Ottawa

What did the Conservatives promise on health transfers?

The Harper government is apparently eager to cap increases to health transfers after 2016 and is apparently willing to argue that their election promise to increase transfers at 6% per year was limited to two years. The Ontario government seems to think that’s not quite what the Conservatives promised.

… Ontario government officials pointed to an interview Mr. Flaherty gave to the CBC during the campaign. “We will keep it at 6 per cent for whatever the duration of the agreement is,” Mr. Flaherty said last April, adding that the length of the new accord will be negotiated with the provinces. “It could be two years, five years, whatever.”

During the election—on Friday, April 8, to be specific—Michael Ignatieff promised to maintain the 6% increase and challenged Stephen Harper’s willingness to do likewise. The Conservatives duly responded.

Here is how the CBC reported that day’s events.

When Conservative Leader Stephen Harper released his party’s platform on Friday, he said he would continue the six-per-cent health transfer increases, though he didn’t specify they would go beyond 2014. “This government has been very clear not just in this document but in all our budgets,” Harper said. “We are planning on a six-per-cent ongoing increase for health transfers. We have been very consistent on this.”

A Conservative spokesman later said the transfers would continue past 2014, the first time the Conservatives have pledged to maintain the escalator clause at six per cent after the 2004 health accord concludes. Leona Aglukkaq, who was the health minister in the last session of Parliament, has only ever pledged to maintain them until 2014.

In an interview with CBC’s Power & Politics with Evan Solomon on Friday evening, Finance Minister Jim Flaherty confirmed the base figure will remain the same. “The annual growth figure that we’ve been using these past several years will continue at six per cent,” Flaherty said. Asked by Solomon whether that would continue past 2014, Flaherty said yes.

Here is how CTV reported that day’s events.

“What we are saying today is when that accord runs out in 2014, our government — a Liberal government — will commit to maintain the six per cent escalator in health investment into the future so that all provinces can have stability as they plan to maintain, extend, renew and improve amazing facilities like this one,” Ignatieff said, speaking at Hamilton’s Juravinski Cancer Centre.

Within moments of that speech, the Conservatives responded, saying that a six per cent rise has already been factored into their long-term plan. Campaign spokesman Ryan Sparrow said in an email to The Canadian Press that “we are flattered to see Mr. Ignatieff agree to our commitment.”

And here is how the Sun reported the situation.

The Liberals, Tories and NDP all committed Friday to maintain the current 6% compounding increases set out in the 2004 Health Accord. And while the Liberals officially promised to keep the payments increasing beyond 2014, when the accord expires, both Conservative and New Democrat party officials confirmed their parties’ pledge to do the same beyond the deal’s expiry date, too.

The official Conservative election platform actually included no mention of the 6% escalator, but in a news release sent out 17 days later, the Conservative campaign referenced the promise three times.

Our low-tax plan to eliminate the deficit while protecting Canada’s universal health-care system by maintaining 6 per cent annual increases in federal transfers to the provinces and territories … A re-elected Conservative Government will build on our strong record of protecting Canada’s universal health-care system by increasing funding for health care by 6 per cent per year and making sure that Canadians see better treatment from the new money … Eliminating the deficit while protecting Canada’s universal health-care system by increasing federal funding by 6 per cent per year.

Reelected on May 2, the Conservatives then wrote the 6% promise into the Speech from the Throne.

Our Government is committed to respecting provincial jurisdiction and working with the provinces and territories to ensure that the health care system is sustainable and that there is accountability for results. It will maintain the six percent escalator for the Canada Health Transfer, while working collaboratively with provincial partners to renew the Health Accord and to continue reducing wait times.

If there was an asterisk to that promise, I’ve so far only been able to find it referenced in a piece from the Canadian Medical Association Journal, originally published on April 18.

When the writ dropped for the 2011 federal election, no one expected any of the political parties to spell out their intentions for annual transfer payments for health care made to the provinces after 2014, once the current intergovernmental health accord expires. In fact, conventional wisdom held that it would be foolish to do so, given that there was no way to forecast what the economy might look like or how much the government might be able to afford. Moreover, experts argued that any promise to maintain unconditional 6% annual increases in health transfers ad infinitum would put the government of the day behind the eight-ball at the negotiating table. Why would any province agree to any manner of accountability measures if they knew the federal government would open its coffers come what may?

Conventional wisdom, though, quickly proved wrong as the Conservative, Liberal and New Democrat parties indicated that the 6% escalator clause will be maintained post-2014 (www.cmaj.ca/earlyreleases/4theRecord.dtl). They essentially affirmed their stances in response to a health spending question in CMAJ’s 2011 election survey (see below).

But each of the vows come with something on the order of a rider.

The Conservatives have been careful to limit their escalator commitment to that specified in the recent federal budget (www.budget.gc.ca/2011/plan/Budget2011-eng.pdf). In that budget, which was not approved by Parliament, an increase in federal transfers for health care is prescribed for exactly two years after the accord expires, i.e., to $44.7 billion 2014–15 and $47 billion in 2015–16. When asked if that constitutes a commitment ad infinitum, a Conservative spokesman carefully restated that the escalator commitment is precisely that specified in the budget. Translation: the promise doesn’t necessarily extend beyond 2015–16.

If anyone can find Mr. Harper, Mr. Flaherty or any other Conservative candidate stating on the record that the 6% promise covered only the two fiscal years after 2014, please let me know.

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