Premiers close 2-day summit, call on feds to stop negotiating health funding through the media

Canada's premiers ended their two day summit in Victoria B.C. by calling on the federal government to stop negotiating through the media and sit down with them to discuss the future of health-care funding.

"Twenty-four months ago, we werecollaborating in an unprecedented way," B.C. Premier John Horgan, this year's chair of the Council of the Federation, said Tuesday in Victoria.

"There was unprecedented collaboration and the federal government was right there and we applauded that engagement and now, eight months later, we're exchanging notes through the media. Where'd the love go? Everything was so fine and then it wasn't."

Horgan said Prime Minister Justin Trudeau promised the premiers that, once the pandemic public health emergency was over, the two sides would meet to hash out the future of health-care funding in Canada. No such meeting has been setand his callsfor a sit-down meeting have gone unanswered.

"I've written to the prime minister in December, no response," Horgan said."We've sent a package of principles that we felt would guide a discussion. No response. And now it's, 'We want you to spend it on specific things.'

"We're fine with that but there's differences and nuances depending on where you live."

Horgan said that because each province's health systemhas different needs, the federal government and the prime minister must engage with them individually.

The premiers say the federal government is only covering 22 per cent of health-care costs in Canada. They say they want that federal share raisedto 35 per cent and maintained at that level over time.

The federal government, meanwhile, disagrees with the maththe provinces are using to determine who should pay for what.

"It's past time for the federal government to stop quibbling, to stop saying that we don't have a problem with our publicly funded national health-care system, and sit down at a table with the 13 premiers from provinces and territories," Horgan said.

A disagreement overbasic facts

In 1977, the way the federal government funds health care was changed. Direct federal funding for hospital and physician services was reduced and the provinces were given authority to collect more in income and corporate taxes to fund health services directly.

The federal government says the tax points given to the provinces cover between nine and 10 per cent of the cost of publichealth-care services. The premiers say the Canada Health Transfer (CHT) the largest federal transfer to the provinces covers about 22 per cent of the cost.

The federal government says that when the CHT and those tax points are combined with the money Ottawa spends on bilateral deals for long-term care, home care, mental health and some other services, the portion of health care spending covered by the federal government in 2021-22 came closer to 38.5 per cent.

"Right now, the federal spending to support public health care is about a third of all spending," Intergovernmental Affairs Minister Dominic LeBlanc told guest host Paul HunteronCBC News Network's Power & Politics Monday.

"They use this fake figure of 22 per cent because they deliberately refuse to acknowledge that $20 billion was generated last year by provinces and territories in tax points that the Government of Canada withdrew from, and they then took up immediately to generate revenue for themselves."

WATCH | Premiers call on Ottawa to provide morehealth-care funding:

Premiers call on Ottawa to increase health-care funding

2 years ago

Duration 2:24

Canada's premiers are pushing hard for a meeting with the prime minister, and more money for health care, as they wrap up a two-day meeting in B.C.

Lee Soderstrom, a retired associate professor of economics at McGill University who has studied the economicsof health care in Canada, said the figure cited by the federal governmentis about right.

"The provinces have already long received about 35 per cent of their total spending on health care. Moreover, contrary to critics of federal cost-sharing, Ottawa has not reduced its share of provincial health costs," Soderstrom said in an email to CBC News.

Horgan said Tuesday that while the federal government can quibble over who pays for what,Canadians simply wanta system that works.

"Back and forths about what number is correct, are tax points as relevant as they were in the 1990s today, as we look forward, those are debates that we should be having together, not through the media," Horgan said.

"That's why we are reinforcing today our unanimity to have the federal government call a meeting. We'll arrive we can sit down and solve these problems for Canadians."

Strings attached

A federal government official speaking on background told CBC News that the premiers' demand for a $28 billion annual increase to the CHT without a discussion about what the money would be used for will not fly with Ottawa.

LeBlanc repeated that position again on Monday. He saidthat any increase in federal health-care funding mustcome with conditions andwith a commitment from the provinces to maintain current levels of funding and keep pace with any increases in federal funding.

"Of course there'll be strings attached in the sense that we're not going to increase the federal spending to provinces for health care so they can then reduce their own spending. That would be absurd," LeBlanc told Hunter.

Horgan said that provincial governments are held accountablefor how they spend money through their respective budgeting processes and that every dollar provinces spend is debated in regional legislatures.

"The so-called strings make it sound like there's some sort of a serf relationship here," Horgan said. "We are co-governors. We are equal orders of government. There's not a hierarchy here, we are the same, and we're saying we need to sit down collectively and figure out where we go from here."

Federal Health MinisterJean-Yves Duclostold CBC News Network's Power & Politics Tuesday that details of thespecific outcomes the federal government would tie to any additional health funding can be worked out between himselfand provincial health ministers.

Horgan and Ontario Premier Doug Ford dismissed that proposaland saidit would beinsulting for Prime Minister Justin Trudeau to refuse to meet with them.

"It's pretty disingenuous when you have the minister come out and say, 'Here are a few ideas and, by the way, hand it over to your ministers of health," Ford said. "Its just one request, come to the table It's unacceptable. We need to sit down."

Horgan also said that he does not see how the provinces can continue to have discussions on sharing the costs of a national pharmacareor dentalprogram until the overall funding issue has been put to bed.

"We shouldn't be doing that until we have a firm foundation for our entire program," Horgan said.

Affordability and global challenges

The premiers also released a five-page communique asking the federal government to help them tackle cost-of-living, supply chain and labour challenges facing Canadians.

The premiers said they need federalhelp in unsnarling supply chains, fighting climate change, improving energy and food security, improving mental health and addictions services, bolstering Arctic sovereignty and addressingthe labour shortage.

Ford said Ontariois facing a once-in-a-generationlabour shortage. He saidthe federal government needs to help bring in economic migrants to fill hundreds of thousands of job vacanciesin his province.

"As of this morning, the numbers Ireceived fromour team, we're short 378,000 people," Ford said. "That's 378,000 people that could be contributing to our economy and ... if we don't fill those jobs, someone else around the world will fill them."

Ford said one of the biggest roadblocks tofilling those posts is a cumbersome immigration process that can take up to 26 months to bring an immigrant to Canada and declare them qualified to enter the workforce.