OTTAWA — The Trudeau government may not be winning friends among Canada's premiers as they try to wring more health-care funding out of Ottawa, but its hard line seems to be garnering support from an unlikely ally.
Interim Conservative leader Rona Ambrose, herself a former health minister, supports the idea of a results-driven approach to federal health funding. She also agrees that more money isn't the only solution.
Rona Ambrose speaks in the House of Commons on Dec. 13, 2016. (Photo: Adrian Wyld/CP)
And a huge increase in federal health spending over the last decade, indicators like hospital wait times remain a disappointment, Ambrose noted in a recent interview with The Canadian Press.
Those positions don't leave a lot of daylight between herself and federal Health Minister Jane Philpott, Ambrose acknowledged: "I noticed."
There's less than a week to go before the Liberal government is scheduled to meet with the provinces and territories to try and find common ground on a new health accord and a federal health-funding plan.
The two sides appear to be far apart, particularly when it comes to health transfers.
'Money is not the answer anymore'
Provinces and territories are worried they will be left with big holes in their budgets if Ottawa allows the annual six-per-cent increase in transfers to fall to three per cent in April, as it's already scheduled to do.
The federal government has accused the provinces of channelling health payments into their general revenue pools, and wants to take a new approach that allows it to measure results from any extra investment.
In many respects, Ambrose appears to agree with that idea.
"For the last 10 years, health care's been increased by about six per cent every year — that vastly outpaces the growth in the economy," she said.
"I think there's an acknowledgment by everyone in the system, including leading health-policy experts, that money is not the answer anymore. There's got to be other solutions and it has to result in better outcomes."
Health Minister Jane Philpott speaks in the House of Commons on Oct. 5, 2016. (Photo: Sean Kilpatrick/CP)
The Liberal government invited health ministers from across the country to join federal Finance Minister Bill Morneau next week in Ottawa when he sits down with his provincial and territorial counterparts.
Before the meeting, Morneau will notify the provinces and territories about the size of next year's transfer payment amounts.
Saskatchewan Health Minister Jim Reiter, who received an invitation to the meeting early Wednesday, said in an interview that he plans to attend. But when asked about the chances of a deal, Reiter replied: "I really don't know."
"If whatever number's on there — if that's hard and fast — then I'm not sure exactly what we're supposed to be negotiating next week," he said of Morneau's forthcoming transfer calculations.
"It just concerns me that somehow there's this insinuation that transfers from the federal government aren't being spent on health care."
Analysis shows provinces didn't boost health spending
Independent analysis has shown that for years, the provinces didn't boost their health spending by anything close to six per cent per year.
The Canadian Institute for Health Information said the annual average growth in health spending by provincial governments was just 2.7 per cent between 2011 and 2015.
The last health accord expired in 2014 and, after refusing to renegotiate it, the previous Tory government unilaterally declared that the six per cent escalator would end in 2017.
The provinces want the feds to extend the six per cent increase to help them deal with the pressures that an aging population continues to exert on their ability to deliver quality health care services.
Feds could shave $1.1B off payments
Instead, the increase is set to fall — either to its earlier level of three per cent or the three-year moving average of nominal gross domestic product growth, whichever of the two is higher.
Morneau's fall economic statement included projections that nominal GDP would expand by 1.8 per cent in 2016, 4.3 per cent next year, 3.7 per cent in 2018 and four per cent in 2019.
If health transfers were left to grow by three per cent next year — instead of six per cent — the federal government would shave nearly $1.1 billion from its combined payments to the provinces.
Ambrose, who served as health minister under then-prime minister Stephen Harper from 2013 to 2015, said even a three per cent floor would still cost the federal government a lot of money each year.
"This can't just be about throwing more money at the issue."
Some provinces have suggested they could accept lower annual increases in health transfers if Ottawa agrees to finance a long-term health accord that targets improvements in home care, mental health services and innovation.
The Liberal government has promised an additional $3 billion over four years, specifically for home care. They have also signalled a willingness to increase that sum.
Earlier this week, Ontario Premier Kathleen Wynne proposed a 10-year federal funding plan that would see federal health transfers increase by 5.2 per cent a year.
She cited reports by the Conference Board of Canada and the parliamentary budget officer that have suggested 5.2 per cent is the actual rate of inflation on health-care systems.