Trudeau lays out markers on health care, climate change and pipelines

As the federal government steels itself for intense end-game negotiations with the provinces over health care, climate change and pipelines, Prime Minister Justin Trudeau drew the lines he isn't willing to cross.

Trudeau laid out his markers at a news conference Wednesday in Ottawa to coincide with his return to the House of Commons after the summer break and several international trips.

• Premiers call for meeting with prime minister on health-care funding
• Ottawa favours targeted health-care spending over increased transfer to provinces

Federal Health Minister Jane Philpott is in the middle of negotiating a new multi-year health accord with the provinces. Trudeau noted the ongoing negotiations and said Canadians expect a health care system that "adjusts to an aging population" highlighting his government's election commitments "around increasing home care."

But in any new health accord agreement the provinces have made it clear they want the ability to set their own priorities, spending any additional money where they think it is needed most.

Trudeau's home care comments indicate that if new health money is provided to the provinces, some of it will have to be earmarked for a home care plan.

"We are going to work with the provinces. We are going to make sure we are creating a system that works for Canadians while respecting the Canada Health Act," he said. "That's what people expect."

Philpott has already made moves to remind the provinces that the federal government would not tolerate a subversion of the Canada Health Act.

No more user fees

Earlier this month Philpott sent a letter to Quebec's Health Minister Gaétan Barrette notifying him she would deduct from Quebec's forthcoming health transfer an amount equal to the user fees doctors offices have been charging in that province.

Barrette has since said he will eliminate user fees in Quebec, such as $20 to $300 for eye drops or $500 for colonoscopy equipment, which have totaled from $50 million to $100 million annually.

• Justin Trudeau won't rule out imposing carbon price plan on provinces
• 'Now is not the time': Sask. Premier Brad Wall says of carbon tax

Trudeau also drew his line in the sand on climate change.

After meeting with the premiers in Vancouver in February four working groups were formed to address key areas: clean technology and innovation, carbon pricing, mitigation and adaptation.

Those groups will be reporting back to the federal Environment Minister Catherine McKenna this fall before more concrete proposals are debated at a first ministers meeting some time after that.

National price on carbon

Those proposals are supposed to become the basis for how Canada will meet the climate change targets it set when it committed to the deal last December.

"All provinces are agreed that we have to follow through with the Paris agreement. And all provinces also agreed that carbon pricing is an essential part of the mix in terms of how we will reduce emissions," Trudeau said.

Saskatchewan Premier Brad Wall has expressed vehement opposition to a nationally imposed carbon tax, saying now is not the time to tax the already struggling resource sector. Trudeau, recognized regional difficulties Wednesday, but showed no indication he was willing to back down from his international commitments.  

"Canada is not a one-size-fits-all place. There are different concerns, different needs, but we share a same objective; to reduce our emissions and that is exactly what we are working on. As for ratification we'll be doing that in the coming weeks," he said.

As pipeline proponents continue push the federal government for approval to construct new projects to bring oil to tidewater Trudeau reaffirmed that he had no intention of budging on his campaign commitments.

"As I have said before, the Great Bear Rainforest is no place for a crude oil pipeline and I haven't changed my opinion on that."