Three Policy Pathways for Federal Health Care Funding in Canada


  • Trevor Tombe UofC



Federal health care funding has long been a source of policy debate in this country, a situation exacerbated recently by the COVID-19 pandemic and the calls by premiers for a massive expansion of the Canada Health Transfer. In this paper, after briefly reviewing the evolution of federal health care funding in Canada since the 1950s, we formulate three potential policy pathways federal policymakers might consider in order to improve health care funding in the country. The first pathway is the status quo, which simply preserves the Canada Health Transfer (CHT) as is. Explaining what the status quo entails is important to gauge the potential impact of the two other pathways we formulate, which depart from the status quo in a significant manner: first, the implementation of demographic adjustments that add to CHT as populations age; and second, the creation of a joint federal-provincial-territorial taxation regime. While the second pathway would constitute a form incremental change, the third one would be transformative in nature and, therefore, more challenging to implement, which is not a reason to exclude it for consideration, especially if we take a more long-term view of potential policy change in fiscal federalism. These three potential pathways should allow policymakers to consider how to adapt to changing circumstances while addressing the concerns of citizens and the demands of provincial/territorial governments. We do not support one or another of these policy pathways; instead, we explain what they are and what impact they could have, leaving the reader decide what option they prefer.






Research Papers