Week 11: Canadian Federalism, the Canadian Social Union and Health Policy

Question 1

Pre 1980

Answer 1

1957- Hospital and Diagnostic services act
1966 Medical care act
1977 Established programs financing (EPF)

Question 2

1966 Medical care act

Answer 2

Funded through Canadian assistance plan (CAP)
50/50 cost sharing

Question 3

1977 Established programs financing act

Answer 3

Shift from cost sharing to block funding
Transfer of tax points to provinces/territories
Increased based on economic growth and population growth

Question 4

Transfer of tax points to provinces/territories

Answer 4

Federal government reduced what is collected in federal tax from citizens and allows provincial government to increase taxes at a similar rate

Question 5

What caused the greatest one-time decrease in the proportion of health care spending paid for by the federal government?

Answer 5

Established programs financing

Question 6

Canadian Health Coalition and Ontario health Coalition

Answer 6

Advocate in favour of publicly funded health care system in opposition to user fees and privatization
Federal government should pay a larger share of health care costs

Question 7

1980-1984

Answer 7

Maintaining government roles

Question 8

1984-1988

Answer 8

Restraining social program costs

Question 9

1988-1997

Answer 9

Restructuring the role of government

Question 10

1997- present

Answer 10

Repairing the social union

Question 11

1984-1988 Restraining social program costs

Answer 11

Weakening of government commitments to health and social programs
Neoliberalism strongly influenced government policy

Question 12

How much of a reduction in health transfers from federal to provincial/territorial government occurred btwn 1986-1998?

Answer 12

41.2 billion

Question 13

1988-1997 Restructuring the role of government

Answer 13

Concern with government budget deficits due to the economic recession
Significant reduction in federal health care spending

Question 14

What replaced EFP in 1995?

Answer 14

Canada Health and Social transfer

Question 15

Canada Health and Social Transfer

Answer 15

Federal contribution at a rate based on the previous year with adjustment for GDP at provincial level
One funding envelope for health care, social spending and post-secondary education

Question 16

Federal spending cuts made during Canada health and social transfer act

Answer 16

$6 billion

Question 17

Repairing the social union (1997-2016)

Answer 17

1. Recognition that the social union was deteriorating
2. 1999 budget
3. Health accords
4. 2011 Conservative scaling back
5. 2015 Liberals promise new health accord

Question 18

Recognition that the social union was deteriorating

Answer 18

Relationships btwn levels of government was becoming less cooperative and less constructive and the existence of shared set of norms, standards and objectives of social citizenship were lost

Question 19

1999 budget

Answer 19

Increase in health and social transfers of 11.5 billion from federal gov to provinces and territories

Question 20

Health Accords

Answer 20

2000 health accord
2003 health accord
2004 health accord

Question 21

2000 health accord

Answer 21

Accord on health care renewal
Increase of 21.2 billion over 5 years
Further specific funds for diagnostic and emergency equipment, primary care reforms and adoption of modern IT system

Question 22

2003 health accord

Answer 22

Established health council of Canada
Separated Canada health and social transfer into Canada health transfer and Canada social transfer
Added more federal funding for primary health care, home care and drug coverage

Question 23

2004 health accord

Answer 23

Increased funding of 41 billion over 10 years
6% increase per year
Additional targeted funding for wait time reduction, primary care, home care and drug coverage

Question 24

2011 Conservative scaling back

Answer 24

Once 2004 accord expired in 2014, the conservative government increases health transfers by 6% per year until 2016 after which they would tie increases to economic growth (3.5% per year)

Question 25

2016-2017 Failed health accord negotiations

Answer 25

Federal government proposed a 3.5% increased in funding per year with no additional increased tied to economic growth
$11.5 billion in additional funding for entire 10yr period for mental health, home care and drugs

Question 26

Did the provinces and territories accept the proposed health accord made by the federal gov in 2016/2017?

Answer 26

NO

Question 27

What happened instead of the proposed federal accord in 2016/2017?

Answer 27

Federal government signed bilateral agreements with each province and territory

Question 28

What did the bilateral agreements lead to?

Answer 28

$31 billion shortfall
Gives provinces and territories incentives to cut costs (pressure)
Decreased federal authority to play a role and improve medicare
National pharmacare program unlikely

Question 29

What reduction in funding by the federal government has occurred since medicare was established?

Answer 29

Went from 50% to 22% today

Question 30

July 2019 premiers call for new health accord

Answer 30

Calls for new Canada health transfer increase of 5.2% and an increase in federal contributions from 22% to 35%

Question 31

Social union framework agreement (1999)

Answer 31

Umbrella under which governments will concentrate their efforts to renew and modernize Canadian social policy

Question 32

Primary objective of Social union framework agreement (1999)

Answer 32

Reform and renew Canada’s system of social services
Recognizes that reform is best achieved in partnership among provinces, territories and federal government

Question 33

Liberal vs Conservative federal health care base funding

Answer 33

Provide same level of funding

Question 34

Which era of funding least reflects the influence of neoliberal ideology?

Answer 34

Repairing the social union

Question 35

What is most likely to be the increase in core federal funding for Ontario’s health system from 2021 to 2022?

Answer 35

3.5%

Question 36

What are the criticisms of the social union framework agreement ?

Answer 36

Lacked an enforcement mechanism
Quebec was not a signatory
Failed to change politics of social policy

Question 37

What year did provincial governments fund the greatest proportion of the costs of their health care systems?

Answer 37

1998

Question 38

What percentage of health care costs does the federal government currently pay for?

Answer 38

22%