PAUL CHIASSON/THE CANADIAN PRESS file photo It long looked like Quebec would be the ground zero of a challenge to the status quo in the health-care system. But the latter is proving as resilient in that province as in the rest of the country.
MONTREAL—Don’t count on the next Quebec premier, whoever he or she may be, to challenge the Canada Health Act. The three main leaders all support a one-tier public health system. And that is part of a Canada-wide trend in the endless debate over the future of medicare.
In one of his first federal-provincial acts as a majority prime minister last year, Stephen Harper took steps to take his government out of the play of the health-care debate.
He declined to put strings on future federal health transfers to the provinces.
Harper made it clear that as far as he is concerned, the premiers are in charge of the system. On his watch, they are apparently not to look over their shoulder for directions (or extra help) from the federal government.
At the time many predicted that an era of greater federal detachment from the health policy area would lead to an era of greater privatization of the system.
But so far the pendulum has been swinging the other way with friends of medicare taking over the corridors of provincial power and the upper levels of the medical establishment.
Take the Canadian Medical Association. In the recent past, the association that represents the country’s 76,000 physicians, residents and medical students flirted with private health care.
These days, it has moved on to a different barricade.
The CMA’s incoming president, Anna Reid, is the first to hail from the Northwest Territories. She has worked on the emergency frontlines of one of the country’s more remote areas. The two-tier system she worries about is one borne out of social inequalities and geographical challenges.
The NDP is the party most identified with medicare. Its fortunes have been on the rise in most provinces, including Ontario, over the past year.
In British Columbia, polls suggest the New Democrats could be in power within the year.
In Alberta, proponents of a greater privatization of the health system lost a round when the Wildrose Alliance went down to defeat in last spring’s provincial election.
The party proposed to address the wait time issue through the expansion of the private health-care network.
Moreover, the voters who made the difference for Tory Premier Alison Redford in that election mostly hailed from the progressive pro-public system side of the spectrum.
It long looked like Quebec — where medicare does not enjoy quite the sacred cow status that it has achieved elsewhere in Canada — would be the ground zero of a challenge to the status quo. But the latter is proving as resilient in that province as in the rest of the country.
Quebecers were responsible for the elevation last year of the NDP to official Opposition status in the House of Commons.
That was preceded by a failed attempt by Premier Jean Charest to introduce user’s fees in the health system. He had to beat back in retreat in the face of a vocal public backlash.
At the time, polls showed that a majority of Quebecers would have wanted the federal government use the Canada Health Act to prevent the introduction of Charest’s fees, even if that would have involved trampling on an area of exclusive provincial jurisdiction.
The Coalition Avenir Québec was partly built on the foundations of the defunct Action Démocratique du Québec. But not all of the latter’s tenets survived the transition.
Among those that did not was a longstanding commitment to introduce more private health care to the province — even if that meant challenging the Canada Health Act.
Gaétan Barrette, the outspoken doctor François Legault is proposing to install as health minister of a possible CAQ government, has cast himself as an advocate of the public system.
In the platform that was published on the weekend, the concession to the ADQ of a pilot public-private health-care project was downgraded to a footnote.
It may be that the government least friendly to medicare in Canada these days is the one that least wants to have a hand in the system. From the perspective of the future of the country’s top social program, that may yet turn out to be a happy coincidence.