The new federal government under Justin Trudeau has a chance to do something that will have a much bigger impact than legalizing marijuana, changing election laws or building roads and bridges.
Those promises have gotten the lion's share of attention (along with an expanded refugee admittance program) but another promise has flown under the radar. But it can't hide in plain sight forever.
I'm referring to Trudeau's election promise to arrive at a new health care funding accord with the provinces. Reaching that goal is critically important to provincial governments, which have faced extraordinarily funding pressures to maintain even status quo levels in their health care systems.
The promise was on display, albeit briefly, last week when the country's health ministers met in Vancouver. The meeting wrapped up with pledges to from both federal and provincial governments to work together to reduce the cost of prescription drugs, and to cooperate on such issues as health innovation.
Federal health minister Jane Philpott has left the door open to coming up with new health accord, which is encouraging. In fact, there seems to be a renewed sense of cooperation on health matters between Ottawa and the provinces.
To illustrate how important a new accord is, just look at any provincial government's annual budget. Almost half of it is spent on health care, whose relentlessly spiraling costs put the squeeze on other important parts of that budget, whether they are education, social services or anything else.
It wasn't always thus. Not only have health care budgets exploded, partly as expensive new technology has made possible all kinds of health services unheard of when the public system was first created.
But the federal government's share of funding health care has shrunk significantly as it has off-loaded costs onto the provinces. In 2015, the provinces spent $145 billion on health care, while the federal government contributed a little more than $30 billion.
The federal Liberal government of the 1990s was the first to start greatly reducing health transfers to the provinces. It eventually established the 10-year health accord after loud protests from provincial governments, but the former Harper government declined to renew it and instead arbitrarily tied health care funding increases to economic growth.
But economic growth rate hovers around two to three per cent, which is much lower than the annual percentage increase to health budgets. And the increases are to be distributed on a per capita basis, which penalizes places like B.C., whose older population costs more because it uses the health care system more often.
Any graph that charts health costs by age group shows an incredible spike in costs for those age 75 and over (only infants, in their first year, incur costs comparable to a 75-year-old).
In B.C., 17.5% of the population is age 65 or more. The national average is 16.1%, while the prairie provinces are much lower (11.6-14.8%). Only the Atlantic provinces, at 18.4-19%, have an older population than B.C.
That may not look like a big gap, but it can mean the difference of hundreds of millions of dollars in health care spending. The B.C. government has rightly argued federal health care funding increases should be based on demographics, which will help cover the costs of all those retirees who relocate here from places like Alberta and Saskatchewan.
Over a period of just a few years, the cost to B.C. of a per capita funding formula versus one that reflects demographics could far exceed whatever Ottawa spends on infrastructure in this province.
B.C.'s health budget will approach $18 billion in the coming year, an increase of about $500 million from year to year. And the following year it will receive another $500 million or so, and so on. The federal government's funding increase each year comes nowhere near that kind of spending increase.
The gloom of the latter years of the Harper government which seemed to have settled on so many things -- including provincial-federal relations -- appears to have been lifted with the election of a new government.
We'll see if the new prime minister brings some much needed sunshine to funding a health-care system that everyone uses, but which costs so much.
Keith Baldrey is chief political reporter for Global B.C.
