From www.hilltimes.com
By ALLAN MASLOVE |
Published: Friday, 01/08/2016 12:00 am EST
In the Speech from the Throne and since, the new Liberal government has clearly said it is ready to re-engage with the provinces and territories on health care. This is a welcome development. For most of the past decade, the Harper government was distinctly unwilling to provide any leadership or even play a secondary role in health care reform.
The fact that the new Trudeau Liberal government is ready to work with the provinces and do so quickly is a big step forward. But the prospect has likely raised many expectations of what new arrangements might emerge.
First, many players will be looking for more money to flow from Ottawa to the provinces. But the Harper government, even as it withdrew from active participation, committed to adequate transfers to the provinces until 2024. There may be legitimate debates about the distribution of those transfers across the provinces, and there may be some new funding called for to support new initiatives in areas such as pharmacare or mental health, but the federal money now on the table in support of the range of health care services is more or less adequate.
The health care problems we face are not the result of insufficient spending. In fact, more money may be counterproductive.
The primary focus of any new accord needs to be on the structure of the federal-provincial arrangements. The most commonly visualized instrument seems to be a return to something like the Health Accords of 2003 and 2004. Indeed, the Minister of Health referred to a promised re-engagement in these terms. What these accords did was to identify a number of problem areas—most notably, wait times—where provinces pledged remedial actions to remedy them and Ottawa committed to increasing cash transfers to be used at the discretion of provincial governments.
The expression at the time was that the cash transfers would “buy change” necessary in the health care system. But the link between the provincial actions and the federal money was tenuous at best in 2003—and all but absent in 2004.
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