The Premiers want more money, but will they get it?

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We're back after a ten million month summer (time has basically come to a stop during this pandemic — anyone? anyone?) and what better way to celebrate our return than with a speech from the throne.

It sounds exciting — speech from the throne! My stepson asked me if there would be a throne in England and a sword fight. I told him the literal answer to his question was no, but otherwise, he's kind of right. The swords could be out after this throne speech because the stakes are so high; the prime minister has promised a vote of confidence will follow which means an election could too.

Political nerds like myself have spent the last four weeks (as I write that I realize I'm a bigger nerd than I even thought) trying to figure out what the speech will say. Will it talk about being green? Getting out of the red? There are so many possibilities. 

The premiers have jumped in on the game too. They have a wish list for the throne speech, one, that for the most part, varies depending on the province but maintains one common thread; money.

Money, money, money. If there's one thing a group of premiers can get on the same page about, it's asking the federal government for more money. Their ask in this case is also not a new one; an increase to the Canada Health Transfer, or the CHT. 

Before you start snoozing, let me explain. I promise this stuff is actually really interesting. Health care is always a concern for Canadians, but even more so right now (you know, in the middle of a pandemic). Funding the delivery of health care is a dual dance-card kind-of-thing where the federal government and the provinces share the burden. 

Under former prime minister Stephen Harper, the government changed the annual rate of increase for the CHT. They call it the escalator (sounds like a type of superhero but I assure you, it's not). The current government, led by Prime Minister Justin Trudeau, adopted the formula set out by the Tories when it was set to come into force in 2017. 

Cue the outcry from the provinces; from the time it was suggested by the Tories to the time it was implemented by the Grits and ever since. The pandemic has only amplified the ask from provinces. Saskatchewan Premier Scott Moe (the outgoing head of the Council of the Federation) and newly re-elected New Brunswick Premier Blaine Higgs were both on Power and Politics this week making the case. 

"Where it started out originally [ it ] was kind of a 50/50 split: federal, provincial. Now it's like an 80/20 throughout the country; 80 per cent provincial, 20 per cent federal," Higgs told me. "And that's a problem; we have rising health care costs everywhere."

Late last week the prime minister agreed to a conference call, focused on the subject, to happen sometime this fall. And while that might raise expectations that there's more money coming on a permanent basis, my guess would be; not so fast. I say that for a couple of reasons. 

First, the federal government just handed a giant wad of cash to the provinces. $19 billion, up from the $14 billion the prime minister initially offered. Between $10 billion and $11 billion of that is specifically for health care. 

Second, in the past, the Liberals have focused additional transfers to provinces on targeted areas. Think back to the 2016/2017 saga over funding for mental health and home care. The then health minister Jane Philpott went from province to province until she had a deal with each of them. One by one they broke rank with each other after originally saying they would band together and not take side-money until they got a substantial increase to the CHT. 

Philpott, now out of government and heading Queen's University's School of Medicine, says the federal government might repeat what worked for them last time; rather than an overall increase to the CHT, it could deliver more targeted funding for long term care and perhaps even pharmacare. 

"Will the federal government come forward and say we will actually provide additional dollars, probably in the order of billions, to support better long term care," Philpott posed as a possibility. "That will allow the federal government to say that there have to be certain national standards, which many are calling for as a mechanism to be able to deal with what we've seen in the last number of months."

So my guess is a big promise to increase the health transfer escalator (there's an exciting phrase) is not coming in the throne speech per se; but we do know there will be a "conversation" in the not too distant future and probably some movement on the federal government's part by next year. "Some" movement though likely won't be anywhere close to what the provinces want. I say that with the caveat that my predictions have been savagely wrong before; so don't hold me to it.

Read more : This is just one part of the Minority Report newsletter. In this week's issue, Éric Grenier looks at where the parties stand in the polls ahead of the throne speech. Sign up for the newsletter here and it will be delivered directly to your inbox every Sunday.