Napoleon Bonaparte once referred to England as a "nation of shopkeepers." He meant it as a grievous insult, considering himself and his own nation as artistic and cultured.
Napoleon fits well in the highbrowed tradition of putting down business and commerce as activities, and those who work in them. So do some Albertans.
As the leadership for the Alberta Progressive Conservative Party unfolds, the lack of good policy ideas on health care has been notorious. It is indicative of the impasse that we have reached in Canada over what essentially has become a sacred cow.
Health care has become an inalterable icon, but it must not remain so. This is a time when our leaders should be the most innovative and inventive as we face impending demographic and fiscal crises.
As if the compounded effect of such crises on health care was not enough, we also face an acute problem of political sclerosis. This acute illness is manifested in the inflexible attitude that health care, such as it is, must not change.
This attitude is widespread among the population, and it has cemented an absence of leadership on the question. Put more clearly,
few if any leaders have exhibited the courage to lead into seriously needed health care renewal.
The crisis will not be solved by doctors and administrators. The obstacles to renewed health care are political because the obstacles are us. Granted, there is a willingness to tinker here and there with the largely clogged system, but the central blockage is the attitude resisting fundamental change to address the source problem. This sclerotic attitude only concedes that there are minor details to fix, but it holds fast to the notion that the centrally planned, single-payer scheme is sound.
The idea that the principles of health care in Canada must never change is wrong.
There is a number of ways by which we resist change on health care, all of which are variants of the same idea that no one should have better care. It is a principle that springs from envy instead of rationality.
The most typical way to resist change has been to say that we "don't want an Americanized system." One PC leadership hopeful recently declared, and all the others agreed with her, that health care should not be "commercialized." This is a similar expression of the statement about Americanization.
It is an equally disingenuous formulation because the system is commercialized. Eye and dental care are publicly commercialized. There are also fully available commercial medical enterprises, most of which are in Quebec and in Ontario, for example.
One facility in Westmount, Que., looked after former Liberal leader Paul Martin's medical needs. The Kensington abortion clinic here in Calgary is a commercial enterprise. Doctors make a profit.
The attitude that things must never change is often a nuisance coming from individuals, but such rigidity in the minds of political leaders is dangerous in the extreme. It is well worth naming its faulty assumptions. The attitude shows an unwillingness to adapt to changing circumstances when social and economic circumstances are always changing.
Change is the nature of life. The rejection of novelty shows a sense of unbending infallibility. It presupposes that the way things were created may not be challenged or called into question. Finally, and the most dangerous feature of all, it demonstrates a spirit closed to being convinced by evidence, and there is ample evidence showing improvements in health-care delivery that will serve citizens can come through market solutions.
As a consequence, the sclerotic attitude is stagnation's best friend.
Many European countries have greatly improved their public health systems by opening them to commercial alternatives. The British health-care system, which once served as a model for Canada's, has incorporated market initiatives with great success. The same can be said for Sweden. Even in France, Napoleon's imperial prejudice has been set aside and they have embraced market solutions.
So, why reject even the possibility of such changes for the benefit of most Albertans?
The anti-commercialization argument truly is a red herring. There is no inherent evil in enterprise. Commercialization has given us improvements in clothing and in housing; in pharmaceuticals and alternative medicine; in energy development and its better rationalized consumption; in arts and sports; in air, maritime and land transportation; in infrastructure and construction.
But commercialization, even the political leaders of China have recognized, requires openness.
Albertans don't need Napoleonic prejudices toward enterprise blocking improvements in health care.
They do not need a new bogey man. What they need is innovative solutions. What they need is courageous leadership willing to provide effective, practical and beneficial solutions.
