No Treasure CHST for Health Services

This commentary argues that, if health care is underfunded as many people believe, the solution does not lie in increasing federal transfer payments to the provinces under the Canada Health and Social Transfer (CHST). There is no guarantee that an increase in federal transfers under the CHST would go to health care because the CHST is a block fund which the provinces can spend wherever they please – including tax cuts, if they wish. While Ottawa needs the CHST to enforce the conditions of universal medicare as set out in the Canada Health Act – provinces which contravene the Act can have their transfer payments reduced – the CHST does not require the provinces to provide any particular level of funding for health services. Canadians must hold their provincial governments to account when it comes to the level of health care spending. However, the federal government could spend more on health in other ways – e.g., conditional transfers to help the provinces bring home and community care more fully within the medicare system, innovation and health research, federal laboratories and public health functions.

ISBN – 1-894159-10-1