Tuesday, August 11, 2009

The PM punts on health care

Updated (12:35 p.m.) below.

A missed opportunity for the PM as he whiffs on a big fat pitch down the middle on health care. The PM declined to defend Canada's system in a major media interview in the U.S. A few thoughts below but first, here's the relevant excerpt from Harper's interview with ABC:
Tapper: I know you don’t want to get involved in the domestic U.S. health care reform –

Harper: You bet.

Tapper: But, there is a Canadian woman who is appearing in a TV ad. She is from Ottawa and she had a brain tumor and she said that if she relied on Canadian health care, she would have died. But she came to the United States to have it treated. And as you know, this is a criticism even within Canada of Canadian health care that the waits are too long. Are you concerned about this problem in the Canadian health care system and how do you respond to those criticisms?

Harper: Well, first of all, I am not going to get involved in the health care debate in the United States. I know that this is a – I know from our own health care debates historically in Canada that this is a very difficult, very tricky issue.

All across the world, health care systems of all kinds of different shapes and sizes have significant – have significant challenges. And, obviously, I can’t comment specifically on a Canadian woman who may have had one type of experience with our health care system, with the American health care system.

In Canada, health care is principally the responsibility of our provincial government. The federal government provides some transfers. We do some of the drug regulation, a number of other activities.

But it is principally a system run by our provincial government. So first of all, I don’t feel qualified to intervene in the debate. And it is a very complex debate. And as President Obama said, “there is a unique American health care system that’s evolved in a different way.” And I think that the American public themselves has to arrive at its own solutions for reform.

Tapper: But are waits in your country too long?

Harper: I say, once again, that-

Tapper: That’s not about your health care system-

Harper: Yes, but the responsibility for the health care waits, in our country, are the responsibilities of provincial governments.

I have taken the view, as the federal prime minister very different than some of my predecessors as I don’t lecture the provinces publically on how they should be running their health care systems.

What we try to do is work with them in a cooperative manner so we can be helpful in addressing the challenges.

All around the world, what we are seeing all around the world is important to understand is that there have been tremendous breakthroughs in medicine. We can treat more things, more ways through new technology, drugs than ever before.

At the same time, all of this costs money. If you are prepared to spend an unlimited amount of money, you can do an almost unlimited number of things in people’s health care. But you don’t have an unlimited amount of money no matter what your system is. And these are challenges that every system has to address.

But I’m not – I’m not going, quite frankly, criticize how our provinces are running their health care systems because I know the challenges that face them are very big. (emphasis added)
Where to start...

First of all, you can understand somewhat a desire not to want to be seen influencing the U.S. debate. It is an internal domestic political matter for the U.S. and we would not appreciate American politicians intervening in ours. But if we were loudly and roundly criticizing the Americans for a comparable policy in the midst of a Canadian debate, we wouldn't be very surprised to hear them defend themselves, would we? And that's the situation here. We've been inundated with sustained attacks against our health care system. Not that it's perfect or doesn't need improvement. But you'd think the Prime Minister of the country could muster up a sentence or two to defend a Canadian institution that many Canadians do in fact take pride in, particularly in comparison to the American system. I find myself wondering what Jean Chretien would have said to Mr. Tapper. Probably a patented humorous zinger of some sort to puncture the American blowhard-fest yet stand up for Canada. Don't think Mr. Chretien would have missed the opportunity.

Also telling is the "provincial responsibility for health care" talking point. A similar approach was wheeled out by Health Minister Aglukkaq on H1N1 recently. Harper's mention of this constitutional, hands-off position four times in the interview above, combined with the casual "we do some drug regulation" and "we provide some transfers" come off as a significant shirking of leadership on a major issue in the country. And a very dispassionate response as well. This is an issue that's stirred a lot of passions to the south and even here as many Canadians are following what's being said. The accountant-like tonal treatment of the issue seems off.

Seems like there's an opening here on a national issue. If Mr. Harper doesn't want to lead on the issue and prefers to dodge questions on wait times, I'm sure there's someone else who'd like to do so. Shirking is not what we need at a time when our health care system is in fact experiencing a crisis, i.e., the medical isotope shortage, contributed to by the Harper government's very own failure to act to take steps to provide alternative sources following the December 2007 shutdown of Chalk River.

And the very fact that Mr. Harper would actually say he's "not qualified to intervene in the debate" as it's a provincial issue, the major takeaway from the interview...a puzzler. In fact, you could probably term that one a pretty significant gaffe that may reappear at an opportune moment. The Canadian Prime Minister not qualified to speak to health care when our system is under the klieg lights of an American media and political maelstrom. Very telling. We can do much better than that for leadership.

Update (12:35 p.m.): Report on Harper's wait-times guarantee promises to the Canadian public:
I was with Harper in Winnipeg last Dec. 2, when he promised the Canadian people a health care wait-list guarantee. I was in Ottawa on Jan. 2 when he made health care, not Canada's international role, one of his government's first five priorities. I was in Ottawa on April 4, when Michaƫlle Jean read this Throne Speech commitment on behalf of Harper's new government: "It is time Canadians received the health care they have paid for. The government will engage the provinces and territories on a patient wait-times guarantee for medically necessary services."
He used to have a lot to say about health care from his position as a national leader, now, not so much.