Health Minister Jane Philpott says the Liberal government won't increase the health-care funding formula imposed by former prime minister Stephen Harper's government.
"That conversation is largely a conversation between finance ministers and at this point I have no reason to believe that we're going to change that," Philpott said in an interview with Evan Solomon, host of CTV's Question Period.
The provincial and territorial governments have been guaranteed six per cent increases in their transfers from the federal government since former prime minister Paul Martin struck a deal with them in 2004. In 2011, with the deal approaching expiration, the Harper Conservatives told the provinces and territories that they were cutting the annual increase, known as an escalator, to three per cent - with the possibility of more depending on the country's economic growth.
The new formula is to start next April, despite six years of protests by the premiers.
"I do not intend to push for an increase in the escalator," Philpott said.
"I know that the provinces and territories are hoping for new investments in health care, and I hope that we will be able to deliver those. We've already made it clear about [committing] $3 billion for home care. I want that in the 2017 budget."
But Philpott warned the only way to get new health funding into the next federal budget is to reach agreement "by roughly the end of this year." She says she hopes to meet her provincial and territorial counterparts around mid-October to work on a possible deal.
"I want more investment…. We're prepared to discuss further investments in areas like innovation," she said.
Prime Minister Justin Trudeau promised during last year's election campaign to collaborate with his provincial and territorial counterparts on a new health accord, but the only money the Liberals pledged was $3 billion for home care.
Nova Scotia Premier Stephen McNeil says the decrease in the annual escalator will be the second hit to provincial health budgets, which could change how services are delivered. On top of the change to the annual increase, the Conservatives amended the funding formula to base it on size of population alone, without taking into account the average age of the province's citizens. That's hurt provinces with older populations who require more health care and earn smaller incomes, resulting in less tax revenue.
"Let's see what the negotiation looks like," McNeil said in an interview on Question Period.
"This is the number one issue for every Canadian province. This is our single biggest line item, delivering health care to our citizens."
The Canadian Institute for Health Information, which collects and analyzes data on health care, reported in 2015 that total health spending in Canada hit $219.1 billion, or $6,105 per Canadian. CIHI also reported health-care spending isn't keeping pace with inflation and population growth, and that it's decreased an average of 0.6 per cent a year since 2011.
This year, the federal government will transfer $36.1 billion to the provinces and territories for health care, out of a total federal budget of $296.6 billion.
An agreement is possible, McNeil said, if the federal government offers substantial funding for home care, adolescent mental health, or catastrophic drug coverage, all of which are costly for the provinces.
"Let's see if that's the number they stick with. Let's see if they add on to that, quite frankly, in terms of the delivery of adolescent mental health or mental health in general... What do they add in terms of catastrophic drug coverage that we as the provinces are already covering? Can we use some of the funding that we have then to continue to deliver the services, looking at wait times and making sure that we have physicians in communities across the province?"
"As long as they're coming forward with the kind of funding that will be required, there will be some flexibility in some of the funding that we have. But it has to be substantive enough that we can deliver the services that Canadians expect from coast-to-coast."