Health Care: The Forgotten Issue.

This is an interesting article. There have been a few ads I believe that mention health care. One of the Conservatives ads is about Liberal broken promises on health care and I recall the Liberals trying to scare people away from the Tories by referring back to Tory cutbacks. But as Nelson Wiseman points out the three parties have a somewhat similar health care policy and people do not feel the system is in danger from any party. However the Conservative policy mentions private public partnerships which might mean more privatisation. The article gives a helpful summary of each party's position including the Greens.

Thursday » September 20 » 2007

Health care: the forgotten issue
Voters consistently list wait times and doctor shortages among their top concerns, so why, asks Mohammed Adam, is no one talking about health care on the election trail?

Mohammed Adam
The Ottawa Citizen


Wednesday, September 19, 2007



CREDIT: Wayne Cuddington, The Ottawa Citizen
Wait times for surgery, doctor shortages, the provincial health tax: These issues have been nearly invisible so far in Ontario's election campaign. Political observers say health care is not a 'wedge issue,' so the election is being fought over other, more divisive issues.

It is the issue that affects us the most, but as party leaders battle over religious school funding and trade barbs over who is more trustworthy, health care has taken a back seat in the Ontario election campaign.

With the Liberals making public education the centrepiece of their campaign, the Tories pinning their hopes on leadership and integrity, and the NDP concentrating on jobs and poverty, health care virtually fell off the radar in the first week of the campaign.

All the major parties have substantial sections on health care in their platforms, which election experts concede most people don't read, but gives party leaders something to point to as their commitment to the issue.

Despite its importance and an acknowledgement that Ontario's health care system remains in considerable trouble, University of Toronto political scientist Nelson Wiseman says it is not the top issue on the campaign trail because it is not a wedge issue.

People act on their concerns when there are major differences between parties on a significant issue. But with little to choose from between the parties' health care stances, Ontarians don't sense any threat to the system no matter who wins. The parties, therefore, are free to explore other issues and milk them for political advantage.

The first and only time health care was raised on the hustings by any of the leaders was on the third day of the campaign -- and it was in the context of Premier Dalton McGuinty's broken promises.

In a press release, the Progressive Conservatives listed important events that took place around the world on Sept. 12, among them, a broken Liberal promise to improve health care and solve the "doctor shortage."

In London, Conservative leader John Tory chided the Liberals for not keeping their promise and promised action. The same day, NDP leader Howard Hampton promised a rebate on the health premium Mr. McGuinty introduced after vowing never to raise taxes.

Surprisingly, the Liberals haven't made health care a campaign issue either. Not one word has been uttered on what was a signature issue for the government in its first term. Last Friday, Health Minister George Smitherman made a campaign stop in Ottawa to speak, not about health care, but about public education, jobs and prosperity.

It wasn't that way a few months ago when wait times and doctor shortages were top-of-mind issues in the health care debate. Ontario doctors were critical of doctor shortages, pointing out an alarming statistic -- the province was short 2,000 doctors, leaving one million adults and 130,000 children without a family physician.

The opposition hammered the Liberals for their failings, more particularly for having little to show for spending millions of dollars to reduce surgical wait times for cancer, cardiac care, hip and knee replacement, cataracts and diagnostic tests.

Mr. Tory, in particular, constantly challenged the government's assertion that wait times had improved significantly, pointing out that the provincial auditor general had questioned the reliability of the government's measurement of wait times for diagnostic tests. There seemed no doubt then that it was going to be a big campaign issue.

The silence on wait times has been deafening.

Dr. Janice Willett, a Sault Ste. Marie gynecologist and president of the Ontario Medical Association, says health care remains a major public issue and if it has faded from the campaign agenda, it hasn't faded from public consciousness. Indeed, the latest Ipsos Reid/CanWest poll listed health care as the second most important issue for voters, behind education. To keep the issue alive, Dr. Willett embarked on a provincewide tour to generate discussion on it.

"It is core to the Canadian system of belief and it is a core interest to people," Dr. Willett said.

"We need the province to continue to take steps to strengthen our health care system. It is important that people know what the party platforms are on health care."

Mr. Wiseman says health care remains very important, but it is not the No. 1 issue in the election because people don't sense, as they did under Mike Harris, that the system is under threat.

"It was a bigger factor last time because Harris-Eves had been there for eight years and there was a sense that social programs were under threat," Mr. Wiseman said.

"People just don't believe now that the system is going to change fundamentally, whoever is elected. Look at their platforms. They are not very different."

Over the next four years, the Liberal plan includes the expansion of their wait-times strategy to cover emergency room visits, children's surgery and general surgery. They also promise to deliver access to a family doctor to 500,000 more Ontarians, hire 9,000 nurses, help people quit smoking by removing the provincial sales tax from nicotine patches and create 100 more spaces in medical schools.

In four years under the Conservatives, Mr. Tory says health spending would be $8.5 billion more than current Liberal spending. The Tories will kill the Liberals' health premium, increase the number of doctors, work to repatriate doctors to Ontario and build new health care facilities. The party will also improve long-term care by upgrading 35,000 "below-standard" spaces. The Tories will also "involve the private sector where there are opportunities to shorten waiting lists and improve access to high-quality, publicly funded care."

The NDP will offer a health tax rebate of about $450 a year to individuals who earn $80,000 or less a year. The party will stop the "privatization" of health care, establish a minimum standard of care for seniors and increase their daily food allowance.

The Green party will put more resources into health promotion, disease and accident prevention. It will also ensure that safe drinking water and clean air become basic rights.

With virtually no major disagreement on health care, Mr. Wiseman says the parties are free to do what campaign politics is all about: find a wedge issue and play it up. For the Liberals, that issue is public education, while the Tories believe it is all about leadership and integrity. The NDP sells itself as improving life for working families, but has yet to discover a defining issue.

Colleen Savage, president of the Cancer Advocacy Coalition of Canada, says the time for even greater scrutiny of party platforms is when people are not paying close attention and the parties aren't talking about the issue. Radical changes can slip past if no one is paying attention, she warns.

"One of the problems with elections is that they are short, fast and intense. Often it is after they are over that people say, 'Oh, I didn't understand that. I didn't know about that'," Ms. Savage said.

"That's why these issues have to be raised and discussed in the media and in the leaders' debates."

Sid Noel, a political science professor at the University of Western Ontario's King's College, says politicians usually take their cue from the public on major issues. But health care is not a burning issue because Ontarians may have developed a "mature understanding" of what's involved. And some of that may be due to what can be loosely described as the Michael Moore effect. The U. S. filmmaker's documentary on the U.S. health system may have convinced some people that despite the inadequacies of the Canadian health care system, it is fundamentally better than the one in the U.S.

"People still rank health care at the top, but they don't believe there is a reason to panic," Mr. Noel said.

"There may be a certain sense among some people in Ontario that whatever the problems of health care, there is a catastrophically worse system across the border."

But Mr. Noel says the campaign is only entering its second week and no one should discount the possibility of health care re-emerging as the top issue. All it takes is one mishap to raise the public temperature -- as the Tories found out this week.

A comment by Conservative MPP Frank Klees that Ontarians should pay a $5 user fee any time they go to the emergency room or see a doctor, put the Tories on the defensive as Liberals accused them of having a hidden agenda "to gut public health."

The Liberals tied the comment to a Conservative plan that they claim would cut $3 billion from health care. Mr. Tory has reiterated his commitment to the public system and disavowed Mr. Klees' comment, but experts say he can't afford more of such views.

"It takes only one incident and if something suddenly happens, health care will rise to the top," Mr. Noel said.

© The Ottawa Citizen 2007








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