Could Maxime Bernier kill universal health care?
Maxime Bernier’s
proposal to end federal transfer payments to provinces to help fund health services would make the Canada Health Act “unenforceable,” says a spokesman
for his front-running campaign for the Conservative Party of Canada’s leadership—which means the fate of universal care would rest entirely in the hands of provincial governments.
In an email exchange with
Maclean’s this week, Bernier’s director of communications, Maxime Hupé, at first asserted that even if Ottawa stopped sending the provinces any money for health, the law would continue to apply. “Provinces would still have to respect the Canada Health Act that ensures universal coverage,” Hupé initially said.
But that was a strange claim. The landmark 1984
federal law’s purpose, as clearly set out in the act, is to establish the rules provinces must comply with to qualify for transfers. Provincial health insurance plans, the act stipulates, must be publicly administered, comprehensive, available to everybody, portable and accessible—or the federal government can hold back money.
Pressed for reasons why provinces would still have to adhere to the act’s five principles if billions in annual transfers were no longer at stake, Hupé said he consulted with Bernier’s policy advisor and corrected the campaign’s position. “The CHA is only enforceable politically by the threat of reducing transfer payments,” he said. “Without transfer payments, it is unenforceable.”
Yet Bernier argues that universal health care would survive in Canada if Ottawa left it up to the provinces. He points to the force of public opinion—not just in Canada, but throughout the developed world, except in the U.S.—which remains solidly behind universal coverage.
Bernier’s plan calls for the federal government to give the provincial governments room to hike their taxes, making up for the loss of transfers. (In 2017-18,
federal Canada Health Transfer to the provinces is expected to total just over $37 billion.) After that, he says the provinces would assume full responsibility for health, which falls under provincial jurisdiction in the Constitution.
“With this reform, the provinces will no longer have excuses, but they will be empowered to fix the system,” Bernier said last fall in
his key speech on the subject. “They will stop constantly begging for more money and won’t be able to blame Ottawa for their failure to tackle wait times.”
His reference to wait times is critical.
Bernier builds much of his case for radical reform around long waits for care. Indeed, a survey by the Commonwealth Fund, a New York-based foundation that studies health care, found Canadians tend to wait longer to see a doctor than patients in 10 other developed countries.
It’s far from clear, though, that highlighting frustrations over wait times will be enough to make Bernier’s plan a politically saleable one for Conservatives. In the past, the party’s election strategists have rejected Liberal and NDP claims that Tories were not really committed to universal care backstopped by Ottawa’s spending power. On his way to winning a majority in the 2011 campaign, for example, Stephen Harper’s campaign repeatedly declared that Conservatives “strongly support for the Canada Health Act.”
Ontario MP Michael Chong in the leadership race. Chong has been blunt in his criticism of Bernier’s health policy. “By eliminating the federal health transfer, and proposing to do a one time tax-point transfer from the federal government to the provinces, he’s effectively eliminating the Canada Health Act,”
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Could Maxime Bernier kill universal health care? - Macleans.ca