When federal parties make election promises that fall under provincial jurisdiction, they’re admitting they’ve run out of ideas on how to govern at the national level.
They all do it.
The Conservatives recently pledged to spend $1.5 billion on new MRI and CT scan equipment. They wouldn’t buy the machines themselves, because the feds don’t run health care. The party says, if elected Oct. 21, they would pay provincial governments to buy them.
They were silent on who would pay to operate the machines. That’s odd, because running the scanners is far more expensive than the capital cost of buying them — hospitals have to hire and train staff and create space to house the equipment.
Who’s going to pay for that?
Some provinces may not even need more MRI or CT equipment; maybe they already have a budget to buy their own.
This is the problem when federal parties make blind, uninformed promises in areas of provincial jurisdiction.
The Liberals have made similar commitments. The most blatant one is a recent promise every Canadian would have access to a family doctor. It’s one of the most ludicrous pledges made this campaign.
Most family doctors are not salaried employees. They operate private practices or work in clinics. They bill provincial governments for their services. The feds have nothing to do with that. Their only role is to send transfer payments to the provinces to pay for a minority share of health-care costs.
Ottawa doesn't hire or recruit family doctors. Besides, even provincial governments can’t realistically guarantee everyone will have access to a family doctor.
The Liberals also pledged to create a national pharmacare program. They’ve released few details on how they would do that, or what the program would look like.
Manitoba already has an income-based pharmacare program, with deductibles. Would it replace that? Would the feds try to convince the province to create an entirely new one? What would happen to those who already have prescription drug coverage through their employers?
The NDP have made a ton of promises that fall under provincial jurisdiction, and it went even further on health care: expand medicare to include prescription drugs and dental coverage. The NDP wants to make it all "free."
In order to do that, it would have to add those services to the Canada Health Act as insured services, which would cost tens of billions a year.
Those services would fall into the "single-payer" category, where people could only get dental and prescription drugs through government. Employer-based coverage would be banned, no one would be allowed to buy their own dental or drug coverage and Canadians would be prohibited from paying out-of-pocket for them. Those services would become "medically necessary" under the Canada Health Act, the way it is now for hospital and physician services.
Considering the federal government’s share of health-care funding has dropped substantially over the years, it’s doubtful the provinces would agree to add dental and prescription drugs to medicare and expect Ottawa to maintain its funding share.
Besides, most Canadians already have their own drug or dental coverage, or can afford to pay out of pocket for them. Do they really want government prohibiting them from doing so?
There are a minority of Canadians who do not have dental or drug coverage and can’t afford to pay out of pocket. We need policy options that target them specifically. You don’t blow up an entire system that works for the majority of people to solve a problem for 20 per cent, or less, of the population.
Either way, federal parties should come clean on what they mean when they propose "national" systems of any kind, especially when they fall under provincial jurisdiction.
Better yet, why don’t federal parties stick to federal issues, such as employment insurance, the military, Indigenous issues, taxation, and criminal law? Those are areas where they can enact policy.
Federal parties have made some pledges in those areas. But they have this annoying habit of shifting back to provincial jurisdiction with vague and unrealistic promises they think will win them votes.
Canadians should be wary of that.
Tom has been covering Manitoba politics since the early 1990s and joined the Winnipeg Free Press news team in 2019.
Updated on Wednesday, September 25, 2019 at 9:59 AM CDT: Corrects typo