By Thomas Walkom National Affairs Columnist,Toronto Star, April 20, 2011
The Liberals warn that Stephen Harper is out to gut medicare. This isn’t entirely accurate. The Conservative Prime Minister’s approach to Canada’s universal health-care system is more nuanced. His aim is not to destroy medicare directly but to stand aside and let others do what they will.
The others in question are the provinces. Provincial governments pay the bulk of public health-care costs. All are looking for ways to cut spending. Some, most notably Alberta and Quebec, have long resented Ottawa playing a role in an area that constitutionally lies within their jurisdiction.
As the Canadian Medical Association Journal reported last month, at least five provinces (including Ontario) are turning a blind eye to private clinics that break the law.
Some defy the federal Canada Health Act by charging patients for medically necessary services. Others ignore provincial laws aimed at maintaining the integrity of medicare — such as those that prevent physicians from operating both inside and outside the public system.
Harper’s federal government has been even more remiss.
Medicare exists as a national program for only two reasons. The first is money. As long as Ottawa gives cash to the provinces, it can require each recipient to operate a provincial medicare program that adheres to the Canada Health Act.
The second is enforcement. The Canada Health Act permits (and in one case requires) Ottawa to withhold money from provinces that break the rules.
Most of the time, Ottawa prefers not to confront recalcitrant provinces. Still, between 1984 and 2006, the federal government levied penalties averaging about $400,000 a year.
Since Harper came to power, however, federal medicare penalties have shrunk to about $84,000 annually.
Sometimes, it is not what someone or a government DOES but what it DOES NOT DO that needs to make the frontpage headlines. It is not that Harper did something to warrant the exclusion vote that Canada sought for the seat on the Security Council, but rather the attitude to global relationships that suffered under Harper.
His government's silent acquiescence in the face of growing numbers of provincial for-profit medical clinics is a sure sign of his corporatist, capitalist support for private, for profit health care....which he himself describes as "not waving a finger at how the provinces deliver care."
His government's failure to provide adequate information, and his failure to censure his own minister (Oda) when she doctored a letter of agreement with Kairos, by inserting the word "NOT," were other signs of inaction, stone-walling, disrespect for parliament that brought about the motion and vote of contempt for Parliament. And then, Harper completely dismisses that vote as "bickering" rather than acknowledge his full complicity and responsibility, apologize and THEN move on.
Parents who abuse their children physically, emotionally and even sexually and refuse to apologize for their attitudes, actions and spoken words, even though there is perhaps no physical wound as evidence, are either too proud or to contemptuous of such submission and vulnerability and in their refusal to acknowledge their responisbility, they are even more brutally abusive...it is in the denial and the cover-up, or the minimizing of their acts, or their omission of positive acts of appropriate parenting that they are most contemptible.
That is why so many Canadians are turning up at Liberal party meetings to listen to Ignatieff and to give him and his party a reasoned, careful and perhaps a chance to form a national government.
We are neither stupid, nor willing to be taken for granted, as Harper is hoping...and he will do anything and everything both overtly and covertly, by omission, to help to repress the voter turnout, counting on his narrow base to bring him to victory.
And, in Quebec, as the now infamous Conrad Black opines, voters may actually come to the conscious realization that they would be far better off with at least one-third of the members of a Liberal cabinet than they would be with 50 Bloc members left knocking on the doors of executive power.