Aglukkaq's letter to provincial health ministers: slip-slidin' away

PostMedia’s Jason Fekete is a good reporter who writes about serious things, so I’m a little nervous to note I read Leona Aglukkaq’s new letter to provincial health ministers pretty much the opposite of the way he reads it. Maybe I’ve got it wrong. Wouldn’t be the first time. Let’s go through it.

Fekete says Aglukkaq is “calling for more teamwork” and “urging the provinces” to adopt a national approach to measuring health outcomes and “proposing greater collaboration.” An activist, what. Before I explain why I read it differently, I’ll point out that at least Fekete and PostMedia think a statement from the federal health minister on health transfers is worth covering. I sure do think they’re right on that, and at this hour they don’t have a lot of company.

Anyway. Aglukkaq’s letter is short enough to run in full. Here you go:

I am writing to follow up on my letter of December 20, 2011 and this week’s Council of the Federation meeting.

I have appreciated the opportunity to meet with several of you in recent weeks to discuss how we can best work together to deliver on our collective commitment to a health system that provides all Canadians with timely access to the best health care possible.

I welcome the Council of the Federation’s initiative to form the Health Care Innovation Working Group and I agree that “more can be done together”. In that spirit, I reiterate my commitment to work with you to address our shared priorities in the renewal of our heath care system.

 As you know, the federal government invests over $1 billion in innovation through the Canadian Institutes for Health Research, Canada Health Infoway, and other programs supporting research and health human resources. This is in addition to our recently announced long-term, stable funding arrangement that will see transfers reach $40 billion by the end of the decade. Federal health care contributions will continue to increase to record levels, and we have certainty around future levels of the Canada Health Transfer and other major federal transfers. This stability and a shared commitment to innovation and accountability provide a solid foundation for our efforts to optimize the results of our health care investments.

 I would be pleased to continue to engage in intergovernmental discussions and actions with respect to innovation, improved accountability and other areas that will enable better, more sustainable health care. We could also pursue a coordinated approach to measuring and reporting performance across jurisdictions in order to improve health care for Canadians.

 As health ministers, we are all focused on improving the health of Canadians and our health care system, and Canadians are best served when we work together. I look forward to further discussions with you on these matters as we work together to improve quality of life of families from coast to coast to coast.


Leona Aglukkaq, P.C., M.P.

Second paragraph: “The opportunity to meet with several of you” is a subtle way of saying she hasn’t met with all of them as a group. (UPDATE: Well, she did meet them in Halifax on Nov. 24-25, before the feds tabled their transfer plan. My bad.) Which is why Christy Clark and the other premiers sounded like kids at the dance who can’t find anyone to dance with when they met earlier this week. Harper federalism is built on private meetings in different cities, which ensures the provinces can’t gang up on the fed, and that it won’t be clear who’s telling the truth if accounts of all those conversations diverge.

Third graf: “More can be done together,” she says — quoting the provinces — and then she “reiterates” her “commitment” to work with them. But then she reveals what she thinks working with the provinces is. The feds already spend $1 billion on innovation, she asserts, citing two programs introduced by Jean Chrétien more than a decade ago, and then she spends the rest of a long paragraph justifying Jim Flaherty’s “announced” — i.e., not proposed and not negotiable — “long-term, stable funding arrangement.” Now, as I’ve already written, the provinces should be pretty happy with what Flaherty proposed announced. But if they’re hoping for more, or for some kind of innovation sidecar newer than anything Chrétien did, so far they’re not getting much from Aglukkaq.

Onward. “I would be pleased to continue to engage in intergovernmental discussions,” apparently much like the ones she’s already had in a series of capitals that have left her admiring the Chrétien legacy and Flaherty’s December announcement. “We could also pursue a coordinated approach to measuring and reporting performance across jurisdictions.” I dunno; what do you wanna do? I dunno; what do you wanna do? Well, we could pursue a coordinated approach to measuring and reporting. I’ve seen more urgent phrasing in my day.

And here we are at the bottom of the letter. “I look forward to further discussions with you on these matters.” How much does she look forward to those discussions? Here’s a hint: she proposes no date, no venue and no agenda. For a test of her eagerness, watch for her response when a provincial minister proposes a date, a venue and an agenda.

I don’t think this is a complete stonewall. I suspect there will be something in the next budget that the feds can point to as a contribution to (pick one) innovation, collaboration or accountability. But I see nothing in this letter to suggest it will substantially modify or supplement Flaherty’s announced transfer schedule.

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