Medical Care Act was discontinued. It was replaced by Established Programs Financing. This gave a bloc transfer to the provinces, giving them more flexibility but also reducing the federal influence on the health system. Almost all government health spending goes through Medicare, but there are several smaller programs. Provinces developed their own programs, for example, OHIP in Ontario, that are required to meet the general guidelines laid out in the federal Canada Health Act. The federal government directly administers health to groups such as the military, and inmates of federal prisons. They also provide some care to the Royal Canadian Mounted Police and veterans, but these groups mostly use the public system. In 1996, when faced with a large budget shortfall, the Liberal federal government merged the health transfers with the transfers for other social programs into the Canada Health and Social Transfer, and overall funding levels were cut. This placed considerable pressure on the provinces and combined with population aging and the generally high rate of inflation in health costs, has caused problems with the system. The 2002 Royal Commission on the Future of Health Care in Canada, also known as the Romanow Report, was published. The Canadian Health Coalition formed in 2002. In 2004, the First Ministers came to an agreement with the federal government on a ten-year plan to improve Canada's healthcare. Areas of focus included wait times, home care, primary care reform, national pharmaceuticals strategy, prevention, promotion and public health, aboriginal health, and the First Nations and Inuit Health Branch (FNIHB) at Health Canada. In 2006, Stephen Harper won the federal election on a "platform that pushed for a mix of public and private health care, provided that health care stays publicly funded and universally accessible". Healthcare debates in Canada Canada has robust debates between those who support the one-tier public healthcare, such as the Canadian Health Coalition, a group that formed following the publication of the Romanov Report in 2002, and a number of pro-privatization organizations, such as the conservative Fraser Institute, that call for a two-tiered healthcare system. American organizations that support privatization of health services, such as the Cato Institute and the Americans for Prosperity have focused criticism of the Canadian healthcare system on wait times. Wendell Potter, who had worked for multinational American health insurance company Cigna from 1993 until 2008, told PBS that the American health industry felt threatened by Canada's