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Posted Jan. 11/07
A province’s ability to provide health care depends on the reliable transfer of funds from the federal government. During the deficit fight in the 1990s, the transfer was cut dramatically and repeatedly, affecting the provinces’ fiscal ability to deliver health care. With the First Ministers’ Accords on Health Care Renewal in 2003 and 2004, the health transfers were restored. But will the same thing happen again to the health care transfer during times of economic crisis?
- Allan Maslove was the founding dean of the Faculty of Public Affairs. (Photo: Trevor Lush)
Allan Maslove, professor in the School of Public Policy and Administration, examines the changing patterns of intergovernmental fiscal relations. He looks at ways to restructure the transfer to make it more secure.
“When the federal government played games with the transfer, the provinces debated its role in health care and became distrustful,” says Maslove. “If there is a way to make the transfer more secure, could the federal government have a stronger national voice for health care? There could be a case made for a continuing, stronger federal role if the provinces were assured of constant funding.”
Maslove’s solution, published in How Ottawa Spends 2005-2006 – an in-depth annual examination of how the federal government spends the tax dollars of Canadians and sets national policies and priorities, published by the School – is to create the Canada Health Security Fund: a fund set up outside the normal budget process that would protect designated annual revenues. To access the funds, provincial governments would need to meet conditions for providing health care.
“There is a partial precedent for such an arrangement,” he says. “The government already has off-line funds for things like the Foundation for Innovation.”
While such a fund would offer less budgetary control to the government in power than the normal process, Maslove feels that health care is a sufficiently unique public service that it justifies a special funding arrangement.
“Citizens would see no differences in their taxes,” he says, “but with a predictable revenue flow for the provinces, they should see better quality services.”