National standards or territorial autonomy? Public opinion and the politics of fiscal federalism for healthcare in Canada

Focusing on public opinion, this paper studies the politics of fiscal federalism by analysing support for the level and conditionality of intergovernmental transfers for healthcare. Leveraging a representative survey of the Canadian population conducted in 2022, we show that preferences for fiscal federalism reflect territorial identity and ideology. Left-wing respondents are more likely than right-wing ones to prefer higher, conditional transfers. However, Canadians with a predominant provincial identity prefer more decentralisation and therefore unconditional transfers, regardless of their ideology. Hence, the politics of fiscal federalism cannot be strictly understood as a reflection of a left-right cleavage; identity also matters.