Week 11: Canadian Federalism, the Canadian Social Union and Health Policy Flashcards
Pre 1980
1957- Hospital and Diagnostic services act
1966 Medical care act
1977 Established programs financing (EPF)
1966 Medical care act
Funded through Canadian assistance plan (CAP)
50/50 cost sharing
1977 Established programs financing act
Shift from cost sharing to block funding
Transfer of tax points to provinces/territories
Increased based on economic growth and population growth
Transfer of tax points to provinces/territories
Federal government reduced what is collected in federal tax from citizens and allows provincial government to increase taxes at a similar rate
What caused the greatest one-time decrease in the proportion of health care spending paid for by the federal government?
Established programs financing
Canadian Health Coalition and Ontario health Coalition
Advocate in favour of publicly funded health care system in opposition to user fees and privatization
Federal government should pay a larger share of health care costs
1980-1984
Maintaining government roles
1984-1988
Restraining social program costs
1988-1997
Restructuring the role of government
1997- present
Repairing the social union
1984-1988 Restraining social program costs
Weakening of government commitments to health and social programs
Neoliberalism strongly influenced government policy
How much of a reduction in health transfers from federal to provincial/territorial government occurred btwn 1986-1998?
41.2 billion
1988-1997 Restructuring the role of government
Concern with government budget deficits due to the economic recession
Significant reduction in federal health care spending
What replaced EFP in 1995?
Canada Health and Social transfer
Canada Health and Social Transfer
Federal contribution at a rate based on the previous year with adjustment for GDP at provincial level
One funding envelope for health care, social spending and post-secondary education
Federal spending cuts made during Canada health and social transfer act
$6 billion
Repairing the social union (1997-2016)
- Recognition that the social union was deteriorating
- 1999 budget
- Health accords
- 2011 Conservative scaling back
- 2015 Liberals promise new health accord
Recognition that the social union was deteriorating
Relationships btwn levels of government was becoming less cooperative and less constructive and the existence of shared set of norms, standards and objectives of social citizenship were lost
1999 budget
Increase in health and social transfers of 11.5 billion from federal gov to provinces and territories
Health Accords
2000 health accord
2003 health accord
2004 health accord
2000 health accord
Accord on health care renewal
Increase of 21.2 billion over 5 years
Further specific funds for diagnostic and emergency equipment, primary care reforms and adoption of modern IT system
2003 health accord
Established health council of Canada
Separated Canada health and social transfer into Canada health transfer and Canada social transfer
Added more federal funding for primary health care, home care and drug coverage
2004 health accord
Increased funding of 41 billion over 10 years
6% increase per year
Additional targeted funding for wait time reduction, primary care, home care and drug coverage
2011 Conservative scaling back
Once 2004 accord expired in 2014, the conservative government increases health transfers by 6% per year until 2016 after which they would tie increases to economic growth (3.5% per year)
2016-2017 Failed health accord negotiations
Federal government proposed a 3.5% increased in funding per year with no additional increased tied to economic growth
$11.5 billion in additional funding for entire 10yr period for mental health, home care and drugs
Did the provinces and territories accept the proposed health accord made by the federal gov in 2016/2017?
NO
What happened instead of the proposed federal accord in 2016/2017?
Federal government signed bilateral agreements with each province and territory
What did the bilateral agreements lead to?
$31 billion shortfall
Gives provinces and territories incentives to cut costs (pressure)
Decreased federal authority to play a role and improve medicare
National pharmacare program unlikely
What reduction in funding by the federal government has occurred since medicare was established?
Went from 50% to 22% today
July 2019 premiers call for new health accord
Calls for new Canada health transfer increase of 5.2% and an increase in federal contributions from 22% to 35%
Social union framework agreement (1999)
Umbrella under which governments will concentrate their efforts to renew and modernize Canadian social policy
Primary objective of Social union framework agreement (1999)
Reform and renew Canada’s system of social services
Recognizes that reform is best achieved in partnership among provinces, territories and federal government
Liberal vs Conservative federal health care base funding
Provide same level of funding
Which era of funding least reflects the influence of neoliberal ideology?
Repairing the social union
What is most likely to be the increase in core federal funding for Ontario’s health system from 2021 to 2022?
3.5%
What are the criticisms of the social union framework agreement ?
Lacked an enforcement mechanism
Quebec was not a signatory
Failed to change politics of social policy
What year did provincial governments fund the greatest proportion of the costs of their health care systems?
1998
What percentage of health care costs does the federal government currently pay for?
22%
