The Government of Canada and provincial/territorial governments will agree on a framework of accountability for these new social initiatives and investments. The inter-provincial collaboration model was recently proposed as a new model of federalism16. This model suggests that Ottawa return social programs to the provinces through unconditional funding. The provinces would then agree with each other on maintaining standards. There is no guarantee that such agreements will be concluded, but it has been argued that the engagement of Canadians in these programs would ensure the introduction of this aspect of the model.16 There are also concerns about the likelihood of provincial cooperation without federal direction.17 The latest SUFA clause promises a review at the end of three years (including the participation of “social policy experts”). Given that the first three years of the SUFA ended on February 4, 2002, it is essential to assess its effectiveness and impact on Canadian social policies, particularly with respect to early childhood and education policies. In a detangled model of federalism, there is very little interdependence between the two levels of government. Each level has a clearly defined constitutional role, and each has a “waterproof” role. Untangled federalism was the original form of federalism, which worked in the health care system, because the health care system was constitutionally a provincial domain with low federal participation.4,5 In a unilateral federal model, there is a great deal of interdependence between levels of government. The relationship is hierarchical, with the federal government having the capacity to compel provinces to manage programs in a certain way. The development of public medical and hospital insurance was a step towards a unilateral federal relationship. The federal government agreed to match provincial spending on these dollar-for-dollar programs, if certain standards were met, a system that created a new interdependence between the two levels of government.6,7 Ottawa`s commitment to the terms of its funding made the relationship hierarchical. In a collaborative model, there is an interdependence between the two levels of government, but no constraint on the part of the federal government.
Instead, agreements are concluded through discussion and consensus. On the other hand, there is no interdependence in an interprovincial collaboration model. In this model, the provinces are working together to get agreements on how programs should be implemented, and the federal government is largely excluded. The framework agreement and the health agreement can be seen as the approval of a “national” health system, with a reaffirmation of national standards and principles of the Canada Health Act. The main advantage of a movement towards a more collaborative relationship is the potential to break the deadlocks that have existed between thought leaders and the provinces in the development of new health initiatives. The first major test of the framework agreement and the health agreement will be the development of national initiatives in pharmaceutical and home care. To date, the development of these programs has been hampered by provincial mistrust of Ottawa in reducing CHST transfers. The federal states are concerned that the federal government will agree first on the cost-of-ownership of these programs and, subsequently, on the reduction of its premiums, as has been the case with health and hospital insurance.