The white cat and black cat of medicare

Monday 24 May 2004, by Murray DOBBIN

IF the actual campaign is anything like the warmup, this election is going to be a sorry spectacle — a contest between two parties, both dedicated for a decade to dismantling medicare, competing for votes on the pledge to save it.

It will be a competition for who will get to guard the henhouse, the fox or the coyote. Both Paul Martin and Stephen Harper, and their parties, will dismantle medicare and swing the doors wide open to private health care if we give them the chance.

For his part, Martin has done more than any other elected politician in Canada — including Ralph Klein, Brian Mulroney and Mike Harris — to systematically and deliberately erode the foundations of medicare. He not only cut the federal contribution to medicare by 40 per cent, but eliminated the legislation that gave Ottawa its leadership role in health for nearly two generations.

Established Program Funding was the foundation document for universality, ensuring that the provinces spent federal transfers on medicare. Martin repealed this law, cutting the provinces loose to spend the money any way they pleased. For seven years he steadfastly refused to use large budget surpluses to restore long-term funding to medicare. He still refuses to do so. And his health minister, Pierre Pettigrew, made it clear this month that private clinics were on the order-paper of a Martin government, despite his desperate mea culpa the next day.

In British Columbia, Premier Gordon Campbell has withdrawn legislation, demanded by the Chrétien government, that would have banned private surgery clinics, saying Martin would be more "flexible" on the issue. The prime minister has also hired former Hill & Knowlton B.C. lobbyist Bruce Young — well-known for his work with the Coalition for Healthcare Options, a group of private surgical and diagnostic clinics that promote privatized medicare — as a senior campaign operative there. And Martin also has recruited former Alliance MP Keith Martin who, just days after joining the Liberals, enthused: "The exciting thing on health care is that Paul Martin (has not said) he’s going to be wedded to the Canada Health Act."

All the shadow-boxing between Harper and Martin aside, both sing from the same hymn book, and they know it. Indeed, Martin probably could not have accomplished his 1995 budget assault on universal medicare without convenient pressure from the Reform Party. Harper, as Preston Manning’s chief policy advisor, developed Reform’s policy of "provincializing" health care, a euphemism for gutting the Canada Health Act. Manning and Harper repeatedly blocked Reform constituency resolutions supporting universal medicare, and instead promoted user-fees, extrabilling and private insurance.

As medicare was steadily eroded under Mulroney and Martin, Harper happily took credit for Reform’s assistance in the process. In a speech to the National Citizens Coalition (NCC), which he later headed, Harper said: "Universality has been severely reduced. It is virtually dead as a concept in most areas of public policy."

As for the new Conservative leader’s recent pledge on health care, there is nothing in it that precludes more private medicare, and he is still dedicated to devolving even more power to the provinces. His complaint about being demonized on medicare would be more credible had he not been so consistent for so long as an enemy of public health care. The NCC was literally founded as an attack organization against public medicare. It ran full-page ads asking Canadians how they would like to have "your open-heart surgery done by a civil servant," warning that "More Canadians will die" if the Canada Health Act were implemented. When Harper says he was proud of the NCC, he presumably means pride in this decades-long attack on medicare, which continued right up until he took over as its president in 1997.

Any suggestion from Harper that he has suddenly embraced a key feature of the Canada that, in 2002, he called "a second-tier socialistic country, boasting ever more loudly about its... social services to mask its second-rate status," can’t be taken seriously. The Conservative leader and the extreme right-wing advisors he has surrounded himself with, like Tom Flanagan of the University of Calgary, are devotees of Margaret Thatcher and, like the lady herself, "not for turning."

So there you have it, Martin and Harper, the tweedle-dum and tweedle-dee of privatized medicare. Or, as Tommy Douglas would have described them, the black cat and the white cat. The mice had better pay close attention this time around.


Sun May 23 2004

Winnipeg Free Press

Murray Dobbin is a Vancouver-based writer and Research Associate with the Canadian Centre for Policy Alternatives. His latest book is Paul Martin: CEO for Canada?, published by James Lorimer Ltd.

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