Goodbye majority, hello minority: What the federal election means for health care

After a campaign that saw more personal mudslinging than policy messaging, the conclusion of the 2019 federal election could not have been more fitting. The Liberals lost their majority and will now require the support of either the NDP, the Bloc Québécois, or the Conservative Party to pass legislation in the House of Commons. Meanwhile, despite winning the popular vote, the Conservative Party could not muster enough support to top the Liberals in number of seats won.

Here are the three key election takeaways from the team at Santis.

The Liberal’s health care agenda will move left.

With the NDP likely to hold the balance of power, we expect health care issues to feature prominently in any formal or informal arrangement between the Liberals and the NDP – with national pharmacare an area of natural alignment.

Although the Liberals have committed to moving forward with the recommendations of the Hoskins Panel, public pronouncements thus far have not been matched by action. With the NDP advocating for a more ambitious pharmacare model, Justin Trudeau and his team may be pushed to go further and move faster then they had originally intended.

Reviewing the NDP’s election platform, there are incredibly specific (and somewhat unrealistic) health-related commitments – including amendments to the Canada Health Act that would fund specific hospitals and medical schools. We expect that many of these proposals will get watered down or fall off the radar entirely, especially since many of the commitments would move the federal government squarely into areas of provincial responsibility.

The fundamentals of governing will get harder.

Historically, minority governments have been unable to hold confidence in the House of Commons for a full four-year term. Recent minority governments in Ontario and in Ottawa have lasted between two and three years, meaning Canadians should be prepared to head back at the polls before 2023. 

Resistance from Conservative Premiers across the country will add to ongoing governing challenges especially given recent calls from the provinces for a new approach to health and social transfers. In the last four years, the Trudeau Government has focused more on conditional funding for specific health system challenges rather than large general health transfers to provinces. However, the Trudeau Government has maintained pre-existing funding increases to the Canada Health Transfer. We expect provincial and territorial leaders to use the precarious situation of a minority government to press for more money and more freedom to spend it.

The Liberals, however, still possess significant regulatory authority. The government can exercise this power without soliciting the support of other parties to craft and implement regulations. This power could result in a focus on operational and incremental changes, rather than sweeping, strategic changes.

The “Big 3” have wins and losses to reconcile.

The Liberals found their way to re-election – but hold zero seats between Winnipeg and Vancouver. While the Liberals managed to maintain their hold as the governing party, they were reduced to a minority and lost seats in every province, largely as a result of losing ground with the progressive voters who secured their 2015 victory.

  • Tory turnout was impressive – but the loss will sting. The Conservatives won the popular vote and increased the number of seats they hold from 99 to 121. However, the Conservative Leader remains in Official Opposition to a Liberal Party that won the most seats with 157.
  • The NDP lost badly – but gained crucial influence. NDP Leader Jagmeet Singh was able to stay above the fray with respect to political mudslinging during the campaign, but his party lost 20 seats, including all but one seat in Quebec. The silver lining? The party is best positioned to prop up a Liberal minority government.
  • The Bloc Québécois are the true “winners” in this election. The resurgence of the Bloc speaks more to Quebec’s dissatisfaction with the major parties, however, the result is a party with 32 seats that will be predominately focused on regional grievances.
  • The Green Party’s caucus now stands at three, further demonstrating voter willingness to reject the “Big 3”.
  • The Peoples’ Party of Canada, on the other hand, didn’t make any headway in this election and looks likely to vanish from the national scene as Leader Maxime Bernier failed to secure his own seat.

The bottom line

We now have a minority government that will likely look to the NDP for support as it tries to pass legislation and govern properly despite confronting emboldened opponents and losing control over parliamentary committees.