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Medicare, Meech Lake, and the Federal Spending Power

In the spring of 1987, Canada's first ministers agreed to a package of proposals for reforming major elements of the country's constitution. The package, which has come to be known as the Meech Lake Accord, contains a number of significant provisions, one of which deals with the federal spending power and national shared-cost programs. This provision stipulates that the federal government must compensate provinces that decline to participate in future national sharedcost programs, but immediately adds that such compensation is conditional upon the non-participating provinces establishing “a program or initiative that is compatible with the national objectives.” The provision has led to a great deal of debate and discussion. Of special interest, and concern for some, has been the possible effect of the provision on the capacity of the federal government to use its spending power to set up national shared-cost programs. Some contend that Ottawa's capacity would be severely restricted or even eliminated by the provision. Others claim that it would have little or no impact, that the Accord would simply constitutionalize present practices. These conflicting views on the implications of the Meech Lake Accord for shared-cost programs doubtless flow from many sources, but a major one appears to be differing views on the present ability of Ottawa to establish these types of arrangements.