Harper on health care: hard to make it a vote-driving issue

The Liberals have been making a late-campaign push to turn Stephen Harper’s past remarks about health care into a big election issue, and it’s hard to blame them. Those painstakingly selected quotes from Harper are certainly more germane to an actual policy file than any of miscellaneous old Michael Ignatieff lines the Conservatives creatively cut and paste into their attack ads.

Still, I doubt dredging up Harper’s past pronouncements on health is doing him much harm. He has a solid track record of not tampering with the status quo. His calls for Ottawa to step away from dictating health policy and let the provinces overhaul the system date from back before his creation of the new, more cautious Conservative party in 2003.

Even in Harper’s first campaign as Conservative leader in 2004, the Liberals found it impossible to make his earlier statements matter much. Paul Martin was only able to turn preserving public health care into a winning issue for his Liberals in that election when he was handed fresh material—notably from Ralph Klein, then Alberta’s premier, who intruded into the campaign by saying, less than two weeks before voting day, that he planned to introduce reforms to his province’s health system that might be seen as violating the sacrosanct Canada Health Act.

The astounding timing of Klein’s comments allowed Martin to raise the specter of a hidden agenda on the right, and challenge Harper to renounce a fellow Alberta Tory. I happened to be covering Martin the day he revamped his stump speech to highlight the new theme, and I remember the feeling of vigor flowing into what had been a enervating campaign.

And so Martin eked out his 2004 minority, setting the stage for the 2006 election, which Harper of course won. In between came a stretch, particularly in the spring of 2005, when Harper spoke quite a bit about substantially revamping the relationship between Ottawa and the provinces. But he sounded acutely aware—maybe based on his recent election experience—that he needed to prevent the discussion he wanted to spark about the balance of federal-provincial roles from narrowing into a health-care debate.

I was never able to figure out exactly what Harper had in mind, beyond broadly disentangling federal and provincial functions, while shifting some taxation power to the provinces. For what it’s worth, here’s part of a brief Q & A we published in the May 9, 2005, issue of Maclean’s, after I caught up with Harper when he was on a southern Ontario speaking tour:

Q.  If you become prime minister, you say you’ll negotiate a comprehensive deal with the provinces on which level of government does what and how tax money will be divided.

A. What I’m promising requires significant agreement. But my sense from talking to the premiers, and even some of our major municipal leaders, is that there would be a willingness to get on with doing it. What’s happening now is that the Liberal government, because it won’t admit there’s a fiscal imbalance, is fumbling around trying to solve it by doing one-off deals, maybe on health care or gas tax, as it did with the Atlantic provinces. What it’s trying to do is to dribble out money to say it’s addressing these problems while retaining its enormous surplus. I don’t think that’s good enough. I would rather have the federal government focus on the things it can do and let the other governments get on with the issues they are supposed to deal with.

Q. Won’t you be vulnerable to charges that what you really want is no federal role in setting standards, especially in health care?

A. We’re not talking here about a major realignment of responsibilities. We’re talking about giving the other levels of government the finances to fund their own. Martin signed a health-care deal last fall that was more devolutionist than I would propose.

That was about all he would say on the matter. As Prime Minister he hasn’t pushed for anything that I would call a “significant agreement” on rebalancing fed-prov roles. But there’s incremental movement in that direction. Under Finance Minister Jim Flaherty’s budget outlook, the federal government taxes and spends less, as a portion of GDP, year after year, while keeping up steady increases in transfer payments to the provinces, presumably enhancing their ability to do more.

This is obviously not the stuff of campaign-trail fireworks. There are no inflammatory quotes to pounce on, just numbers to sift. Ultimately, though, the future of health care, and much else, probably depends more on these trends in the capacities of governments than on anything the Prime Minister has said in the past or is likely to risk saying in the future.

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