Ending federal transfers could save Canada's health care system

One of the great advantages of the federal system is that it allows for policy experiments. Academics can theorize about the best way for government to deliver services, but until it is actually tried we don’t really know what will happen. Provinces can learn what went wrong and what went right in other jurisdictions, and Canadians can enjoy better outcomes.

A good example of this is welfare reform in the 1990s. It started with a few provinces making minor adjustments or major changes. Quickly other provinces saw the benefit and made their own reforms, often side stepping pitfalls that the earlier provinces had fallen into. Thus we enacted, what has to be some of the most important public policy reforms in Canadian history, through learning from one and other.

The same thing can happen with health care. To some extent it already does. Provinces fiddle with governance structures and shifting priorities. Still, real reform is hampered by the federal government. The Canadian Health Act prevents any real ingenuity and experimentation.

The federal government uses its deep pockets as a club to prevent innovation in health care policy from the provinces.

This is why I agree with Maxime Bernier that federal transfers to provinces should be ended and provinces should collect more taxes directly.

This will remove the federal government’s club. Provinces will finally be able to enact the changes that they have been itching to do for years, the sort of changes that will give us a chance at making health care sustainable in the long term.