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What will Trudeau’s promised Canada Health Accord look like?

Health care rally

It would appear that a Canada Health Accord is back on the table with incoming Prime Minister Justin Trudeau. One of the key promises in the Liberal platform this election stated, “We will negotiate a new Health Accord with provinces and territories, including a long-term agreement on funding.” Today, the Globe and Mail reports, “After almost a decade of Stephen Harper’s Conservatives insisting, dogmatically, that health is strictly a provincial jurisdiction, the biggest change in Ottawa will be philosophical or cultural – the arrival of a government that believes Ottawa has a key leadership role to play in health care.”

Hopefully part of that “key leadership role” will be a greater share of funding to the provinces for public health care.

In December 2011, the Harper government announced a new funding formula – not negotiated with the provinces, but rather presented in a unilateral fashion – that meant the federal government would commit to a six per cent annual increase in 2014 to 2016, but then just a minimum three per cent annual increase between 2017 and 2024. In January 2012, then-Parliamentary Budget Officer Kevin Page said he expected this funding formula would cost the provinces about $31 billion over the ten year period. In July 2012, the premiers forecast the cut would be $36 billion.

But while the implication has been that Trudeau will not cut that $36 billion, that promise is not exactly explicit, and as the Globe and Mail article notes, “Mr. Trudeau has promised to promptly negotiate a new health financing deal, but has not made any firm financial commitments or set a deadline other than to say he will convene a first ministers conference every year.”

In the lead-up to those federal-provincial negotiations for the Canada Health Accord, the Council of Canadians will continue with its longstanding campaign demands for a 10-year accord annual 6 per cent increase in health care transfer payments to the provinces, at least 25 per cent federal funding of provincial health care costs, a prohibition on user fees and privatization, and a commitment to public solutions.

Additionally, the Liberal platform also promised to make “prescription drugs more affordable”. The Globe and Mail highlights, “[During the election, Trudeau] spoke mostly about doing bulk buying to bring down costs, but also made clear that his priority will be to ensure patients with so-called ‘catastrophic’ costs for expensive drugs used to treat cancer, arthritis get help.” Regrettably, this promise is not the same as a public drug insurance plan, otherwise known as pharmacare. That said, the Romanow commission (back in 2002) did recommend catastrophic drug coverage as a first step towards pharmacare. The Council of Canadians will call on the Trudeau government to fully implement pharmacare.

And the Liberal platform is clearly pro-free trade stating, “Trade is vital for our economy. It opens markets, grows Canadian businesses, and creates good-paying middle class jobs.”

But the Canada-European Union Comprehensive Economic and Trade Agreement (CETA) and the Trans-Pacific Partnership (TPP) mean longer corporate patents for pharmaceutical drugs, delays to the introduction of lower cost generic drugs, and higher costs to the public purse for these drugs. CETA would mean an additional two years of patent protection with the aim of providing about thirteen years of market exclusivity for pharmaceuticals. The TPP would provide a monopoly extension of five years as a minimum standard (with a voluntary standard to extend that by another three years) on biologic medicines. The CETA provision alone could cost our public health care system up to $1.65 billion every year.

Our argument is that “free trade” is not compatible with public health care and pharmacare. And Canadian public opinion is decisive on these issues. An Environics poll commissioned by the Council of Canadians in December 2013 found that 65 per cent of Canadians oppose longer patents for prescription drugs in CETA. And an Angus Reid poll released this July found that 91 per cent of Canadians support a national pharmacare program. The Liberals stated in their election platform that, “Properly negotiated and implemented, free trade agreements are good for the Canadian economy.” Given the implications on health care, do the Liberals believe that CETA and TPP were “properly negotiated”?

Among the other questions at this point:

  • Who will be the health minister? We will know on November 4 when the cabinet is sworn in, but the Globe and Mail has speculated that it could be Hedy Fry, Carolyn Bennett, John McCallum or Ralph Goodale.

  • When will the federal-province conference to negotiate a Canada Health Accord take place? The date has not been announced, but it would make sense for it to take place before April 2016 (the expected timing of the new Liberal government’s first budget).

For more on our campaign to defend and expand public health care, please click here.