The Gods of the Copybook Headings

Averting National Bankruptcy

Jim Flaherty acts conservatively:

But Flaherty caught his provincial counterparts off guard, handing them a set 10-year revenue-sharing plan and saying later there would be no negotiations. “They would want more, of course,” Flaherty said of the provinces. “And that’s what they mean by negotiations, that it should always be 6 per cent forever, even if the economy is only growing at around 2 per cent,” Flaherty told CBC-TV.

With health transfers to the provinces at nearly $27 billion this year, the Harper government says Ottawa cannot afford to continue with annual funding increases that are not linked to economic growth and the level of government revenues.

The provincial governments are apoplectic. How dare the federal finance minister not give them whatever they want! For the moment this is, as Ontario's Dwight Duncan noted, a unilateral offer. It's not a deal and it is likely just a starting point in the political negotiations. Whether Mr Flaherty and Mr Harper have the intestinal fortitude to battle with ten provincial governments, the Tommy Douglas' worshiping MSM and panicky voters remains to be seen.

Jason Clemens and Brian Lee Crowley note:

First, they told the provinces that Ottawa is not an ATM and would not continue to enable their undisciplined spending behaviour through ever-growing transfers. Finance Minister Paul Martin didn't just stop increasing the transfers for health and social services - he cut the absolute amount transferred.

Second, and crucially, however, the Liberals provided the provinces with greater flexibility and autonomy in designing, regulating, and providing social welfare. They did this by removing conditions attached to federal social transfers and eliminated most national standards for social assistance. Less money coupled with greater autonomy and flexibility meant that the provinces had the power and incentive to actually solve welfare problems.

The Grits did not extend the same freedom in health care, due to its sacred cow status, and the last sixteen years have seen stagnation in reforming Medicare. The Flaherty plan would still have the government throw a lot of money at our health care system. The current plan, drawn up by Paul Martin and the provincial premiers in 2004, is simply a higher level of extravagance. Canada, as Crowley and Clements note, has one of the most expensive health care systems in the world. Money isn't the problem, it's the system.

As I've noted before, the Canadian health care system is unlikely to be reformed directly. A politician openly questioning the public policy logic behind Medicare would be skinned. Since fiscal reality is, ultimately, inescapable and politicians are a slippery lot, another route will likely be taken. Medicare will be reformed through delisting, previously covered health care services being pushed out into the private sector. The system will "de-evolve" back to its origins as a last resort for catastrophic illness or accident. 

That process could take years, even decades. Minister Flaherty's tightening of the spigot may help speed up the process. Politically he has staked himself the fiscal high ground: Rein in spending or we wind up like Greece. The provinces will scream that this is a cut, a lie the MSM will be complicit in propagating. Harper Tories Cut Health Care! Expect a ten part series in the Star about overworked nurses in the new year. 

Increasing spending at a rate in line with economic growth and inflation is not a "cut." A cut is a reduction, not an increase at a lower rate than hoped. Language is the first casualty of politics. The proposed restraints by Minister Flaherty are, well, sensible, so far as anything in the upside down world of socialized medicine can be described as "sensible." 

A decade ago I would have suspected that Flaherty was on a fool's errand. The public will never tolerate such a "cut." Times have changed. The fiscal situation is bleaker and the voters are fatigued with provincial-federal bickering. The Premiers have been crying poverty for so long that it ceases to have much resonance. The emergence of alternative media, from humble blogs up to outlets like Sun News, mean that the MSM echo-chamber no longer has its traditional monopoly. 

Take this little trick, from our friends at the Red Star:

Ontarians will face reduced health services later this decade under Prime Minister Stephen Harper’s plan to scale back Ottawa’s transfer payments to the provinces as of 2017, warns Dwight Duncan.

Most people don't read an article, they scan it. If you're only catching every other word you might just miss that the above is not a statement of fact, but merely the opinion of the Liberal Ontario Finance Minister. There are no quotations marks. This is a common trick for the MSM, used even more frequently in television, a medium conducted with the ADD addled viewer in mind. 

Repeating certain key words, like "cut", followed by "Prime Minister Stephen Harper" and the inattentive will begin to think that the PM is advocating a cut. Since it is a common theme in the MSM, as well as the school system, that Conservatives are "cutters" who care more about money than people, it's a repetitive messaging that dovetails with preconceived notions.

How many Canadians know that, over the last thirty years, federal Liberal governments have a better track record of balancing budgets than Conservative ones? Or that Mike Harris' "vicious" cut backs on social spending were driven in large part by the Paul Martin directed cuts in transfer spending. It isn't that the media has lied, so much that they have positioned the truth in such way as to be easily overlooked. 

Mr McGuinty and Mr Duncan are hoping the truth of Medicare's extravagance will continue to be overlooked. Here's to hoping otherwise.

 

Medicare Malpractice

Just keep spending...

"We have clung to that model with absolute tenacity, even in the face of evidence that it is no longer the right model," Mr. Dodge says. He outlined some ways in which the system could be changed, then apologized if his speech was starting to sound a little prosaic.

"But it kind of has to be prosaic," he added. "Unless we get it off the emotional, we're never going to solve the damn problems."

The budget crunch won't be addressed by piping in more money, he says. "Forty years ago, if your knee was bad, we gave you a cane," as Mr. Dodge put it. Today, when more costly treatment is available, it is inevitably done.

The Sum of All Fears

For an ex-NDP premier of Saskatchewan:

Romanow, who in 2001 headed a royal commission on the future of health care, said the public system is more efficient than a blend of public and private care. He cited the United States where health costs are 15 per cent of the gross domestic product, far below Canada where it is 10 per cent.

"The notion of private and public is a bit of a mistaken debate," he said. "The evidence is very, very clear that the core provision of health services is more effectively done through the public model."

Now Roy Romanow is a smart guy. Being a life-long member of the NDP is not a sign of low intelligence, just a lack of common sense. Like many other defenders of Medicare he is fixated on the American model. As noted last week, there are many developed countries with two tier health care systems, most of them are run more efficiently than Medicare. The United States is also a weak benchmark, being a high outlier in terms of health care spending. Why does a man who once headed a royal commission on health care reform not know this? Or at least fail to make mention of it?

The desperation of Medicare's defenders can be found in this old rhetorical sleight of hand: Focus on the inadequacies of the American system to hide the short-comings of the Canadian system. When it is mentioned that Canadians, at least those with means, are still trickling south to avoid waiting lists, the issue goes back to money: Well, if we spent more money then waiting lists would disappear. 

The argument works well enough, unless you keep in mind that one of the key arguments in defence of Medicare is that it is more efficient than a two-tier model. So if it's more efficient why do you need more money? Not just more money than is being spent now, but more money than is being spent by other countries? Leaving aside the weak logic of the position, there is little mention of other developed countries in Canadian health care debates. A vital question that is not being asked is this: Why are other rich nations able to deliver universal health care insurance while spending less than us?

But let's say you've never heard of these mythical places called "Europe" and "Japan." When it comes to health care policies the Canadian Left are like those US Congressmen who boast about not having passports. Think of it as the North American Health Care Perimeter.  Beyond these shores is terra incognita for health care debates.

The Dutch health care system has private insurance companies, albeit regulated and subsidized, playing a large role. It's the way Obamacare would work in theory, albeit not in practice. As a percentage of GDP the Dutch spend slightly more than us. Waiting lists, however, are not a prominent feature of the Dutch system, or indeed practically any other two tier system. No mention of the Dutch approach as an alternative to Medicare. Now when the topic is drug policy, the Left heaps praise upon the "Dutch model." It seems the only thing the almost 17 million people of the Netherlands do is smoke pot, troll red light districts and buy wooden shoes.

Ditching our largely socialized health care system, for their partially socialized health care system, might be a sensible, if hardly ideal, improvement. That would mean, of course, challenging the reverend memory of Tommy Douglas. Speak ill of Saint Tommy and his admirers on the Left will rally. After all these years the legend of the man from Weyburn remains impressively intact.

Ultimately the debate over health care in Canada is not about health care. It is about national identity, a certain historical narrative and the political struggles between Left and Right. For the Left Medicare is a symbol of what makes Canada better than other countries, especially the United States. For the Right it is proof that this country has veered too far to the Left since Dief was Chief. What Canada needs today is an open debate on health care. A debate that stops fixating on the Americans and starts fixing the Canadian system.

 

Dalt's Health Care Time Machine

The Dalt makes some promises:

The Liberals kicked off the last week before the provincial election campaign by appealing to seniors with a promise to bring back doctor house calls.

Health Minister Deb Matthews announce plans on Sunday to spend $60-million annually for a program that would allow health care providers visit seniors and others who may otherwise find it difficult to leave their home.

To put that in perspective, total health spending in Ontario for 2010 is $46 billion. The Dalt has basically flipped Ontario seniors a dime and told them not to spend it all in one day. Those who remember Canadian health care before Medicare, yes we did have medicine in those days, will recall that family doctors would routinely make house calls. They stopped doing this not because they became lazy, or because the world has moved on, but because they could no longer charge for doing so. 

If Dr. Smith is getting paid X to see you, regardless of where and when, then he'll see you in his office when he feels like it. And it really is when he feels like it. The last time the Liberals were running Queen's Park in the late 1980s they reduced the number of slots in provincial medical schools. This was done in the name of saving money. Being politicians they failed to understand that:

1) Ontario's population will keep growing thanks to all those immigrants you're bringing in.

2) A disproportionate number of doctors are baby boomers. Guess what happens when they, and the other members of their cohort, hit 65?

There is planning and then there is government planning. The latter rarely extends beyond the next election cycle. When you add socialism on top of ordinary short-sightedness, then you get modern Canadian health care. Not to worry. Because the aging boomers will not overload the system:

Fears that Canada's aging population could lead to soaring health-care costs may be greatly exaggerated, say researchers, who suggest that the predicted "grey tsunami" may turn out to be more like a "grey glacier."

{...}

They concluded that neither the sharpest rise in cost nor the larger share of the increase was driven by the aging population, but by factors that can be controlled by health-care providers or policy-makers.

Well not yet.  Nor perhaps ever. Socialized health care has a wonderful feature that helps reduce costs: rationing. In other words, they're going to start pulling the plug on grandma. They is already done covertly, through waiting lists, not funding new "experimental" treatments and delisting certain services.

If anyone questions this privatization on the sly, they say that Medicare and the provincial health plans are designed to cover what is "medically necessary." Who decides that? Why doctors whose paychecks are signed by the Ministry of Health. When conservatives criticize global warming they are denounced as being in the pay of Big Oil. Why are doctors who defend socialized health care not criticized for being in the pay of Big Health?

The one chance that Ontario seniors have of not getting the plug pulled is their electoral muscle. Old people vote. What else do they have to do on election day? The very young are too stoned and ill educated to know or care. The middle aged are too busy working to pay for everyone else. Past 60 that fresh hospital smell becomes only too familiar. Vote early, vote often and vote for more money being spent on health care.

Governments spending money, however, rarely solve problems, though they often create quite a lot. Every government since the days of John P Robarts has spent more money on health care. Yes, even nasty old Mike Harris increased health care spending, despite Paul Martin rolling back the federal contribution to Medicare. We are among the world's top health care spenders per capita. That includes spending significantly more than Australia. We don't get what we pay for.

Government health care means bureaucratic health care. Much of those many billions that has been tossed into the Medicare fire over the last forty years has gone into fatter administrative pay, fancier hospitals and rather less to hum-drum things like doctors and nurses. Bureaucratic empire building is an elemental force of government. The more government you have the more paper-pushing, versus actually doing, you're going to get.

The nominal goal of Medicare is universal access. Prince or pauper, all Canadians would have a right to decent and timely care. Yet the problem of not everyone being able to afford health care is no different from people not being able to pay for food, housing or transportation. If the issue is purchasing power than give more money, or the equivalent, to those who need it. We don't nationalize Loblaws to ensure everyone has enough to eat. Yet we follow such an absurd logic in something far more complex like health care.

Medicare is not about helping the poor. It's about socialist ideology and left-wing nationalism. A universal one-tier system was the product of an age when serious, intelligent and learned men believed government could run things more efficiently than the private sector. Place things in the hands of the bureaucrat and his political masters and wasteful competition will wither away. Indeed it did, replaced by forms of waste and inefficiency unknown to operators of private businesses.

Socialism lacks the cache it once had, yet by lasting close to half a century Medicare has become institutionalized. We are so used to it we cannot imagine plausible alternatives. Should anyone dare to suggest any they are denounced as traitors. Single tier medicine is one of those things that distinguishes us from the Americans. It helps reassure Canadians that they are morally superior to the dollar chasers to the South of us. To challenge Medicare is to challenge Canada itself, or least some people's version of Canada.

 

The Price of Free Health Care

Pretty steep actually:

Why do we allow this system to continue? Perhaps because we think of health care as something the government provides to us for free, and that we’re lucky to get it. But that’s wrong. There’s nothing “free” about health care. We all pay for it with our tax dollars. The average Ontarian pays $3,799.62 annually for health care, according to the Fraser Institute. Across Canada, because of the progressive nature of our government’s revenue collection, better-paid tax payers contribute a lot more than that. A recent Fraser Institute analysis by Milagros Palacios and Nadeem Esmail indicates that the top 30% of Canadian taxpayers by income (those who claim income of $97,486 or more) pay annual health-care costs starting at $10,612. The top 10% of taxpayers pay at least $32,056 annually.

 

Canada's Gerontocracy

For a simple explanation why reforming the welfare state is so tricky, see the below:

About 75 per cent of Canadians over 65 are reliable voters, meaning they voted in the last federal, provincial and municipal elections, according to the Statistics Canada General Social Survey (and nearly 90 per cent vote in federal elections). Among 25- to 44-year-olds, the proportion of reliable voters is closer to 45 per cent. Targeting older voters is clearly an efficient way to campaign.

And as political scientist Christian Leuprecht points out, rural ridings, which are often only half or one-third the size of urban ridings, also tend to be older. That makes seniors’ votes even more significant in areas such as Atlantic Canada, rural Quebec and Northern Ontario, where several races will have a significant impact on the election. 

Younger voters - they ones paying the taxes right now - also live disproportionately in urban and suburban ridings, which are underrepresented in the House of Commons. It makes very good political sense to distribute monies from current net taxpayers in urban ridings, to current net tax takers in rural areas, Quebec and the Maritime provinces. Since for these voters government money - in the form of CPP, Old Age Pension, Guaranteed Income Supplement - is a much bigger chunk of their overall family income they have every incentive to fight any serious benefit cuts. Being past working age they also have little disposable income but a great deal of disposal time.

Seniors possess the most powerful justification (or rationalization) for protecting their government financed benefits. They spent a lifetime paying into the "system" and now expect the "system" to take care of them. Unfortunately the system is broke. The vast sums poured into the welfare state ponzi scheme over the last half century have largely evaporated.

Some monies did flow into genuine capital projects: schools, physical infrastructure and training programs. Most was spent on current expenditures. All those years the Boomers thought they were pre-paying their own hip-replacements they were in fact just paying their Grandma's. Without a steadily growing workforce out to prop up the system, there is no money to make up the shortfall.

A politically courageous thing to do would be to transform the welfare state, removing its middle class entitlement aspect and refocus it as a needs based system. The extension of the welfare state up the income ladder in the 1960s - through Medicare, university tuition subsidy increases and regional development grants - was a political decision made to ensure the system's longer term electoral viability.

Given the demographic trends of the era - to say nothing of the remarkable naivety of pundits and politicos at the time - it seemed a sound calculation. Making the welfare state middle class also made it fiscally unsustainable. Paying for food and shelter for a small percentage of the population is one thing, paying for the health care, post-secondary education and even employment of a hugh chunk of the population is something else entirely.

Since political courage is the rarest of elements, with the possible exception of astatine, this is a crisis that will be solved (i.e. badly muddled) through a mixture of inflation, delisting and stealth tax increases in the form of user fees. We are already seeing a sharp increase in the availability of private health care insurance - for services not covered by the provincial health systems. As a practical matter this will be only way to control costs without a significant jump in waiting times for medical procedures.

The public does not understand the process that is now underway. They will discover the subtle scaling back of the welfare state at point of contact. Procedures and medicines once government covered will require out of pocket - or insurance - payments.  It is privatization by stealth and subterfuge. Given the political winds that now blow there is little likely alternative.

When in Canada...

...expect Third World health care...

Cameroon’s high commissioner is suing The Ottawa Hospital for malpractice and negligence after his wife was sent home from the emergency room with flu medication only to later deteriorate from an undetected condition to the point where surgeons had to amputate her arms and legs.

The trouble began on the morning of Oct. 23, 2009, when Mercy Azoh-Mbi, a geologist, suddenly felt feverish and weak. She was transported to hospital by ambulance and registered at the Civic campus emergency room at 2:08 p.m, according to the $30-million statement of claim.

The high commissioner, Solomon Azoh-Mbi, brought along information about his wife’s medical history, including the fact she had had a mitral valve replacement in 2004.

For the multilateral fetishists in the audience, what does an incident like this do to Canada's international standing? Send your diplomats to Canada and expect arguably worse medical care than they get at home? In a third world country?

Vote for Stalemate

I've left you all on tenterhooks, haven't I? 

Here we are well into the first week of the writ period and Publius has yet to throw his support behind any of the parties. No doubt each of the party leaders are anxious.

Have the years of anger and frustration at last exploded? Will he demand the overthrow of Stephen Harper at all costs! Even supporting the NDP if necessary!

Or will your humble correspondent ask you to consider the overlooked virtues of Michael Ignatieff? As soon as I figure out what those might happen to be. It'll come to me. Just give me a few moments...

No. I ask you on May 2nd to vote for paralysis. Vote for the status quo. Let us keep going down this particular road to our Canadian version of perdition. Do nothing. In politics it's usually best.

Let us forget the pretence that ordinary MPs are anything but parliamentary cannon fodder. We have a presidential election campaign being conducted within a parliamentary system. We must measure the chefs according to their sins, both venial and mortal.

None of the leaders are very palatable. We face a three way choice (four ways if you live in La Belle Province) between a pragmatist, a political incompetent and an economic illiterate. By relative merits it would seem that Stephen Harper is the best choice. Though in the same sense that manure is preferable to toxic waste.

The Prime Minister has effectively demanded a majority government from the Canadian electorate. The alternative, he says, is a stark one: The Grand Coalition of Evil. Lord Iggy's has insisted that he would never join such a Coalition. Even though he signed - belatedly - the December 2008 Coalition Deal. Who knows? The Grits triggered this pointless election. They just might be dumb enough to form a Coalition with the two other opposition parties. Such a move would destroy the Liberal Party for a generation. It would drive Blue Liberals and Grit centralists into waiting Tory arms.

A more practical danger is Stephen Harper winning a majority government. At some level I'm tempted to give the Tories enough rope to hang themselves. We had to be all middle of the road because of the minority blah, blah, blah. Fine. Here's a big thumping majority. Perhaps the Wheat Board and long-gun registry would go. Perhaps. The problem with compromising your principles to win a majority government is that you then have to compromise your principles to keep that majority.

The Conservative Party of Canada needs new leadership. Since there is little chance of Harper losing the keys to 24 Sussex in this election - unless The Toronto Star finally does locate that hidden agenda in a cupboard somewhere - only another minority government might force his resignation. Even a few seats short of the majority mark would start the countdown clock. This will be Stephen Harper's fourth election as leader of the united Right.

This doesn't mean a quick exit. Instead something similar to the aftermath of Pearson's second failure to win a majority in 1965. After two years, and with the prospect of another election looming, the bow-tie wearing PM was forced to bow out. Had it not been for 1967 being the centennial year, it's likely the Grit caucus would have pushed out the Nobel Laureate sooner. 

I'll leave to another time a sorting out of Harper's likely successors. We are on the hustings now. While the Harper Conservatives have proven a disappointment, that does not mean the Conservative Party itself does not have potential for re-generation. With governments through out the world being forced to retrench, now is an excellent opportunity for a fresh face to present a fiscally sound and smaller government political platform. A new vision of national unity could be projected, stepping away from two generations of Quebec appeasement and would - among other things - strengthen this country's economic union and wind down the inter-regional beggar-thy-policies of the last half century.

This is unlikely to happen if Stephen Harper wins a majority. It will be interpreted by both party operatives and the grassroots as a vindication - albeit a belated one - of incrementalism. That there has been very little improvement in the fortunes of conservative ideas and policies, only in the fortunes of the Conservative Party, will not matter. Winning has a powerful impact on perceptions. Often we don't care what we win so long as we win something. That a Tory Majority now would be a shallow victory for the values its members have long claimed will not be immediately understood.

Whether it takes a few years, or a decade, the stoical Conservative base will begin to revolt as surely as they did in Mulroney's last years. They will do so for the same reason. The party has not lived up to its avowed principles. It will be better for all if that process happens in next two years rather than later.

Another Tory minority government will keep the incompetents in the Liberal Party away from the levers of government, while allowing time enough to choose a genuinely small c-conservative leader and reorient policy. After three hard fought elections in five years, the finances of the Grits are precarious and their fund raising apparatus has yet to be properly modernized in wake of the Chretien-era campaign finance reforms. The opposition will be at its weakest in years. The Conservative Party the most susceptible to change since Harper's accession in 2004.

My best recommendations is to vote strategically. This is something of a gamble but it seems the percentage swings in the popular vote from 2008 will be small in most parts of the country. In ridings where a sitting Conservative MP has little chance of being defeated, if possible consider voting for a Libertarian or independent candidate. Even a shift of a few hundred votes would signal to local riding associations dissatisfaction with the Tories' leftward drift.

Where the Liberals hold relatively safe seats, a vote for the Conservative or Libertarian candidate would weaken the Liberal party - less money through the vote subsidy scheme - but not aid Harper's bid for a majority in a significant way. In the so-called Big Fifty swing ridings is where the call becomes harder

My own instinct would be to maintain the riding in the hands of the incumbent. Change as little as possible the political landscape in the Commons. These swings ridings will be watched closely by the local and even national media. It should be possible to tell where the political wind is blowing in most them through out the campaign. Local candidates also do independent polling. A step up in the nasty-factor in tactics by these candidates - such as out of the blue accusations of fraud - may give pretty good clues as to who is getting desperate. Extensive lawn sign vandalism is often another tell-tale.

In these swing ridings vote Tory to keep a Tory in power, or vote Liberal to keep a Liberal in power. A vote for an independent might easily allow a vote split in the wrong direction, changing the make up of the House of Commons. I would, however, make an exception in the cases of especially egregious local candidates. Julian Fantino in Vaughan comes to mind quite readily.

This might seem all a bit excessive. A few hundred or a few thousand votes can hardly swing an election one way or another? In a first-past-the-post electoral system they can and do. Pierre Trudeau clung to power in 1972 by a margin of two seats and a few hundred votes. In 2008 six ridings were subject to recounts because of the narrow margin of the outcome. The Tories are a dozen seats short of majority. This will be a hard and close fought election. Don't imagine the votes of you and your friends cannot make a difference.

Ronald Reagan famously joked that status quo was Latin for the mess we're in. For the longer term future of Canada, the mess we're in is a good place to be. For now.

 

Clash of the Titans

Or a reasonable facsimile for modern Canadian politics:

Increasingly, Jason Kenney and Justin Trudeau look like the future of their parties.

That’s not the same as saying they’ll be their parties’ leaders. That’s in the hands of card-holding party members and the fates. But each man carries in him something of the culture of his own political movement. Both will be around for many years yet. Their influence can only grow.

So much of Stephen Harper Conservatism is now run by, through, or on the sufferance of Jason Kenney that he has become his leader’s indispensable man, a C.D. Howe for a new and stranger age. 

Heavens. C.D. would have eaten Kenney for breakfast. I suspect the old Grit stalwart would have been impressed by Stephen Harper. A grumpy technocrat's grudging respect for another grumpy technocrat. Howe's background was engineering grain silos, Harper economics and public policy activism. At some level they both believed that smart people with flow charts can run the world. Thing is that Harper should know better.

Where Paul Wells nails it is in the concluding passage:

Quebec’s nationalist elites saw Trudeau as a laughable throwback to outdated values. So far he keeps beating them. Canadian conservatives see him as a laughable throwback to outdated values. His party will sink or swim on its ability to keep those values relevant in a new era. The Liberals’ silver-spoon multiculturalist will sink or swim with it.

This isn't as trite or obvious as it sounds. Trudeau is his father's champion. He assumed that mantle the moment he began that hysterical eulogy more than a decade ago. You might think a defence of Trudeaupian values in modern Canada is as redundant as coal marketing in Newcastle. The hand of the Charter, official multiculturalism, the Canada Health Act and an overly generous welfare state are very much with us. The force that inspired them, however, is dead. Government grows bigger through inertia, not passion.

Take Paul Martin's ill-starred proposal for a national daycare program. It's the sort of 1960s style big government solution to a fashionable problem of the day. It died a sad and lonely death, supplanted by a fairly modest Tory mandated tax credit. When Medicare was introduced its advocates were driven by an almost religious zeal. A zeal not unrelated to the fact that the program's leading advocate was a former Baptist minister. This wasn't just another government program, it was a moral crusade for social justice. Very few felt the same way about national nanny care.

What the younger Trudeau represents is an attempt to re-inject passion into the Trudeaupian project. Whether he succeeds or fails will say much about what Canadians expect from their government. Is it just Santa Claus, dispensing pork and subsidized social services, or should its ambitions be grander? Weaning people off the teat of big government isn't going to be easy because big government is easy. It promises all things to all people. A very pleasing lie.

The welfare state began as a project to alleviate suffering among the poorest of the poor. Its advocates soon realized that so expensive a program, which benefited only a small percentage of the population, would lack proper political support. Public housing, social assistance and food subsidies could be sold to the middle class as part of a package deal. Agree to fund these freebies for the poor, and the government would provide subsidized university tuition, socialized health care and superhighways to the expanding suburbs.

It was a political deal whose economics has been compared to an intergenerational ponzi scheme. Its architects little imagined that the birth rate would begin to dip below replacement level within a generation of its inception. This was mitigated by a reopening of our borders to immigrants. So long as the immigrants who arrived were high-skilled, or willing to acquire economically valuable skills soon after arrival, this new wave of post-war immigrants was a tremendous boon. The cost of their rearing had been borne by their mother countries. They arrived in the prime of life and were by nature people of higher than average ambition.

That was then. Today the ambitious have little reason to come to Canada and finance grandma Mackenzie's nursing care. Our economic and social life seems designed to discourage procreation among the old stock groups accustomed to high living standards. The welfare state is broke. The multicultural project has failed abysmally, its pieties ignored by the ambitious among the post-1968 immigrant groups, and cynically exploited by ethnic and religious grievance mongers. Justin Trudeau has yet to figure that out. The vital question is whether a critical mass of the Canadian electorate understands the new reality.  

The Priorities of Modern Canada

Bilingual tax collectors...

The Canada Revenue Agency has 40,000 employees but the department is spending at least $42,900 helping one worker, who has dyslexia, learn French.

The employee, who has not been identified, has already had two years of federal French language training at two different schools all to no avail, CRA documents show. Now, the federal tax agency is turning to a private school in Ottawa for one-on-one training to help the staffer pass the government’s language test.

...versus cancer stricken mothers:

She was commenting on the case of Jill Anzarut, a 35-year-old mother of two young children, who was told she is ineligible to receive the drug Herceptin, which costs about $40,000, because her tumour, at 0.5 centimetres, was deemed too small.

That Ontario medical guideline is in contrast to British Columbia, Alberta and Saskatchewan, all of which cover the drug for smaller tumours; Manitoba covers it on a case-by-case basis.

Ms. Matthews said the issue is best left to experts, adding: “I am not an expert and I cannot have opinions. I have to rely on the opinions of the experts.”

So why do we have non-experts running a field as technically demanding as medicine?

The exceptional access program is a patient safety valve, with a 12-member committee of doctors, pharmaceutical experts, health economists and members of the public making a decision, in some cases in as little as 72 hours, said Ontario Health Ministry spokesman Andrew Morrison.

But Sarah Palin was crazy when she talked about "death panels."

These two stories are eloquent expressions - for those still paying attention - of the nature of modern Canada. Bilingualism in its current form, especially as it relates to employment policies in the federal government, is a continual act of appeasement toward Quebecois nationalism. Rather than being an attempt to promote a more bilingual Canada - which is an impracticality - official bilingualism was instead a covert form of pro-Francophone affirmative action.

Yet so central has this policy of appeasement become to our government that nothing is thought of paying a small fortune to educate a dyslexic paper shuffler in French. There is, of course, no practical reason for training this bureaucrat in another language. Unless we are to believe there is a shortage of Francophone tax collectors in Canada.

The myth of national unity through appeasement contrasts with the myth of socialized health care. We are told that a system of socialized medicine is more compassionate than private alternatives. There is nothing in the story of Jill Anzarut that suggests compassion. There is also no such thing as socialized health care. It is a polite euphemism for monopolistic and bureaucratic health care. The Medicare Cult's defenders argue that the alternative to government care is a heartless free market, interested only in penny pinching and profit making. Does not, however, the actions of the Ministry of Health sound exactly like the caricature of a heartless corporate penny pincher?

In a free market Jill Anzarut would have had the choice to buy private health care insurance that provided coverage for the treatment being sought. Instead she - and the other twelve million residents of Ontario - have no choice in what OHIP will or will not cover. She can pay for this particular treatment out of pocket (which is not always the case) but she must do so while also paying into OHIP.

In any health care system - like any other part of the economy - resources must be rationed. In a free market consumers have a say in how those resources are rationed. In government health care there is no say, except through the cumbersome and often ineffective method of the ballot box. Assuming there is a political party willing challenge the Medicare Monopoly.

Welcome to modern Canada. State of the art medical treatments for mothers of young children? No. Extensive language training for dyslexic tax collectors? Yes.