Planned changes to Ottawa’s Canada Health Transfer in the 2028-2029 fiscal year will likely result cuts of more than $50 billion for health care in Canada’s provinces and territories over the subsequent decade, a report published this early morning by the Canadian Federation of Nurses Unions concludes.
That is, of course, unless Canada’s provinces decide to put more money into their public health care systems to make up for the expected shortfall of federal cash – and we all understand why that’s not going to happen, even in provinces that unlike Alberta aren’t bent on dismantling public health care entirely and replacing it with a U.S.-style health care catastrophe.
The report by Canadian Centre for Policy Alternatives health policy researcher Andrew Longhurst and CFNU government relations officer Nate Little projects that if the Canada Health Transfer escalation formula reverts as planned to its previous rate from the 5-per-cent growth in the rate paid since the 2017-18 federal fiscal year the result will be a loss of $51.8 billion from what would have been paid if the rate continued to rise at 5 per cent a year as it does now.
That’s an estimate, of course, so while someone is likely to argue it could be less, history suggests it will likely be more.
Sorry, dear readers, but this is complicated because the federal formula for determining how much to pay through the Canada Health Transfer is based on projections of Canada’s gross domestic product and have changed for various reasons from time to time over the years.
So, as the CFNU report puts it, with “the CHT growth escalator reverting to a three-year moving average of nominal GDP growth with a 3-per-cent floor in 2028-2029 … the federal government projects that nominal GDP growth will be about 3.8 per cent per year from 2008-2009 to 2030-2031.” Ottawa expects an average growth rate of 3.8 per cent annually in that time frame.
This is the kind of calculation that makes ordinary citizens’ eyes glaze over as they return to working out how to feed the kids and gas up the truck right now. By the way, had the 6-per-cent escalator rate in effect from 2006-07 to 2017-18 remained, the loss to cumulative CHT funding would be approximately $98 million lower, the report indicated.
As the report’s authors explained, the cut to funding currently anticipated by Ottawa “risks plunging provincial and territorial health care systems into a deeper crisis.” I would suggest, though, that “risk” is the wrong word here. A worse crisis is a virtual certainty.
What that means, in case there’s any doubt in your mind, is more deterioration in Canada’s health care system, more excuses for provincial governments like Alberta to propose co-pays, private billing and private insurance as “solutions,” and a swifter drift for most of us into the Third World system that exists already south of the U.S.-Canadian border.
As CFNU President Linda Silas put it more politely in a news release accompanying the report this morning, the expected cuts will “create a drastic reduction in public health care funding, and it is patients, nurses and health care professionals who will bear the weight of this austerity measure.”
“There is no way around it,” she continued, “a reduction in federal funding will hurt access to care for everyone in Canada.” Well, not quite everyone. Don’t worry, the ultra-wealthy will be just fine.
The report’s authors note that additional cuts to federal health care are also looming: $1.2 billion for home and community care and mental health and addiction care set to expire next spring and $600 million more for long-term care will expire soon after that.
Short-sighted cuts to public health care, Ms. Silas said, “come with the added risk of making privatization schemes even more appealing to provinces and territories. We know that public health care creates strong value for our economy and at the same time delivers better patient outcomes and better access to care than for profit services.
“Now is the time to invest in Canada’s public health care system, not undermine it,” she concluded.
Indeed. But while Prime Minister Mark Carney may lead a political party called Liberal, other than the fact there are no known or suspected Alberta separatists in his caucus, there is not a lot of light between his policies and those of the Opposition Conservatives. To give him his due, though, they’re more competently delivered than they likely would have been by a government led by Pierre Poilievre.
That said, for all his talk about nation building, Mr. Carney seems to have missed the obvious point that Canada’s public health care system was and continues to be the greatest national-building project since the railroad-building spree of the 19th and early 20th centuries.