Friday, July 16, 2010

The first symptoms

Ideally, Jim Flaherty's musings about health care would be dismissed as a matter of the Harper Cons grandstanding on a provincial issue only to be ignored by the provinces themselves - so that the rest of us could safely do the same. But Flaherty has linked his talk about wanting to limit provincial spending to the negotiations on a federal/provincial funding formula. And with Flaherty having used public money on the federal level to push regressive policies on issues ranging from tax harmonization to infrastructure privatization, there's plenty of reason for concern about what will happen on the health front.

So let's take a closer look at what Flaherty does and doesn't want to see in provincial management of health care as part of his conditions for federal funding:
Jim Flaherty told the Telegraph-Journal's editorial board on Thursday that provincial spending on health care is growing at a rate that outstrips economic growth, a situation that is unsustainable over time.

"The provinces are going to have to look at their budgets and figure out ways of providing health-care services without rampant growth," Flaherty said.
Flaherty said when he was provincial minister of finance in Ontario in the 1990s, health-care funding was growing at a rate of about seven per cent per year, while the economy was only expanding at about one and a half per cent annually.

"You know what that means," he said, "That health-care spending, most of which is non-discretionary, ends up squeezing out funding for colleges, universities, public schools, social services - those being the other big areas of provincial government spending."
Now, the most obvious point of concern in Flaherty's statement is the emphasis on changing provinces' "ways of providing health-care services". Which should be entirely familiar as the first verse leading to the tired refrain of "privatize!".

But there's another part of Flaherty's framing that may be even more dangerous. After all, Flaherty's focus is entirely on provincial spending on health care and its perpetually-exaggerated impact on government budgets. But Flaherty doesn't seem the least bit concerned with overall health care spending - offering the most direct hint yet that he'll be pushing provincial governments to abandon parts of the field entirely, with a greater reliance on private funding to make up for the constraints Flaherty wants to place on the provinces.

All of which is to say that the less influence Flaherty has on the shape of future health care funding, the better. But since the provinces may have no choice but to deal with his officials at least for the time being, it's also worth recognizing the problematic elements that Flaherty wants to build into the system, and making it clear that Canadians don't want to see the federal government pushing an anti-social health care regime on the country.

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