Brad Wall prescribes collaborative federalism to improve health care
TheGlobeandMail.com – news/politics
Published Friday, Jan. 13, 2012. Jane Taber
Saskatchewan Premier Brad Wall is planning to push his provincial colleagues to band together and ask Ottawa for a health care innovation fund that would provide extra money for projects to improve patient care.
“What we’d like to focus on is, over and above the transfer, is the federal government going to be interested in partnering with provinces on outcomes-specific innovations that we propose?” Mr. Wall said in an interview on Friday.
He will take his proposal to the premiers’ meeting in Victoria next week, and told The Globe and Mail that he believes the federal government has left the door open to doing more on health care than it is currently offering.
“I am hopeful. I am hopeful,” he said. “This discussion can’t just be about cash… it’s got to be about how health care is going to get better… and more sustainable.”
Last December, Finance Minister Jim Flaherty shocked his provincial counterparts when he gave them a take-it-or-leave-it health accord. The 10-year deal gives the provinces a 6 per cent annual increase in the money Ottawa transfers to them for health care until 2017. After that the increase is tied to the nominal GDP.
More than 40 per cent of Saskatchewan’s budget goes to health care; other provinces’ budgets are similarly consumed. Mr. Wall noted the new accord has divided the premiers – MOST in the West like it and those in the East are not so happy. Nova Scotia’s Darrell Dexter, for example, believes the new funding formula will hurt smaller and less wealthy provinces such as his.
Mr. Wall said an innovation fund could be used to help finance projects such as Saskatchewan’s program to reduce waits for some kinds of surgery, such as orthopedic.
“Over and above the transfer, we would like the federal government to consider an innovation fund that would work with the provinces on these kinds of initiatives,” he said.
Mr. Wall said he doesn’t have a dollar figure in mind for the fund. Rather, he wants the premiers to discuss the concept, which he believes should be raised with the federal government.
“Well, we’re going to push that,” he said. “The health transfer issue itself has taken up a lot of oxygen because we have this divide in terms of the provinces and I respect everyone’s position… So depending if there is any oxygen left, sure, we can talk about this notion of an innovation fund and proposing something like that with the government.”
Mr. Wall acknowledges the Harper government’s “unilateral declaration” did not foster good will, but he and his officials are not dwelling on that.
He said an innovation fund could also help the provinces set up electronic health records.
“Here is a way to drastically improve health care in a country that is still very rural… electronic health records can really improve health care delivery and make the system much more efficient and probably in the long term save a lot of money,” he said.
All provinces, he argued, are facing “massive” costs in terms of converting to digital records.
“There is a role for the federal government if we can tie it to outcomes,” he said. “So we’re going to ask the question anyway. And say, sure the transfer’s the transfer but now let’s talk about ways to improve health care – and both parties should be at the table for that.”
He said comments from Federal Health Minister Leona Aglukkaq after the release of the accord give him some hope that the federal government may be interested in doing more than simply the transfers.
In a letter to the provinces, Ms. Aglukkaq proposed to work with them to find a solution to spiralling health costs.
Mr. Wall said Ms. Aglukkaq is to visit his province next week and will be meeting with his health minister.
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