Bilateral health care deals are not new. In the 1950s, most health deals were bilateral arrangements between Ottawa and specific provinces, with the federal government retaining the right to determine how its money was spent.
These bilateral arrangements were largely replaced in the 1960s by a more hands-off system in which Ottawa transferred money to the provinces under a general understanding that it would be used for health-related purposes .But now there seems to be a feeling in Ottawa that the provinces are botching medicare — that they are using federal money simply to prop up a wasteful status quo instead of transforming the system.
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