The Sixth Estate

The range of off-the-cuff commentary on the new health “deal” from the professional media is predictably pathetic. There’s the usual variety of pro-government shills nodding sagely and agreeing that Canadian healthcare is expensive and unsustainable, even though as far as First World countries go we’re solidly middle-of-the-road, and spend only a fraction of what the Americans do on a per capita basis.

One extreme I really didn’t expect, though I can’t say it surprises me, is the position that Jim Flaherty did us a favour by dictating his terms rather than negotiating an actual agreement with the provinces. That link goes to Don Martin, who apparently feels that a dictatorship is far superior to a federal democracy because it involves much less boring diplomacy. As I say, this hardly surprises me: since at least the end of April, when they endorsed this government en masse, the majority of the corporate media has been alternating between calling for authoritarianism and weakly fretting about how many eggs will have to be broken to make the new Canadian omelette.

Update: In the “maybe they’re just stupid” department, the Globe & Mail throws its hat into the ring by suggesting that we could develop an “efficient” system and drop our wait times down to German or Dutch levels if only we made physicians work overtime and handle “minor” questions over the phone. This statement cannot possibly have been made by anybody who actually personally knows a practicing physician. In any case, the reason Germany and the Netherlands have less problems getting access to doctors is because they have 1.5 times as many doctors per capita as we do. As I have repeatedly stated, and will keep on stating, you can’t make resources more efficient if they don’t exist in the first place.

It doesn’t seem to have occurred to them yet that this might be a problem. Instead, the media is doing its best to play up how great Canada is. They don’t have much to go anymore, since our international reputation is in tatters, we are one of the most anti-science governments in the First World, our healthcare system is going to be slashed and privatized, and our economy is teetering on the precipice.

You can see how difficult the task becomes by checking out another pro-government piece published today, by Maclean’s, which makes the patently preposterous claim that Canada is the best in the world because more Canadians than Americans think their country is the best in the world. Since not all countries can be better than every other one, this is a ridiculous question, better for measuring nationalist delusion than anything objective. The author, Nicholas Kohler, realizes this, and promptly moves to his second argument: that Canada is a good place because there are a number of famous Canadian singers, like Justin Bieber, who say so, too. I think I would be insulting my readership if I wasted your time explaining exactly why this “reasoning” is breathtakingly pathetic.

But let us return to healthcare. Since austerity is the name of the game for the next decade, I would like all those who are welcoming this “agreement” (and that will be the last time I call it that, since it was dictated under duress) to answer the following question for me. It’s the most important question to ask, and so it doesn’t surprise me in the least that nobody is answering it:

Who should be denied healthcare so that we can reduce our commitments to healthcare?

Should it be heart surgery, perhaps — just as our aging population will start requiring more and more of it? How about cancer treatments — ironically, just as geneticists were starting to get a good handle on how we might eventually cure this disease? Reducing wait lists? Providing family doctors for all Canadians? Please identify to me which service we were going to provide with the extra healthcare funding, which you think is unnecessary. And be specific.

I already know what the pundits will say. They will prattle on about how we won’t actually need to cut anything because the new austerity regime will encourage everyone to find efficiencies. This is as absurd as it sounds on its face, much like telling a middle-class family that if you cut their take-home pay by $15,000 they won’t even notice because they’ll make their grocery budget more efficient. There are a limited number of major cost drivers in healthcare, and we don’t have any control over any of them: an aging population, a need for more doctors, and a need for new, patented drugs. We can cut more bureaucracy at the top, but there isn’t enough left to cut to make more than a mild dent in the problem.