| Chapter 1: | Examining Provincial Variability |
for the improvement of medical equipment, plus $500 million for health information technology. The 2003 First Ministers’ Health Care Renewal Accord established funding arrangements to accelerate primary and home-care services and to develop an electronic health-record system. It also sought to focus attention on funding for catastrophic drug coverage and advanced diagnostic services. The federal government added an extra $11.5 billion of health care funding to the provinces for fiscal years 2000 through 2005 (Simpson 1999). It has since introduced additional funds, providing $34.8 billion for 2003 through 2008 (Finance Canada 2003a, 2003b). Federal sources anticipated that this would return the average federal level of spending for health care in the provinces to 37 percent—if one includes tax points given by the federal government to the provinces in 1977 under the Established Programs Financing Act (Finance Canada 2004, 2005).
A September 2004 First Ministers’ Meeting added a further $41.2 billion over a ten-year period (Spurgeon 2004). In this accord the first ministers agreed to develop comparable health indicators for public reports on waiting times, as well as benchmarks defining reasonable waiting times. (Because of the 6 percent escalator in the current Canada Health Transfer, these funds are being progressively folded into the Canada Health Transfer budget; Forest 2010.) The first ministers also agreed to establish targets for waiting times in five areas: cancer, cardiac, diagnostic imaging, sight restoration, and joint replacement. In addition, in April 2004 the federal revenue block grant to the provinces and territories was separated into a health transfer and a social transfer, providing for somewhat greater accountability and transparency with respect to health care outlays to the provinces than the previous CHST grant. Finance Canada estimated that the federal government’s share of total public sector spending for the provinces and territories for 2007–2008 was 38 percent for cash and tax transfers. In 2009 such spending had reached over 40 percent for cash and tax transfers (Finance Canada 2009; Canadian Institute for Health Information [CIHI] 2009).