Week 11- Canadian Federalism,The Canadian Social Union and Health Policy

Question 1

1980-1984 federalism

Answer 1

• Maintaining government roles

Question 2

1984-1988 federalism

Answer 2

• Restraining social program costs

Question 3

1988-1997 federalism

Answer 3

• Restructuring the role of government

Question 4

1997-present federalism

Answer 4

• Repairing the social union

Question 5

What act was created in 1957

Answer 5

• Hospital insurance and diagnostic services act

Question 6

What act was created in 1966

Answer 6

• Medical care act

Question 7

What act was created in 1977

Answer 7

• Established programs financing

Question 8

Medical care act

Answer 8

• Funded through canada assistance plan
• 50/50 cost sharing

Question 9

Established programs financing

Answer 9

• Shift from cost sharing to block funding
• Transfer of tax points to provinces and territories
• Increases based on economic and population growth (goes down during recessions etc)

Question 10

What was the goal in 1980-1984

Answer 10

• Maintaining government roles

Question 11

What was the goal in 1984-1988

Answer 11

• Restraining social program costs

Question 12

What was the goal in 1988-1997

Answer 12

• Restructuring the role of government

Question 13

What happened during restraining social program costs

Answer 13

• Weakening of government commitments to health and social programs
• Reductions of $41.2 billion in health transfers

Question 14

What happened during restructuring the role of government

Answer 14

• Concern with government budget deficits
• Significant curtailment of federal health care spending
• One funding envelope for health care, social spending, and post secondary education
• Federal spending cuts of $6 billion

Question 15

What happened during repairing the social union

Answer 15

• Recognition that social union was deteriorating
• 1999 budget
• Health accords

Question 16

1999 budget

Answer 16

• Increase in health and social transfers of $11.5 billion

Question 17

Health Accord

Answer 17

• Provides provinces and territories with stable health funding and sets national standards

Question 18

2000 health accord

Answer 18

• Increase of $21.2 billion over 5 years and provided further specific funds for diagnostic and emergency equipment, primary care reforms and adoption of moder IT systems and provincial health care systems

Question 19

2003 health accord

Answer 19

• Established health council of Canada, separated CHST into CHT and CST. provided more homecare and catastrophic drug coverage and established the health council of canada to monitor and report on health care and population health issues

Question 20

2004 health accord

Answer 20

• Increase of $41 billion over 10 years. Known as the ten year plan to strengthen health care. Prime minister Paul Martin described it at the time as the fix for a generation. It provided for an increase of 6% in base funding per year, along with additional targeted funding for wait time reduction, primary care, home care and drug coverage, which altogether represented an increase in federal funding of $41 billion over 10 years

Question 21

What happened in 2011

Answer 21

• Federal conservative government unilaterally announced scaling back of increases starting in 2014. The federal government unilaterally announced that when the 2004 health accord expired in 2014, they would keep the 6% increase in health transfers until 2016/2017, after which they would tie increases to economic growth, including inflation, which they estimated would be about 3.5 to 4% per year. But they promised that increases would never be less than 3%

Question 22

What happened in 2015

Answer 22

• Liberals win federal election promising new health accord with the provinces and territories. Justin Trudeau became prime minister

Question 23

What happened in 2016-2017

Answer 23

• Failed health accord negotiations

Question 24

Failed health accord negotiations

Answer 24

• Federal government tabled “take it or leave it” proposal - it adopted the Harper government’s increase of only 3.5% per year, with no additional increase tied to economic growth , along with $11.5 billion in additional funding in total for the entire ten year period for mental health, home care and prescription drug innovation
• Rejected by provinces and territories

Question 25

Bilateral agreements with each province and territory

Answer 25

• Estimated $31 billion shortfall - ontario’s share is 13.6 billion
• Gives provinces/territories incentives to cut costs (privatization & user fees)
• Decreases federal authority to play role to protect and improve medicare
• National pharmacare program unlikely

Question 26

When did calls for a new health accord happen

Answer 26

• July 2019