Nothing to see here, says Philpott, but Quebec lands blows over health costs

Anyone who showed up to watch a federal cabinet minister battle it out with her Quebec counterpart over health care funding negotiations would leave disappointed, warned Health Minister Jane Philpott.

That turned out to be wishful thinking.

Quebec's Gaetan Barrette and Philpott delivered conflicting visions of health care's future Thursday,underscoring a growing dispute between the federal Liberals and provincial and territorial leaders over a promised new health accord.

"At the beginning of the day, it always starts with funding — always," Barrette said in his speech to a conference organized by Canada 2020, a self-described progressive think tank, and the Canadian Medical Association.

"At the end of the day, it ends with what we can afford, which is never enough."

Prime Minister Justin Trudeau promised a new, long-term health funding agreement with the provinces and territories, but the premiers are unhappy that Ottawa appears intent on limiting federal funding increases to three per cent a year.

An annual increase of six per cent was set out in the last health accord, negotiated with then-prime minister Paul Martin in 2004, which expired in 2014. The previous Conservative government started the clock ticking on lowering that increase to three per cent, a cut that's scheduled to kick in at the end of the fiscal year.

The premiers are ramping up the pressure, demanding face time with Trudeau to discuss the issue — and they want a commitment before they are willing to talk about climate change, an issue dear to the Liberal government's heart.

Yukon Premier Darrell Pasloski, the current chairman of the group representing the premiers of Canada's 10 provinces and three territories, laid out the Council of the Federation's demands in a Sept. 15 letter to the prime minister.

The letter, obtained by The Canadian Press, says that if such a meeting doesn't happen soon, the federal government should feel obliged to delay retooling the funding formula for a year until both sides can reach an agreement.

Changes in the funding formula that are scheduled to start in the next fiscal year could cost the provinces $1 billion next year alone, the premiers say.

"With the 2017-18 federal budgetary cycle beginning in the coming weeks, it is important that first ministers act before these changes begin impacting Canadians," Pasloski wrote.

Philpott has been trying to shift the conversation away from the Canada Health Transfer by talking about a health accord that would set priorities in the areas of home care, palliative care, mental health and making prescription drugs more affordable.

Previous health funding agreements, she said, have failed at addressing fundamental structural problems with the Canadian health care system.

"Too often they have taken the status quo and inflated it," Philpott said in her own speech to the conference, which came immediately before Barrette's.

"I'm convinced that we have an obligation as the government of Canada to do more than simply open the federal wallet."

Barrette, however, appeared equally convinced of what sounded like the polar opposite.

"We need to fund first what is currently provided and needed before we get into newer programs," he said in his own speech.

Afterward, he said any talk of conditions such as improved efficiency or program areas is a "trap" the federal government is laying for the provinces and territories.

"Talking about conditions is their way not to talk about funding, and we're all trapped," he said.

"We're all talking about conditions: strings attached, no strings, loosely attached, tightly attached, whatever, but we are not talking about the real thing that comes first — funding."

Barrette also stressed the importance of getting a new health accord in place.

"It would be damaging to Canadians if we were not to have a proper health accord by the next budget. It would be damaging. There is no other word."

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