Once upon a time, Canada braced for a protracted and possibly painful health care funding debate between the federal government and the provinces. Some expected it to be a wedge issue of sorts in the last federal election, with each party stepping up to claim that it was best placed to preserve health care. However, when the writ dropped last spring and the governing Conservative Party of Canada (CPC) issued its platform, the debate ended before it started at the federal level. Right out of the gate, the CPC matched the Liberals’ promise to maintain the six per cent compounding increases set out in the 2004 Health Accord until 2014 and beyond. Indeed all the federal parties agreed and it became the great non-issue of the 2011 race.
Health care funding re-emerged in the Ontario provincial election just a few months later, with Liberal Premier Dalton McGuinty apparently making some inroads with allusions summoned by comments like his leader’s debate retort, “Who do you want sitting at the table with PM Harper to negotiate a new health care accord for Ontario?”
But McGuinty’s defender dreams also fell flat when the big announcement came from the feds in December. "In surprise move, Flaherty lays out health-spending plans til 2024," The Globe and Mail’s headline read. The CBC called the proposal a "bombshell."
The deal laid out a no-strings-attached arrangement for health care funding and eclipsed any kind of wrangling with the provinces. When the first ministers met this past weekend, it was not to strategize in advance of negotiations with the federal government as they had expected. It was to figure out how to react to an agreement the federal government said was a done deal. It’s certainly a bold move and one that will be discussed for at least as long as the deal is set to last (10 years). The premiers argued it was an “unprecedented and unacceptable” act of unilateralism on the part of the federal government.
It was also unexpected. Recall the Conservative Party platform released in April. It said:
RENEWING THE FEDERAL-PROVINCIAL HEALTH ACCORD
… Canadians expect and deserve timely access to high-quality health
care services. To help achieve that goal, we will work collaboratively
with the provinces and territories to renew the Health Accord and to
continue reducing wait times.
In our discussions we will emphasize the importance of accountability
and results for Canadians – better reporting from the provinces
and territories to measure progress, and guarantees covering additional
medically necessary procedures.
In the spirit of open federalism, when renewing the Health Accord we
will respect the fact that health care is an area of provincial jurisdiction
and respect limits on the federal spending power …
Campaign documents are just that, campaign documents, so it’s hardly fair to expect subsequent policy to directly mirror them. Yet they do mean something, and so it’s interesting to look back at them with the benefit of hindsight. The impression that the document gave at the time – to voters and presumably premiers alike – was that “discussions” and a collaborative approach would be employed by the CPC to achieve a national objective (high-quality health care). Ten months later, it seems that is simply not on.
But what’s equally interesting is the reference to “open federalism” in the third paragraph. To students of federalism and political junkies alike, open federalism has a very specific meaning as laid out by Prime Minister Harper in a 2006 speech when he was still the leader of the opposition. It argued that “a new way of life between federal and provincial governments was needed, one that would see the federal government back off from issues the provinces were supposed to control.” Mr. Harper put forward a principled view of a new federalism, one that features a strong central government that focuses on “genuine” national priorities like defence and the economic union, while extracting itself from provincial duties as laid out in the Constitution. It seems to also mean shifting the federal role in shared programs.
But it’s also worth asking if voters reading the 2011 election platform understood this as a distinct approach to federalism or how it might play out in this context of health care. I’m not sure that when I read it I connected it to that new vision of federalism which Mr. Harper laid out. Perhaps the premiers didn’t either. If they had, they may not have been so surprised by the health care funding announcement. And certainly anyone who merely grazes the platforms at election time could be forgiven for just seeing “open federalism” as a sunny way to describe how nicely collaborative discussion between the provinces and the federal government would be.
What do you think, reading the platform now, do you see the signs of what was to come? Do you see a contradiction between the sentiments expressed and the actions taken, or did the CPC actually give a fairly clear portrayal of what they might do on the health care file? Tonight’s program will talk about whether the prime minister’s approaches are substantially reshaping federalism. Do you think it’s high time for a shake-up for federalism? Would you have liked it to be a bigger part of the election last May? Are you happy with the direction that a new “open federalism” offers the country?
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(Photo Courtesy of The Office of the Prime Minister)
