The Harper government's decision to tie health funding increases to nominal GDP by 2017 could motivate some provinces to turn down the federal cash, walk away from the standards set in the Canada Health Act, and introduce their own dual public/private system.
This scenario was put forward by the Globe and Mail's John Ibiston who believes it might make sense for some provinces to develop their own health care system, independent of Ottawa.
"Federal funding currently accounts for about 20 per cent of provincial health budgets," he wrote in his column on Tuesday.
"If costs increase annually above nominal GDP, which they might as the population gets older and sicker, then the federal contribution could become proportionately so meager that one or more provinces may decide it's cheaper to impose copayments or let the rich purchase private care, and forgo the federal cash."
At least 6 provincial and territorial ministers voiced their displeasure with the new plan introduced, unilaterally, by Finance Minister Jim Flaherty in Victoria on Monday.
"The provinces will lose out on $21 billion over the life of the deal," Ontario Finance Minister Dwight Duncan said, according to CBC News.
"True, it does not take place for a few more years … But it represents a significant move away from the health-care table by the federal government."
Quebec Finance Minister Raymond Bachand called the process "totally unacceptable."
But Ibiston explains that Quebec, Ontario, and the other provinces have little choice but to accept the new deal.
"Liberal prime ministers Paul Martin and Jean Chrétien caused no end of trouble because they wanted to impose national standards on the health system as the price for any increased funding," he wrote.
"Since the federal government is attaching no conditions to this deal, thus requiring no protracted negotiations, it alone decides how much it will give."
It's a take it or leave it deal - we'll see if any provinces 'leave it' come 2017.
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