OTTAWA - Provincial officials are setting the stage for a tough round of negotiations when they meet the federal health minister this week in Toronto to discuss the future of health-care funding.
Speaking separately, Ontario Premier Kathleen Wynne and Quebec Health Minister Gaetan Barrette re-affirmed the need for more federal money for health care.
"There are a number of areas that all of the provinces are struggling with, and at the same time, we recognize that there needs to be some base-funding increase," Wynne said last week in Ottawa. "So that's the conversation that we're going to have with the federal government."
And Barrette warned that any attempt to put conditions on how health-care dollars are spent could fuel the province's sovereigntist movement.
"If the federal government intends to feed the sovereigntist camp and its new leader in Quebec, that is exactly what they will do," Barrette said in an interview last week.
Provincial health ministers will sit down with Health Minister Jane Philpott on Tuesday to negotiate a new health accord.
Prime Minister Justin Trudeau promised a new, long-term health funding agreement with the provinces and territories, but the premiers are unhappy that Ottawa appears intent on limiting federal funding increases to three per cent a year.
An annual increase of six per cent was set out in the last health accord, negotiated with then-prime minister Paul Martin in 2004, which expired in 2014.
The previous Conservative government started the clock ticking on lowering that increase to three per cent, which is scheduled to kick in at the end of the fiscal year.
Wynne, who has been a close ally with Trudeau on most matters, said the federal government "wants to work with us."
However she also predicted that "it won't be an easy conversation." She expects an eventual agreement, but "exactly how long that will take, I don't know. And exactly what that will look like, I don't know."
Philpott has previously tried to shift the conversation away from the Canada Health Transfer by talking about a health accord that would set priorities in the areas of home care, palliative care, mental health and making prescription drugs more affordable.
Previous health funding agreements, she said, have failed at addressing fundamental structural problems with the Canadian health care system.
But Barrette pushed back against suggestions Ottawa could set such priorities, noting the Liberals have agreed to accept the cap-and-trade systems set up by Ontario and Quebec to fight climate change in lieu of a carbon tax.
"Why is this the approach with climate change and not with health?" he asked. "Explain that to me."
Ake Blomqvist, a health economist at Carleton University, expects the negotiations between Philpott and her provincial counterparts will be bitter. He said it's unfortunate that a discussion about one of the most important issues in Canada has come down to "bickering" about money.
"The main issue that concerns me is that a lot of intelligent and highly paid people spent all their time on this bickering about money," he said, "when in fact there are many things that probably should be done in health policy in terms of reforming the way our system works."
Efforts to get Ottawa to provide more money to the provinces have been underway for months. Yukon Premier Darrell Pasloski, chairman of the group representing the premiers of Canada's 10 provinces and three territories, laid out some demands in a Sept. 15 letter to Trudeau.
The letter said that if such a meeting doesn't happen soon, the federal government should feel obliged to delay retooling the funding formula for a year until both sides can reach an agreement.
Changes in the funding formula that are scheduled to start in the next fiscal year could for example cost Ontario $1 billion and $39 million for Manitoba, the provincial health ministers said.
— With additional reporting by Keith Leslie in Ottawa and Vicky Fragasso-Marquis in Montreal.
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