Medicare debate under cone of silence

This is from the Star.
The silence is good cover to mask the deterioration of the system and privatisation by stealth. I just wonder how long the Canada Health Act prohibition against co-payments will last. Off loading of costs to individual pocketbooks seems to be a pervasive "solution" that governments employ as they downsize "entitlements" and strive to streamline government to serve its core constitutents, global capitalist corporations. The mantra to cover this is "competitiveness".

Medicare debate under cone of silence TheStar.com - Columnist - Medicare debate under cone of silence
June 30, 2008 Chantal Hébert
OTTAWA
The simultaneous replacement of Ontario and Quebec's veteran health ministers earlier this month was the result of a coincidence, but George Smitherman and Philippe Couillard had more in common than just the fortuitous timing of their departure from their portfolios.
To their respective credit, they each served for five years, breaking the revolving-door pattern that had turned their provinces' health departments into ministerial pit stops on the way to more manageable responsibilities.
Their tenure started at a time when repairing a battered health-care system had become job one for every government in the country. Indeed, both Dalton McGuinty and Jean Charest were originally swept into office on the promise to fix health care. On that basis, they literally staked the success of their governments on the performance of their health ministers.
That gamble did pay off. McGuinty was re-elected with a second majority.
Jean Charest owes a significant part of his narrow victory in the last Quebec election to Couillard's enduring credibility.
But while Smitherman and Couillard acquitted themselves well in their political missions, they leave behind a system whose root problems have ultimately defeated their efforts. That is not for lack of throwing money at the issue.
Over the past five years, the federal and provincial governments have reinvested massively in the system, with health-care spending at times outpacing the rate of the growth of the economy by a ratio of two to one.
All that money has bought some relief, but not the lasting cure that was originally contemplated.
On Friday, Yves Bolduc, the doctor that Charest hand-picked to replace Couillard, declared that reducing hospital wait times in Quebec would be one of his top priorities. That has been the mantra of successive Quebec health ministers for the better part of two decades.
And earlier this month, the Health Council of Canada reported that the sweeping reforms that were promised at the time of the 2003 First Ministers' Accord on Health Care Renewal have failed to materialize.
With billions of federal and provincial dollars come and gone, the scope of the medicare net is continuing to shrink for lack of being adjusted to the changing perimeter of the health system.
With the economy entering a downward cycle and the federal surplus almost a memory, it is far from clear that balanced government budgets can continue to go hand in hand with the maintenance of the system, let alone ever allow for its overdue modernization.
Health-care spending accounts for almost half of Ontario and Quebec's public spending. Each province currently devotes twice as much to health as to education. And there is no reconciliation in sight between the declining curve of Central Canada's economy and the rising course of health spending.
The Liberals will shudder at the analogy, but it is too bad that no federal party has ever had the courage to do for medicare what Stéphane Dion's "green shift" is about to do for climate change.
He may go to his political grave for it, but the Liberal leader has at least put the pros and cons involved in walking the talk on global warming on the table for Canadians to debate.
By comparison, the medicare debate is in a political cone of silence. No party has the guts to make the case for a different medicare mix, but none of the expensive plans designed to ensure its future has delivered truly sustainable results.
Chantal Hébert is a national affairs writer. Her column appears Monday, Wednesday and Saturday.