Who will save our health care system? The Conservatives won’t! by Baldwin Reichwein

Canada’s health care system is complex, costly and it is an evolving creature. Health is important for individuals and the health of a nation’s population is equally important. The two go hand in hand. The development and evolution of a national system was slow and bumpy. There are benchmarks, a key one the 1984 Canada Health Act. It sets out appealing criteria: universality, accessibility, portability, comprehensiveness, and public administration. Federal cost sharing, however, decreased significantly over the last few decades, as has national leadership in health care.

Currently the primary federal contribution reaches the provinces via the Canada Health Transfer (CHT) and comes in block funding in the form of tax points and cash transfers. The First Ministers in 2004 signed a 10-Year Plan to Strengthen Health Care (better known as the Health Accord) in response to the aftermath of the drastic cuts of the 1990s. Increases were made by the federal government in the base adjustment, topped by an annual six percent escalator. The Harper government respected the agreement in terms of cost sharing, but has made no attempt during its tenure in office to incorporate Home Care, Pharmacare, or Long Term Care under the CHT.

In 2011, the late Jim Flaherty, Minister of Finance, announced that the CHT would continue to grow at six percent annually until 2016-17. But beginning in 2017-18 the CHT will grow in line with a three-year moving average of nominal gross domestic product (GDP) growth, with funding guaranteed to increase by at least three percent per year. Unless the ground rules change the CHT won’t be reviewed until 2024. The change in the funding formula was not negotiated with the First Ministers and subsequently the federal government did not renew the Health Accord and let it expire earlier in 2015. The federal Parliamentary Budget Officer (PBO) projected in his 2013 Fiscal Sustainability report the impact of the new arrangement from 2012 until 2087. He advised that the CHT as a percentage of provincial-territorial and municipal spending will decline to 12 percent during the last 25 years of the period noted (the CHT contributed 20.4 percent of all medicare costs in 2010-11). Dr. Chris Simpson and Owen Adams opined that it will be just a question of time before the provinces and territories challenge the federal government’s moral authority to enforce the Canada Health Act when their contribution to the funding of medicare is eroding quickly. Provincial and territorial governments will find it increasingly difficult to provide quality health care when facing an aging population.

The Canadian Health Coalition interprets Harper’s plan as an intention to eliminate national health care. The CHC points to Harper replacing the equalization portion of the Canada Health Transfer (CHT) with an equal per capita transfer. Alberta gained in the short term because of its unique growth in population to date; other provinces already face demographic challenges and find it difficult to provide quality health care. The CHC forecasts a cut of billions of dollars in federal funding into the future with an eventual reduction to less than 12% in years. The CHC also forecasts an accompanying withdrawal of federal enforcement of national standards contained in the Canada Health Act. Enforcement of standards is a concern at present, for example, in cases of double billing.

There are two primary issues that warrant attention in relation to health care: funding and ideology. The party in power has demonstrated indifference at best and at worst opposition to “all” Canadians having access to timely, necessary and affordable health care services. Instead of strengthening the system the Conservatives download on the provinces with resulting increased privatization of essential services. The thrust towards a federal minimalist position on health care is unacceptable. The question remains. Which party will step up to the plate to provide national leadership and save our health care system?

Baldwin Reichwein is a retired social worker with a career background in social and health programs.


It is not clear what role the members of the Alberta NDP government will choose to play in the federal election. Relations between the Alberta leadership and federal leader Thomas Mulcair became strained after Mulcair used the technical term “Dutch disease” to correctly describe what was happening to the Alberta and federal economies: the focus on a single sector, oil extraction, was jeopardizing the development of a more broadly-based economy. He did not invent this term, which economists, conservative and radical, use frequently, but the Conservative media and Big Oil claimed that he was calling the oil industry a “disease” and made it difficult for Albertans and Canadians to have an important conversation about economic diversification.

But analysis of the campaign promises of the federal NDP with the pledges that elected the NDP in Alberta on May 5 demonstrates that it will be a godsend for the Alberta government if Thomas Mulcair becomes prime minister, particularly if he leads a majority government, though a Mulcair-led minority dependent on the Liberals would also likely be able to introduce many of the pledges in the NDP platform. The federal Liberals are however at odds with the Alberta government’s philosophy and priorities on a number of issues. An NDP federal government would, to put it bluntly, help to fund many of the priorities that the provincial NDP set for itself in this year’s provincial election and give them a national character. The arguments of the Alberta right wing that the province will price itself out of the economic competition for new businesses would fall apart if policies initiated in Alberta are followed by other provinces because of federal leadership.

The Alberta NDP and the federal party are particularly aligned on the issue of implementing a universal childcare policy. The provincial NDP pledged in May to regulate and subsidize childcare to insure that the top rate for quality daycare in the province drops to $25 a day. The federal NDP is going them one better with a plan to cap childcare at $15 a day through subsidies amounting to 60 percent of daycare costs with provinces to provide the remaining funds necessary to ensure the capped childcare costs. The result would almost certainly parallel what happened when the federal plan for universal medicare was introduced in 1968. Though only Saskatchewan had chosen to introduce a universal provincial plan before the feds came into the game, the generous subsidies provided by Ottawa and popular support for a universal program forced all provinces to establish a universal scheme. At the moment only Quebec has a universal scheme and Alberta’s plans to provide a similar program to Quebec’s will be made far easier if the federal government is funding much of the plan. And when all the other provinces join in, the conservative cries of “you are making us uncompetitive” will fall apart quickly.

While the federal Liberals at the end of Paul Martin’s period in government joined the NDP in the latter’s longtime commitment to universal daycare, the election of the right-wing Harper government put the kaibosh on universal daycare. Harper, contemptuous of feminist arguments that the high costs of childcare limited women’s ability to participate fully in the workforce, argued that families rather than the government should determine how money for childcare was spent. So he introduced a modest Universal Childcare Benefit that went to families and did nothing to regulate daycare or its costs. In recent months Justin Trudeau has gone into competition with Harper regarding the size of the benefit and has justly lamented its lack of progressivity. Still, the result has been a weakening of the Liberal commitment to universal daycare–they don’t reject it but are vague about how much they would spend on it, having pledged so much money to the childcare benefit.

The Alberta NDP government would also benefit from Mulcair’s pledge to make $15 the minimum federal wage. It would apply to both federal employees and to contractors hired for federal works.   We have already seen that the business lobby in Alberta is screaming at the provincial government for planning to raise the minimum wage to $15 by 2018, claiming that requiring companies to pay more than slave wages to all employees will hurt Alberta companies relative to companies in other provinces. But if the federal government were to set the same minimum as Alberta and impose it on all companies that deal with the feds, it won’t be long before other provinces have raised their minimum wage to $15.

Despite the Alberta government’s concerns about the language that Mulcair uses regarding both the fossil fuel industry and the environment, their perspectives on these issues are almost perfectly matched. The Alberta government has called for the expansion of refineries in Alberta and Canada as opposed to simply exporting oil and the jobs that go with upgrading and refining. Mulcair has similarly made clear his intention to promote refineries as part of his economic diversification strategy. His call for more federal support for non-fossil-fuel industries similarly fits well with the province’s desire to expand its role as an energy superprovince with fossil fuels gradually becoming less of the total picture. The Liberals would also likely be far more supportive on these files than Harper, the prisoner of Big Oil, but their support for the Keystone pipeline which involves only raw bitumen places him somewhat outside of the consensus that the federal and provincial NDP have on the necessity of increasing Canada’s role as a downstream producer of gasoline and other fossil fuel products.

There can be little doubt that the return of the Harper government to power would be a disaster for the Notley government. They would be dealing with a federal government that heaps scorn on social, environmental, and economic diversification programs. There would be a federal-provincial struggle over who should determine the future of Alberta and whether we are really in a “new Alberta” or in a twilight zone where a progressive provincial government faces nothing but roadblocks from an old-style, corrupt, corporate-controlled federal government that looks very much like the provincial PC government that we defeated in May. Progressive voters who voted for the NDP in May (or for that matter, the Liberals or Greens or even the Alberta Party) should give some thought to what their vote in the federal election might mean for their provincial vote. That is true whether they choose to vote for their favourite federal party, their favourite candidate, or for a party/candidate whom they believe is the “strategic candidate.”


The election of an NDP government in Alberta was opposed by every daily newspaper in the province and by the entire corporate sector. So will they be gallant losers and give the new government a chance to implement its promises, waiting till the next election to try to show the wrongheadedness of a better distribution of wealth and power in Alberta, better environmental policy, and other such examples of “socialist rot”? Of course not. Both the corporations and the corporate media will oppose the new government every step of the way. But much of the dirty work will be undertaken not by the corporations or the media directly and in their own name. Instead the corporations will operate through so-called “research institutes” whose “findings” the corporate media will report without critique and without allowing rebuttals from non-corporate social actors. Here is the take of a recent Canadian history book, of which I am one of three co-authors on why these research institutes were established, how they are funded, and what they have achieved for their funders. Full disclosure: I wrote this section of the book, though my co-authors approved the wording. The book in question is Margaret Conrad, Alvin Finkel, and Donald Fyson, History of the Canadian Peoples Volume 2: 1867 to the Present, Sixth Edition (Toronto: Pearson, 2015).

From 1945 to 1975, as the interventionist state grew in Canada, business interests attempted to shape public opinion against expensive social programs, corporate taxes, and state regulation of industry through campaigns by traditional business organizations such as the Canadian Chamber of Commerce and the Canadian Manufacturers Association. They had little success in swaying public opinion. A survey presented to the 1965 Canadian Chamber of Commerce convention suggested that most people discounted what business organizations had to say as self-interested propaganda.

Gradually, the leaders of large corporations in Canada began following their American and British counterparts in establishing allegedly non-partisan, non-profit “research institutes” and “think tanks” to conduct and disseminate research meant to create public support for state policies that corresponded with the corporate agenda. Such efforts began modestly with the creation of the National Citizens Coalition in 1967 by Colin M. Brown, a London Life insurance agent who opposed universal medical insurance. The NCC was incorporated in Ontario in 1975 and expanded its focus to include campaigns against many government programs and unions. Between 1998 and 2002, Stephen Harper, who later became a Canadian prime minister, was president of the NCC.

While the NCC focused primarily on political campaigns, the Fraser Institute, founded in Vancouver in 1974, styled itself as an independent research group with a focus on market-oriented solutions to social issues. Its founder, Michael Walker, an economist at the University of Western Ontario, received financial support from MacMillan-Bloedel, the forestry giant, which was at loggerheads with British Columbia’s NDP government from 1972 to 1975. Walker claimed that the Fraser Institute, as a non-profit research organization, was controlled by its staff, and not its funders. In practice, its well-paid staff knew that their research results had to conform to the funders’ interests. The organization received charitable status, making contributions to its work tax-free. In 1975, the Institute generated revenues of $421,389, which would explode to almost $11 million by 2010.

The Fraser Institute published studies of its research results, along with a monthly magazine, and a bi-monthly newsletter. It also sponsored student essay contests, held seminars for students, and created internships. Most importantly, it created close relationships with the media, which often published the Institute’s results without raising issues about its funders or underlying ideology, and without reporting the views of scholars or public figures who took issue with Fraser’s assumptions and methodologies in its research.

Before long, the Fraser Institute inspired copycats. The Montreal Economic Institute was founded in 1987, followed by the Canadian Taxpayers Foundation in 1990, the Atlantic Institute for Market Studies in 1995, and the Frontier Centre for Public Policy, a Prairies grouping, in 1997. The C.D. Howe Institute, which had its origins in the work of the C.D. Howe Memorial Foundation, became an independent organization in 1982, with funding from major corporations and investors. The previous year, the Conference Board of Canada emerged from its former incarnation as a wing of an American business think tank, and by the early 2000s employed about 200 people. Each of these organizations had public relations departments that made use of sophisticated communications techniques to shape public opinion. Supporters and detractors alike credited the seemingly objective corporate-sponsored research institutes for a major shift in public attitudes regarding the relative roles of government and the private sector. They also played an important role in encouraging support for free trade.

Opponents of neo-liberalism, particularly in the labour movement, funded competing research institutes such as the Canadian Centre for Policy Alternatives, which began work in Ottawa in 1980, and Alberta’s Parkland Institute, founded in 1997. These organizations had modest funding relative to their corporate counterparts and far less coverage for their findings in the corporate-controlled media.[i]

[i] On think tanks and research institutes in Canada, see Murray Dobbin, The Myth of the Good Corporate Citizen: Canada and Democracy in the Age of Globalization (Toronto: James Lorimer, 2003). Their impact in other countries is explored in Richard Cockett, Thinking the Unthinkable: Think-tanks and the Economic Counter-Revolution (London: Fontana, 1995).


Well, it’s living they’ve found, deep in the ground,
And if there’s doubts, it’s best they ignore them.
Nor think on the bones, the crosses and stones
Of their fathers that came there before them.
In the taverns of Edmonton, fishermen shout
Haul it away! Haul it away!
They left three hundred years buried up the Bay
Where the whales make free in the harbour.

-Stan Rogers, “Free in the Harbour”

You don’t spend too much time in Alberta without running into a Maritimer, a
Newfoundlander or someone one-generation removed from Atlantic Canada. When I lived in New Brunswick a decade ago, it was estimated that a jumbo jet load of people was leaving the province every month headed to Alberta or Saskatchewan. Some were relocating permanently, others were engaged in transcontinental commuting – six months in Fort Mac, six months back home in Saint John.

This pattern of domestic migration has been going on for some time. Excepting the interruptions of periodic busts, the booms have attracted new arrivals to Alberta since it became a rich province about 70 years ago. We all know why Atlantic Canadians come. Here is a resource rich province with a labour shortage, offering wages unimaginable down east. Yet, as we think about Alberta’s future, we might cast a thought to the past of Atlantic Canada, to the century of prosperity that resulted in all those big Victorian houses in places like
Halifax and Saint John. There was work aplenty in the timber stands that helped build the British navy in the age of sail, in a fishery that fed millions, in rich seams of coal. The economic history of the region is complicated, but to imagine that Alberta lucked into the wealth of abundant natural resources while Atlantic Canada did not is to take a very short term view.

Atlantic Canadians have seen the window close on resource economies before. The age of sail ended in the age of steam. Coal fell out of favour as the fuel of choice for railways and home heating. Technological advance made for the ecological devastation that exhausted the once staggeringly abundant stocks of cod. It is only retrospect that makes these endings appear inevitable. And, they were not sudden – people and some companies held on and did not give up easily, even as the smart money in the big houses of the region shrewdly invested their fortunes elsewhere.

By 1958, coal mining in Springhill, Nova Scotia was in trouble. Only one shaft, the #2, was in operation and it was one of the deepest in the world. The miners knew it was dangerous and they said so loudly. But the union wanted to protect the jobs and the company wanted to get the coal out and the warnings were ignored. When the disastrous “bump” came, the normally jocular banter among miners at the coal face had been silenced for weeks. They kept going down the pit, though, however grimly. The day of the bump, 75 of them re-emerged in coffins.(1)

The national press chose to focus on the heroic rescue efforts and miraculous survival of a minority of the miners in this, the third major Springhill disaster. Today, we have a Heritage Minute about it that focuses on a surviving miner, acknowledging in only one sentence “so much death.”(2) It is not the grisly aftermath of the disaster that resonates with me, however. It is the image of the silent miners, showing up for work every day knowing that it was only a matter of time until fate would determine whether they would be lucky or unlucky, whether among the quick or the dead.

Canada was a free country in 1958. Why did they keep working? Why didn’t they move to Alberta? Perhaps some of them did. For those that stayed, however, we can imagine that the choice seemed like no choice at all. There were kids to feed and bills to pay. Yes, the disaster would come, but perhaps not today. Perhaps not to me.

Here in Alberta, we know that our window will not stay open forever. The G7 has
committed to stop combusting fossil fuels by the year 2100.(3) Technological advance – whether it comes in the form of battery powered cities(4) or compact fusion(5) — may shut it considerably sooner than that. And, let us hope so, since our disaster when it comes will not be a sudden bump, leaving a small town devastated, but, potentially, an irreversible change in the planet’s climate with catastrophic global implications.(6)

Yet to tell the people of Fort McMurray (or downtown Calgary) to leave the oil in the soil is like telling the miners of Springhill not to show up for work. There are mortgages, car payments, commitments, expectations, and hopes. And maybe the disaster won’t come, or won’t come for us. How do you end a gold rush while the gold can still be found?

The thing about ghost towns, Northrop Frye once observed, is their lack of ghosts. They don’t last long enough to produce them: to accumulate generations, long history, the crosses and the bones weighing on the minds of Nova Scotia fishermen in an Edmonton tavern that Stan Rogers sang about. If Alberta does not wish to expand its collection of ghost towns, a strategy needs to be developed for sustaining both economic and ecological life here beyond 2100. We need to demonstrate that our abundant wind and sun can allow us to transition into a new energy economy. We need to think about what we might do with our fossil fuels besides shipping them somewhere to be processed and burnt.

Ultimately, we have to make a commitment to stay. Not just that we will stay, but that our grandkids and their kids after them will stay here too. Otherwise, we’ll have in a few generations a folk singer looking back nostalgically to the Alberta version of ‘goin’ down the road.’ We’ll have to hope, as well, that there’ll be a road left for us to travel.

KIRK NIERGARTH is a historian and teacher in Calgary.

  1.  This story is told in greater detail in Ian McKay, “Springhill 1958,” New Maritimes, 2 (December 1983/January
    1984), 4-16.
  2.  https://www.historicacanada.ca/content/heritage-minutes/maurice-ruddick
  3.  http://www.cbc.ca/news/politics/prime-minister-stephen-harper-agrees-to-g7-decarbonizationby-
  4.  http://www.teslamotors.com/powerwall
  5.  http://www.lockheedmartin.ca/us/products/compact-fusion.html
  6.  http://www.theguardian.com/environment/2015/jan/07/much-worlds-fossil-fuel-reserve-must-stay-buried-preventclimate-