Lifting the veil of tiers
Mark Steyn - Monday,11 July 2005
Our Thought For The Day comes from M. Philippe Couillard, minister for health in the government of Quebec, speaking in the National Assembly in Quebec City: “Il est faux et tendancieux d’établir un lien entre la participation du privé . . . ” What’s that? Oh, you want it in our second language (politically speaking)? Okay, here goes:
“It is false and tendentious to establish a link between private participation in the health system and the degree of progressiveness of a society. How can you maintain that societies like France, England or Sweden are less socially advanced than Quebec on the basis of private-sector participation in their health systems? It’s obvious this makes no sense. The Scandinavian countries themselves have private participation in their health systems. As far as I know, nobody accuses them of being conservative or socially backward.”
Magnifique!
Yet M. Couillard is a political neophyte, head of surgery at the Sherbrooke University Medical Centre until he got elected to the National Assembly and catapulted into Jean Charest’s cabinet. I don’t doubt he’s a big socialist wet, like everyone in Quebec except Mario Dumont, yours truly and maybe two or three others. But he’s nevertheless got to the nub of the issue with a clarity that is apparently beyond any official spokespersons for the Conservative party. I’ve written before in this space about that sick-making moment in the 2000 election debate between the party leaders, when Stockwell Day held up a card saying “NO TWO-TIER HEALTH CARE” and Joe Clark went and scored out the “NO” in order to expose the Alliance’s (all together now) “hidden agenda.” What a disgusting spectacle: two nominally “conservative” leaders competing to see who could most prostrate themselves before Liberal party orthodoxy. Joe would have been better scoring through the “TWO” since “NO TIER HEALTH CARE” would at least be an accurate characterization of the present system.
M. Couillard has now made the obvious point--that “two-tier” doesn’t mean we’d be adopting the heartless ways of the hated Yank oppressor but rather the ways of Sweden, Holland, France and the rest of the EU’s impeccably progressive pantywaist jurisdictions. On health care, Canada’s reflex anti-Americanism has somehow effortlessly swollen into anti-Swedism, anti-Europeanism, anti-worldism--to such a degree that even the Conservative party feels it’s politically unwise to dissent from the national retreat into pathological isolation.
Some years ago, after a frustrating experience at my local CLSC in Montreal, I wrote a column in the National Post in the course of which I made the same argument as M. Couillard. In response, the paper published a letter from a reader claiming that one of the great virtues of socialized medicine was the way prominent wealthy influential figures such as Steyn and the prime minister were forced to use the same system as everybody else and therefore gained a much greater insight into its workings than we would if we lived in America, Britain, Belgium, Denmark, or the rest of the civilized world.
He’s wrong on that. On health care, I vote with my feet and drive south. There’s already private participation in Canada’s health system: it’s just that, like U.S. computer firms using Bangladeshi call centres, we outsource it to backward jurisdictions like Buffalo. If the money Canadians spend on private health care in America was to be spent in our diseased Dominion, we’d be keeping doctors and nurses north of the border instead of training them for the U.S. market; they in turn would be creating jobs at home for administrative personnel, janitors and so forth; and all the parties involved would be paying taxes in Halifax and Winnipeg instead of Atlanta and Houston. C’mon, it’s a no-brainer, as the receptionist at the Quebec hospital told the patient when he asked if this was the one with an MRI machine.
So the only reason for maintaining the prohibition is because of a reluctance to let go of the bedrock principle--equality of crap, universal lack of access--even though it’s already meaningless in practice. If he seriously thinks that when the prime minister’s taken to emergency at the Royal Victoria, poor ailing Paul has to sit there for 48 hours as the average Quebecer does in an emergency room, then my National Post reader is clearly in need of a sadly unavailable brain scan.
With hindsight, it was all but inevitable that the unravelling of the state monopoly on health care would begin in Quebec. With Mr. Martin protesting that there would be two-tier health care in Canada only over his--or, more likely, your--dead body, M. Couillard and his colleagues took a cooler look at the decision. They’re already paying for private health care anyway: in Quebec, you get diagnosed with cancer and then sit around for months on end waiting for your treatment until finally, when the tumour’s metastasized and spread from your eyebrows to your toenails they ship you down to Fletcher Allen in Vermont to die in a foreign hospital unsurrounded by tiresome loved ones but with terrific premium cable albeit in a language you don’t speak. Any reform of the system to comply with the Supreme Court decision can hardly fail to be advantageous on all fronts--medically, fiscally, and politically, in the sense that, if Martin and co. are serious about resisting similar moves in Ontario and elsewhere, the new Quebec health regime will be one more feather in the cap of its “distinctness” and quasi-sovereignty.
Quebecers look on every question from the same perspective: what’s in it for us? Framed in those terms, the Supreme Court decision is an opportunity. In the rest of Canada, on the other hand, both left and “right” performed dismally. Warren Kinsella huffed about the “cloistered arrogance” of “judicial activists,” something his party doesn’t seem to object to when it comes to imposing “gay marriage” on the country. On the right, alas, there’s even less for us to cheer. Canadian health care staggers around like Frankenstein’s monster, and about as well stitched up, and in the end the first silver bullet in its chest comes not from conservatives but from activist judges, Quebec Liberals, and the province’s “Charter of Human Rights and Freedoms,” adopted in 1975 and now dignified by the court with a spurious constitutional authority unique in Canadian provincial law and possibly half a millennium of British parliamentary tradition.
But, if that’s what it takes, so what? If we’d waited for Stephen Harper, we’d all be dead, of C. difficile if not old age. The sad fact is conservative ideas in general and conservative leaders in particular were entirely irrelevant. Only now that the issue can be played out on the Ottawa–Quebec axis is anything happening.
Out on the wild shores of the scary extremist Christian-right “hidden agenda,” meanwhile, Stephen Harper’s most recent pronouncement on the subject was a ringing endorsement of the status quo: “I will never compromise public health insurance in the country because it is the only system that most Canadian families, including my own family, have ever used.” Well, yes, and the same could have been said of feudalism in tsarist Russia.
But, if it was too much to expect the Conservatives to take a lead on this issue, they could at least follow. Instead, Peter MacKay, hotly tipped by many as the winning candidate in the campaign to be the next Conservative loser, refused to get with the program. Rising in the House of Commons, he deplored the Supreme Court decision, which would “open the door to further deterioration of the publicly funded health care system in Canada,” and claimed the government had “brought medicare into peril” and would leave us with “a 10-tier system of private-public health care.”
The Trudeaupian left can only marvel: with enemies like that, who needs friends? Here was the deputy leader of the “Conservative” party demanding the Liberals lock the stable door even after the horse was galloping off with the Quebec health minister in the saddle cheerfully crying “Tally ho!”
As for a “10-tier system of private-public health care,” well, that’s pretty much what the British North America Act had in mind, isn’t it?
Many of us on the right believe that government health care alters the relationship between the citizen and the state in profoundly unhealthy ways. But, if the Tories aren’t willing to argue that, is it too much to ask that they at least be as robust as the Quebec Liberal party on the matter? The health care statements are revealing because they suggest that hammering the Martin government solely on competence and fiscal management is not merely tactical, in the wake of Adscam, but strategic.
Either way, it’s a disaster. Whatever the merits of the Gurmant Grewal tapes, politically it was amateur hour all the way. You could hardly ask for a better image of the self-defeating oppositionism of Canadian Conservatism than an MP reduced to taking “stress leave” for a controversy he himself launched. One hardly raises an eyebrow at the news that Canadian immigration, so accommodating of the Khadrs, is now investigating whether Mr. Grewal should have his citizenship revoked and be deported to Liberia. Oh, well. As I understand it, under Liberian health care, the waiting time for “stress” treatment is a lot shorter.
Conservatives win when they champion ideas. When they don’t, they’re either a carny freakshow, like Mr. Grewal, or an irrelevant backwater, like Mr. MacKay.
Mark Steyn - Monday,11 July 2005
Our Thought For The Day comes from M. Philippe Couillard, minister for health in the government of Quebec, speaking in the National Assembly in Quebec City: “Il est faux et tendancieux d’établir un lien entre la participation du privé . . . ” What’s that? Oh, you want it in our second language (politically speaking)? Okay, here goes:
“It is false and tendentious to establish a link between private participation in the health system and the degree of progressiveness of a society. How can you maintain that societies like France, England or Sweden are less socially advanced than Quebec on the basis of private-sector participation in their health systems? It’s obvious this makes no sense. The Scandinavian countries themselves have private participation in their health systems. As far as I know, nobody accuses them of being conservative or socially backward.”
Magnifique!
Yet M. Couillard is a political neophyte, head of surgery at the Sherbrooke University Medical Centre until he got elected to the National Assembly and catapulted into Jean Charest’s cabinet. I don’t doubt he’s a big socialist wet, like everyone in Quebec except Mario Dumont, yours truly and maybe two or three others. But he’s nevertheless got to the nub of the issue with a clarity that is apparently beyond any official spokespersons for the Conservative party. I’ve written before in this space about that sick-making moment in the 2000 election debate between the party leaders, when Stockwell Day held up a card saying “NO TWO-TIER HEALTH CARE” and Joe Clark went and scored out the “NO” in order to expose the Alliance’s (all together now) “hidden agenda.” What a disgusting spectacle: two nominally “conservative” leaders competing to see who could most prostrate themselves before Liberal party orthodoxy. Joe would have been better scoring through the “TWO” since “NO TIER HEALTH CARE” would at least be an accurate characterization of the present system.
M. Couillard has now made the obvious point--that “two-tier” doesn’t mean we’d be adopting the heartless ways of the hated Yank oppressor but rather the ways of Sweden, Holland, France and the rest of the EU’s impeccably progressive pantywaist jurisdictions. On health care, Canada’s reflex anti-Americanism has somehow effortlessly swollen into anti-Swedism, anti-Europeanism, anti-worldism--to such a degree that even the Conservative party feels it’s politically unwise to dissent from the national retreat into pathological isolation.
Some years ago, after a frustrating experience at my local CLSC in Montreal, I wrote a column in the National Post in the course of which I made the same argument as M. Couillard. In response, the paper published a letter from a reader claiming that one of the great virtues of socialized medicine was the way prominent wealthy influential figures such as Steyn and the prime minister were forced to use the same system as everybody else and therefore gained a much greater insight into its workings than we would if we lived in America, Britain, Belgium, Denmark, or the rest of the civilized world.
He’s wrong on that. On health care, I vote with my feet and drive south. There’s already private participation in Canada’s health system: it’s just that, like U.S. computer firms using Bangladeshi call centres, we outsource it to backward jurisdictions like Buffalo. If the money Canadians spend on private health care in America was to be spent in our diseased Dominion, we’d be keeping doctors and nurses north of the border instead of training them for the U.S. market; they in turn would be creating jobs at home for administrative personnel, janitors and so forth; and all the parties involved would be paying taxes in Halifax and Winnipeg instead of Atlanta and Houston. C’mon, it’s a no-brainer, as the receptionist at the Quebec hospital told the patient when he asked if this was the one with an MRI machine.
So the only reason for maintaining the prohibition is because of a reluctance to let go of the bedrock principle--equality of crap, universal lack of access--even though it’s already meaningless in practice. If he seriously thinks that when the prime minister’s taken to emergency at the Royal Victoria, poor ailing Paul has to sit there for 48 hours as the average Quebecer does in an emergency room, then my National Post reader is clearly in need of a sadly unavailable brain scan.
With hindsight, it was all but inevitable that the unravelling of the state monopoly on health care would begin in Quebec. With Mr. Martin protesting that there would be two-tier health care in Canada only over his--or, more likely, your--dead body, M. Couillard and his colleagues took a cooler look at the decision. They’re already paying for private health care anyway: in Quebec, you get diagnosed with cancer and then sit around for months on end waiting for your treatment until finally, when the tumour’s metastasized and spread from your eyebrows to your toenails they ship you down to Fletcher Allen in Vermont to die in a foreign hospital unsurrounded by tiresome loved ones but with terrific premium cable albeit in a language you don’t speak. Any reform of the system to comply with the Supreme Court decision can hardly fail to be advantageous on all fronts--medically, fiscally, and politically, in the sense that, if Martin and co. are serious about resisting similar moves in Ontario and elsewhere, the new Quebec health regime will be one more feather in the cap of its “distinctness” and quasi-sovereignty.
Quebecers look on every question from the same perspective: what’s in it for us? Framed in those terms, the Supreme Court decision is an opportunity. In the rest of Canada, on the other hand, both left and “right” performed dismally. Warren Kinsella huffed about the “cloistered arrogance” of “judicial activists,” something his party doesn’t seem to object to when it comes to imposing “gay marriage” on the country. On the right, alas, there’s even less for us to cheer. Canadian health care staggers around like Frankenstein’s monster, and about as well stitched up, and in the end the first silver bullet in its chest comes not from conservatives but from activist judges, Quebec Liberals, and the province’s “Charter of Human Rights and Freedoms,” adopted in 1975 and now dignified by the court with a spurious constitutional authority unique in Canadian provincial law and possibly half a millennium of British parliamentary tradition.
But, if that’s what it takes, so what? If we’d waited for Stephen Harper, we’d all be dead, of C. difficile if not old age. The sad fact is conservative ideas in general and conservative leaders in particular were entirely irrelevant. Only now that the issue can be played out on the Ottawa–Quebec axis is anything happening.
Out on the wild shores of the scary extremist Christian-right “hidden agenda,” meanwhile, Stephen Harper’s most recent pronouncement on the subject was a ringing endorsement of the status quo: “I will never compromise public health insurance in the country because it is the only system that most Canadian families, including my own family, have ever used.” Well, yes, and the same could have been said of feudalism in tsarist Russia.
But, if it was too much to expect the Conservatives to take a lead on this issue, they could at least follow. Instead, Peter MacKay, hotly tipped by many as the winning candidate in the campaign to be the next Conservative loser, refused to get with the program. Rising in the House of Commons, he deplored the Supreme Court decision, which would “open the door to further deterioration of the publicly funded health care system in Canada,” and claimed the government had “brought medicare into peril” and would leave us with “a 10-tier system of private-public health care.”
The Trudeaupian left can only marvel: with enemies like that, who needs friends? Here was the deputy leader of the “Conservative” party demanding the Liberals lock the stable door even after the horse was galloping off with the Quebec health minister in the saddle cheerfully crying “Tally ho!”
As for a “10-tier system of private-public health care,” well, that’s pretty much what the British North America Act had in mind, isn’t it?
Many of us on the right believe that government health care alters the relationship between the citizen and the state in profoundly unhealthy ways. But, if the Tories aren’t willing to argue that, is it too much to ask that they at least be as robust as the Quebec Liberal party on the matter? The health care statements are revealing because they suggest that hammering the Martin government solely on competence and fiscal management is not merely tactical, in the wake of Adscam, but strategic.
Either way, it’s a disaster. Whatever the merits of the Gurmant Grewal tapes, politically it was amateur hour all the way. You could hardly ask for a better image of the self-defeating oppositionism of Canadian Conservatism than an MP reduced to taking “stress leave” for a controversy he himself launched. One hardly raises an eyebrow at the news that Canadian immigration, so accommodating of the Khadrs, is now investigating whether Mr. Grewal should have his citizenship revoked and be deported to Liberia. Oh, well. As I understand it, under Liberian health care, the waiting time for “stress” treatment is a lot shorter.
Conservatives win when they champion ideas. When they don’t, they’re either a carny freakshow, like Mr. Grewal, or an irrelevant backwater, like Mr. MacKay.
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