Question Period with Premiers at the Fairmont Empress in Victoria, B.C., on July 12.CHAD HIPOLITO/The Canadian Press
The bad news is that we are still at the liar’s-poker stage of federal-provincial negotiations on health care.
That’s the part where everybody bluffs and bluffs to try to gain an advantage before having to show what they’re really going to put on the table.
The premiers had a group news conference on Friday to tell us, again, that Prime Minister Justin Trudeau must hold a meeting to discuss forking over an additional $28-billion a year to the provinces to fund health care.
But the preems are not, at least collectively, willing to discuss anything other than their demand for money.
They say they aren’t willing to negotiate with the feds about publishing additional data or indicators on results in the health care system. Manitoba Premier Heather Stefanson, this year’s chair of the premiers’ group, said the provinces already provide accountability.
They aren’t willing to discuss targeted federal transfers for certain types of things – for example, mental health. Ontario Premier Doug Ford said provinces need flexibility to move money between different “buckets.”
When asked what the premiers are willing to discuss other than their demand for money, Ms. Stefanson didn’t list anything. She said they don’t want to negotiate through the media. Saskatchewan Premier Scott Moe piped in to say premiers can’t negotiate with themselves over what the federal share of funding would be.
To sum up, the premiers want Mr. Trudeau to have a meeting with them but only to ask for $28-billion a year. It seems like it would be a short meeting. Why not send an e-mail?
The premiers know they won’t get the massive $28-billion a year. They want a pressure-packed in-person meeting that forces Mr. Trudeau to come out, on TV, and say what sum he will provide. Which is why Mr. Trudeau doesn’t want to agree to that meeting until they are willing to discuss other things.
Health Minister Jean-Yves Duclos, speaking to reporters after the premiers’ news conference, stressed that what the feds want to talk about is data and indicators that measure results. “The problem is, until now, the premiers refuse to speak about those results,” he told reporters.
Another problem, a big one, is that the feds haven’t explicitly told the provinces what kind of results indicators they want, in writing. They haven’t made a proposal. Their demands for data about results have so far been mainly a way to rebuff the premiers’ demands for lots of money with no strings attached.
It is liar’s poker. It’s your money – and will cost you the same no matter which government pays – and your health care. It’s their game.
There are a lot of half-truths and untruths in this debate, including the premiers’ misrepresentation of how much the feds pay because they refuse to count the tax points that provinces asked for back in the 1970s.
Yet Quebec Premier François Legault put his finger on the real issue when he pointed out that health care is a big share of all provincial budgets, around 40 per cent, and because of an aging population, the costs are growing at a faster pace – 5, 6, or 7 per cent each year – than any other government cost.
It is reasonable to ask the feds, the keepers of the Canada Health Act, to take on some responsibility for making Canada’s health care system sustainable.
It’s also reasonable for the feds to expect the provinces to talk about more than money, and to set some additional indicators, across provinces, that tell members of the public more about how their health care system is doing.
Both of those things are in the public interest.
There is good news in the fact that, according to federal Intergovernmental Affairs Minister Dominic Leblanc, there are some productive talks going on behind the scenes with some provinces. Except that the premiers say there are no federal proposals and no progress.
As a group, the premiers’ position is that they don’t want to talk to Ottawa about data and indicators, but in Friday’s news conference, some premiers appeared less adamant. New Brunswick Premier Blaine Higgs said there should be talks and “let’s see where the discussion goes.”
Maybe there will be some shifting as the days to next spring’s federal budget count down. So far, it’s a game of bluff.