Cory Morgan: Trudeau's Surprise Position on Provincial Health-Care Initiatives Is Welcome

Cory Morgan: Trudeau's Surprise Position on Provincial Health-Care Initiatives Is Welcome
Prime Minister Justin Trudeau and Premier Doug Ford tour the General Motors CAMI assembly plant in Ingersoll, Ont., on Dec. 5, 2022. (The Canadian Press/Nicole Osborne)
Cory Morgan

For the second time in as many months, Prime Minister Justin Trudeau has surprised me on the national health-care file, and in a positive way. The health-care system has been well-established as a sacred cow in Canadian politics. Many politicians will decry the state of health care in the nation, but few will dare to muse about changing the system itself. Trudeau hasn't exactly been an advocate for systemic health-care reform, yet he has been signalling that he is receptive to supporting it.

During a year-end CBC interview with Rosemary Barton last December Trudeau said: “If I were to send people all the money they need in the provinces, there is no guarantee that folks would be waiting less time in the hospitals. There is no point putting more money into a broken system.”

It was a bold statement from a prime minister who is not typically inclined to give frank, clear statements on policy issues. Trudeau didn’t try to walk back his statement and it’s clear he didn’t misspeak. Not only did he admit the system is broken, but his statement could also be interpreted as an invitation for provinces to start changing the system.

Premier Doug Ford has taken the invitation to heart and his proposals to change aspects of Ontario’s health-care provision model are being supported by the prime minister. When interviewed by Susan Delacourt of the Toronto Star on the issue, Trudeau said: “I’m not going to comment on what Doug’s trying to do on this one. … We’re supposed to say a certain amount of innovation should be good as long as they’re abiding by the Canada Health Act.”
The usual suspects have gone wild over Trudeau’s statement. NDP leader Jagmeet Singh said, “The real question is, where does the prime minister stand if he says he's going to defend public health care, and he's allowing this to happen in Ontario?”

The delivery of health care is a provincial jurisdiction and premiers don’t need the prime minister’s permission to expand delivery options, even if they are private. Singh’s posturing and demands run contrary to the Constitution, but that is of little concern for an opposition leader who wants to paint himself as a defender of public health care.

The health systems in every province are severely stressed right now. Surgical backlogs and staffing shortages are common, and premiers are forced to examine changes to the system. The Canada Health Act only prohibits extra billing for insured services, it doesn’t prohibit private delivery of care. Every province has all sorts of private provision options, from diagnostic services to walk-in clinics. Whether expanding the scope of private surgical facilities will take pressure from the system remains to be seen, but it isn’t in contravention of Canadian health-care legislation.

Aside from seeking to increase the number of private medical services in Ontario, Premier Ford plans to introduce changes to legislation loosening rules for interprovincial migration of health-care workers. Under the changes, health-care professionals moving to Ontario will be able to immediately begin working rather than enduring bureaucratic delays with regulatory colleges. This move could indeed help address Ontario’s health-care worker shortage, but it will also spur more competition between provinces for those workers. This could lead to some testy relations between premiers.

Now for the politics of it all.

Why would Trudeau wade into an issue that may threaten his governance deal with Singh and could lead to interprovincial battles over health-care provision?

Ford was very supportive of the Trudeau government during the COVID-19 pandemic while federal restrictions were put in place. Is Ford now calling in favours from Trudeau?

It’s an odd alliance, but Trudeau could feel obligated to have Ford’s back now, and perhaps is hoping for support from Ford when the next federal election comes. It was interesting hearing Trudeau referring to Ford informally as "Doug" rather than "Premier Ford." It does imply they have developed a close relationship.

Premier Danielle Smith has made no secret of her intention to make major changes to Alberta’s health-care system, including implementing a controversial plan for personal health-care savings accounts. Will Trudeau maintain his hands-off approach to provincial innovation when it comes to Alberta as he has with Ontario? It would be quite a demonstration of a regional double standard if he didn't.

Perhaps Trudeau is trying to end his coalition with the NDP. He will need a deal-breaker to do that, and supporting the expansion of private health-care options in provinces could lead to that. How can Singh keep supporting the Liberal government when it departs so far from NDP principles?

Whatever the reasons may be, Prime Minister Trudeau has become an unlikely champion for provincial health-care initiatives, including expanding private care options. Canada needs to allow provinces to innovate, and let’s hope Trudeau’s uncharacteristic pragmatism on the issue continues.

Views expressed in this article are opinions of the author and do not necessarily reflect the views of The Epoch Times.