Harper’s health care agenda driven by ‘theory and politics

By Brent Patterson
Council of Canadians
January 20th, 2012

Globe and Mail columnist Jeffrey Simpson writes, “Prime Minister Stephen Harper is going to give money to the provinces without any strings, conditions or demands. It’ll be the first time since medicare began that a federal government has handed money over carte blanche. Broadly speaking, two reasons explain his decision – one theoretical, one political.” Simpson argues, “The politics of his decision have been almost completely ignored, but they’re important for those who think about political angles all the time.”

Theoretical - his view of federalism

“Mr. Harper believes, when it suits his purposes, in a kind of classical federalism wherein the two levels of government more or less stay out of each other’s jurisdiction. He thinks Liberal governments abused Ottawa’s constitutional ’spending power’ to intrude into provincial jurisdiction, especially in social policy such as health care and daycare. Conservatives would rather use the federal tax system, or unconditional grants to the provinces, thereby respecting classical federalism.”

Political - distancing his government from health care demands

“Governments can never spend enough money to satisfy those who want more health care in the form of more doctors and nurses, equipment, hospitals, community care, drug plans, research and so on. The less Ottawa has to do with health care, the easier the politics. …By offering health-care increases of 6 per cent for five years to the provinces, Mr. Harper has provided himself with a strong defence. He can say right through the next election that his government is spending at exactly the pace of the Paul Martin government. Who can complain about that? The anticipated drop in indexing from 6 per cent to 4 per cent or 5 per cent thereafter won’t figure in the next election, since the decline is hardly momentous. Put simply, Mr. Harper is trying – and he’s likely to succeed – to take health care off the federal political agenda for the next four years, or at least give himself a plausible line of defence should it unexpectedly arrive.”

But while it may be a calculated political move driven by personal ideology, as Simpson argues, Harper is ultimately setting the stage for a massive reduction in federal funding for public health care and an increase in its privatization under a mistaken view of federalism.

Funding cuts

Postmedia’s Jason Fekete has reported, “The smaller annual increases in health transfers will cost the provinces approximately $31 billion over the life of the new 10-year health plan, Parliamentary Budget Officer Kevin Page said. Under such a scenario, federal finances would be sustainable over the long term, allowing Ottawa to balance the books much more easily. However, the financial health of the provinces would only worsen - forcing provincial and territorial governments to either raise taxes to generate more revenue or cut programs and services, Page said.” Postemedia’s Mark Kennedy adds, “Moreover, if the funding plan stays in effect beyond 2024, the implications are stark: The federal share of medicare spending would gradually fall from its current level of 20.4% - eventually hitting 13.8% in about 40 years, and then 11.9% two decades after that.”

Privatization


Kennedy has also reported, “Roy Romanow, who led a royal commission on health care a decade ago, said in an interview that he is worried the Harper government has adopted a deliberate strategy of leaving health care to the provinces - possibly to foster the development of more private, for-profit medical companies. …(Romanow) said that his commission found that Canadians viewed health care as a ’social good’ and that the national medicare system should be built on that foundation. …’To say, ‘Goodbye and good luck’ could be the beginning of the end of a reformed modern-day functioning health care system,’ said Romanow. ‘If that argument is advanced, we have a prescription for a patchwork-quilt series of programs by the provincial governments based on their fiscal capacity. It will mean more privatization in more provinces, or some combination of private and public.’”

Federalism

That Postmedia article also notes, “Romanow said Harper’s interpretation of how the Constitution spells out responsibility for health care to provinces is wrong. He said there is a long history of federal prime ministers - dating back to Conservative John Diefenbaker and Liberal Lester B. Pearson - using the federal spending power to help build a national health system. Romanow said only the federal government can provide the leadership to set programs and standards.”

The Council of Canadians


We believe:

1 - the Canada Health Act must be enforced to stop private health care services
2 - the federal government must commit to a 10-year health transfer plan that would see at least a six per cent increase in funding annually
3 - public health care must be broadened to include pharmacare, continuing care, dental care and Aboriginal health
4 - the federal government should not pay less than 25 per cent of provincial health care costs
5 - there should be a single omnibus health care accord, not bilateral deals with the provinces

For Council of Canadians blogs on the Canada Health Accord, please see http://canadians.org/blog/?s=%22health+accord%22.

Jeffrey Simpson’s column can be read at http://www.theglobeandmail.com/news/opinions/jeffrey-simpson/the-politics-of-harpers-medicare-decision/article2308425/.