Who will blink first on health care?

Hey there, time traveller!
This article was published 17/03/2017 (3174 days ago), so information in it may no longer be current.

OTTAWA — Who knew health-care funding negotiations could turn into a political drama that might make an excellent episode of Veep?

While it is rare for such negotiations to end up being conducted so publicly, it is not rare for Manitoba and Ottawa to be at odds.

From the CF-18 contract fight in the 1980s to Manitoba’s objections to the Meech Lake Accord, or even more recently quite a nasty fight over settlement service programs for immigrants that Ottawa unilaterally took back control over in 2012, Manitoba’s relationship with Ottawa has most often been covered with thorns.

In 2004, Canada and the provinces sat down to talk about health care and struck the 2004 health accord, which added more than $16 billion to federal health transfers. Manitoba was also an agitator back then.

Premier Gary Doer’s NDP government insisted Ottawa had to pay its share and was among the provinces that succeeded in keeping every provincial government unified against Ottawa.

But the political scene back then was different. Prime minister Paul Martin had a tenuous minority government facing a growing challenge by a Conservative Party united under Stephen Harper. And Martin was still blamed for the health-care funding cuts he made to the provinces as finance minister a decade earlier.

At the same time, many of the provincial governments were politically solid. Doer was riding high in Manitoba. Quebec premier Jean Charest and Ontario premier Dalton McGuinty were early into their first terms. Alberta’s Ralph Klein had been premier for a decade in a province that had not elected anyone other than a Tory for more than 30 years.

Economic growth was also good and governments at both levels were not nearly as stretched to balance the books as they are today.

So the premiers went into those negotiations on far different footing. They banded together for a unified position, saw weaknesses in the federal government they could take advantage of and got Ottawa to sign over the entire kitchen sink, with a dishwasher and microwave added as bonuses.

Fast-forward to 2017, and the political and economic situations are very different. Gone are the federal surpluses that gave Ottawa room to be generous, replaced by deficits three times as big as Prime Minister Justin Trudeau promised and no end in sight to the red ink.

Trudeau, despite this, is on solid ground politically and still enjoys a decent-sized lead in the polls.

The provinces, on the other hand, are also mired in red ink, and many are helmed by premiers facing their own political demise.

Christy Clark in British Columbia is behind in the polls just weeks before the B.C. election is set to begin. Ontario’s Kathleen Wynne has approval ratings so low you can barely see them on a graph without squinting. Premiers in Newfoundland and New Brunswick are equally unpopular over measures to offset growing deficits.

Saskatchewan’s Brad Wall is doing well in polling numbers at home but caved to the health deal to keep one of his government’s pet projects from being shut down by the Canada Health Act. His private MRI experiment — allowing people to pay for their tests as long as the clinic provides a test to someone on the public waiting list for every test they do privately — now has a year’s grace to prove it’s not hurting the public system.

Needless to say, the provinces had weaknesses and Ottawa figured out what each one was and played them like a Sidney Crosby in an Olympic final. To quote one of Doer’s favourite phrases — the feds put the puck in the net. Again. And again. And again.

Then they got to Manitoba, where the premier is new and not vulnerable politically.

Pallister has proven time and again over the past year he has no qualms about not playing Ottawa’s game. So it was in the fall he tried to play hardball with Trudeau’s climate change pact that will force provinces to introduce some form of carbon pricing.

Manitoba is almost certainly going to introduce a carbon tax. Pallister’s chief environmental adviser, David McLaughlin, is a proponent of one going back to his time as the head of the National Roundtable on the Environment and the Economy. Pallister knows how much it would mean to Trudeau politically to have a Tory premier onside the carbon-tax train, given the intense opposition to the scheme by the federal Conservative party.

So Pallister played the card, withholding support for the climate change plan unless Trudeau ponied up more for health care. He tried, however, and failed, to get any other province to stand with him.

A few weeks later, the provinces went into health-care talks united, and came out without a deal when Ottawa wouldn’t budge from its offer. Pallister continued to press for unity. It took two days for Ottawa to find the first crack, and less than five days to get three provinces to break from the pack.

Now, Manitoba is the only holdout. It is asking for more money for indigenous health programs and $5 million for the opioid crisis.

It still wants additional cash in annual transfers but seems to have conceded that will not happen.

Federal officials were apoplectic when Pallister accused Ottawa of linking the climate change deal to the health accord this week, given it was Pallister himself who did just that in the fall.

But Ottawa didn’t just leave it at climate change. They pointed out to the province that the money for an unrelated $60-million manufacturing research facility will lapse by the end of March unless Finance Minister Bill Morneau and the prime minister agree to extend it into next year’s budget.

That sent Pallister into a rage, and thus the negotiations that had until now been behind closed doors became public.

At this point, neither government is smelling rosy. The Liberals look a little like bullies and Pallister looks a little like a mule.

There is $400 million for Manitoba patients on the line. Neither government wants that money to disappear. Someone is going to crack. It’s about 50-50 right now who it will be.

Mia Rabson is the Winnipeg Free Press parliamentary bureau chief.

mia.rabson@freepress.mb.ca Twitter: @mrabson