OTTAWA — A resolution of how to address the health-care funding crisis in Canada may be within reach, the Star has learned.
Sources say the Trudeau government is looking at a hybrid solution to the ailing system: offering not only more stable ongoing money through increased Canada Health Transfers to the provinces, but also additional funding for provinces through separate bilateral agreements for those willing to embrace shared priorities, such as expanded mental health and long-term care services.
As political pressure mounts on all leaders faced with crises in overrun hospital emergency rooms, and provinces looking to draft their budgets in the weeks ahead, talks have progressed quickly in the past several days, sources said.
A first ministers’ meeting could soon be scheduled, although federal and provincial officials tell the Star no date has been set and no deal or deals have been finalized. But three sources suggested a meeting could be held not long after next week’s federal cabinet retreat.
Any health agreement may not be finalized before such a meeting of the premiers and Prime Minister Justin Trudeau.
However, federal and provincial sources say there is now a broader consensus among several premiers behind closed doors on how some federal funding could be tied to shared priorities.
Newfoundland and Labrador Premier Andrew Furey, an orthopedic surgeon, said in an interview with the Star that the two sides — Ottawa and the provinces — were never that far apart.
“I think we’re very close. I’m quite optimistic, moving forward, and hopefully we can land on a deal in the not-too-distant future,” he said.
“I don’t know if it was rhetoric or political positioning, but we’ve always, as a province and, I can tell you, multiple premiers have always been fairly aligned with the concept of shared priorities.”
“I think we were concerned that there would be jurisdictional creep, but I don’t think the federal government has the desire, the agency or ability to run a health-care system,” said Furey, adding the key to any agreement is that shared priorities “need to be flexible, both within jurisdictions and between jurisdictions.”
“And I think there is a willingness in the federal government to recognize that and work bilaterally with provinces,” he said. For Newfoundland and Labrador, he said, “those shared priorities would be access to primary health care, virtual care, surgical wait times, expanding access to mental health and addiction services, and, recruitment and retention of health-care professionals.”
Those priorities are among the federal government’s asks in return for increased funding, along with a commitment to adopt a nationwide health-care data-collection system that would feed into each of those areas.
On Thursday, NDP Leader Jagmeet Singh amped up the pressure on hastening health-care talks, tying Trudeau’s next moves to the fate of his governing agreement with the Liberals.
“We have the power to do many things. We have the power to withdraw support. We have the power to make things difficult for the government in Parliament. We have many options and all those options are on the table,” Singh said on the second day of the NDP’s caucus retreat in Ottawa.
Singh has already stated that this year’s federal budget will be the next test of his support for the NDP’s deal with the minority Liberals, which would trigger an election if broken.
The country’s health-care crisis has emerged as a central priority during the retreat, with Singh declaring Wednesday that “straight up, no privatization” should be one of the conditions Ottawa puts to provinces.
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Singh was partly referring to Premier Doug Ford, who last week unveiled a plan to expand the number of surgeries provided at for-profit clinics.
In Windsor on Thursday, Ford — who last week said he could live with federal strings attached to additional health funding — told reporters the health-care system “needs to be tweaked.”
“When something’s broken, you just don’t put the blinders on and, you know, not have the political will to do something. We’re moving forward and making sure that we improve health care.”
An Ontario official, speaking to the Star on background, said Thursday “we’re certainly feeling like a deal is more imminent than it has been and we’re hoping for something sooner than later.”
A federal source with knowledge of provincial health-care talks said the tenor of the negotiations was more positive than it was late last year, when premiers and Ottawa were locked in a standoff over what to agree on — and by when.
“We’re starting to see public overtures from provinces that are willing to accept … conditionality as part of increased funding,” said the source, who spoke to the Star on the condition they not be named.
The source said Ford’s comments last week marked a “big turning point” in the state of talks, adding that some of the premier’s comments aligned with ideas Ottawa had put on the table during a health summit in Vancouver in November that ended in flames.
Ford and Quebec Premier François Legault — representing the two largest provinces — have both publicly said they are not opposed to better health data sharing with Ottawa, with Legault saying that in his own talks with Ford and Trudeau, they discussed data and not tying strings or “conditions.”
Legault told reporters Wednesday that his province already makes data available publicly and “we don’t have a problem sending it to Ottawa … Are other provinces going to accept providing (Ottawa) as much data as we do?” Legault asked. He said that’s up to Trudeau and Health Minister Jean-Yves Duclos “to negotiate.”
Legault said he is looking to a deal on increased health transfers within weeks, in time to include in his province’s spring budget.
More and better data-sharing has been a priority of the federal government, which says it is tied to providing the public an accurate picture of the health system’s performance, best practices, and better outcomes.
Publicly, several premiers bristled at such demands, saying health care is a provincial responsibility for which they are already accountable to their own electors.
The premiers have long claimed the provinces pay 78 per cent of health-care costs with the federal government covering only 22 per cent of what was intended to be a shared-cost program. They want Ottawa’s contribution increased to 35 per cent.
But the federal government says its share is already about one-third due to a transfer of federal tax points to the provinces decades ago. Ottawa lowered its basic income tax rates in the 1970s so provinces could raise theirs at the same time.
Tonda MacCharles is an Ottawa-based reporter covering federal politics for the Star. Follow her on Twitter: @tondamacc
Raisa Patel is an Ottawa-based reporter covering federal politics for the Star. Follow her on Twitter: @R_SPatel
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