Trudeau strikes 'underwhelming' cost-share agreement on health care

Ahead of the prime minister's meeting with the premiers, the feds gave the provinces and territories a 9.3% rise in healthcare transfers, amounting to $49.3 billion in the 2022/23 fiscal year. Tuesday’s announcement provides an additional $2 billion top-up, bringing it to $51.3 billion.

Trudeau strikes 'underwhelming' cost-share agreement on health care
The Canadian Press / Sean Kilpatrick
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The Globe and Mail reported Monday that Prime Minister Justin Trudeau is set to table over $100 billion in federal health-care funding to bolster struggling health-care systems across the country. 

According to a senior federal source, Trudeau will meet with provincial premiers and territorial leaders Tuesday to hash out the specifics, including a 10-year funding proposal from Ottawa that would inject tens of billions of dollars on top of earlier planned increases to the Canada Health Transfer (CHT). 

The source said the feds would allocate a large sum of the new money for separate bilateral deals targeting key areas such as primary care.

"We know that is what Canadians expect. Whether it is more family doctors, ending the backlogs on mental health services or stopping the overwhelming number of our ERs, we will invest with the provinces and ensure results for Canadians," said Trudeau Monday evening.

Trudeau also told reporters that the agreements are needed to address each province's and territory's specific needs, such as primary care, long-term care facilities, mental health and home care.

"That's the way of ensuring that we're respecting provincial jurisdiction on health care while ensuring that the federal government is there."

Intergovernmental Affairs Minister Dominic LeBlanc expects all deals to be completed before this spring's federal budget. 

On Tuesday, the Globe and Mail confirmed that the premiers would receive $46.2 billion in new healthcare funding over ten years — significantly less than the provinces and territories demanded.

The Trudeau Liberals intend to divide the new federal money between the baseline funding sent to provinces and territories through the CHT and $25 billion for separate bilateral deals targeting primary care and mental health.

Ahead of the prime minister's meeting with the premiers Tuesday, the feds gave the provinces and territories a 9.3% rise in healthcare transfers, amounting to $49.3 billion from the $45.2 billion projected payments in the 2022/23 fiscal year.

Per Tuesday’s announcement, the health transfer will receive an additional $2 billion top-up, bringing it to $51.3 billion. 

Additionally, the feds proposed boosting the annual health transfer increase to 5% a year for five years, up from 3% under the previous cost-sharing agreement.

However, Trudeau's new cost share comes with strings attached, including that none of the funds will go to non-healthcare spending and that the provinces and territories will not reduce their contributions to medicare.

"I can agree to that," said Newfoundland and Labrador Premier Andrew Furey. "No doubt about that."

Similarly, BC Premier David Eby pledged provincial healthcare spending would continue to rise under his government.

However, Manitoba Premier Heather Stefanson expressed reservations about commenting on an agreement she has yet to see.

"It's very difficult to comment on something we haven't seen," she said. "We want to ensure we have enough money for [education and social services] as well."

Quebec Premier François Legault outright condemned Trudeau for having "strings attached" to federal funding. But he said the premiers "will form a united front" on the back of this agreement to aid their healthcare systems struggling with rising costs, staff shortages and backlogs in surgeries and diagnostics.

Trudeau will roll out his government's funding proposal after the meeting with the premiers wraps up in the late afternoon. 

The premiers pressed for an immediate, no-strings-attached increase to the CHT to bring the federal share of health care funding to 35% — a $28 billion hike. However, provincial sources conceded before the meeting that they expect Ottawa to fail to meet that request.

Stefanson and Legault told reporters Tuesday morning that they preferred an immediate $28 billion cash injection with no strings attached. Still, the latter said he would be happy with a "substantial" increase.

"We are open to a first step in the right direction," said Legault. He added, "a substantial amount would be welcome, even if it isn't the total amount."

Stefanson added that the bottom line request from premiers is that Ottawa provides them with "predictable and stable long-term funding" for the CHT.

"I'm optimistic that we can work together," she said.

Trudeau previously claimed: "There is no point putting more money into a broken system."

"One of the only levers I have is saying, 'I'm not giving you this money with no conditions.' I will fully participate in funding it as long as those real improvements are made."

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 2022, median wait times for Canadians were 27.4 weeks — the longest ever recorded — up from 25.6 weeks in 2021 and 195% higher than the 9.3 weeks in 1993 when the Fraser Institute first tracked wait times. 

At least 13,581 patients died while waiting for surgeries, procedures and diagnostic scans in 2021/22 — up from the previous year's total of 11,581. 

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

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