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The leaders of Canada's provinces and territories are in Ontario Premier Doug Ford's backyard today, looking to craft a policy agenda they hope will be palatable to the minority Liberal government in Ottawa.

While many of the premiers have met one-on-one with Prime Minister Justin Trudeau since the Oct. 21 election, the Toronto-area meeting is the first time all the premiers are meeting as a group since voters returned Trudeau to Ottawa with a second mandate.

On the way into the meeting Monday, all premiers who spoke to the media said they will be looking for more money from Ottawa to shore up provincial budgets, some of which have been hit by sinking oil prices and soaring health-care costs.

Manitoba Premier Brian Pallister said health care will be the most pressing agenda item at this meeting. He said the federal government is pushing a national prescription drug plan at a time when the country's existing health care system is already stretched.

"Our patients are waiting longer and longer for surgeries, emergency rooms, for hips and knees, you name it. This is an issue we need to focus on. Pharmacare — we can get to that later. Let's get the sustainable funding for health care," he told reporters on his way into the meeting Monday.

Ford has said health-care funding is a top priority for premiers gathered at the Council of the Federation meeting in Toronto. (Evan Mitsui/CBC News)

The Council of the Federation, which is composed largely of conservative-minded premiers, are meeting at Ford's suggestion in an airport hotel not far from his Etobicoke North riding.

Ford, who was wearing Winnipeg Blue Bombers jersey Monday after losing a bet to Pallister over the Grey Cup, is also keen to make health-care funding a priority at the one-day meeting.

The premiers have been pushing Ottawa to lift the current health care spending growth cap — currently set at three per cent each year — to help provinces tackle their single biggest budget line item.

Ford said the Canada Health Transfer — the money the federal government sends to the provinces and territories to help them pay for health care — should grow by 5.2 per cent a year to better address mounting costs in the sector as the country's population ages.

The Liberal campaign platform pledged $6 billion over four years in new health spending, with funding earmarked for boosting the number of doctors, a move toward a pharmacare program and improvements to mental-health services.

Pallister said Monday there should be fewer strings attached to the funding Ottawa sends to the provinces, adding the policy area falls under provincial jurisdiction.

Ford: 'We'll get over these bumps'

Ford, a Progressive Conservative, has tried to present Ontario as unifier at a time when national unity seems to be threatened by fractious relations between Ottawa and the resource-rich provinces in the West. It's a role the province has played in the past during the constitutional squabbles of the 1980s and 1990s.

"With a group of premiers — all 13 are showing up — we're going to have disagreements, but I think that's healthy, to be very frank," Ford said.

"We have to listen to the people out West and listen to their concerns. A lot of people are struggling out West. I mentioned that to the prime minister as well, and he agrees. He wants to support everyone right across this country and I'm going to support the prime minister by making sure we get as much support as possible."

"We want to send the message around the world that we're a united Canada. We're stronger together and we'll get over these bumps," Ford said, referring to disagreements between Western Canada and Ottawa.

B.C. Premier John Horgan, left, and Alberta Premier Jason Kenney, right, are pictured ahead of the Council of the Federation meeting in Toronto, Ont. Kenney is pushing for changes to the federal fiscal stabilization program. (Evan Mitsui/CBC News)

After the Liberal government introduced a series of measures perceived as an affront to the country's natural resources sector, voters this October turfed all Liberal MPs between Manitoba and B.C.

Since the election, Trudeau has restructured his cabinet, redeploying his top lieutenant, Deputy Prime Minister Chrystia Freeland, from the foreign affairs file to intergovernmental affairs as he looks to tamp down growing unease in Western Canada. Freeland, a native of Peace River, Alta., has assumed the national unity file.

Speaking to reporters Sunday ahead of Monday's meeting, Saskatchewan Premier Scott Moe said he hopes the 13 provincial and territorial leaders can reach a consensus on joint priorities they can ask the federal Liberals to act on now — such as a tweak to the fiscal framework and directing more money to the provinces for health care.

The premiers will craft a list of priorities they can present to Trudeau when they all gather for a formal first ministers' meeting, which is expected in January.

"My No. 1 priority is to come to a consensus on a number of issues on behalf of all Canadians, as well as on behalf of providing that guidance from coast to coast to coast to what we have now — a minority federal administration," Moe said.

Moe, the current chair of the Council of the Federation, has had a poor relationship with the federal Liberals. He left a recent meeting with Trudeau expressing frustration, saying he only heard "more of the same" from the prime minister. Moe has urged a radical rethink of Bill C-69, the controversial Environmental Assessment Act that opponents say will make it difficult to build new natural resources projects. Ottawa has so far rebuffed calls for the repeal of, or major amendments to, the legislation.

Prime Minister Justin Trudeau, right, meets with Moe in his Parliament Hill office last month. (Justin Tang/The Canadian Press)

Moe and Alberta Premier Jason Kenney also have urged Ottawa to revisit the current equalization formula, something they have said is unfair.

While a major reworking of the formula seems unlikely, the two western premiers have said they will push for changes to the fiscal stabilization program and they hope to bring the other premiers onside.

Change fiscal stabilization

Kenney — who recently introduced an austerity budget in an effort to get the province back on a more sound fiscal footing amid a prolonged oil price slump — has said Ottawa should retroactively change the formula to ensure his province can tap more money.

The program, which is administered by Finance Minister Bill Morneau, provides financial assistance to any province faced with a year-over-year decline in its non-resource revenues greater than five per cent.

The problem for Kenney is that his province already has been floated the maximum amount the program allows for each year — $60 per person or, in the case of Alberta, $250 million a year — a sum he said is inadequate given the size of the budget hole the province is facing.

In 2015–16, for example, the province's revenues contracted by a staggering $8.8 billion, and yet this insurance-like program paid out just $248 million.

Newfoundland and Labrador Premier Dwight Ball, a Liberal, has said a change to equalization is the "wrong target" but he'd be open to tweaking the stabilization program.

"We need to be able to have a fund that's not tied to equalization, but that can respond within the next year. If Alberta is doing well, Newfoundland and Labrador will do well, Saskatchewan will do well, and so, therefore, all of Canada will benefit," he said.

'Include a deductible'

Academics, including the University of Calgary's Bev Dahlby, have suggested that Alberta focus its energies on securing a new deal from Ottawa on this program, arguing that pursuing a change to the equalization formula (a non-starter for provinces like Quebec and those in Atlantic Canada, which rely on the program as it is currently constituted) is a waste of political capital.

"A fair formula for a fiscal stabilization program should meet the same criteria as any good insurance policy. It should cover only significant losses ... It should include a deductible to ensure that the insured party, the province in this case, still has an incentive to manage their fiscal affairs responsibly. And it should offer simple and transparent terms along with a streamlined claims process," Dahlby wrote in a June 2019 paper on the topic.

"Improving the formula will not save Alberta and other resource-rich provinces from all the pain of the occasional resource bust, but it will help alleviate some of it," he said.

Ford, Moe and New Brunswick Premier Blaine Higgs also signed a memorandum Sunday that will commit the three provinces to studying nuclear reactor technology — the deployment of small, modular reactors. The leaders said it would help their provinces lower greenhouse gas emissions as Canada shifts from coal-fired power plants to less carbon-intensive sources of energy.