Tuesday, February 15, 2005

Principled, Popular, and Right

(updated)

CPC supporters who have been reading the Montreal Gazette (or Inkless Wells) ought to be reacting with horror to the massive and soon-to-be missed opportunity that is Health Care Reform.

Wells has been noting the considerable growth of privately-delivered & privately-paid health care in the City of Montreal. Since my non-NFL-related prognostication has been fairly decent of late, allow me to make a prediction:

At some point prior to the next federal Election Day, the Liberals will come out in favour of these businesses. (Specifically, that they won't be discouraging them, the clinics are not in contravention of the Canada Health Act, and if people with the means want to spend their own money on private care, bully for them.)

Speaking as purely a hack here, this would be an unmitigated disaster for the Conservative Party. What do you do when your rivals, who ostensibly sit to your left, come out with a stance that is consistent with conservative & libertarian principles; is massively popular; and is "right" (i.e. both inevitable and descriptive of the existing situation)? The political alternatives range from awful to awful:

1) Be fully supportive. "I'm glad the Liberals have come to their senses and adopted our secret agenda."
2) Agree with the policy, but rant and rave about how the Liberals demagogued this very issue in the last election. "Once again, the Liberals have said one thing and done another - but we're glad they've adopted our secret agenda." We've seen how effective this approach is - it's not.
3) Oppose the position. "We disagree that Canadians should be permitted to spend their own money on something so critical as their health." Base - what base?

I hope this scenario makes it clear that the only sensible thing for the CPC to do is to come out, right now, in support of private parallel health care (call it two-tier if you will, I don't much care). Since this position is in fact principled, popular, and right, it should be incredibly easy to defend. Again, which of these statements is more likely to attract voters:

1) "Paul Martin says he's against private health care, but his own city is the national capital of private clinics! Why isn't he taking action? What a hypocrite!"
2) "A booming business in private health care is underway in Montreal, and I'm glad Paul Martin's words deploring these types of clinics are just words. These clinics are providing much-needed service to those citizens of Montreal who, for whatever reason, prefer not to use the public system. People own their own bodies - they don't belong to the Government of Canada. And as a bonus, these people are not consuming the limited resources of the public system."

This is so bloody obvious, I'm going to stop now. Regrettably, I don't expect the CPC to follow this advice. They are afraid of kicking up a dust storm of "American-style health" fears - a storm that would be blown away in a week by the stiff breeze of reality and common sense. I'll just close with the Wells quote that introduces the poll linked above:
Sorry if you belong to that half of the population which believes, according to this new Environics poll, that you should be able to buy timely access to health care. No federal party agrees with you.
Attention Stephen Harper: you really, really have to be first on this one.

UPDATE: Per Don Martin in today's National Post (√ěStaples), what's going on in Montreal goes beyond fair liberalization of the system, and an alternative - I guess I should have made sure I knew more details. As such, I would like to make my own position perfectly clear:

1) Legal private facilities totally outside the public insurance system: definitely cool. Free country, my body is my own, etc. etc.
2) Privately operated facilities serving the public insurance system: probably cool. Certainly worth some experiments - there's decades of evidence that profit-seeking corporations can provide services more efficiently than governments. If health care is the exception, I'd like to see that proven in practice.
3) Privately operated facilities working for both the public and private systems, and charging the public clients out-of-pocket: not so cool at all. This is a real problem area; see Andrew Coyne's archives, if they're up again.

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