Although the provinces and territories had generally managed to balance their budgets and eliminate deficits by the early twenty-first century, health care costs continued to increase, and some experts and pundits were claiming that these expenses were distorting provinces’ plans for future growth in other areas. In addition, studies indicating the high price of end-of-life care pointed to the aging population becoming a threat to medicare. Thus, when Paul Martin succeeded Jean Chrétien as prime minister, one of his key goals was to alleviate Canadians’ fears about waiting lists and the future of medicare. In the spring 2004 election campaign, Martin and his party accused Stephen Harper and the Conservative Party of supporting Klein-style privatization. Since the Alberta premier was talking about opening private clinics in contravention of the Canada Health Act, there appeared to be substance to the Liberals’ claim, although this did not win them a majority vote and, when Prime Minister Martin met the premiers in September 2004 to discuss a further accord, there was great skepticism about the Ten-Year Plan to Strengthen Health Care. Indeed, the First Ministers’ Conference almost broke down over the federal expectation that the provinces would establish benchmarks to compare how they were controlling waiting lists for procedures relating to cancer, cardiac care, diagnostic imaging, cataract surgery, and hip and knee replacements. But, with the promise of $5.5 billion of the $41 billion federal commitment over 10 years targeted at reducing wait times, the provinces and territories agreed to increase access to medical services and aimed to have provincial standards in place by December 2005.
It was agreed that similar improvements were to occur in home care and primary care. By 2011, each provincial and territorial government was expected to have 50 per cent of its population enrolled with multidisciplinary health teams that would provide care 24 hours a day, seven days a week. And for Aboriginal Canadians and those in the North, more funding was offered to aid in transporting the sick. As well, all the provinces and territories, except Quebec, agreed to work on a national pharmaceutical strategy. Outside the meeting, health care providers and the public watched anxiously to see if the deal- making would produce real change.