Premiers put focus on health care funding in meeting with PM

As Prime Minister Justin Trudeau meets with the premiers today, competing priorities could undermine a national approach to fighting the pandemic.

The premiers demanded this meeting to discuss their call for a permanent annual boost of $28 billion to health-care transfers. 

Ontario Premier Doug Ford said he wants to see a firm timeline for increased funding and hoped the meeting would end with "good news."

"We're going to be pushing the prime minister hard. We need to know where we're at on the Canada Health Transfer by, at minimum, the spring budget," he said.

While Trudeau has agreed to a conversation on transfers, federal sources say the prime minister wants to keep the focus on the immediate threat posed by the second wave of the coronavirus — and that no formal commitment to a specific funding boost is likely to come out of the meeting.

"We understand that there is an important conversation to be had on health care services and delivery," said a senior federal official speaking on background. "But there are also some more urgent things that need to be discussed."

Bloc Québécois Leader Yves-François Blanchet accused Trudeau of holding Canadians "hostage" by delaying a funding commitment to use it as an electoral advantage.

"And mark my words ... he will come with a budget in March, and we might not even be called to vote on this budget. And he will tell the Canadians and the Quebecers, 'If you want all those tens of billions of dollars to get out of the pandemic, of which I'm the new hero, you have to vote for me,'" he said today.

"And this will have been taking Canadians and Quebecers hostage, as hostages for months, because he wanted to get re-elected. That's pretty bad."

Canadians want 'change,' says CMA chief

Dr. Ann Collins, president of the Canadian Medical Association (CMA), said the first ministers must deal with the acute problems facing the health system as well as the chronic ones. She said the pandemic exposed cracks in what was already an ailing health-care system — plagued by long waits for tests and surgical procedures and gaps in long-term care.

"To come out and give an indication that it's status quo, that is unacceptable," she said. "Not only is it unacceptable to the CMA, it's unacceptable to Canadians. This is what Canadians want to see. They want change, they want assurance that their leaders care about their care, about our health-care system."

Right now, the provinces spend $188 billion on health care and the federal government covers $42 billion, or roughly 22 per cent of total costs. The increase proposed by the premiers would see the federal government cover 35 per cent of health costs.

The premiers have said long-term funding is needed to meet rising health system costs caused by factors that predate the pandemic, such as an aging population and the increasing expense of new medical technologies and drugs.

Trudeau stresses urgent pandemic needs

The difference in priority focus between the premiers and the prime minister was laid bare in opening remarks before the meeting.

Trudeau stressed the billions in supports the government has provided to help the provinces with personal protective equipment (PPE), contact tracing and other measures to deal with COVID-19.

"The last few months have been some of the hardest our country has ever faced," he said.

"Throughout, people have had each other's backs. Canadians have rallied together and they are counting on their leaders to do the same — so let's get down to work."

Trudeau said that funding of health care remains a priority and the government is determined to give Canadians a strong health-care system.

Quebec Premier François Legault, who is chair of the Council of the Federation, said long-term health-care funding is the top priority.

"The subject that unites us at the outset is the financing of health care," he said. "We are first here to talk about the huge problem of health transfers, where the federal government finances only 22 per cent although it has, in the long term, better financial capacity then the provinces and territories."

Legault said while the federal government is dealing with a massive deficit, it's in a stronger long-term financial situation than the provinces and territories.

'Legitimate questions'

As competing priorities strain efforts to come to a consensus at the first ministers' table, so too will federal doubts about how some provinces have handled the second wave, the federal source said.

"We're not going to be strident and critical of the premiers. Canadians don't want that," said the senior official. "But there are some legitimate questions that should be asked of provinces.'' 

Those questions centre around how certain provinces have or have not used the resources Ottawa has sent them to deal with the pandemic, said the source, adding that there is significant frustration at the federal level over how some provinces have been slow to scale up testing and contact tracing, despite getting billions of dollars in federal cash.

This week, Ontario's financial accountability officer reported the Ford government is sitting on more than $12 billion in unspent pandemic reserve funding. Rapid tests — which some premiers loudly demanded — sit unused in some provincial warehouses.

One provincial source said the federal government had promised to hammer out the health transfers issue at this meeting and is now trying to "dilute" those talks with vaccine discussions.

"There are many channels for conversations that are happening with senior officials around the vaccine on a daily and hourly basis," said the source. "But there is only one place and one table where a substantial conversation can happen around sustainable health-care funding and fixing Canada's health-care system, and that is around the FMM table."

Jurisdictional squabbles

Another potential sticking point is jurisdiction. In demanding a surge in federal health funding, the premiers also are insisting that Ottawa send the money with no strings attached.

This is a source of frustration for a federal government that has bankrolled the bulk of the pandemic response — often in areas of provincial jurisdiction — and is pushing for national standards in long-term care.

Conservative Leader Erin O'Toole said there must be more collaboration between the federal and provincial governments and more federal funding without conditions.

"It can't be Ottawa setting the terms for the provinces," he said.

NDP Leader Jagmeet Singh said consecutive Liberal and Conservative governments have "starved" the health-care system.

"This is wrong and it needs to stop," he said.

But the federal official said the government's first focus must be on the pandemic emergency.

"We are not out of the woods yet. We are in far deeper woods when it comes to COVID."