I've been watching the reactions to Thursday's Supreme Court decision regarding the government monopoly on health care with some interest, which probably isn't surprising. As background for anyone who missed it here's the original Globe and Mail report on the ruling.
In a narrow 4-3 ruling, the court said that prohibitions on private insurance are invalid since the public system has failed to deliver medical in a timely, reliable way.
In
an article in today's
Toronto Star Linda McQuaig tackles the issue. Her summary of the potential problem with a two-tier medical system is cogent enough.
Once the rich start buying their services outside the public system, they resent paying taxes to support it.
They press for, and usually win, tax reductions, leaving inadequate funds for the public system.
As the public system deteriorates, it ends up serving only the poor ? who have little clout with governments.
Politicians don't mind letting the poor sleep on the street, so they aren't likely to mind if the poor lack timely access to hip replacements.
But I have a problem with the last two paragraphs of her article.
The Supreme Court has breathed new life into the privatization campaigns of right-wing think tanks.
Expect to hear lots more from the Fraser Institute, whose ideas are just as unpopular with Canadians today as they were a week ago, but who now have four judges backing their cause.
If the privatization campaigns of right-wing think tanks are more compelling now than they were, it isn't the fault of the Supreme Court. They didn't cause the lengthening in wait times or the difficulties that our health care system is experiencing. If there's a crisis in the Canadian health care system the judges didn't create it, they're just responding to it. McQuaig doesn't explictly use the term "judicial activism" but I can hear it in the background. And if you want to see it more explicitly you can look no further than Warren Kinsella's
June 10th entry:
... the judicial activists on the Supreme Court of Canada have given the rest of us their own public policy Vietnam: in their cloistered arrogance, they wish us to believe that destroying Medicare will save it.
As I understand the decision, the government has been told that if it wishes to maintain its monopoly on health care it
must maintain certain minimum levels of service and at the present time that standard isn't being met. In doing so, the Supreme Court is standing up for the individual in the face of government mismanagement and inaction. That, in part at least, is exactly what we should expect of the Supreme Court and if that's activism I'm all for it.
Kinsella would have us believe that our world changed abruptly on Thursday but that's simply not true. What happened is that a situation whose foundation was laid a long time ago finally found its way into a Supreme Court session which is the only way that Supreme Court judges will have the opportunity to make a ruling.
A decade ago the Chrétien government with Paul Martin as Finance Minister abruptly slashed transfer payments to the provinces. That left the provincial governments, who are responsible for the delivery of health care, scrambling to make up the sudden revenue shortfall. You can certainly argue that in the face of burgeoning debts and deficits the federal government had to act, but I can argue that they cut too quickly and without thought as to how it would affect social programs like health care and education. Ten years later we're still seeing the consequences of those cuts rippling through the system.
Since then we've had a much ballyhooed report from Roy Romanow on how to repair and improve our health care system. And since that report was issued Romanow and others have repeatedly expressed their frustration at the way governments at all levels are dragging their feet about implementing his recommendations and keeping the commitments they've made. While the provinces are quick to demand more money, and take credit for saving health care when they win some concession out of the feds, they're as guilty as the feds at not making good on their commitments.
So don't blame the judges. They didn't create the problem and when they defend the individual against the government they're doing exactly what we pay them to do. And don't look to the judges to solve the problem because they can't.
And that's why I think it's a mistake for those who support single payor health care to dwell on the subject of so-called judicial activism. It shifts the debate away from where it needs to be. It shifts the focus away from governments and politicians who are responsible for the current state of affairs and who are the only ones who can do anything about it. Of course that means they'll have to stop playing politics with the issue and get down to the admittedly difficult job of actually doing something about it. But that's what we pay them for.
And by the way, if I thought the Supreme Court was actually agreeing with the Fraser Institute I'd be shouting "We're doomed! Doomed, I tell you!" as loudly as anyone.