Canadian federal-provincial/territorial funding of universal health care: fraught history, uncertain future

As the COVID-19 epidemic continues in Canada and financial pressures mount on all levels of government, the federal-provincial/territorial cost-sharing framework for universal publicly financed coverage of physician and hospital services -- commonly referred to as Medicare -- has once again become a...

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Bibliographic Details
Published in:	Canadian Medical Association journal (CMAJ) 2020-11, Vol.192 (45), p.E1408-E1412
Main Authors:	Naylor, C David, Boozary, Andrew, Adams, Owen
Format:	Article
Language:	eng
Subjects:	Analysis Budgets Canada Health Act Coronaviruses COVID-19 Economic development Elevators & escalators Federal funding Federal government Finance GDP GNP Gross Domestic Product Gross National Product Health aspects Health care expenditures Health care policy Health care reform Hospitals Insurance coverage Intergovernmental fiscal relations Medical equipment Medicare National health insurance Per capita Political aspects Primaries & caucuses Social aspects
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Summary:	As the COVID-19 epidemic continues in Canada and financial pressures mount on all levels of government, the federal-provincial/territorial cost-sharing framework for universal publicly financed coverage of physician and hospital services -- commonly referred to as Medicare -- has once again become a point of contention. In Sep 2020, just days before a federal Speech from the Throne, Canada's provincial and territorial premiers called for the federal government to become " full funding partner" in health care spending, raising its contribution to provincial and territorial health spending from 22% to 35%, an increase of $28 billion per annum. Yet, to the expressed disappointment of the premiers, the Throne Speech offered no increases in federal funding for health. Instead it reiterated the Government of Canada's previous commitment to "a national, universal pharmacare program" and set out some steps toward that goal. Although Medicare remains one of the social programs that Canadians value most highly, its stability, and any potential expansion of Medicare services, such as pharmacare, depends on a robust federal-provincial/territorial cost-sharing framework. Yet, the conflicting perspectives of different levels of government pose major challenges to any expansion of public coverage or pursuit of national health care reforms.
ISSN:	0820-3946 1488-2329