How Ottawa can help fix health care: first, send less money
Neither can it be ascribed to any deficiency in federal assistance, much provincial rhetoric to the contrary. Total federal transfers in fiscal 2020, the last year before the pandemic, had; at $79-billion, they accounted for 18 per cent of provincial program spending, up from 14 per cent in 2002.
The Prime Minister will meet with the premiers early next month. Expectations that they will announce a deal there and then have been played down. But all of the noise over the past few weeks has been to the effect that the two sides are edging closer to an agreement: a sizable increase in federal transfers, in return for provincial acceptance of a handful of federal conditions, including – gasp – that they should publish comparable data on the state of their respective health care systems.
But another great dollop of federal cash, on top of the increases the provinces have already received, is not only unhelpful: it is a disaster. It would be a disaster even if Ottawa had the money,. It will probably be less of a disaster than it might have been, depending on how restrictive the rest of the federal conditions prove to be. It may even shorten wait times in the short run, just as the Martin “fix” did. But it will only make things worse in the long run.
With the benefit of hindsight we can see how misconceived the “buy change” thesis was. Politicians, like most people, are fundamentally risk-averse: they would rather avoid pain than receive an equivalent dose of pleasure. The political returns from reforming health care, if any, are far off in the future; elections have to be won in the here-and-now.
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