There is no better example than public health, even more to the forefront during the prolonged COVID pandemic. While this remains a provincial responsibility under our constitution, the federal government has paid a substantial portion of the costs for many decades. Yet because the money is provided unconditionally, the federal level has no way of ensuring that these funds (or the revenues from the “tax room” that it provides to the provinces within the income tax field) are actually allocated to health care. Indeed, various provinces have allocated at least some of the money to other purposes or used it to support cuts in provincial taxes. The result has been a patchwork of programs that vary widely even though diseases like COVID pay no attention to provincial boundaries (or international ones for that matter). The provincial premiers met again recently and, as usual, demanded more federal money for health care while rejecting any suggestion that the federal government should have assurances that it would be spent where intended. A good summary of the ever-changing federal-provincial financing of health care is provided by Picard. [Opinion: Squabbling over the federal-provincial split in funding won’t fix the health system - The Globe and Mail]
We Pay No Matter Who Provides Health Care
Overlooked in the ongoing federal-provincial squabbling over the financing of health care is the fact that the money comes from the same pockets no matter who provides the revenue. Our system of health care in Canada was already under pressure before the COVID pandemic hit and things are now close to the breaking point. This is not the time for provincial posturing and more financial demands – especially when provinces like Ontario ended the past fiscal year with well over $1 billion unspent of the federal funds provided to deal with COVID. With hospitals overwhelmed and some emergency departments closing periodically from lack of staff, one wonders why funds aren’t being directed to this critical situation. Why is the Ontario Government still capping public sector wage increases to one percent annually at a time of several labour shortages? Why has that government only extended (at the last minute) a paid sick leave program covering just three days for work missed from COVID? Such an arrangement will inevitably have people returning to work prematurely, further spreading this relentless disease.
Enough is enough! We are sick of the bickering and posturing, the efforts to claim credit or shift blame. As we face the almost certain escalation of COVID later this year, federal and provincial politicians must put aside their differences and focus exclusively on how best to allocate funds and resources to combat and overcome this health crisis. That may be a tall order, but the crisis we face is unprecedented and demands no less.