Negotiations on a long-term, health funding agreement with the provinces and territories will be at risk if the federal government doesn't bring more cash to the table, British Columbia's health minister said Tuesday.
In an interview with The Canadian Press, Terry Lake said he is troubled by recent signals from Health Minister Jane Philpott that the federal Liberals plan to limit annual health increases to three per cent — half the six per cent increase set out in the last agreement.
There is "no question" that annual increases of just three per cent would put B.C. under enormous fiscal pressure, especially with an aging population, Lake said. He noted provincial and territorial ministers have asked Ottawa to return to more traditional levels of health funding.
Lake said while he maintains a strong relationship with Philpott on issues including harm-reduction strategies and addressing B.C.'s opioid epidemic, he is concerned about the financing agreement as ministers prepare to meet in Toronto next month.
"I do think there's a bit of a risk if we don't make some progress on ... the discussion over the Canada Health Transfers, that there is going to be a lack of willingness to work together on a health accord," Lake said.
All of the health ministers understand there cannot be "unbridled" growth on health spending, he added, stressing the need for a sustainable system.
"It is a bit, ironic, I think, that a government that is really defending the Canada Health Act and public health care in Canada seems to be stuck on a very Conservative mindset around funding health care," he said.
Lake also admitted he was "shocked" when a promised $3 billion over four years for home care failed to materialize in the last federal budget, adding he doesn't know why this money has yet to flow.
Alberta Health Minister Sarah Hoffman said Tuesday the federal home care money would be welcome and the sooner the better, but she declined to comment directly on the rate of the federal health transfer, merely saying she looks forward to meeting her counterparts.
"I think if we have open dialogue and sharing of what our pressures are, then it enables my colleague, the federal minister of health, to be able to be a partner with me in the delivery of the Canada Health Act," she said.
Ontario and Manitoba were not as tight-lipped about their expectations.
In a statement, Ontario Health Minister Eric Hoskins said his province cannot support an earlier federal policy which would reduce growth in provincial health transfers next year to a level tied to nominal GDP growth.
"Ontario is not alone in expressing its concerns about the changes that the previous government introduced for the funding formula, which could represent a $1 billion decline in federal funding in 2017-18 alone," Hoskins said.
"We hope that the federal government will show some flexibility and a willingness to listen to the provinces and territories and work together with us in a collaborative way."
Manitoba Health Minister Kelvin Goertzen also acknowledged a dip in the federal heath transfer rate could represent a shortfall of $39 million from his province's heath-care budget.
"That's not an insignificant amount of money when the needs are great and growing," he said.
Speaking outside the Commons on Tuesday, Philpott tried to separate the discussion on the health accord from the push back on the transfers.
She characterized the Canada Health Transfers as financial mechanisms, while she stressed the accord is a shared arrangement.
"The health accord is basically an agreement between the federal government and the provinces and territories about what are our priorities for health," she said. "Where are the areas that we can actually work together to address some of the gaps in the health care system?"
Saskatchewan Health Minister Jim Reiter said the dialogue cannot be divided.
"Health care is the biggest part of our budget — it is about 40 per cent of the Saskatchewan budget overall and an increasing share," he said.
Reiter said his province is "obviously disappointed" about a proposed three per cent escalator clause, noting it will mean the province gets $30 million less.
"That's a significant hit to us."