What to watch for as Canada's premiers meet in Victoria

It's been three years since what used to be a staple of the political calendar — the annual summer premiers' gathering — was held in person.

As the Council of the Federation reconvenes, Canada's premiers are packing a lot of familiar baggage, particularly when it comes to their demands of the federal government.

After meeting frequently — sometimes weekly or biweekly — earlier in the pandemic, the premiers now feel "ghosted" by Ottawa, B.C. Premier John Horgan, the chair and host of this year's gathering, told CBC Radio's The House on the weekend.

It's unclear what might be delivered between now and Tuesday night, since only one side of the federal-provincial table is gathering in Victoria. Nevertheless, here's what's on premiers' minds.

It was already the biggest expenditure in premiers' budgets and an oft-cited top priority for voters. Then COVID-19 put unprecedented stress on health infrastructure that advocates warned wasn't up to code even before the pandemic.

"When you look at our health-care system compared to other, comparable countries, it's been deteriorating in terms of the quality of care and the timeliness of care over a long period of time," Canadian Medical Association president Katharine Smart told CBC's The Current last week. "That's not only about dollars. That's about failing to modernize the system."

Still, it's the dollars premiers were talking about before travelling to Victoria. They reminded Canadians, yet again, that the federal share of health-care spending (22 per cent, they calculate) is nowhere near where it used to be (35 per cent) or needs to be (as much as the 50 per cent it once was, as Alberta's Jason Kenney and Manitoba's Heather Stefanson have told us).

So they're asking Ottawa, yet again, to sit down and negotiate larger Canada Health Transfer payments.

WATCH | More health care funding is a key demand for provincial premiers:

It's not that Justin Trudeau's Liberal government doesn't agree that more health-care funding is necessary, although officials take issue with the 22 per cent calculation, arguing the premiers' math ignores their revenue from federal tax points transferred to the provinces since 1997.

While both sides call for a more "adult conversation" on health-care funding in place of a "sterile" debate on percentages that now resembles a stalemate, the premiers' request last fall for an urgent first ministers' meeting on health care was rebuffed.

Why? Provincial elections in Ontario (this spring) and soon, Quebec (this fall), apparently made for difficult political timing in Ottawa's eyes, even though last winter's supply and confidence agreement with the federal NDP has presumably given Trudeau's Liberals more space to work something out without fear of a writ period of their own.

As chair, Horgan (a New Democrat) along with Newfoundland and Labrador Premier Andrew Furey (a Liberal) and Saskatchewan Premier Scott Moe (representing more conservative premiers), have been trying to engage Trudeau in what they say is a non-partisan way. But it hasn't worked.

"As the kids say, we've been ghosted by the federal government," Horgan said. "I know the prime minister is committed to this, but it's a matter of timing and tick-tock goes the clock, as far as I'm concerned."