Still waiting

It's no secret that many of the elements included in the Cons' budget had already been announced prominently, while some (particularly the fiscal imbalance plan) were important enough to stand out in even in the midst of a budget. But it's worth noting that what appears to be the Cons' entire solution to a main priority on coming to power was slipped in as an extra - and that there doesn't appear to be much reason for many (or perhaps any) provinces to take the Cons up on the bulk of their wait-times funding offer:

(R)eluctant provinces have been given more than $600-million to comply, even in a small way, with federal demands that they guarantee that certain medical treatments will be provided within clinically acceptable amounts of time.

Any province that limits waiting times for at least one procedure selected from five priority areas -- cancer care, heart care, cataract surgery, joint replacement and diagnostic imaging -- will share in a one-time pot of $61-million.

The funding amounts to something of an about-face for the Conservatives, who have said repeatedly they will provide no additional money for the guarantees -- requirements that the provinces pay to send patients elsewhere when treatment is not available locally in a timely manner.

At least $10-million will go to each province that falls in step with the Conservative plans, and another $500-million will be divided among those same provinces on a per capita basis. The three northern territories will share the remaining $12-million provided.

The funds can be spent any way the province or territory chooses. For Ontario, the decision to sign on to the federal demand for guarantees will mean an additional $205.5-million this year. For Quebec, it will mean $125.6-million. And even tiny Prince Edward Island stands to gain $12.1-million.

Now, it's a small plus that the Cons are at least now willing to offer some funding rather than trying to impose their promise on the provinces without offering any support. But while the Globe's coverage seems awfully sure that all provinces will sign on to the plan, such an outcome seems far from certain.

Let's note first the goofy structure of the funding. By setting up a fixed pool of funding to be distributed on a per-capita basis only among the provinces who participate, the Cons have ensured that each province which signs on will decrease the possible funding available for other provinces.

That may make for some interesting prisoner's dilemma-type situations among the provinces. But it surely isn't the most effective way to get as many provinces as possible onside. And it doesn't seem the least bit unlikely that once one of the largest provinces decides to put itself at the Cons' mercy in dictating its wait times, the others (along with most smaller provinces) will conclude that the diminished potential return isn't worth the cost of implementing the Cons' proposed guarantee.

But then, it could be that no province will see it as worth its while to sign on - particularly given the danger than any commitment will prove to be entirely one-sided.

After all, there's still the strong possibility of an election taking place before the budget passes: a province could easily commit to wait times targets this month, then see the government fall (or engineer its own demise) in April before the budget has moved through Parliament. Which would leave any province agreeing to the Cons' terms with no guarantee of receiving any funding at all...while a public promise would presumably be rather difficult for any province to backtrack from.

Of course, the Cons could have avoided this difficulty by setting a more reasonable deadline than the end of this month. And there's no apparent reason why such a later deadline wouldn't have worked for either side.

As for the smaller envelope of funding for meeting one priority, that'll likely be seen as more reasonable for more provinces based on the relative costs and benefits involved. But at that same time, it's also likely to ensure that each province focuses on meeting only the cheapest of its "guarantees".

And of course all of the above leaves aside the serious problems with a limited wait times program in general.

Notwithstanding the problems with their plan, the Cons will presumably claim that their limited offering completes their list of five initial priorities. But nobody should be surprised if many or all provinces indicate in short order that the Cons' idea of sufficient (and sufficiently-assured) funding is far from enough. Which would properly place the wait-times guarantee alongside the commitments to accountability and child care as areas where the Cons have gone through the motions without ultimately getting much done.