Hopes low that dinner with PM will lead to health deal

Prime Minister Justin Trudeau and the premiers will discuss the broad outline of a new health accord at a working dinner on Friday night, but multiple federal and provincial sources say it is unlikely to lead to a deal.

The premiers demanded this discussion on health care as a condition of their participation in the first ministers' meetings on climate change. Several premiers say that health transfers trump climate as the number one federal-provincial issue and wanted to deal directly with the prime minister in an attempt to jolt the stalled talks.

Earlier this week, the federal government signalled a willingness to sign a longer-term health accord with the provinces in a bid to end that standoff.

• Ottawa open to long-term health accord with provinces: source
• Justin Trudeau agrees to discuss health care with premiers Friday

The rate at which health transfers increase is set to decline next year to three per cent a year, from six per cent.

The Liberals have been promising a top-up of $3 billion over four years, but only if the provinces agree to spend it on home care and mental health services.

A senior federal official told CBC News this week that Ottawa is willing to extend the timeframe of that offer — essentially, more money for more years, but still with the condition that it goes to home care and mental health. 

But while some provinces were encouraged by that flexibility, others doubt it will be enough to reach a final agreement.

Some provinces — notably Quebec — don't want any strings attached to the health transfers.

In a broader sense, the provinces argue that health transfers are too low. Right now, 22 cents of every health care dollar comes from Ottawa. The province want to that to increase to 25 cents, but are willing to give Ottawa a few years to reach that level.

Then there are specific regional demands from the four Atlantic provinces and Manitoba, who want extra money to deal with demographic challenges such as an aging population and higher incidents of chronic disease.

Deal could come late December

A federal source, speaking on condition of anonymity, conceded Friday's dinner was unlikely to win over the premiers. But it might lead to a road map for a deal later this month, at a finance ministers' meeting tentatively set for Dec. 19, that could be expanded to include the health ministers.

Provincial reaction on that is mixed. Some provinces are willing to let that happen if it leads to a new health accord. Others are reluctant to move these talks down from the first-minister level. One provincial source, speaking on condition they were not named, told CBC News that the premiers took a stand when they demanded a first ministers' meeting on health and don't want to punt the final negotiations to their ministers.

Federal Health Minister Jane Philpott has been pushing to sign a new health accord by the end of this year. Talks, to this point, have not gone well. In October, health ministers clashed during a day of tense negotiations. Since then, Newfoundland and Labrador has publicly complained that talks have "gone silent."

Officials from some provinces have complained that it has been difficult to get the federal government to engage on health care, or any issue not connected to the prime minister's climate change agenda.