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Les Leyne: Liberal-NDP plan for dental, pharmacare coverage could sideline premiers' pleas for more health money

Canada’s premiers have been tearing their hair out about Ottawa’s declining share in the funding of health budgets
Prime Minister Justin Trudeau meets with B.C. Premier John Horgan during a break from the GLOBE Forum at the Convention Centre in Vancouver on Tuesday, March 29, 2022. THE CANADIAN PRESS/Chad Hipolito

National dental care and pharmacare represent the biggest expansion of medicare since it was invented.

But you have to wonder how much money they’re going to suck away from the federal transfers to provinces that keep basic health care operational.

Canada’s premiers have been tearing their hair out about Ottawa’s declining share in the funding of health budgets across the country for years.

The council of the federation, the name they call themselves when they get together, mounted yet another campaign on Tuesday on that theme. Premier John Horgan currently chairs the entity.

As part of the “awareness campaign,” he stressed the need for increased, predictable and sustainable federal funding. It flows from the Canada Health Transfer, which is how the federal government moves health funding to the provinces.

The council of premiers said it is the most effective mechanism for Ottawa to support significant improvements for all Canadians while enabling provinces and territories to address their own needs.

The federal government currently covers about 22 per cent of provincial health care budgets. Premiers want that hiked to 35 per cent, plus guaranteed five per cent hikes every year after. That would be an increase to $69 billion a year from $42 billion last year, for starters.

So they reiterated their invitation to Prime Minister Justin Trudeau to begin negotiations without further delay so that an agreement can be finalized as soon as possible.

But they are extending the invitation to someone who just agreed to adopt the NDP’s dental care dream in order to secure his term in power for three more years.

The new federal Liberal-NDP confidence agreement stipulates that the dental care for lower-income families (under $90,000 a year) will start this year and be fully in force by 2025. Independent estimates of the cost are difficult because the scope isn’t defined. But it will be in the billions.

The confidence agreement, which has the effect of a signed contract just like the B.C. version in 2017, also requires “continued progress toward a universal national pharmacare program” by passing a Canada Pharmacare Act by the end of 2023. It would essentially match what B.C. has, and likely be even more expensive than the dental care program.

So in the middle of an on-going push by premiers for more secure funding to keep basic health care functioning, Trudeau has committed to two dramatic expansions of health care.

Canada’s health-care system is a dilapidated old mansion that needs a full-scale renovation. But the confidence agreement means that he’s going to build two expensive new wings on the old pile as it stands.

The confidence agreement doesn’t ignore the perpetual funding crisis of the system as it exists.

It recognizes the system is “stretched” because of COVID, and the parties realize that additional ongoing investments will be needed in the immediate future.

But that section is a lot vaguer than the specific promises on pharmacare and dental care. It contains a lot of boilerplate background about the need to work together and get better data. That’s been the federal Liberals’ holding line for the past few years when premiers come begging for more health money. Worth noting: it doesn’t even mention the Canada Health Transfer specifically.

Horgan sat down with Trudeau for an hour in Vancouver on Tuesday. He pressed the case for more cash, among other topics. But he must have debated how to raise questions about these expensive new promises while the premiers are still begging for basic funding. He signed a similar confidence deal with the Greens in 2017, so he knows the first imperative is power.

Earlier in the day his government was subjected to another grilling about critical failures in the health care system as it exists today. Opposition Liberals charged that 200,000 more people have lost their family doctors over the NDP term, bringing the number to 900,000. They pressed Health Minister Adrian Dix on the shortage of GPs, delays in opening a new medical school and the roadblocks that impede foreign-trained doctors from practicing in B.C.

Dix cited urgent and primary care centre expansions and said 634 family doctors have been added in five years.

Liberals reminded him the physicians’ master agreement with the province expires Friday. That could prompt another reminder of how acute the need for more federal health money is.

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