TILMA and Medicare

An editorial in today’s Calgary Herald begins with the usual praise for TILMA, but ends by suggesting a new interprovincial deal on healthcare:

Yet, for Ottawa to attempt to remedy matters by intruding itself into relations between the provinces would not only provoke reflexive opposition but, even if carried through by force majeure, be unlikely to work.

Certainly, the Canada Health Act has not led to congruency among provincial health programs: Treatments approved in some provinces are not available in others, for instance, a reality that mocks the portability requirement of the act.

. . .

However, when two provinces agree to harmonize their standards while upholding their jurisdiction, the constitutional arguments are satisfied: The rest of the country should applaud their initiative and, it is to be hoped, seek to emulate their example.

. . .

First commerce, then health?

It is always advisable to walk, before attempting to run.

However, by attempting to show how mutual advantage can arise from friendly agreement, Canada’s two western provinces may turn out to be on the leading edge of a more efficient federalism.

The two governments deserve every encouragement in negotiating an agreement.

What does the Herald have in mind? The Canadian Press recently reported:

Alberta is taking a “leadership role” that he expects other provinces will follow, says the premier.

The strategy includes buying drugs with neighbouring provinces “on a much larger scale” to reduce costs, and using new labour mobility agreements to recruit doctors and nurses from other provinces.

Provincial governments co-operating to maximize their market power in buying pharmaceuticals is an excellent idea. However, progressives were proposing this approach long before corporate Canada’s latest round of hyperventilation about supposed “internal trade barriers”.

More generally, I suspect that many Canadians would not welcome the healthcare policies that Alberta’s Conservatives and BC’s Liberals would likely champion. Indeed, “the Canada Health Act has not led to congruency among provincial health programs” largely because these two provincial governments have aggressively deviated from this Act.