18°c Overcast
14°c Cloudy periods
Winnipeg Free Press - PRINT EDITION
Health transfers: One size doesn't fit all
Imagine a health system in which everyone was allocated the same number of doctor, hospital and diagnostic appointments and hours -- regardless of their health or need.
It wouldn't take many seconds to dismiss this as an absurdity. Yet when it comes to federal funding for health care, one size fits all is exactly Ottawa's position.
Starting in 2014-15, the cash portion of Ottawa's Canada Health Transfer (CHT) will be distributed to the provinces on an equal per-capita basis. There will be no regard to the relative strength of provincial tax bases (a new development) nor any allowance for the relative health or demographic age of provincial populations (a longstanding problem).
You may say there's a difference between allocating medical dollars and medical appointments. But the dollars pay for the appointments. If there aren't enough federal bucks to make up for differences in provincial wealth or health, care will be rationed more severely in provinces with weaker finances, older populations and more illness.
Until the Harper government changed the rules a year ago, the health cash each province received was balanced with a second part of the CHT -- a share of taxation Ottawa ceded in the 1970s, when it reduced its share of the total tax base by 13.6 per cent for personal income tax and by one per cent for corporate tax, leaving the provinces to assume this share.
These transferred "tax points" were worth more, on a per-capita basis, in provinces with higher incomes. So Ottawa used the cash portion of CHT to provide some balance. Provinces with lower per-capita tax transfers got more per-capita cash (and vice versa). When CHT tax points and cash were added together, each province got the same total per-capita value.
Now, Ottawa is treating the tax transfer windfall as ancient history and redefining fairness so only the cash will be distributed on an equal per-capita basis. Next year that will mean $1 billion more for Alberta, which already has the lowest health burden as a share of GDP.
This will come out of growth in health cash for other provinces, falling hardest on those such as the Maritimes, with the lowest-value tax transfers and the highest health-cost burdens.
In the end, that's not a viable way to fund universal health insurance. Provinces do need to be more efficient and innovative in health-care delivery. But only Ottawa can provide the key element of financial stability that bridges the inevitable unequal distribution of health and wealth in the real world.
-- The Canadian Press
Republished from the Winnipeg Free Press print edition November 10, 2012 A15
More Analysis
- Back to Top
- Return to Analysis
Poll
Most Popular Analysis
- Shocking exclusion
- Will stereotype perceptions of crack cocaine go to pot?
- Manitoba showed that a 'Senate' can be abolished
- Ford puts Toronto on the map at last
- Airports belong to Canadian taxpayers
- Vancouver water cheap, unmetered
- Flat-rate property tax tabled
- To call 'Cliffy' a character doesn't do him justice
- Boston bomber love-bombed by fangirls
- Smart people SLEEP LATE
- Ford puts Toronto on the map at last
- BlackBerry: off the mat, hitting back
- 'Most hated man' in Senate
- Physician networks a way forward for health care
- Lower drug prices, lower costs, better care?
- What is Struthers afraid of?
- Can't lose when ends justify means
- How to humble wing nuts
- Smart people SLEEP LATE
- A decade after Mad Cow — the legacy of a crisis
- Don, it's not about nakedness
- Speeding fine only half of it
- Ashton might try to get the facts straight
- Canadian to expose alien collaboration with U.S.
- Ford puts Toronto on the map at last
- 'Done deal' offends Whiteshell cottagers
- Smart people SLEEP LATE
- Manitoba could follow B.C. on surrogacy issue
- City council can't decide which bus to ride
- The Angelina Jolie effect
- Shocking exclusion
- What is Struthers afraid of?
- How to humble wing nuts
- Bill 18 is perfect example of bad law
- THIS IS NO WAY TO MAKE A POINT!!!
- Harper embraces multilateralism on Arctic issues
- Elijah's essence was most easily found in the wilderness
- Manitoba showed that a 'Senate' can be abolished
- Mental health system lacking funds, awareness
- 'Genetic engineered' might save planet
- 'Done deal' offends Whiteshell cottagers
- Kim Sigurdson It's time for government fish monger to cut bait
- Speeding fine only half of it
- How CBC and others torque ratings
- Where is Canada's strategy to help Ukraine?
- Mother Nature springs into action
- Female chiefs needed
- Ashton might try to get the facts straight
- 'Longevity pensions' a promising idea
- Fisher could have been paid $16,000 for his 'wasted fish'
Ads by Google
You can comment on most stories on winnipegfreepress.com. You can also agree or disagree with other comments. All you need to do is register and/or login and you can join the conversation and give your feedback.
Have Your Say
New to commenting? Check out our Frequently Asked Questions.
The Winnipeg Free Press does not necessarily endorse any of the views posted. By submitting your comment, you agree to our Terms and Conditions. These terms were revised effective April 16, 2010.