Yes He Can; No We Won't
Unlike Canada, our counterparts in the United States have known of the liabilities of their health system for years. Like Social Security, the “third rail” of American politics, healthcare stymied everyone and anyone who dared touch it to bring about reform. Political careers were lost over attempts to expand public healthcare at the state and federal levels.Until Obama came along. His was a transformational presidency, at least in intent. Following a difficult first year, he and House Speaker Nancy Pelosi conspired to break out of the democratic malaise and go for the gold ring. Their success, though mixed, is a clear sign that our neighbour is going through a revolution some have likened to the civil rights legislative triumphs of the 1960s.Canadians witnessed this with a kind of collective smugness. “Now they're starting to think our way,” some mused, with a certain measure of truth. Yet there remains this one fundamental difference in approach: the Americans have broken free and moved forward on this massive issue, while Canadians are desperately holding on to a health system in decline and refusing to admit it. The issue is not so much about healthcare; it’s about leadership.It was less than a decade ago that we heard that the federal and provincial governments had constructed a new healthcare act for the new generation. Few seemed to notice, or care, that the federal government had just adroitly negotiated a deal that downloaded a virtual monopoly of health responsibilities and costs to the provinces themselves. The result left Canadians with no real partner in Ottawa for health and healthcare and a gradual decline in services across the board.Are Canadians aware of this current reality? Seniors definitely are. As they scan the various options available to them for their later years, they are increasingly aware that affordability will be a challenge. This encroaching “grey tsunami” will likely challenge the very underpinnings of our entire system, and with the bulk of Canadians approaching retirement age in the next few years, many with less than healthy pension plans, the optics just aren’t good.Internationally, the decline of our once robust healthcare system has brought on some embarrassments. Cuba, for instance, which has 1/40th of the GDP of Canada, nevertheless has the same level of outcomes as this country for child and maternal health. How can we explain that? One of Obama’s first acts as President was the granting of $25 billion (US) for basic research funding in health, yet we just finished cutting $148 million from health councils and $27.6 million from the National Research Council.A recent poll by Nik Nanos revealed what we already know: “Nine of out ten Canadians remain supportive of universal healthcare … delivered by a single insurer, the government.” Yet this very system is receiving precious little support from their federal government – hasn’t been for years. Every occasion where this subject has been introduced in the House of Commons has met with the same answer: “We are working with the provinces and territories.” Yet at all levels the plea has been for more federal leadership in a system that is deemed national in scope.Canada’s ability to properly sustain its health and healthcare system is far simpler than what the Americans are now embarking upon; yet the outcome will be decided by political leadership itself. It hardly requires a “Canadian Obama” to set this right, but it does reveal the urgency for the kind of visionary leadership that established our universal system in the first place. It’s not coming. When Obama lifted the multitudes be saying, “Yes, we can,” his counterparts in the north could only mutter, “Not right now.”