Front Burner - Trudeau’s $196B pitch to fix health care

Episode Date: February 8, 2023

Prime Minister Justin Trudeau met with all 13 of Canada's premiers on Tuesday to pitch his plan for increased health-care funding to provinces and territories. The measures would amount to over $46 billion in new funding and – combined with what Ottawa was already planning to pitch in – totals almost 200 billion in total federal health-care spending over the next decade. Today, CBC chief political correspondent Rosemary Barton breaks down the details of the proposal, discusses why many provinces and territories say it isn't enough, and recaps the latest from Ottawa.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Jamie Blissow. Canadians deserve to know that every new dollar being announced today is exactly that, a new dollar that will go towards the improvements in health care that Canadians need. That is Prime Minister Justin Trudeau speaking in Ottawa yesterday after hosting a meeting with all 13 of Canada's premiers.

For over two years now, provinces and territories have been asking for a new deal on health care funding. And yesterday, Trudeau pitched his big plan, more than $46 billion of new spending over the next decade. So if we add that to what the feds were already planning to pitch in, that would mean almost $200 billion in federal health care spending over 10 years. Now is the time to step up, to meet this moment, to do what it takes to reinforce the defining Canadian institution that is universal public health care.

Ottawa's proposal might seem like an eye-popping amount of money, but it's actually still quite a bit less than what the provinces and territories wanted. For more on this, I'm joined once again by CBC's Chief Political Correspondent, Rosemary Barton. And we're going to talk about this deal and then later catch up on what's been happening in Ottawa since Parliament's return. Hey, Rosie, how's it going? Hey, Jamie. Thank you very much for being with us at the end of what I know is a very long day for you. So let's start with the big news.

What kind of new money did Trudeau propose to send to the provinces and territories through an increase to the Canada health transfer? So in total, there's like just over $46 billion that is new money. That's over 10 years. The total package is almost $200 billion. I know those sound like whopping sums, right? They sound like huge, huge numbers. However, they're not even near what the provinces were looking for and were asking for. To give you an idea, they wanted $28 billion more a year. This year, the federal government's saying we'll give you about $4.6 billion. So big,

big gap, right? But they are doing one thing that the provinces had asked for. They asked for the increase of the Canada health transfer for the new floor of that increase to be 5%. They're saying we can do that. We'll do that for you for four, five years. And they're also putting $25 billion on the table for these one-off deals, these bilateral deals with provinces. Right, right, with each individual province. And I know like a big sticking point in recent negotiations has been that the Liberals wanted like strings attached to the new funding, right? So tying money to quantifiable improvements to healthcare in a bunch of categories. And

now that we finally have their proposal, are there conditions that they want tied to this money? It's funny because if there was one person who would have the most to say about conditions, it would be Quebec Premier François Legault. And he no longer even considers what Ottawa put on the table, conditions or strings. So that to me is pretty telling that it's palatable to Quebec. That being said, there are things that the federal government is asking for. They want to see some action plans about how the money is going to get spent. They want to see some targets. And they want all of that to be made public, not just to Ottawa, but to people that live inside provinces so they can see if provinces are reaching their goal. And then the other caveat is that they want the money to be spent on health

care. They give you this big broad space where you can spend it, family doctors, mental health, modernizing your health system. There's lots of lots of flexibility and room but they don't want to see you going and building bridges and roads with this health care money. So it's just sort of make sure that they protect against that. Okay. And you mentioned that the premiers were asking for a lot more than this. How did they react to this proposal? You know, it's interesting. They certainly knew that they weren't going to get the $28 billion, right? I think that that had been pretty obviously

telegraphed from Ottawa. Really high anchor. You got to start big though, right? That's right. If you think it's a negotiation, and I'm not sure that that's what this is, but we can get into that. You know, words like disappointing. Oh, this is a good starting point. Let's see where we can go from here. We didn't get the good part of the $28 billion that we were asking for in the basis. This is a step towards the right direction. What we see this as is a starting point. We did have a number put before us it was significantly less than I think what we were asking for obviously but I think it is something that has been put before us and it is a step in the right direction as you've heard. That's the kind of language that was used by premiers and they've sort of left it now

that they're going to go back, look at it in detail, regroup as a group and then see where they go from here, if you believe that to be true. I think the reason I'm hesitating to say that that's actually going to happen is because there were already signs of cracking in that united front at the press conference. A lot from Atlantic premiers who really need the money because they have an aging population and are under a lot of strains. You could already hear some of the language from those premiers saying, oh, yeah, it's not enough, but we really need it. Because, I mean, you know, some money is better than no money. And that's kind of where we're at.

Right. I'm not happy, but I'm going to take this money. That's right. One thing I wanted to ask you about is that health care transfers from the feds have been fairly steadily increasing for almost two decades. But of course, like we're talking to experts all over the place on the show all the time who say our health care systems are in a state of crisis. So what about the argument that more money really might not be the solution here? Yeah, I mean, I think that's an argument that the Prime Minister articulated, certainly on Tuesday night, when he spoke to reporters, I think it's something that any premier health minister that I've talked to recently has also said, there is no solution here that is just going to be throwing money at the problem.

And I think that we see, to be fair to provinces, I think we see attempts at innovation and attempts at fixing things inside their own regions. You know, whether it be in Newfoundland and Labrador, the premier sending his health minister to Ireland to recruit people, whether it be in British Columbia trying to set up a better system for family doctors. And there's examples of that right around the country. Saskatchewan, they're trying to recruit nurses from the Philippines, all sorts of attempts to solve the problem. So I don't think anyone thinks that this is going to solve it overnight. But there is still a need for money to do some basic things like hiring more people. That's a big piece of it. And I think provinces need to know that the federal government is also committed to trying to fund some of these innovations. You know, even if it's something as which sounds as basic as data sharing, that might actually help in the long run,

if you have a better idea of how many doctors are out there in the country, and where they can go and how they can help. Talking about innovation, another strategy that some have described as innovative that we've talked about on the show before is moves towards using private for-profit clinics more to do surgeries like a knee replacement or cataracts, right? Ontario is the latest province to move in this direction. And it's, of course, pretty controversial, right? Critics say it's not the best use of public funds, and it can be the slippery slope to a two-tier healthcare system. And did the feds chime in on for-profit facilities at all? Like, are they entering this debate? So in the press release, it's very clear that the parameters under which the Canada Health Transfer and other money will be given is that it has to respect the Canada Health Act. And that means that it is publicly funded health care.

I think where there is room and the place where Ottawa seems to be allowing some room is exactly the example in Ontario, although, as you said, other people do it too. And that is the use of clinics for profit places that deliver healthcare, but they do it with funds, public funds. What would be crossing the line, obviously, would be if someone said, well, you've got to pay for your cataract surgery, or you've got to pay extra. That would be a breach of the Canada Health Act. And I think then you'd see Ottawa intervene and get aggressive. Now, when Doug Ford was asked, did this come up in your closed-door meeting, he said... No, that conversation never came up. When the Prime Minister said, did it come up...

I don't mean to contradict anyone, but the very first thing I brought up was the fact that upholding the Canada Health Act, the principles within, is an absolute non-negotiable priority of this government. I wasn't in there, but it's clear to me that that's the position Ottawa has taken. Now, interestingly, the NDP is really trying to make hay of this idea that the Prime Minister calls this innovation, instead of saying, you know, this is the devil incarnate, we can't go down this road. And that's because the NDP wants to portray themselves as the great defender of healthcare, and because they don't want to get left out of this conversation as so often happens. And I feel like I have to ask you before we move on is, I know we talked about this eye-popping

number, even though it's less than what the provinces wanted. But the country is still in over $1.1 trillion in debt, right? So maybe can you put this in big picture for me? Well, I mean, I think a couple of things. The federal government is still in better shape and has still more access to money than the provinces, right? Because they have greater taxation powers. So they have more revenue coming in. And although they're deeply in deficit because of the pandemic, there is still more potential to get out of it. So that's the first thing. The second thing,

though, and I think this is where it gets problematic for provinces, and I'm sure you've talked about this many times, is there are a lot of provinces right now who have a surplus, who have a lot of money in the bank, Alberta, BC, others. And so the question for provinces is generally, well, why don't you use that money to help Canadians and help your own province with healthcare? And their answer is, this is not a sustained situation for us. We might have a surplus this year and not the next year. We need to know that we can count on this money over time. And so that's why they come to Ottawa, who, to be fair, has a shared responsibility in this policy, in this policy area. So they do have to fund it to some extent. You know, you're right. It is a drop in the bucket

compared to what the federal government has to spend and, you know, has spent on other big ticket items. So that's probably why, too, you're hearing some of the disappointment from the provinces. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization. Empowering Canada's entrepreneurs through angel investment and industry connections. Hi, it's Ramit Sethi here.

You may have seen my money show on Netflix. I've been talking about money for 20 years. I've talked to millions of people and I have some startling numbers to share with you. Did you know that of the people I speak to, 50% of them do not know their own household income? That's not a typo, 50%. That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. That's healthcare, but maybe since we've got you here,

we could also talk about what's been going on. I see what's happening. Since we've basically captured you. That's right. Since we last spoke for our first episode of the year, you predicted, of course, everything that was going to happen in politics this year. And today, let's just talk about some of the stories that have been playing out since the House of Commons resumed just over a week ago. And first, last time we talked about how the liberals had essentially backed themselves into a corner with their firearms bill last year.

Bill last year, they added a broad definition for assault style rifles that would be banned, which drew a lot of anchor from hunters, including indigenous hunters and sports shooters. And they took heat from across the political spectrum, like including the NDP, which is a hard thing to do on gun control. And so how did the Liberals respond last week to that? I mean, in a pretty stunning reversal of what they had put forward that kind of caught me off guard. It was a Friday late on a Friday, which is what we call sort of take the garbage out day in Ottawa when governments tend to put things out there that they are sort of embarrassed to do. And that certainly was the case here. They pulled out both the amendments that had anything to do with assault style weapons or regular shotguns, as it turns out, which were also on this list, and had, let's be clear, nothing to do with the intent of Bill C-21, which is about freezing the sale of handguns. It was about red flag laws. It was about buybacks for rifles. It was about a whole bunch of other things.

It was about buybacks for rifles. It was about a whole bunch of other things. They really stuck that on there, much to the shock of the NDP, who are sort of their partner in many ways and who actually have, as part of their agreement, the promise that they won't get surprised by the government, much to the shock of the Conservatives and to many, many other groups. You have never seen, I think, well, I'm sure I've seen it, but I don't remember it, a piece of legislation go from, okay, this is probably going to go ahead to everyone hates it. It's been totally screwed up. It's a disaster. So there seemed to be finally a recognition of that on the part of the Liberal government, and they dumped the amendments and have now gone back to the original intent of the bill. A couple of things I think that are still problematic for them. The public safety minister, Marco Mendocino, says,

OK, we didn't get this right, but this is still something we want to deal with. But we're going to go back to the drawing board. There's been a ton of reflection and there will be more of it. But I am committed to charting out a course forward. So that's that's the first thing. What will it look like going forward? It won't be a part of this, but what will it be? And it allows the conservatives to say exactly what they said last Friday, which is, A, you know, this is a great victory for us and for gun owners. And also, don't be fooled. The liberals are going to come for your guns and your rifles anyway. Today's humiliating climb down that we have forced Trudeau to make is a temporary pause in his plan to ban hunting rifles.

And, you know, it exposes again this issue that I feel like we cannot have a federal election without talking about guns. And again, you can see the disparity between the parties, but also the way that they sort of crassly use it as a political wedge issue, whether they want to admit it or not. So the other big topic that we've covered a lot is the consulting for McKinsey. So since we learned the Trudeau government has spent over a hundred million on contracts with the firm, a parliamentary committee, which is supposed to probe contracts, has now questioned people, including Dominic Barton, the former global head of McKinsey and formerly Canada's ambassador to China. And what kind of questions have MPs been asking of these witnesses generally? Like, how has this committee been going?

Well, first of all, Dominic Barton's not related to me at all, just so everybody knows. So I'm not involved in this story. You are not friends with him. I don't have his cell phone number. He doesn't have mine. This is a major, major line of questioning in the committee. Yeah, I mean, listen, I think that the story itself,

and I know you've done a lot of work on it, the story itself about this McKinsey company and all of its reputational issues, receiving at least $116 million, possibly more in contracts, is possibly problematic. Possibly. I don't know, because we don't know the circumstances around which the contracts were given. We don't know what kind of work was done. We don't know if it's value for money. But that conversation has all quickly been overtaken by the politics of it, which is, was Dominic Barton the global chair of McKinsey? Is he friends with the liberals? And is this why this happened? Thank you, Mr. Barton, for being here today. Would you consider yourself a friend of the prime minister, the current prime minister, Justin Trudeau? No, I consider myself having, no, I'm not a friend. I have a professional relationship. So the committee work has been really overshadowed by the politics of it to the point where we're goofing around about the cell phone number but that was actually one of the questions to Dominic Barton. Mr. Barton would you consider yourself a close personal

friend of the Prime Minister? No I'm not a close personal friend of the Prime Minister. Would you say he's one of your five best friends? No. One of your ten best friends? No. One of your 25 best friends? No. One of your 25 best friends? No. One of your 50 best friends? No. Do you have his personal phone number? I do not. Do you and the Prime Minister exchange birthday cards every year? No.

Birthday presents? No. Do you and your wife go out to dinner? And most of these contracts happened, we should say, after Dominic Barton had left. I mean, certainly he then became the ambassador to China, but he did some pretty substantive things for Canada by getting the two Michaels released. So it just became a conversation that I don't think had a lot of value for Canadians who might actually be concerned about this. which might actually advance the story and our understanding of what happened, but it's really up to her. For now, there's just this government review of the contracts, which, you know, how independent or complete that will be, we don't know. But I think the broader issue of why the public service feels the need to subcontract out so much of this work is the piece that we're missing. We heard from one witness, a professor

about that, who really pointed MPs to that issue and said, this is what you guys should be talking about and looking at. Is there some problem with the public service that we can't get them to do this? Do they not have the right training or the right people working there? Those are all good questions, but they don't seem to be, sadly, the questions that are being examined by this committee. It is really strongly still very political. Yeah, yeah. And I think that professor is Amanda Clark. She's done some really great work. It's maybe worth mentioning here, like, it's not just McKinsey, that there's tons of contracts that have gone out to lots of consulting firms. And Amanda's really highlighted that. So

agree. I also was hoping for some more substantive answers and questions. Lastly, let's talk about the conservatives. So late last year, in addition to blaming the Liberals for inflation, leader Pierre Polyev started talking about Canada being quote-unquote broken. Do you ever feel like everything's broken in Canada? I mean, here we are. Most beautiful place in the world, beautiful British Columbia, the Pacific, the Vancouver skyline, and another tent city. And in recent weeks, he's doubled down on this idea of not just the economy,

but really everything feeling broken in this country. Crime is raging out of control in our streets. Our people are desperate that they'll have to lose their homes because of rising inflation. Everything feels broken. Oh, I just offended Justin Trudeau. How effective do you think this strategy has been so far? Listen, I don't think he would still be doing it if it was not effective. You know, obviously, we've seen some polling suggesting that it's effective.

I would imagine he's doing his own polling showing that. And you can see how part of that narrative makes sense, right? Yes, the economy is slowing. That's a very difficult and challenging thing for government, especially when you're trying to fight inflation. And then you can see sort of what we would call in Ottawa own goals by the government when they have things like, for instance, their trade minister, Mary Ng, is found to have broken ethical rules by giving contracts to one of her friends. You know, so there's there sort of becomes this story that the Conservatives can start to paint about a tired government that is not finding solutions or not the right solutions seized on given a series of, first of all,

killings of police officers, but also an increase in violent crime over time. So, you know, I think that there is part of that that works. It's certainly how you start to establish the idea that you need to change government if you can start to, you know, give the impression that they're not fixing things for you. But I think that the caution there for the Conservatives and for Pierre Poiliev is the other half of that argument, which is solutions. And we don't have a lot of them yet from the Conservative leader. And that might be fair, because we're not in an election. It's not his job right now. His job is to hold the government to account and oppose. But I think if you're starting to plant the seed with Canadians that things aren't working, then you pretty quickly have to be able to tell them

what would work and give them a sense that there's a light at the end of the tunnel and that you can point them to the things that would work. So I'm interested to see whether we start to hear any of those things in the next months, even though I still don't think there's going to be an election right now, Jamie. But I think that's where we're going to have to see a little bit of a shift. You can't just be sort of the Debbie Downer of the room, right? You also have to have something to lift Canadians up. And so we'll see whether he can get there. Well, you have been right for the first month and a bit of 2023.

That's probably the end of the record now. There's no election yet. No, there's no election. Rosie, thank you very much. Always a pleasure. Thanks for having me. All right, that is all for today. I'm Jamie Poisson.

Thanks so much for listening, and we will talk to you tomorrow. Thank you.