On health care, calling Jean Chrétien [transfer limits]

TheGlobeandMail.com – news/opinions/editorials
Published Friday, Apr. 08, 2011.

Remember the “fix for a generation” promised for health care? Canada is now in a fix for a generation. Michael Ignatieff and Stephen Harper are both promising, in one form or another, to continue the 6-per-cent annual hike in health-care transfers to the provinces, in seeming perpetuity. Forget the notion of “buying change.” Just buy.

The pressure to innovate has been removed at a stroke. At least when (in 2004) Liberal prime minister Paul Martin put in the 6-per-cent-a-year escalator clause for 10 years, there were some strings attached, however loosely. A balanced view of what that deal produced suggests that, while the promises fell largely short (on primary care reform, electronic records, catastrophic drug care), other areas showed worthy progress, including a cut in wait times on key areas of care and the purchase of new diagnostic equipment. The 6 per cent wasn’t just handed over. There was a negotiation.

Ottawa has given away any leverage it might have had in negotiations, now that Mr. Ignatieff included the 6-per-cent clause in his platform promises, and Mr. Harper put it in his platform budgetary projections. The government will be little more than a bank for the provinces.

The parties may succeed in loving medicare to death. As a new study co-written by David Dodge, the former Bank of Canada governor, shows, health services, public and private, could eat up nearly 20 per cent of gross domestic product by 2031, up from roughly 12 per cent today. Without pressure for efficiency, the system will drag down government, and personal, budgets. Even if Canadians are demanding limitless cash, eternally, for health care (a questionable assertion), the role of government leaders is to protect medicare (from itself, if necessary), other services and taxpayers, not give away the store.

It almost makes one long for the days of that tough-skinned old negotiator, Jean Chrétien.

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