THE CANADIAN ideal of equal health care available across the country will be dead under the Harper government’s new funding plan, says Premier Darrell Dexter.
“I think it’s absolutely clear that if the federal government proceeds without amendments, there will be different levels of care, different health-care systems, in different parts of the country,” Dexter said Monday.
“You cannot deny the differences that exist between the regions.”
When federal Finance Minister Jim Flaherty surprised the provinces in December with a non-negotiable health transfer plan that runs until 2024, he changed the way health payments are made in two fundamental ways.
First, provinces will receive the cash with no strings attached, as opposed to the previous accord, in which funding was tied to fulfilling the principles — tenets that include universality, accessibility and comprehensiveness — of the Canada Health Act.
Second, payments will be calculated solely on a per capita basis, which will benefit booming western provinces. In particular, Alberta will receive about $1 billion more per year.
Dexter said this change will derail the vision outlined in Canada’s Constitution that all provinces should be able “to provide reasonably comparable levels of public services at reasonably comparable levels of taxation.”
With Nova Scotia’s seniors projected to almost double in number over the next two decades, the province wants health-care transfers to factor in demographics.
Flaherty’s plan “means there is a larger burden on poorer provinces with the most vulnerable economies,” said Dexter.
The provinces are split. Six — Nova Scotia, Newfoundland and Labrador, P.E.I., Quebec, Manitoba and Ontario — publicly oppose Flaherty’s plan while others have either stayed mute or, as in the case of British Columbia, supported it.
It is on this divided landscape that premiers will meet Sunday in Victoria to try to hammer out a new national health accord to set standards after the current agreement expires in 2014.
That 2004 accord was negotiated in tandem with a funding deal. With money now off the table, according to Flaherty, there are questions about whether a new accord will come to be at all.
Federal Health Minister Leona Aglukkaq has signalled that it is up to the provinces to decide how they want to proceed but has said she hopes to see some kind of new agreement.
“Minister Aglukkaq has suggested to her provincial and territorial counterparts that advancing work on common indicators should be a priority,” said a Health Canada spokesperson Monday.
Some provinces have not given up on Flaherty and the federal government changing their minds. Dexter said he hopes the provinces can reach an agreement at Sunday’s meeting and present a united front to compel Ottawa to change its deal.
Ontario Premier Dalton McGuinty said Monday he wants the Harper government to go back on its no-strings-attached approach and link health transfers to provinces meeting national standards.
Flaherty addressed the issue in a news release when he announced the plan last month.
“Our landmark investment means health-care funding will continue to grow at record levels and in a fiscally sustainable manner. This investment will help ensure our health-care system is there when Canadian families need it,” he said.
The right-wing Atlantic Institute for Market Studies think-tank has often disagreed with Dexter on health-care issues but backed him up Monday, at least to a point.
AIMS research director Don McIver agreed with the premier that there will be widely varying levels of service in the future. However, he said the ideal of roughly equal health care does not exist now.
“Divergence is an immediate reality; that’s what’s happening now,” said McIver.
“Every province has got a different set of rules, regulations and realities.”
McIver said his main hope is that all sides will drop what he sees as posturing and focus discussions on what should be funded and what should be health-care priorities.
Flaherty’s plan continues to increase health transfers to the provinces by six per cent up until 2016-17, at which point it will be tied to federal gross domestic product growth and inflation.
Dexter said that while the provinces will receive more money, the federal share of health-care costs is dropping and would slip below 20 per cent this year.
In 2011, Nova Scotia was set to receive just under $800 million in health transfers from Ottawa, which would make up about 21 per cent of the Health Department’s budget.