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Even medical care is strictly withing provincial jurisdiction. But the only reason we have universal coverage in the form of Medicare is that the federal govern

Even medical care is strictly withing provincial jurisdiction. But the only reason we have universal coverage in the form of Medicare is that the federal government forced provinces to offer a minimum set of services through the power of funding. I am glad they did it, and I hope they expand it to Pharmacare, but I am not holding my breath.

908B64B197 6y ago
The feds basically offered a subsidy right? It's the provinces that truly made it a centralized public system no?
- smnrchrds 6y ago
  You know how the US forced all states to increase drinking age to 21? That's how Canada forced all provinces to adopt universal healthcare. Essentially, there is a minimum set of requirements the provincial healthcare plans must offer. They are free to not adhere to it, but then the amount of funds they get through Canada Health Transfer (money from the federal government given to provincial governments to spend on healthcare) will get reduced or completely removed. Canada Health Transfer accounts for approximately 10% of all provincial government revenues, at least in Alberta and Ontario that I checked. It's a serious bit of change and a strong incentive to follow federal guidelines. As a side note, the fact that the federal government can use its spending powers to enforce policy that is not within its jurisdiction is very unpopular in Quebec and one of the changes Quebec wants made to the constitution. https://budget.ontario.ca/2019/chapter-3.html#section-6 https://budget.ontario.ca/2019/chapter-3.html#section-6 https://globalnews.ca/news/3496355/quebec-canada-constitution-amend-reopen/ https://globalnews.ca/news/3496355/quebec-canada-constitutio... https://ualawccsprod.srv.ualberta.ca/2019/07/federal-spending-power/ https://ualawccsprod.srv.ualberta.ca/2019/07/federal-spendin...
  - 908B64B197 6y ago
    > As a side note, the fact that the federal government can use its spending powers to enforce policy that is not within its jurisdiction is very unpopular in Quebec and one of the changes Quebec wants made to the constitution. Especially since the fact that the federal government has money to spend for these means that it's collecting too much and for purposes not under it's jurisdiction. Quebec is very wise to want to put an end to this.
    - smnrchrds 6y ago
      The downside is that without federal pressure, we may never have gotten universality, reciprocity, and transferability for programs like Medicare and CPP/QPP. I'm sure provincial governments would love it. But we the citizens would have been worse off.
      - 908B64B197 6y ago
        Some provinces would have. It's up to the citizens of each province to vote for the laws that serves them better, not some overarching central bureaucracy desperately trying to illegally acquire more powers.
        smnrchrds 6y ago
        1) It is legal. The whole point of Quebec wanting to change the constitution is to make it illegal. If it were already illegal, there would be no point in making it illegal again. 2) It is up to the citizens of Canada to vote for laws that serves them better, and they have voted for federal politicians who created, expanded and maintained laws such as Canada Health Act (CHA). The democratic voice in federal election is no less democratic than the provincial election. 2) I don't think any provinces would have created reciprocal systems. Case in point: CHA mandates reciprocity for the services provided under CHA. That is to say, if you are an Ontario resident and you get into an accident in BC and have to go to the hospital, you would not have to pay for the stay. Most provinces offer extra services that are not mandated by CHA. For example, prescription drug coverage and ambulance services. Since these services are not under CHA, there is no obligation for their reciprocity. Lo and behold, none of the provinces reciprocate these services. It is strongly recommended to purchase travel insurance for out of province travels for this very reason—a call in another province may cost you 1000's or 10's of thousands of dollars. Considering that the provinces are doing the very bare minimum they are legally obligated to do by the federal government in terms of reciprocity, I do not believe we would have gotten any reciprocity at all without the federal mandate. Also, Alberta would most probably have US-style healthcare system with US-level prices.

908B64B197 6y ago

The feds basically offered a subsidy right? It's the provinces that truly made it a centralized public system no?

smnrchrds 6y ago
You know how the US forced all states to increase drinking age to 21? That's how Canada forced all provinces to adopt universal healthcare. Essentially, there is a minimum set of requirements the provincial healthcare plans must offer. They are free to not adhere to it, but then the amount of funds they get through Canada Health Transfer (money from the federal government given to provincial governments to spend on healthcare) will get reduced or completely removed. Canada Health Transfer accounts for approximately 10% of all provincial government revenues, at least in Alberta and Ontario that I checked. It's a serious bit of change and a strong incentive to follow federal guidelines. As a side note, the fact that the federal government can use its spending powers to enforce policy that is not within its jurisdiction is very unpopular in Quebec and one of the changes Quebec wants made to the constitution. https://budget.ontario.ca/2019/chapter-3.html#section-6 https://budget.ontario.ca/2019/chapter-3.html#section-6 https://globalnews.ca/news/3496355/quebec-canada-constitution-amend-reopen/ https://globalnews.ca/news/3496355/quebec-canada-constitutio... https://ualawccsprod.srv.ualberta.ca/2019/07/federal-spending-power/ https://ualawccsprod.srv.ualberta.ca/2019/07/federal-spendin...
- 908B64B197 6y ago
  > As a side note, the fact that the federal government can use its spending powers to enforce policy that is not within its jurisdiction is very unpopular in Quebec and one of the changes Quebec wants made to the constitution. Especially since the fact that the federal government has money to spend for these means that it's collecting too much and for purposes not under it's jurisdiction. Quebec is very wise to want to put an end to this.
  - smnrchrds 6y ago
    The downside is that without federal pressure, we may never have gotten universality, reciprocity, and transferability for programs like Medicare and CPP/QPP. I'm sure provincial governments would love it. But we the citizens would have been worse off.
    - 908B64B197 6y ago
      Some provinces would have. It's up to the citizens of each province to vote for the laws that serves them better, not some overarching central bureaucracy desperately trying to illegally acquire more powers.
      - smnrchrds 6y ago
        1) It is legal. The whole point of Quebec wanting to change the constitution is to make it illegal. If it were already illegal, there would be no point in making it illegal again. 2) It is up to the citizens of Canada to vote for laws that serves them better, and they have voted for federal politicians who created, expanded and maintained laws such as Canada Health Act (CHA). The democratic voice in federal election is no less democratic than the provincial election. 2) I don't think any provinces would have created reciprocal systems. Case in point: CHA mandates reciprocity for the services provided under CHA. That is to say, if you are an Ontario resident and you get into an accident in BC and have to go to the hospital, you would not have to pay for the stay. Most provinces offer extra services that are not mandated by CHA. For example, prescription drug coverage and ambulance services. Since these services are not under CHA, there is no obligation for their reciprocity. Lo and behold, none of the provinces reciprocate these services. It is strongly recommended to purchase travel insurance for out of province travels for this very reason—a call in another province may cost you 1000's or 10's of thousands of dollars. Considering that the provinces are doing the very bare minimum they are legally obligated to do by the federal government in terms of reciprocity, I do not believe we would have gotten any reciprocity at all without the federal mandate. Also, Alberta would most probably have US-style healthcare system with US-level prices.