by arthur Weinreb, associate Editor,
September 17, 2004
Colby Cosh, writing in the National Post, committed sacrilege. Cosh mentioned Canada’s constitution; something that should never be mentioned during the never ending discussions that this country constantly has about health care.
Canada’s constitution, The British North american act is hardly ever mentioned, at least in polite company. Since the act was amended in 1982 to include the Charter of Rights and Freedoms, it has been the Charter that has received all the attention. after all it’s the Charter that is the basis of all the sexy issues such as same sex marriage and divorce and the right of terrorists not to be deported if they are likely to be tortured. By contrast, the BNa act is dull, dull, dull.
The British North america act sets out the areas that the federal and provincial governments are responsible for. Power over an area not specifically referred to in the constitution falls to the federal government. Section 92 of the act specifically grants power over hospitals, like institutions and health care to the provinces, not the federal government.
In 1984 the federal government passed the Canada Health act that acknowledges the fact that health care is a provincial responsibility. The CHa contains a mushy feel-good preamble that includes the words, "aND WHEREaS the Parliament of Canada wishes to encourage the development of health services throughout Canada by assisting the provinces in meeting the costs thereof". The theory is that fishermen in Newfoundland (apologies to the CBC) and business tycoons in Calgary should be able to receive similar health care. But in reality, the feds control the purse strings while the provinces are left to provide medical equipment, health care workers and hospitals.
We have just finished the farcical first minister’s conference after Paul Martin promised that he would fix the health care system for a generation. More time was wasted on this horse and pony show in front of the television cameras than it was probably worth. It allowed all the players (except alberta Premier Ralph Klein who left after the first day to do something more important; attend a dinner or watch TV or something like that) to posture for partisan political purposes. and by all reports, the Prime Minister was poorly prepared for the talks.
What makes the health care system in Canada so complicated is that since both levels of government are involved, they spend more time arguing about who is to do what with how much than they do solving problems. as well, the system allows the federal government to dictate to some extent what the provinces have to do without providing sufficient funding to carry it out.
Canada’s constitution should be amended to make health care the sole responsibility of the provinces, save and except the fact that eligibility to access a provincial system should be a right of all Canadians. Let the federal government concentrate on important areas that are within their jurisdiction, such as foreign affairs and defense that seem to be neglected in favour of health care. If Canada were ever subject to a terrorist attack such as the one that took place in Spain, the first thing Paul Martin would probably do would be to run to a hospital to see how long the waiting time was for the injured to receive treatment. Let the provinces run the health care system. There are enough differences from province to province now that allowing health care to be completely controlled by the province would hardly be catastrophic.
This will never happen of course--there are too many political points to be scored by the federal government in convincing Canadians that were it not for them, their health care would be neglected. It’s all politics.
Jean Chrètien and George W. Bush are famous for misspeaking from time to time. It seems Paul Martin has that problem too.
Martin said that he was going to fix medicare for a generation. What he really meant was that it would take a generation to fix it.