Monday, January 30, 2017

Justin Trudeau uses divide and conquer tactic on health care funding

Just before Xmas last December the Liberal government offered the provinces a little more than half of what the previous right-wing Harper government had been paying Canadian provinces.

As mentioned in a previous Digital Journal article, the offer ran for just one day. There was no discussion of alternatives such as the 5.2 percent increase put forth by the premier of Prince Edward Island. Finance Minister Morneau's offer was 3.5 percent over five years. The Conservatives had been paying six percent. The rate will go back to three percent in April unless there is an agreement. The provinces were angry that the Liberal government came with a take-it-or-leave it attitude. They had hoped that there would be discussion and a negotiated agreement. The tactic shows the Liberal government is not willing to negotiate with the provinces but will try to impose policy on them, a policy far less liberal in its funding then that the right-wing Conservatives had been following. Ever since the meeting Ottawa has been trying with considerable success to strike deals with individual provinces.
Three eastern Liberal provinces broke ranks. First New Brunswick struck a deal and then Nova Scotia and, Newfoundland and Labrador. Also in the north Yukon and two territories came to an agreement with Ottawa. Now one of the prairie provinces, Saskatchewan, has also broken ranks and reached an agreement with Ottawa.
Saskatchewan has also reached a separate agreement with the federal government over private MRI clinics. The province will have a one year reprieve to show that private MRI's do not hurt the public health care system. Under the deal Saskatchewan will receive $190.3 million for home care and $158.5 million for mental health services but over ten years. The agreement comes just a day after the agreement with the Yukon, the two territories Nunavut and the Northwest Territories.
While Ottawa may have succeeded in destroying the solidarity among the provinces in opposing the original deal, the five most populous provinces have yet to sign, as well as Prince Edward Island. Even though they have struck a deal with the Liberal government, Saskatchewan and the territories added their signatures to a letter sent by the other provinces to the PM Trudeau:"Premiers remain united and determined in seeking a multilateral agreement. Premiers also recognize that provinces and territories face unique local circumstances, which led some of them to sign bilateral health agreements. However, premiers representing 90 per cent of Canada's population continue to seek a fair deal for long-term health funding from the federal government."
The holdout provinces have said the deal offered by Ottawa last December will further reduce the federal government's share of health spending to unacceptably low levels. Health care is jointly funded by the provinces and the federal government with each province having its own plan that must be in accord with the Canada Health Act. The federal funding helps out particularly those poorer provinces who have problems funding the level of service of richer provinces, so that there is a more uniform quality of service across the country.
The Quebec health minister criticized the Saskatchewan agreement and argued that the agreement on MRI's violated the law as MRI are to be free and publicly paid for. Saskatchewan allows residents to pay for an MRI test in a private clinic. In return the private clinic must offer a scan free to someone on the public waiting list. Back in November Jane Philpott, the federal health minister warned the Saskatchewan health minister that under the Canada Health Act the federal government could withhold funds from provinces that charged for medically necessary services. Federal officials claim that the MRI agreement is unrelated to the deal on funding. Obviously it sweetens the deal for Saskatchewan.
The Saskatchewan Health Minister Jim Reiter said that Saskatchewan would have a year to prove to the Liberal government that its policy on MRI's is consistent with the Canada Health Act. Of course it is de rigeur in Canada for politicians to claim they support our health care system, even Conservative Premier Stephen Harper did so. However politicians at the same time would like to "modernize and improve it" often by having more private involvement which pleases some lobbyists and can bring in more donations. Philpott's office displays the common rhetoric in its statement:"Minister Philpott is committed to working with Saskatchewan to strengthen our publicly funded, universal health-care system, while at the same time upholding the principles of the Act, and has asked officials to work with Saskatchewan officials over the next year in this regard,"Among the ways the Liberals are strengthening the system is by reducing funding and refusing to negotiate funding with the provinces. When a province such as Saskatchewan introduces private for profit services as with the MRIs, it does not punish the province but gives it a year to show that it does not harm the operation of the Canada Health Act. Former Conservative PM Harper who was always criticized by the Liberals provided almost twice as much.

No comments: