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Trudeau offers $46B in new federal cash

Ford welcomes ‘down payment’ as deal falls short of premiers’ demands

ROBERT BENZIE QUEEN’S PARK BUREAU CHIEF TONDA MACCHARLES OTTAWA BUREAU

Prime Minister Justin Trudeau has delivered a 10-year, $46.2-billion prescription for health care.

But Canada’s provincial and territorial leaders say the cash infusion, which fell far short of their funding request, was only a “down payment” on what they need to tackle health challenges.

Trudeau insisted “this isn’t a down payment at all,” calling it a “major federal investment” after a COVID-19 pandemic that “made us take a hard look at the longstanding issues facing our healthcare (system).”

Under what he told premiers was his “best offer,” annual federal transfer payments to the provinces would increase significantly — by $17.3 billion over the next decade — and will include an immediate $2-billion injection to tackle the crisis in pediatric hospitals and emergency rooms, and ongoing wait times for surgeries.

Beyond that, the prime minister set out a separate $25-billion fund over 10 years for bilateral deals that will be negotiated with each province to address four federal priorities.

Trudeau said he is looking to strike accords “within weeks” to improve family health services, hire more doctors and nurses to address backlogs, boost services for mental health and addiction, and modernize the collection of medical data. There will also be an additional $1.7 billion to hike salaries for personal service workers.

Following the 90-minute federalprovincial meeting, Ontario Premier Doug Ford called Trudeau’s blueprint “a starting point, a down payment on further discussions” of what provinces require — and what Canadians demand.

“This is the beginning,” a conciliatory Ford told reporters after the confab with the prime minister.

Manitoba Premier Heather Stefanson, chair of the premiers’ Council of the Federation, agreed it was “a good first step,” but said more will have to be done. “There wasn’t a lot in a way of the new ‘new funding.’ It’s a little disappointing.”

Quebec Premier François Legault said Trudeau told him in December there would be “substantial” new health money with no conditions attached. “I guess we don’t have the same definition of ‘substantial,’ ” Legault quipped Tuesday.

But he welcomed Ottawa’s guarantee to increase health spending by five per cent annually (up from a current minimum of three per cent) and hailed Trudeau’s promise that provinces would have complete flexibility over where to spend the new cash under the umbrella of “shared priorities.”

Legault said the prime minister made it clear that premiers could spend their share in any way they wanted, which he said meant “no conditions” imposed by Ottawa.

Trudeau maintained that he told premiers his government would protect the Canada Health Act guarantee of universal access to publicly paid health services. But Ford noted Trudeau did not impose a requirement that new health dollars should not go to the private delivery of those services.

Overall, the prime minister boasted there would be an increase of $198.6 billion in federal funding in the next decade — most of which is “additional” funding the provinces would be getting under previously budgeted and allocated agreements, and scheduled increases to federal health transfers.

Only $46.2 billion of the overall 10-year total is considered “new money” that the provinces had not anticipated. That works out to $4.6 billion a year — an amount an Ontario official said was “underwhelming” and doesn’t answer the question of who would cover the costs for expanded home care, higher personal support worker salaries or mental-health services after the funding agreements run their course.

Ottawa will also add new funds of $2 billion specifically for Indigenous priorities in health.

Some of the new cash is conditional on provinces committing to improved data collection. Trudeau said that will lead to concrete improvements because “what gets measured gets done.” Ottawa wants provinces to measure:

The percentage of patients with access to a regular family health team, doctor or nurse practitioner.

The number of new doctors, nurses and nurse practitioners.

The size of surgery backlogs due to the COVID-19 pandemic.

The percentage of people aged 1225 with access to integrated youth services for mental health and substance abuse.

The median wait times for mental health and substance use services.

The percentage of people with mental disorders who are unable to get care.

The access to electronic health records.

Federal Health Minister JeanYves Duclos emphasized that the new funding must be used for health-care services and was confident the premiers would “protect the integrity” of the publicly funded system.

“But if that were not to be the case, there are things that I can do as federal health minister, including emitting fines for not respecting the obligations of the Canada Health Act,” Duclos warned.

Federal officials who briefed reporters said the Canada Health Transfer, which is tied to a threeyear moving average of economic growth, will grow significantly by a minimum of five per cent annually, although in 2023-24 it will, as previously announced, rise by 9.3 per cent to $49.4 billion.

Ottawa calculates that transfer to the provinces for health care will jump by 61 per cent by the end of the accord in 2032-33.

Coming into the meeting, the premiers had maintained that the provinces fund 78 per cent of health care while Ottawa ponies up the remaining 22 per cent. They wanted the federal cash contribution to jump to 35 per cent, the equivalent of $28 billion more annually.

Trudeau’s government insists its share is already closer to one-third of costs because in the 1970s, Ottawa lowered its basic income tax rates so provinces could hike theirs at the same time. On Tuesday, federal officials said that taxing power is worth $25 billion this year alone.

Meanwhile, the Canadian Medical Association hailed the federal commitment as “an important step to stabilize and transform our health-care systems.”

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2023-02-08T08:00:00.0000000Z

2023-02-08T08:00:00.0000000Z

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