I suspect the problem is that provinces are reluctant to fund anything  provincial, in this case adequate health care on national standards.  Harper seemed to figure that handing over some money and then walking away from the table was a good idea.  But even his promise in 2006 to reduce wait times was a complete failure and he simply stopped keeping track of the scorecard he established to monitor results.  Whether provincial or federal the taxes are paid by the same citizens, so perhaps the provinces should increase taxes to pay for what they are responsible for if they don't want to accept federal standards.