New column day

Here, on the latest confirmation from the Parliamentary Budget Office that a national pharmacare plan would both improve our health and save public money - and the Libs' and Cons' insistence on standing in the way.

For further reading...
- Brent Patterson weighs in on the Libs' refusal to work toward a national pharmacare plan, while Steve Morgan summarized the case for pharmacare.
- Patterson also discussed a Council of Canadians poll showing 91% public support for the concept, while Angus Reid has reached the same number.
- Canadian Doctors for Medicare pointed out some of the groups in support of national pharmacare. And the National Prescription Drug Utilization Information System has documented the higher costs arising out of private plans.
- The Canadian Labour Congress has developed a petition in support of pharmacare, while the Council of Canadians has set up a letter campaign.
- Finally, the Parliamentary debates on Don Davies' motion to negotiate a national pharmacare plan are here. And I discussed pharmacare here as one of the areas where a federal government could implement a key national program with the general agreement of the provinces (though I'll note that the Council of the Federation's website now seems to have been deleted).

On structural barriers

As the NDP's federal leadership race approaches its conclusion, Tom Parkin has been doing some noteworthy writing on some of the issues which voters may want to keep in mind. And I'll start with Parkin's discussion as to how some of the systems which most deserve to be modeled may not translate easily to Canada's political realities.

In particular, Parkin notes that the Nordic model which holds plenty of appeal for social democrats may not be as easily implemented in a federal system where crucial authority over social and labour policy is held by the provinces:

We should import the Nordic model, say many Canadian social democrats. But—is it coincidental?—the Nordic countries all have a fundamentally different political constitution than ours. They are all unitary nations without provinces, states or territories. Canada is a federation with powers constitutionally divided between two levels of government.

Social democrats at the head of a unitary state have all policy levers and pulleys close at hand. A single Cabinet runs economic ministries, training, health care, education and welfare. It sets laws to shape and encourage—or not—collective bargaining. It runs capital and credit organizations such as the central bank, public pension funds, development banks and housing market credit agencies. In unitary states, a Cabinet can co-ordinate policies that adopt and adapt the social democratic model. We don’t.
...
Understanding federalism and getting the alignment right means a federal NDP leader who is constantly bolstering provincial NDP sections and always has something to say that will be well-received in provincial capitals—at least among social democrats, whether in government or opposition.

Such a stance could also support the NDP’s recent and hard-won success in Quebec. A helpful federal partner that encourages the social democratic development of Quebec—rather than blocks it—could provide a pathway to reorient the Quebec left—regardless of language—to the project of Canada, rather than separation.

But what none of the current federal leadership campaigns have talked about—not specifically, anyway—is how clean energy transition and diversification (or another strategy) could help develop an economy based on social partnership and the stability the unitary Nordics have developed.

...

The point is that to achieve what social democrats hope for, federal New Democrats need to understand and leverage Canada’s federal structure. Water cannot run uphill. Time cannot go backward. And social democracy cannot be implemented from Ottawa.

Creating the social partnership that is the core of social democracy—in the Nordic model, anyway—is a provincial undertaking which can greatly benefit from a strong federal ally. Federal New Democrats need to be social democratic federalists, constantly looking for ways to support provincial social democratic projects in ways that will strengthen social partnerships. It means being powerfully strategic and bold in the places where the opportunities for structural economic change lie.

Social democratic federalism would not only politically align the federal party and provincial sections while setting out a path to social democracy. It may also create an enduring bond among progressives in Quebec and across Canada through an attractive and practical alternative to both separatism and neo-liberalism. It’s time to look with clear eyes about how social democrats make change. Our federal constitution has been a brake on success. But perhaps, with the right strategy, it can become an engine for change.

It's certainly fair to note the difficulties in promising federal action in areas where provinces have both the ability and the inclination to reject it. But it's also worth pointing out (as Parkin does) that Canada's most valued social programs are already the product of cooperation between the federal and provincial governments - and recognizing how jurisdictional barriers have been and can be overcome.

Parkin mentions partisanship as an issue, with particular reference to Kathleen Wynne's choice to thumb her nose at the NDP's 2015 child care plan. But while that may serve as an unfortunate example, it would also figure to rule out the type of ambition which the NDP should be seeking to support.

After all, if the threshold for building a national program is to have one party in power in all provinces at once such as to completely align federal and provincial interests, then it's going to be awfully difficult to make the case that change for the better is ever feasible. And indeed, the Libs themselves would surely be thrilled to operate based on that principle - pointing to the fact that a few provinces have yet to elect NDP governments, and thus claiming that they're the only party which can ever hope to achieve national progress (while glossing over their disinclination to do so).

Moreover, leaving political calculations aside, there's strong evidence to suggest the federal government can be both powerful and opportunistic in shaping provincial decisions - and there's also room for it to act on its own toward many of the points raised by Parkin.

Remember that it was just last year that negotiations broke down between Ottawa and the provinces as a group on health care funding. Within two months, most provinces and territories had accepted virtually all of the federal government's terms. And the final holdout gave in last month, as the pressure to accept incremental funding increases outweighed any disagreement over either the form or content of the federal government's demands.

Few provincial governments would figure to have done anything of the sort in responding to party promises during a federal election campaign: after all, then they'd be in a position to either demand more, or benefit their own party by holding out. But the situation changes when immediate funding is at stake - and so an elected government is in a much better position to actually shape the terms of provincial action.

Of course, that shouldn't be the preferred means of developing national policy. And on the opportunism side, there's plenty of room for the federal government to merely take up the invitations of the body which already pursues change based on the consensus of the provinces.

The provinces' original desire to discuss health care at a common table serves as one prime example as to where a federal government looking for coast-to-coast-to-coast cooperation on a key issue could have found a receptive audience. The Council of the Federation has long been pushing for pharmacare, and has expressed consensus support for improved primary care and seniors' care among other steps toward a healthier Canada. And of course the provinces have already signed on to child care programs which have been limited only by the federal Libs' cynicism and stinginess.

As a result, there's little reason for concern that significant improvements in Canada's social structure couldn't be brought about with the provinces' agreement.

Finally, while the federal government may lack the ability to set up a full bureaucracy to administer all aspects of economic policy, it surely has the authority to set up or manage exactly the "capital or credit organizations" discussed by Parkin. Moreover, it can also establish both public enterprises of its own to act directly where it sees a benefit in doing so, and coordinating bodies to equalize and stabilize economic decision-making across levels of government.

To be clear, Parkin is right in arguing that the NDP needs to be conscious of the limits of federal jurisdiction, and plan its mix of immediate proposals and future plans accordingly. But we shouldn't use federalism as an excuse to shy away from discussing the types of social and economic structures needed to support a more fair society.

Saturday Morning Links

Assorted content for your weekend reading.

- David Olive comments on the world food crisis, making the point that what we're lacking is some link between more-than-sufficient productive capacity and the nutritional needs of less wealthy people around the globe:

(A) permanently higher price for oil spurred successful innovation to reduce our reliance on petroleum products in realms outside of transportation and energy, along with a determined effort to find new sources of oil in increasingly remote places.

The global food crisis, by contrast, has not made us think differently about how we produce and use the fruit of the land. We have no national or global strategies for food-security or for nutrition. Speculators have not been reined in with limits on betting. And the powerful ethanol lobby hasn’t been shown the door, even though the production of ethanol consumes more energy than it returns as fuel.

And, conspicuously in the West, too much crop production goes into highly processed food drained of nutrients and fibre, accounting for a North American epidemic in obesity and diabetes.

- So naturally, your friendly neighbourhood wingnuts are focused on demolishing the few mechanisms left to ensure that mere workers have some say in the allocation of resources and the functioning of our economy.

- Michael Harris' latest column discusses how Canada's premiers are looking for the federal government to actually show some national leadership, rather than retreating as far as possible from the services most important to Canadians.

- Finally, Bruce Johnstone sees the proposed Nexen takeover as a litmus test in the application of the "net benefit" standard for foreign takeovers. And Erin Weir notes that whatever benefit Alberta may receive from a head-office promise, Saskatchewan looks to do nothing but lose out if the sale is approved.

On cooperative efforts

The reports on fiscal arrangements and health care developed in the lead up to this weekend's meeting of Canada's premiers have both received some coverage. But there are a couple of points worth noting which seem to have been largely neglected so far.

On the fiscal arrangement side, we now have agreement among the provinces as to the effect of the Cons' unilateral changes to health care. And while those paying attention may have known all along, Table A.10.B. neatly lays out how Alberta is receiving $8.3 billion in new health care funding over 10 years while every other province faces cuts ranging from moderate to massive.

So no, the Cons aren't merely cutting back on promised health-care funding. Instead, they're actively diverting health-care dollars away from areas of need toward the wealthiest province in the country.

Fortunately, the premiers do seem to recognize that there's a problem when dollars dictate who has access to care. And perhaps the most striking part of the health care report is that even while discussing "innovation": (which is so frequently a code word for selling off pieces of our health care system), the provinces seem to have formed a consensus on a need for cooperation rather than allowing beggar-thy-neighbour market forces to dictate the terms of access to health care providers (italics added):

It is recommended that Premiers endorse the following Guiding Principles for Health HUman Resource Management:

a) Share Evidence: Provinces and territories should share health human resource labour market information to support effective decision-making.

b) Seek Innovation: Provinces and territories should share leading practices and work closely together on innovative approaches to managing labour costs and reducing competition.

c) Respect Interdependence: Provinces and territories should recognize that health human resource management decisions made by individual jurisdictions may have an impact on other jurisdictions.

d) Make Informed Decisions: Provinces and territories should explore and act on areas of mutual interest and common approaches to health human resource management.

e) Integrate Planning: Provinces and territories should work together to strive for an appropriate supply of health human resources at the provincial and national levels.

Of course, all of those recommendations would be far more easily put into effect if we had a federal government interested in supporting a functioning health care system. But at the very least, they seem to reflect some acknowledgment that gratuitous competition is a problem rather than a solution when it comes to ensuring access to health care - and the same principle would seem to be no less applicable within smaller health-care jurisdictions.