[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-396220-105":3,"detail-sidebar-cat-0-en-105":73,"doc-detail-396220-en":122},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":66,"head_meta":68,"extra_data":70,"updated_unix":72},105,"en","no-treasure-chst-for-health-services","No Treasure CHST for Health Services","","This commentary examines Canada’s healthcare financing debate, arguing that critics misinterpret the 1998 Budget’s lack of new transfer increases for provinces. It explains how block funding through the Canada Health and Social Transfer (CHST) works alongside conditional requirements tied to the Canada Health Act. The analysis concludes that raising the CHST cash floor creates enforceable funding for conditions but does not compel provinces to expand health budgets beyond their prior spending plans, illustrated through provincial budget responses.",{"@graph":14,"@context":65},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/no-treasure-chst-for-health-services/396220/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/no-treasure-chst-for-health-services/396220.png","ImageObject",300,407,{"name":42,"@type":43},"BigDaveOnline","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-26",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",7,{"@type":57,"mainEntity":58},"FAQPage",[59],{"name":60,"@type":61,"acceptedAnswer":62},"How is provincial behavior used to assess the impact of additional CHST funds?","Question",{"text":63,"@type":64},"The commentary considers provinces’ actual responses to the increased CHST cash floor, such as changes to health budgets and other uses of the extra money, to infer what they might do with further “extra” CHST funding.","Answer","https://schema.org",{"og:url":32,"og:type":67,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":69,"canonical":32},"index,follow",{"doc_id":71,"site_id":7},396220,1790902611,{"code":4,"msg":74,"data":75},"success",[76,80,84,88,93,98,101,106,111,114,118],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":77,"show_sort_weight":78,"slug":79},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":81,"show_sort_weight":82,"slug":83},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Exam",70,"exam",{"id":89,"doc_module":4,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},5,"Comic",60,"comic",{"id":94,"doc_module":4,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},6,"Technology",50,"technology",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":99,"slug":100},40,"healthcare",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},8,"Research & Report",30,"research-report",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":108,"show_sort_weight":109,"slug":110},9,"Religion & Spirituality",20,"religion-spirituality",{"id":109,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":109,"slug":113},"World Cup","world-cup",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":115,"slug":117},10,"Lifestyle","lifestyle",{"id":119,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":89,"slug":121},19,"General","general",{"code":4,"msg":74,"data":123},{"doc_id":71,"user_id":124,"nickname":42,"user_avatar":125,"doc_module":4,"category_id":55,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":131,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":132,"faqs":133,"seo_title":134,"seo_description":12,"update_tm":135,"read_time":115,"preview_page_count":4},962090896214,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","caledon commentary  \nJune 1998 ISBN\\# 1-894159-10-1  \nNo Treasure CHST for Health Services  \nIt takes no great insight to know that Canadians are concerned about maintaining a high~~ ~~quality universal medicare system. Now that the economy is improving, polls show healthcare services emerging as the highest public priority. With stories almost every day about emergency room overcrowding and doctors’ and other health care workers’unhappiness, it is little wonder that many Canadians would expect governments to put our tax money where our priorities are, and pay more money into the healthcare system.  \nYet the federal government’s 1998 Budget did not announce new and improved transfer payments to the provinces for health care (above and beyond the previously announced $1.5 billion increase in the cash floor for the Canada Health and Social Transfer), even though Ottawa now appears to have enough fiscal room to spend more money on high priority areas. Given public sentiment about health care, it is not too surprising that many commentators, opposition parties and some Premiers criticized the 1998 Budget for its sin of omission; i.e., its failure to increase federal health financing for the provinces.  \nBut the critics are wrong. If health services are underfinanced, the solution is not to increase federal transfers to the provinces under the Canada Health and Social Transfer. Premiers’protestations notwithstanding, the problem of health financing today falls squarely on the provinces, not Ottawa.  \nTo understand why this is so, it is necessary to take a brief excursion into history. More than 20 years ago, a new block fund, called Established Programs Financing (EPF), replaced cost-matching formulae for federal funding of provincial health and postsecondary education (PSE) . Then, in 1995, both Established Programs Financing and cost-matching for social assistance under the Canada Assistance Plan (CAP) were replaced by a single block fund, the Canada Health and Social Transfer (CHST) . In 1994-95, combined CAP and EPF cash payments were $18.0 billion (in constant 1998 dollars): in 1998-99, cash payments under the CHST will be $12.5 billion − a decrease of $5.5 billion in real terms.  \nLike EPF, the CHST is block funding and it is also conditional funding. Block  \nfunding means the amount of money Ottawa pays to a province does not depend upon how much the province actually spends, be it on health or postsecondary education or social assistance or anything else. Conditionalfunding with respect to health services means a province gets the full CHST payment only if the province’s health plan meets the Canada Health Act conditions.1 For Ottawa to be able to withdraw funding as a way of enforcing the Canada Health Act, there must be some money in the CHST to start with. By increasing the cash floor guarantee to $12.5 billion from the original figure of $11 billion, Ottawa has ensured that there will be sufficient cash in the CHST pot to enforce conditions for the foreseeable future.  \nWhat all this means is that the CHST requires provinces to deliver health services consistent with the Canada Health Act, but the CHST does not require provinces to provide any particular level of funding for health services. If the federal government enriched the CHST, the provinces would in no way be required to increase their health budgets beyond what they would have spent on health anyway. Indeed, the provinces could spend the extra federal money in areas other than health, or use it for tax cuts or even to increase their surplus if they wished. In other words, an increase in the federal CHST does not necessarily make any difference at all to health spending by the provinces.  \nBut even if the provinces are not required to do so, had the federal government given the provinces additional CHST money, would they have used it to put more funding into health care than they would have spent anyway? This question is hypothetical and cannot be answered defi","cbCaifZ1GZbz0hQU","https://ap.wps.com/l/cbCaifZ1GZbz0hQU","pdf",22788,"English","# Background: public priority and the 1998 Budget\n## CHST structure: block funding and conditions\n## Why criticism of federal transfers is misguided\n## Historical shift from EPF and CAP to CHST\n## What provinces likely do with “extra” CHST money","[{\"question\":\"How is provincial behavior used to assess the impact of additional CHST funds?\",\"answer\":\"The commentary considers provinces’ actual responses to the increased CHST cash floor, such as changes to health budgets and other uses of the extra money, to infer what they might do with further “extra” CHST funding.\"}]","No Treasure CHST for Health Services | PDF",1790437624]