PM’S sunny days encounter headwinds
Being scolded by Twitter for distorting the truth is a bit like being accused of subverting an election by Donald Trump.
Decent, honest and truthful are not the words that immediately spring to mind when it comes to the social media giant.
Yet Twitter is trying to clean up its act. The addition of a “manipulated media” tag to an edited clip of Conservative Leader Erin O’toole that was tweeted by Chrystia Freeland on Sunday was demeaning and embarrassing for the nation’s finance minister.
In the clip, O’toole made clear his enthusiasm for health-care reform, including use of for-profit providers. But the shortened clip omitted the Conservative leader’s caveat that “universal access remains paramount.”
Despite the rebuke, Justin Trudeau proceeded as if O’toole had proposed a cull on the Canadian beaver.
At his media availability in Halifax, he suggested that the Conservatives are proposing to blow up the public system and allow priority access to the wealthiest.
“It sounds like, put another way of saying, he wants to go back to the Harper era of cuts to hospitals and private investments,” he said.
For one thing, the idea of “Harper-era cuts” is dubious. The Conservatives maintained the six per cent escalator to health transfers negotiated by Paul Martin in 2004 and it was the Trudeau government that replaced it with a minimum increase of three per cent a year in 2016-17. The annual average growth in health spending per capita (after inflation) was 3.3 per cent for the period 1996-2010, after which it dipped to 0.1 per cent in 2010-14. Growth in spending was less steep but it continued.
For another thing, O’toole’s Conservatives have not said they would make cuts if elected. On the contrary, they have said they will increase the Canada Health Transfer by six per cent a year — an investment of $60 billion over a decade. If anything, the criticism should be that an economy growing at two per cent a year cannot afford such largesse.
But, of course, there is no room for reasoned debate when panic sets in.
We have been having these debates for decades — mostly at election time when the Conservatives look as if they might make a resurgence. Trudeau bandied around words like “for-profit” and “two-tiered” but the reality is all countries have a for-profit component in their health-care mix. Canada is 30 per cent private to 70 per cent public, which is about the OECD average; more than the U.K. (22 per cent/ 78 per cent private to public) but less than the U.S. (51 per cent/ 49 per cent).
Trudeau suggested that only the Liberals can rebuild a health system “that works for all Canadians” but did not commit to the same investments as the Conservatives. Instead, he announced $6 billion to reduce wait times, with a further $3 billion targeted at hiring 7,500 doctors, nurses and nurse practitioners.
Voters should be skeptical of any promises made in the heat of the campaign, it goes without saying. In 2019, Trudeau promised that his party “would make sure that every Canadian has access to a family doctor or primary health care team” and earmarked $6 billion for the provinces.
Perhaps the starkest difference between two parties throwing billions at the wall is that the Liberals have no intention of simply transferring money to allow the provinces to spend where they see fit. “It’s about creating outcomes for Canadians. We will work with the provinces on those outcomes,” he said.
The premiers will be thrilled at such an intrusion, no doubt. While they would like to see Ottawa increase its contribution by around $28 billion a year to address the “imbalance” in health spending, they are not keen for the federal government to spread its tentacles into their jurisdiction.
The case for the massive increases in spending promised by the Conservatives has not been made — beyond the obvious one, that it might help them win the election.
Provinces restricted their own spending increases to 2.9 per cent between 201213 and 2016-17. The population is aging but the Canadian Institute for Health Information estimates the cost to the system at an extra $2 billion a year (spry 65-69 year olds cost no more than the general population; people who are more than 80 cost three times that amount). Drug costs have been contained, as has hospital expenditure through controlled admission and same-day surgery. The biggest increases are in physician costs — the home for one in six health-care dollars. Small wonder when family physicians earn $281,000 a year and surgical specialists around $481,000.
Within such complex systems, there is room for reasonable people to disagree on policies. But that’s not what Trudeau is doing. His enlightened view of himself
BUT, OF COURSE, THERE IS NO ROOM FOR REASONED DEBATE WHEN PANIC SETS IN.
means he believes his compassion for the less fortunate distinguishes him from those of different political views.
It is imperative for the Liberals that the focus is on compassion and caring, or the election might come down to results and outcomes — ground on which they are vulnerable.
To go so negative, so early, is a departure for Trudeau and reflects the advice he is getting. In past campaigns, advisers like former principal secretary Gerald Butts and digital campaign chief Tom Pitfield have advocated a “positive, hopeful narrative.”
“You appeal to people’s higher order preferences — you show them you are going to provide them with the help and relief they need ... From a positive place, you own that hopeful narrative again,” Pitfield told me in 2018.
But we are a long way from the sunny ways that Trudeau said was his guiding principle in 2015.
If the sun and the wind are holding a contest to see who can remove the traveller’s coat in this election, as in Aesop’s fable, Trudeau is offering more bluster than radiance.