An Opportunity for the Provinces?
George Smitherman

At the recent huddle of the Premiers out in British Columbia it became
uncomfortably clear that the Prime Minister had beaten them at their
own gain.

Through a series of co ordinated initiatives the Prime Minister defused
the health care bomb even as the conspirators in the sector were
plotting it’s assembly.

It didn’t come cheap mind you. A 6 % escalator in these times sure can
help take the sting out of things. More interesting perhaps is that the
Prime Minister has decided to cap his fiscal risk and move along. This
is a big shift away from the Federal Government saber-rattling about
the Canada Health Act and counter to the earlier signals that the federal
government would be tying money to results.

The really sad bit in all of this is that a federal presence is essential
to achieve a relative equity amongst provincial health care programs.
Furthermore, progress towards some form of national pharmacare is
rendered hopeless, considering the central role the Feds play in the
drug approvals process and other regulatory functions.

The news is not all bad though. It might be counterintuitive but I think
that the Prime Minister has done the Premiers a huge favour. Rather
than spend the next two years preparing for a face-to-face showdown
with the Prime Minister the Premiers are getting on with a process to
display the benefits of the reforms they have already undertaken.

Let us hope that the people who get the privilege of packaging up these
reforms will see this as the defining tasks of their professional careers,
for these reforms offer the promise of Medicare 2.0.

Perhaps it’s not what they had in mind, but I think that they are going to
surprise themselves with what they find.