The annual get-together of Canada's 13 provincial and territorial leaders is an opportunity for the premiers to discuss policy issues and develop solutions. The top agenda item at this year's meeting in Niagara-on-the-Lake, Ont., is health care.

There are sharp disagreements between the provinces concerning how best to deliver health care. Some, including Quebec and Alberta, believe the private sector has a role to play. Others, like Ontario and Saskatchewan, wish to preserve a government monopoly, even if that means restricting money saving reforms. But this debate will take a backseat to accusations Ottawa is not doing its part on the health care file.

The premiers say the federal government's share of health care stood at 50% when medicare was introduced, but has fallen to 16%. They will plea for money and insist Prime Minister Paul Martin, who has promised to spend another $9-billion on health, open the taps even further.

But before Canadians condemn Ottawa's stinginess they need to ask a simple question: Are the provinces being short-changed

A bit of history is necessary. When Canada's public health system was introduced there was a 50-50 split in some areas, but the federal government's total share of health care funding was never higher than 41%. Provinces were left to fund things like mental and tuberculosis hospitals, out-patient services, home care and administration costs. The reality is Ottawa never paid half of provincial health care costs.

This year, provinces and territories will spend approximately $83.5-billion on health. Ottawa contributes directly to these budgets through the Canada Health and Social Transfer. According to the 2004 budget, Ottawa will write them a cheque for $24-billion. This money is allocated not only to health, but also education and social services.

The assertion Ottawa funds only 16% of health care is also incorrect. To arrive at this number the premiers compare the cash transfer to all social spending in their jurisdiction, not only health care. For political reasons, they wish to minimize Ottawa's participation as a way to leverage more federal money. To make Ottawa look cheap their calculations omit one important funding source, tax points.

When the federal government reduced its personal and corporate income tax rates in 1977 to allow provincial and territorial governments to raise these taxes by the same amount a significant tax transfer occurred. (They received 13.5 personal income tax points plus one corporate income tax point.) The result was the revenues Ottawa had previously collected went directly to the provinces and territories to provide the same support for health, education and social services as the cash transfer. The value of the tax points was equalized and has grown with Canada's economy. Today, they are worth $17.5-billion. This is real money the premiers routinely neglect to include in their calculations.

It is reasonable to debate whether or not the tax transfer should still be counted as a federal contribution to the provinces. But any historical comparison of spending levels without the tax points is not only misleading, but also dishonest.

When the tax point money is counted as part of the federal transfer - as it was before 1977 - Ottawa's total jumps to nearly a third. That's higher than the 25% benchmark the provinces are now demanding from the federal government. And if Ottawa's $9.7-billion equalization payment is included as well as the $6-billion it spends on health services for natives, veterans and research its contribution is higher still, hovering at around 40%.

None of this information will help a politician hoping to whack the federal government for being cheap. But truth in budgeting is a good place for any health care debate to begin, and isn't that the point of the premiers meeting