Provinces seek one-year extension of health funding accord while they negotiate with feds

By The Canadian Press
December 8, 2016 - 11:00am

OTTAWA — Prime Minister Justin Trudeau's preference for discussing climate change over health care is being used as an argument by the provinces to justify extending the annual six per cent increase in health funding for at least another year.

Since 2004, federal payments to the provinces for health care have increased annually by six per cent. The Trudeau government intends to reduce that escalator to three per cent starting in April — a move provincial and territorial governments unanimously maintain they can't afford.

As premiers began arriving late Thursday for a first ministers' meeting on climate change, Saskatchewan's Brad Wall expressed frustration that health funding is to be dealt with only as an after-thought Friday, over dinner. Until first ministers have time to conduct substantive negotiations, he said it's only reasonable to extend the six per cent escalator for at least another year.

"This is the third meeting we've had with the prime minister on climate change," Wall said in a brief interview as he arrived for a dinner Thursday night that Trudeau hosted for U.S. Vice President Joe Biden.

"Fair enough. It's important. We've got health care and the economy, other issues to talk about. We're going to squeeze health care in at the end of the day tomorrow," Wall added.

"So I think because we're relegating it to where it is in the agenda and we're leaving it to the last minute, I think keeping the escalator as it is now for a year is a reasonable approach."

The scant time devoted to health care was not the only frustration to emerge Thursday. Indigenous leaders expressed their own frustration that they've been invited to a separate meeting with the prime minister Friday morning, ahead of climate change discussions with the premiers.

Natan Obed, the president of the national Inuit organization, said indigenous people should be directly involved in the climate change talks.

"There are parts of first ministers meetings that are specifically between provinces and territories and the federal government and that's fine, that's fair," Obed said.

"But for anything that affects our rights, that is about us, it doesn't make any sense for the first ministers to consider solutions and decide on solutions on our behalf without us in the room."

He pointed out that climate change, which has affected the North most severely, hurts the Inuit way of life.

Assembly of First Nations Ontario Regional Chief Isadore Day, the organization's co-chair on climate change, said First Nations deserve to be treated with the same respect as premiers and territorial leaders.

"First Nations need to be at that table in a substantive way," Day said. "The pre-meeting is a buffer zone, it is a filter, it is a firewall, it is certainly not an effective way to respect the relationship with First Nations in this country today."

The prime minister is to meet Friday morning with the leaders of three indigenous organizations — Inuit Tapiriit Kanatami, the Assembly of First Nations and the Metis National Council — along with U.S. Vice-President Joe Biden. The indigenous leaders want the premiers there, too, but have no confirmation they'll all come.

The Prime Minister's Office said Trudeau is looking forward to discussions with both the premiers and indigenous organizations to follow up on the government's plans to price carbon and phase out coal by 2030 and to discuss the federal government's recent decisions to approve the Kinder Morgan and Line 3 pipelines. However, there are no plans to formally bring the indigenous organizations into the first ministers' meeting.

The first ministers meeting is expected finalize the long-awaited pan-Canadian climate plan, laying out all the climate measures taken by various governments. However, it's not expected to include a balance sheet showing how each of those measures will help Trudeau reach his goal of reducing carbon emissions by 30 per cent below 2005 levels by 2030 — as he pledged to do at last year's U.N. climate conference in Paris.

Northwest Territories Premier Bob McLeod said provinces and territories are unified in understanding that the cost of doing nothing to fight climate change is far worse than acting to alleviate its effects.

"We all know that northern territories are the most affected by climate change, yet we are only a very small population and a very large land mass," he said in an interview. "A large part of the problem is nationally and internationally."

However, Wall made it clear he's fully prepared to be the odd-man-out; he will not sign onto any framework agreement that includes putting a price on carbon, as Trudeau has vowed to do.

While the dinner talk about health care could prove even more contentious, Nova Scotia Health Minister Leo Glavine outlined Thursday what appears to be a developing deal on health funding.

Glavine said his province could live with a smaller annual increase in the health transfer if the federal government puts enough money into a new health accord, which is intended to target funding on four priorities: homecare, mental health, innovation and pharmaceuticals.

The federal Liberals have promised $3 billion over four years just for homecare, but insiders say they're are open to offering more money over a longer period.

B.C. Health Minister Terry Lake said he'd be quite surprised if a health accord is negotiated by the end of the year, as federal Health Minister Jane Philpott had hoped.

Like Wall, he argued that the sensible thing to do would be to continue with the current six per cent formula while the provinces, territories and the federal government have an opportunity to negotiate a longer-term agreement.

"We've made very little progress moving this forward despite a lot of talk and subsequent meetings," Lake said in an interview, noting a lack of clarity is very difficult for his province to manage while it also attempts to handle a public health emergency over fentanyl.

"We are having a real dilemma putting together our budget not knowing what the contribution from the federal government will be."

—Follow @kkirkup on Twitter

Kristy Kirkup and Joan Bryden, The Canadian Press

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