Harper said Monday there's no more money for the provinces, but that didn't stop the premiers — who say they've heard the no-money mantra from past prime ministers — lobbying for more negotiations and ultimately more cash.
B.C. Premier Christy Clark said the premiers are united in pushing back against Ottawa's take-it-or-leave-it plans for health transfer payments, calling the plan "unprecedented and unacceptable."
"I don't think the conversation is over by a long shot," Clark said after hearing comments Harper made during a CBC program. "I'm not even sure the conversation has ever really started. We need to get it started."
Clark and Canada's other premiers and territorial leaders are meeting in Victoria until Tuesday to discuss health care. She said other prime ministers have said in the past that their offer is final but negotiations have shaken loose more money.
"In the 50 years of these discussions, there's always been dialogue and over those 50 years there have been occasions where the federal government has said this is our final offer and then further negotiation has happened."
That doesn't look likely, judging by Harper's comments.
"I know the provinces will always ask for more money," he told Peter Mansbridge in an interview.
"What I think we all want to see now from the premiers who have the primary responsibility here is what their plan and their vision really is to innovate and to reform and to make sure the health-care system's going to be there for all of us.
"I hope that we can put the funding issue aside and they can concentrate on actually talking about health-care."
Clark has earlier praised much of federal Finance Minister Jim Flaherty's decision to provide health funds to the provinces without strings. But she said the plan to deliver it on a per-capita basis requires tweaking because it does not take into account that seniors cost more to take care of than those who are younger.
"What we will see is a system where we're not able to support seniors care across the country," she said.
"The money that would previously have gone to supporting seniors' care will be going to support people who are in middle age or younger."
Nova Scotia Premier Darrell Dexter agreed, saying Flaherty's per-capita-based funding model introduced last month at a finance ministers gathering in Victoria places "an extraordinary burden on the system."
Flaherty was accused late last year of imposing the new federal health funding plan on the provinces and territories during what Ontario, Quebec and four other provinces said were unprecedented, one-sided meetings.
"Equal funding is not necessarily equitable funding," said Dexter.
"This is the problem. We have 16 per cent of our population currently over the age of 65 in our province. We're going to move from 16 per cent over the age of 65 to almost 30 per cent over the next 20 years."
Ontario Premier Dalton McGuinty said he wants to see Ottawa get back to the negotiating table.
"As a Canadian, I rely on the federal government to bring us all together," he said. "Leadership on health care by the feds is not an option, it's a solemn responsibility."
McGuinty said he was disappointed that Harper said he was not willing to participate in further health-care talks with the provinces.
"We need the federal government to be an active, committed participant in this," he said.
"It is unacceptable for the prime minister to says he's effectively going to passively preside over the evolution of health care in Canada."
Quebec Premier Jean Charest gave a hint of some of the divisions among premiers. Western ones have been mostly supportive of the plan of tying health transfer payments to economic growth after 2017, while the angriest words about the plan have come from east of Manitoba.
"On Canada generally, what I see is interesting and also quite simple," he said.
"There’s two realities in Canada — there are the economies of oil, gas and potash and others. That’s the reality of Canada and once we know that, we need, I think, to be able to make decisions accordingly and that’s the financial situation of the country and we need to take that into account as we move ahead."
Dr. John Haggie, president of the Canadian Medical Association, said the premiers at the meetings have an opportunity to look at new ways to fund and improve Canada's health-care system despite Ottawa's insistence on a strict funding model.
"The opportunity lies in how the provincial and territorial premiers approach that funding envelope," said the surgeon from Gander, Nfld., who is at the Victoria meetings.
"I think there's a lot of scope within there to do things without necessarily demanding simply more dollars."
Haggie said the Canadian Medical Association recently conducted nationwide surveys that indicate nine out of 10 Canadians want national health-care standards, meaning the same level of care across the country.
But the surveys also suggest Canadians were not as supportive about leaving health-care standards up to Ottawa, he said.
Under Flaherty's plan, Ottawa will continue increasing health transfer payments at six per cent annually until 2017. After that, health transfers would be tied to the rate of economic growth and inflation, currently estimated to be about four per cent, but the government will never let the amounts fall below three per cent.
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