Canada’s premiers say they are ready to move forward with negotiations on Ottawa’s bilateral health deals, but they are also calling for a formal review process for future health funding talks.
The review process they are asking for would pertain to existing deals that are expiring and future negotiations on the Canada Health Transfer.
In a letter to Prime Minister Justin Trudeau Thursday, the premiers say they need more long-term predictability in planning for their health-care systems.
They want a formal review process of the federal government’s health-care funding plans to be established for expiring bilateral health funding agreements by January 2025.
Specifically, they point to the “fiscal cliff” of uncertainty over the scheduled expiry of already-established health funding deals, including 10-year agreements signed in 2017 and 2018 with the provinces that earmarked money specifically for mental health, home care and community care for seniors.
A formal review of these expiring deals is needed “to secure service continuity and funding predictability for programming,” the premiers say in their letter.
Provincial and territorial leaders also want a review looking at the “future path and adequacy of the Canada Health Transfer and the escalator.”
“To achieve our shared goals, further constructive discussions are required to plan for the longer term predictability and stability that Canadians expect in their health care systems,” the letter states.
Last week, Trudeau met with all 13 premiers in Ottawa and presented them with a funding package aimed at addressing their demands for more federal investment in health care.
The federal offer will infuse $46.2 billion in new money for health care over the next decade on top of pre-established health funding streams from Ottawa, which altogether will send $196.1 billion to the provinces and territories over the next 10 years.
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The funding package includes a number of elements, including $25 billion in new money for 10-year bilateral deals to be negotiated with the provinces and a $17-billion increase to the annual Canada Health Transfer, which includes an “escalator,” or guaranteed minimum increase, of five per cent over five years — up from the current three-per-cent escalator.
The bilateral agreements will be tailored to each region’s specific needs, but focused on four key areas: improving access to family doctors and primary care; addressing health worker shortages; improving access to mental health and substance use treatment and modernizing the health system through improved collection and sharing of health data.
To access these new funding streams, provinces and territories will have to agree to spend the money on measures that support these priority areas and they will be required to develop “action plans” that describe how funds will be spent and progress measured.
In their letter to Trudeau Thursday, the premiers noted they have been pressing Ottawa for two-and-a-half years to increase the federal transfers to the provinces, and while they have decided to accept the deal on the table, it’s not as much money as they wanted.
“We are disappointed with the limited new federal funding,” the premiers say in their Feb. 16 letter.
“While this first step marks a positive development, the federal approach will clearly not address structural health-care funding needs, nor long-term sustainability challenges we face in our health-care systems across the country.”
That’s why they say a broader review of how health funding agreements are negotiated and determined in the future is necessary.
“We look forward to necessary ongoing dialogue to support the future of health care services across the country – an issue that will always be a fundamental priority for all Canadians.”