Continuing with our series on election issues, this week we’re going to look at healthcare – one of the top three concerns for Canadians according to public opinion polls.

In some ways it’s interesting that this would become a federal election issue since healthcare is primarily under the jurisdiction of provincial governments.  It’s the provinces that are responsible for the administration of medical services and the allocation of funds.

However there is a two-fold intersection with the federal government.  First of all we have the Canada Health Act which mandates the nature and quality of the basic health services that each province must provide for its residents.  This ensures that our medical care is relatively consistent from province to province.

The second is the Canada Health Transfer program (CHT) whereby the federal government transfers money to the provinces to cover a portion of their healthcare costs.  Ottawa includes this amount in their annual budget and then allocates payments to each province equally on a per capita basis.

Now, you may ask, if the provinces essentially control how the funds are spent, why then is this a federal election issue?  Why should it matter whether the Liberals, Conservatives, or any other political party form the next government in Ottawa? Well, normally it wouldn’t matter, except that Prime Minister Trudeau made it an issue a couple of weeks ago by implying a Conservative government would arbitrarily cut the Health Transfer program to the provinces and thereby reduce the quality of healthcare Canadians would receive.  In response to this accusation, Andrew Scheer issued a written guarantee to all the provincial Premiers stating that a Conservative government would commit to increasing the CHT by a minimum of 3% every year that he was Prime Minister. 

So, what exactly does all this mean?  First of all let’s look at Prime Minister Trudeau’s statement that voting Conservative means voting for a cut in health services. 

Prior to 1995, federal health transfer payments to the provinces were never a divisive topic.  But that year the federal government announced a $7 billion cut in this funding.  For the first time the federal/provincial battle lines were drawn over the offloading of health costs to the provinces.  Of course in 1995 the Finance Minister was Paul Martin, the Prime Minister Jean Chretien, and the Liberals were the governing party.  That’s when the first cuts in healthcare transfer payments were introduced – not by Conservatives but by Liberals.

In 2004, nearing the end of the Chretien era, an agreement was reached with the provinces to increase healthcare transfers by a generous 6% per annum over the next 10 years.  The ensuing Conservative governments under Prime Minister Harper honoured this agreement through to its completion in 2014.  They then extended the 6% commitment for another 3 years to 2017, at which time the transfer payments were to become indexed to the annual change in GDP, but with a minimum increase of 3% per year. 

Before that took effect, though, the Liberal Party came to power and we had a new Prime Minister, Justin Trudeau.  In 2017 when the Harper pledge of a 6% annual increase to the CHT ended, the Liberal government sought to strike a revised health accord with the provinces.  Negotiations were tense and acrimonious, and ultimately unsuccessful – rather ironic for a Prime Minister who was elected on “sunny ways” and a new era of collaboration among Canadians.

In the end, Ottawa managed to conclude individual bilateral agreements with each province that mirrored precisely what Harper had proposed – tying the CHT increase to the GDP with a base minimum of 3%.  So, in essence, it was a Liberal government that inherited a 6% Conservative CHT rate and then reduced that to 3% two years into its first term.

With this background, let me break down the numbers into their simplest form.  During the last Conservative government led by Stephen Harper (2011-2015), healthcare transfers to the provinces increased by an average rate of 6.56% per year.  In Justin Trudeau’s four years (2015-2019) the increase has averaged 4.68%.   

In light of these statistics, and remembering that it was a Liberal government who first introduced drastic cuts to the CHT back in 1995, Mr. Trudeau’s assertion that a Conservative government automatically means cuts in healthcare spending simply does not hold waterThe facts and history do not back him up.  To the contrary, Liberal governments have been the worst offenders in this regard in the past 25 years.

But what about Andrew Scheer’s signed commitment?  What is the significance of that?  Well basically he’s promising to maintain exactly the same level of healthcare that the Trudeau government themselves negotiated with each province.  These are 10 year commitments that go until 2027, and Scheer has gone on record as pledging that he will honor them, if not increase the basic support.

So there you have it.  Although healthcare is a major concern for Canadians, it really shouldn’t be a debating point in the upcoming election campaign as both major parties are committed to the same course of action and the same level of funding.  Admittedly, how efficiently the provinces utilize those funds is another question - which might keep healthcare near the top of the list of concerns for years to come! 

Holden Bowker,

Richmond Centre Conservative Association

(Photo Source:

Alice Wong