Canada health ministers funding talks end with one-year bridge

The Canada health ministers funding talks closed Friday in Winnipeg with a one-year, $1.2-billion extension for mental health, addictions and home care, but no promise of the long-term deal provinces had been demanding. Federal Health Minister Marjorie Michel and her provincial and territorial counterparts ended two days of meetings having agreed mostly to keep talking, with another round of negotiations expected before the end of the year. For now, the services the expiring agreements covered stay funded, and the hard bargaining about what replaces them waits for December.

The Canada health ministers funding announcement came late Wednesday, the night before the ministers sat down together. Michel posted on social media that Ottawa would extend funding agreements that were set to expire at the end of March, the Winnipeg Free Press reported. Provincial ministers had spent weeks warning that letting the agreements lapse would have profound and negative effects on patients and on health-care jobs across the country.

The extended agreements cover mental health, substance-use treatment and home and community care, several areas where provinces have been stretching thin budgets. The Canada health ministers funding debate has been sharpest around these programs because they were negotiated as separate bilateral deals on top of the main health transfer, making them the first thing to fall off a cliff when the clock runs out. Wednesday's extension pushes that cliff back, but only by a year.

Bridge dollars, no long-term deal

Michel described the money as bridge dollars rather than a major announcement. "The work is starting today. It's not like a big announcement," she told reporters in Winnipeg, according to the Globe and Mail. Not everyone was reassured. Ontario Health Minister Sylvia Jones said a twelve-month extension of an existing ten-year agreement on the verge of expiring did not fill the province with joy. Manitoba's Uzoma Asagwara, who hosted the meetings, took a warmer view, saying Friday that Michel had been asking sharp questions and listening closely to provincial concerns.

What the ministers did agree on was process. Their officials will start drafting the next stage of agreements, aimed at carrying the health system through the coming decade, and the ministers themselves will meet again by December to take stock. Michel said agreements signed a decade ago need updating, as the Winnipeg Free Press reported,, and promised the redesign would be done together with the provinces rather than imposed by Ottawa. The Canada health ministers funding fight is therefore not over; it has simply been given a timetable.

The Canada Health Transfer question

The deeper dispute is the Canada Health Transfer, the main channel for federal health money. Provinces want the transfer to keep growing at a minimum of five per cent a year. The federal budget instead schedules the minimum growth rate to fall to three per cent later this decade. Manitoba alone received $2 billion from the transfer this fiscal year, up from $1.3 billion nine years earlier, a measure of how much provinces have come to rely on steady federal increases.

Doctor and nurse groups who traveled to Winnipeg left wanting more. The Canadian Federation of Nurses Unions said health care should be treated as an investment and urged the prime minister to defend it more loudly, while the Canadian Medical Association and the Canadian Nurses Association said they wished Ottawa had offered more clarity this week. Both groups had pressed for stable, predictable funding rather than stopgap extensions. The Canada health ministers funding extension was treated as breathing room, not a solution, and it did not settle that demand.

The next test is the federal budget, which has been moved to the fall with no date announced. The Canada health ministers funding bridge keeps current services covered through the extension period, but the provinces made clear they consider a single-year renewal a temporary fix. Whatever happens in December's talks, and in the budget, will determine whether bridge dollars turn into something built to last.

The Canada health ministers funding negotiation will ultimately turn on that transfer, since it dwarfs every bilateral side deal the ministers argue about each year.

Sources: the Globe and Mail via NewsBeep, the Winnipeg Free Press via NewsBeep.