funding will go per conditions set by the feds. 

Trudeau said the conditions to receive the funding include funding family health teams, health workers, and surgery and diagnostic backlogs, funding mental health and substance use, and a modernized, digital health-care system.

Premiers Scott Moe and Danielle Smith said they would not implement a national digital ID as a condition to receive health-care funding, owing to pushback from large swathes of the population in those provinces.

"I will ensure that any agreements with the federal government do NOT include the sharing of any such personal information with the feds or third party," said Smith.

Moe told the Trudeau Liberals in early February that his province would not facilitate a national health-care "digital ID" — even if it's required to secure health-care funding from the feds.

"The Government of Saskatchewan is not creating a digital ID, nor will we accept any requirements for the creation of a digital ID tied to health-care funding," he penned in a public letter to the province.

British Columbia Premier David Eby said the offer represents a reversal for Ottawa after years of contributing an eroding share of the cost of health care. 

"It’s clear that every region of our country is struggling with increased strains on their health care system," said Eby. 

"While the specific pressures are different for each province, the need for support from our federal partner is urgent and acute."

Federal Health Minister Jean-Yves Duclos and Intergovernmental Affairs Minister Dominic LeBlanc have traversed the country to meet with provincial and territorial leaders this week to get separate bilateral funding deals in place.

Duclos and LeBlanc issued a joint statement on Monday welcoming the announcement from the premiers. 

They said their meetings with premiers and provincial and territorial health ministers prioritized improving the country’s 13 health-care systems for patients and staff. 

"There is still much work ahead of us to finalize bilateral agreements with each province and territory, and over the coming weeks, that will be our focus," said the ministers in a written statement.

Nova Scotia Premier Tim Houston lauded Monday’s meeting with federal ministers in Halifax as productive and positive. He said he expects the additional cash immediately to bolster his province's healthcare system. 

"It is clear that we have shared priorities and that the federal goals align with our Action for Health plan," he said in a statement to The Globe and Mail. 

"We’re especially pleased that the federal government has recognized Nova Scotia’s aging population and has factored that into the agreement."

Newfoundland and Labrador Premier Andrew Furey added that he hopes to finalize his bilateral agreement quickly. 

"I look forward to finalizing these bilateral agreements with the federal government to move forward on our shared healthcare priorities with increased investment," said Furey.

However, Doug Ford’s office said they had made specific recommendations about the long-term sustainability of Ottawa’s first and final funding offer. 

"These recommendations toward sustainability and certainty would be data-driven, based on performance, and would always protect personal health information, as was always the intention of the provinces, territories, and federal government," said Ford's office in a statement. 

"Premier Ford will continue to work directly with his fellow premiers and the federal government to finalize the funding agreement."

Ontario's premier said he will provide the list of recommendations to Ottawa in the coming days by letter.

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