|
PRB 98-3E
THE CANADA HEALTH AND
SOCIAL TRANSFER
Prepared by Odette Madore
Claude Blanchette
Economics Division
September 1998
The
federal government uses transfer payments under the Canada Health and Social Transfer
(CHST) to help the provinces carry out their responsibilities in terms of health,
post-secondary education and public assistance. The CHST is a block funding method that
came into force in the 1996-97 fiscal year; it represents a merger of two major programs:
Established Programs Financing (EPF) and the Canada Assistance Plan (CAP). Unlike EPF, it
does not provide an equal per capita entitlement. Nor is it a shared-cost program, as was
the CAP: contributions are not based on provincial expenditures. It operates as follows:
The Federal-Provincial
Fiscal Arrangements Act determines the total amount of CHST entitlement: this is set
at $26.9 billion for 1996-97 and $25.1 billion for the period from 1997-98 to 1999-00.
Thereafter, until 2002-03, the transfer will be adjusted annually according to the rate of
growth in the GDP, but the actual adjustment will be less than the economic growth rate.
Initially, the Act provided
a floor of $11 billion for the cash transfer. The purpose of this floor is to provide
protection against unexpected economic fluctuations that might reduce the total
entitlement or significantly increase the value of the tax transfer, leading to a decrease
in cash transfers to provinces. Bill C-28, which received Royal Assent on 18 June 1998,
raises this lower limit on the cash floor to $12.5 billion for 1997-98 and beyond.
The Act also determines the
method whereby the total entitlement is allocated among the provinces. For 1996-97 and
1997-98, the provinces received their share of transfers made under CAP in 1994-95 and the
EPF in 1995-96. In subsequent years, the provincial shares of the CHST will be established
partly on the basis of the provinces demographic weight within Canada as a whole.
Certain conditions are
imposed on the cash transfer, and provinces that do not comply with these conditions may
have their transfer payments reduced. More specifically, provincial health insurance plans
must comply with the criteria of the Canada Health Act (universality,
accessibility, comprehensiveness, portability and public administration) and must require
no contribution from users through extra-billing or user charges. Nor may provinces impose
minimum residency requirements on social assistance applicants. There are no special
conditions for post-secondary education.
The effect of
the CHST has been to decrease, then stabilize until 1999-00, transfer payments for health,
post-secondary education and social assistance:
From 1995-96 to 1996-97, the
total CHST entitlement decreased by nearly $3.0 billion. Without changes to the initial
legislation, the reduction would have amounted to $4.6 billion between 1995-96 and
1999-00. During the same period, the cash transfer would have declined even more steeply,
by almost $6.5 billion.
The changes introduced by
Bill C-28 will attenuate these reductions. Accordingly, the total entitlement will decline
by $3.1 billion between 1995-96 and 1999-00, while the cash transfer will decrease by $5.0
billion.
Under the
initial legislation, it would have been necessary to apply the cash floor provision in
1999-00. Raising the cash transfer threshold from $11 to $12.5 billion, as provided for in
Bill C-28, will:
Increase the total CHST
entitlement by $216 million in 1997-98, $874 million in 1998-99, and
by $1.5 billion from 1999-00
until 2002-03, or an overall increase of $7.0 billion (see table below);
Strengthen the federal
government's involvement in the system of health insurance and social programs.
|
|