The Framework Agreement on the Social Union (SUFA) was a 1999 agreement reached in Canada between Prime Minister Jean Chrétien and the premiers of Canada`s provinces and territories, with the exception of Quebec Premier Lucien Bouchard. These include equal opportunities, social programs, mobility rights and other rights. With respect to Canada`s new health initiatives, post-secondary education, social assistance and social services funded by intergovernmental transfers, whether funded by blocking funds or funded by costs, the Government of Canada will do so: under the agreement, with the agreement of the federal government and the majority of provincial governments, new transnational social programs with federal funding can also be put in place. As scholar Jennifer Smith notes, “there is no additional requirement for a minimum population” of the provinces that support the programs. While in theory, the federal government could easily achieve new programs by targeting “poorer provinces,” particularly Atlantic Canada, Smith notes that this view “…… that the poorest provinces are indiscriminate programmers.  A final agreement was signed by all provinces except Quebec on February 4, 1999. The key elements of this agreement, which will have an impact on health care, are the reaffirmation of the principles of the Canada Health Act, the commitment to consult with the provinces and territories 1 year before the transfer changes, commitments to cooperate with the provinces in the development of new programs and not new initiatives without the agreement of the majority of provinces, and commitment to a collaborative dispute resolution mechanism.1 The health agreement, the provincial guarantee to comply with the principles of the Canada Health Act and the use of additional federal health care funds for health programs is closely linked to this agreement. In addition, the provinces have agreed to provide information on their respective health systems. Following the announcement of these agreements, Ottawa released its 1999 budget, in which it committed to increase health spending by $11.5 billion over the next five years.
The Social Union of Canada should reflect and express the core values of Canadians: equality, respect for diversity, equity, individual dignity and responsibility, mutual assistance and mutual responsibility. The Social Union Framework Agreement represents a movement towards a more collaborative federalist style in the health field. The main features of this new relationship are the commitment to obtain provincial agreement before new programs are introduced and agreement on a collaborative dispute resolution mechanism. However, in many ways, the relationship remains a one-sided federal relationship. There is no guarantee that Ottawa will not reduce transfers in the future, although it must announce them one year in advance. Provinces are still at risk of fines if they do not comply with the Canada Health Act. In addition, the federal government will now monitor the provinces` health systems more closely. The provinces seemed willing to compromise on their initial demands for greater autonomy in exchange for additional federal transfers. Difficulties that may arise from the current relationship include the inability to resolve disputes over transfer reductions and perceptions at the federal level of violations of the Canada Health Act. In addition, the nature of the collaborative process appears to exclude both public and health care providers from decision-making.
The Government of Canada will consult with provincial and territorial governments at least one year prior to the extension or significant changes to funding for existing social transfers to the provinces/territories, unless otherwise agreed, and will incorporate the time-limit provisions into all new social transfers to provincial and territorial governments.