Federal health spending has outpaced provinces, analysis shows
Despite castigation from provincial premiers over lagging federal contributions to health spending, an analysis of 20 years of health funding data shows that federal transfers have mostly outpaced increases to provincial health budgets.
In 2023, federal health transfers amounted to $47.1 billion, a 212 per cent increase over 2005, when the transfers were $15.1 billion. Total spending by all 10 provinces grew in that time to $221.9 billion up from $86.2 billion, an increase of 158 per cent.
The Canadian Press, in partnership with Humber College StoryLab, collected data on provincial health budgets and federal health transfers from 2004 to 2023 to track annual spending from the launch of the 2004 federal-provincial health accord under former Liberal prime minister Paul Martin.
The findings stand in stark contrast to the rhetoric that has punctuated federal and provincial health negotiations over the last several years, as health systems struggled in the aftermath of the COVID-19 pandemic.
Two years ago, a shortage of health workers led to emergency room closures and extreme backlogs for services across the country and premiers demanded the federal government pay a greater share of the health spending bill.
Former Manitoba premier Heather Stefanson, after a meeting with her fellow provincial leaders at the end of 2022, said health spending used to be split evenly but the federal share had slowly dwindled over time.
Governments originally envisioned that health-care costs would be divided evenly between Ottawa and provincial governments in 1959, before most provinces even had medicare. But the funding model shifted drastically in the 1970s and has changed again many times since.
Rather than slowly dropping off over the last two decades as the premiers suggested, the data shows federal transfers actually grew at a slightly faster pace than provincial health spending since the Martin health accord in 2004.
In 2005-06, federal health transfers grew 39 per cent in one year while provincial health spending grew by six per cent.
That meant the federal share of total health spending jumped to 20.7 per cent from 17.5 per cent.
Federal health-care spending was far higher during the COVID-19 pandemic because of specific transfers. Those extra funds stopped flowing in 2022-23, by which time the federal share of total provincial spending had grown just slightly to 21.2 per cent.
That reality wasn't acknowledged when premiers were clamouring for more federal money after the pandemic, Health Minister Mark Holland said in a recent interview.
It was also not acknowledged in his recent negotiations with provinces as part of Prime Minister Justin Trudeau's proposed $196-billion health deal, which involved signing one-on-one agreements with each province.
"I understand the position of the provinces -- huge demands on them -- but we have been ensuring that we're providing the dollars that are necessary and required to help them in their health systems," Holland said.
"Now what we need to do is to begin to transform how our system functions. We need to move from a crisis-based system where we wait until people are really sick and then we deal with it, to being upstream and avoiding illness and being engaged in prevention."
Ontario Premier Doug Ford declined The Canadian Press's interview request as chair of the Council of the Federation, the official organization of the premiers.
A written statement said premiers "continue to urge the federal government to provide adequate and sustainable health-care funding," also reiterating their concerns that the agreements have an end date.
The premiers call that the "funding cliff," fearing they can't plan for long-term stability when federal offers all have expiration dates.
In February 2023, about 10 days after Trudeau tabled the latest health funding offer, the premiers issued a joint statement to reluctantly accept it.
"While this first step marks a positive development, the federal approach will clearly not address structural health care funding needs, nor long-term sustainability challenges we face in our health-care systems across the country," they wrote.
Getting a clear view of who is paying the growing cost of Canada's health care isn't straightforward.
No government is collecting health spending data on a national scale, and federal contributions are difficult to pin down.
It's important to know how much each government is contributing so that voters can hold them accountable, said Haizhen Mou, a professor with the University of Saskatchewan's graduate school of public policy.
"They have certain expectations on the quality and quantity of health care they receive, however, they cannot hold either level of government accountable, because there's no clear division of responsibility," said Mou, who studies health funding and politics.
"There's no clear, no transparent contribution ratio or expectation for this contribution from either government in the system so far."
The Canadian Press and Humber College StoryLab combed through decades of provincial public accounts and federal transfers to compile the data manually.
Territories were not included because health spending records couldn't be verified in some cases. The territories also receive additional support from the federal government to fund necessary travel and accommodations for some patients that can't be treated near their homes.
The analysis did not account for equalization payments and other federal contributions to provincial general revenues that could ultimately be spent on health.
Nor did it look at tax points transfers, which the federal government includes when it assesses how much money it is giving the provinces for health care. That dates back to 1977, when the federal government lowered its tax rates for personal and corporate income and the provinces could increase their provincial tax rates and take that revenue instead.
In 2023, after the latest health funding offer to the premiers was made public, Ottawa said tax point transfers amounted to $25 billion. However, the provinces do not include tax point transfers when discussing the federal share of health-care spending.
Holland says he's open to finding a way to make information about health spending more available as a way to cut through the political rhetoric.
"I think anything that provides transparency and allows us to get to talking about the material, consequential things that we have to be doing, as opposed to debating over dollar values, I think is helpful," he said.
The new health deals call on provinces to improve the collection of national health data, but makes no specific mention of tracking federal and provincial spending.
The one thing that is clear is that health care spending is growing.
Per capita, Canada's transfers for health grew six times faster than population growth, amounting to $1,115 per person in 2023, up from $427 per person in 2005. Those figures have not been adjusted for inflation.
Among the provinces, per capita spending grew at massively different rates, with Newfoundland's budget soaring 19 times faster than its population, while spending in Nova Scotia and Alberta grew less than two times as fast as the population.
This report by The Canadian Press was first published Sept. 2, 2024.
IN DEPTH
Jagmeet Singh pulls NDP out of deal with Trudeau Liberals, takes aim at Poilievre Conservatives
NDP Leader Jagmeet Singh has pulled his party out of the supply-and-confidence agreement that had been helping keep Prime Minister Justin Trudeau's minority Liberals in power.
'Not the result we wanted': Trudeau responds after surprise Conservative byelection win in Liberal stronghold
Conservative candidate Don Stewart winning the closely-watched Toronto-St. Paul's federal byelection, and delivering a stunning upset to Justin Trudeau's candidate Leslie Church in the long-time Liberal riding, has sent political shockwaves through both parties.
'We will go with the majority': Liberals slammed by opposition over proposal to delay next election
The federal Liberal government learned Friday it might have to retreat on a proposal within its electoral reform legislation to delay the next vote by one week, after all opposition parties came out to say they can't support it.
Budget 2024 prioritizes housing while taxing highest earners, deficit projected at $39.8B
In an effort to level the playing field for young people, in the 2024 federal budget, the government is targeting Canada's highest earners with new taxes in order to help offset billions in new spending to enhance the country's housing supply and social supports.
'One of the greatest': Former prime minister Brian Mulroney commemorated at state funeral
Prominent Canadians, political leaders, and family members remembered former prime minister and Progressive Conservative titan Brian Mulroney as an ambitious and compassionate nation-builder at his state funeral on Saturday.
Opinion
opinion Don Martin: Gusher of Liberal spending won't put out the fire in this dumpster
A Hail Mary rehash of the greatest hits from the Trudeau government’s three-week travelling pony-show, the 2024 federal budget takes aim at reversing the party’s popularity plunge in the under-40 set, writes political columnist Don Martin. But will it work before the next election?
opinion Don Martin: The doctor Trudeau dumped has a prescription for better health care
Political columnist Don Martin sat down with former federal health minister Jane Philpott, who's on a crusade to help fix Canada's broken health care system, and who declined to take any shots at the prime minister who dumped her from caucus.
opinion Don Martin: Trudeau's seeking shelter from the housing storm he helped create
While Justin Trudeau's recent housing announcements are generally drawing praise from experts, political columnist Don Martin argues there shouldn’t be any standing ovations for a prime minister who helped caused the problem in the first place.
opinion Don Martin: Poilievre has the field to himself as he races across the country to big crowds
It came to pass on Thursday evening that the confidentially predictable failure of the Official Opposition non-confidence motion went down with 204 Liberal, BQ and NDP nays to 116 Conservative yeas. But forcing Canada into a federal election campaign was never the point.
opinion Don Martin: How a beer break may have doomed the carbon tax hike
When the Liberal government chopped a planned beer excise tax hike to two per cent from 4.5 per cent and froze future increases until after the next election, says political columnist Don Martin, it almost guaranteed a similar carbon tax move in the offing.
CTVNews.ca Top Stories
B.C. teen with Canada's first human case of avian flu in critical condition, Dr. Bonnie Henry says
The teenager who is sick with the first-ever human case of avian influenza acquired in Canada is in hospital in critical condition, provincial health officer Dr. Bonnie Henry said Tuesday.
Elon Musk and Vivek Ramaswamy will lead new ‘Department of Government Efficiency’ in Trump administration
President-elect Donald Trump announced Tuesday that Elon Musk and Vivek Ramaswamy will lead a new “Department of Government Efficiency” in his second administration.
Here's why thieves may be stealing butter in Canada
The case of the missing butter remains a mystery, but some have ideas on what's behind the unusual crimes.
Former B.C. premier John Horgan dies at 65
Former B.C. premier John Horgan, a popular leader renowned for his affable personality and dedicated public service, has died
Alleged serial killer previously pled guilty to 2018 attack on Waterloo, Ont. bus
The woman accused of killing three people in three days in three Ontario cities also previously admitted to attacking strangers on buses in the Region of Waterloo.
Air Canada to add new routes to U.S., Europe and North Africa in summer 2025
Getting to destinations in the U.S., Europe and North Africa is about to get easier, as Air Canada announced it will be increasing flights to a number of new destinations this summer.
Body found in Montreal park identified as cryptocurrency influencer
The body of a man that was found in a park in the Ahunstic-Cartierville borough last month has been identified as cryptocurrency influencer Kevin Mirshahi.
History in Halifax is slowly being wiped off the map: study
Saint Mary's University archeologist Jonathan Fowler is sounding an alarm with a new study. According to Fowler, the centuries-old architecture that adds to Halifax’s heritage and historic vibe is slowly being wiped away as the city grows.
2-year-old gorilla 'Eyare' dies unexpectedly at Calgary Zoo
A young gorilla at the Calgary Zoo has died. The Wilder Institute/Calgary Zoo announced a member of its western lowland gorilla troop passed away unexpectedly, in a news release Tuesday.
Local Spotlight
'I get in this workshop and everything disappears': N.B. man creates whimsical birdhouses in spare time
Four years ago, Phill Hebb started up "Phil’s Unique Birdhouses" and since then, they’ve made their way all across Canada and into the United States.
N.B. fashion designer honours late mother with unique, award-winning dress
A New Brunswick fashion designer recently won the top prize at a national event for a dress she made using an unconventional material.
Dr. Ronald Weiss, Ottawa's 'Wayne Gretzky' of vasectomies, dies
Dr. Ronald Weiss, who performed nearly 60,000 vasectomies on Ottawa men, establishing him as the "Wayne Gretzky" of the procedure, has died.
Should Toronto tear up its bike lanes to improve traffic flow? Critics say it's not so simple
A congestion crisis, a traffic nightmare, or unrelenting gridlock -- whatever you call it, most agree that Toronto has a congestion problem. To alleviate some of the gridlock, the Ontario government has announced it plans to remove bike lanes from three major roadways.
Local campaign hopes to raise $100K, help children in need during holidays
For the second year in a row, the ‘Gift-a-Family’ campaign is hoping to make the holidays happier for children and families in need throughout Barrie.
The people behind the pictures: Meet the prolific shutterbugs snapping CTV Skywatch weather photos
Some of the most prolific photographers behind CTV Skywatch Pics of the Day use the medium for fun, therapy, and connection.
'There was no stopping this baby from coming': Woman gives birth while on board N.L. ferry
A young family from Codroy Valley, N.L., is happy to be on land and resting with their newborn daughter, Miley, after an overwhelming, yet exciting experience at sea.
B.C. man discovers 115 stuffed animals hidden behind wall, begins donating them to people around world
As Connor Nijsse prepared to remove some old drywall during his garage renovation, he feared the worst.
'We put love into it': Group of N.S. women gather to make quilts for those in need
A group of women in Chester, N.S., has been busy on the weekends making quilts – not for themselves, but for those in need.