Fucked If you Do, Fucked If You Don't

Stephen Harper can't talk about health care, and he can't not talk about health care

For those unfamiliar with the Harper Index, it's an online publication run by the Golden Lake Institute.

The Golden Lake Institute, in turn, is an organization that professes itself to be "a group of individuals and organizations who see themselves on the political Left."

"They feel the Left needs to find new ways to think and talk, and encourage others to think and talk about its political project," their website explains. "We agree with George Lakoff and others who argue that the heart of political strategy is the ability to successfully 'frame' issues in ways that appeal to people's deepest values and understandings."

In other words, the Golden Lake Institute are less a public think tank, as they'd like to portray themselves, and more committed ideological spin doctors.

Like many of the committed ideological spin doctors of Canada's political left, the GLI seem to believe they've created the ulimate political catch .22 for Prime Minister Stephen Harper:

You're damned if you do talk about health care, and you're damned if you don't. But especially if you don't.

Writing in an article appearing on the Harper Index, Eric Mang insists that Harper declining to participate in the American health care debate is part of a secret conspiracy among Conservatives to not talk about health care because they secretly despise it.

Which is ironic. Because when most conservatives in Canada talk about health care they're accused of doing so because they despise it.

It isn't hard to see the pattern that quickly emerges.

In the article, Mang laments Harper's decision not to engage in a full-hearted defense of Canadian health care in an interview on ABC.

Mang insists that Harper's comments in the interview "were revealing, as much for what they did not say as what they did."

In that interview, here is what Harper had to say about health care:

"First of all, I am not going to get involved in the health care debate in the United States. I know that this is a – I know from our own health care debates historically in Canada that this is a very difficult, very tricky issue.

All across the world, health care systems of all kinds of different shapes and sizes have significant – have significant challenges. And, obviously, I can’t comment specifically on a Canadian woman who may have had one type of experience with our health care system, with the American health care system.

In Canada, health care is principally the responsibility of our provincial government. The federal government provides some transfers. We do some of the drug regulation, a number of other activities.

But it is principally a system run by our provincial government. So first of all, I don’t feel qualified to intervene in the debate. And it is a very complex debate. And as President Obama said, 'there is a unique American health care system that’s evolved in a different way.' And I think that the American public themselves has to arrive at its own solutions for reform."

Apparently, judging from his comments, Mang is most outraged with Harper for siding with the Constitution over Mang's interpretation of the Canada Health Act.

"He downplayed the federal government's role in health care, despite our system being a single national plan through the Canada Health Act," Mang fumed. Mang went on to suggest that Harper had done this when he (quite factually) noted that the Provinces are ultimately responsible for heath care in Canada.

Various constitutional legal studies have been very clear on this matter. Yet somehow, in the eyes of the Golden Lake Institute, Harper can't even state that simple fact without it being treated as evidence of some kind of Conservative party anti-health care conspiracy.

Mang goes on to engage in some very distinct oversimplification of his own.

Mang notes polls that suggest that 70% of Canadians believed that Canadian health care was "working well", and that 82% preferred the Canadian health care model to the American model (and rightly so). Mang also cites a Nanos poll that suggests 86% of Canadians favour "public solutions" to health care and prefer public health care to for-profit health care.

Yet more detailed polling information can reveal a very different story.

For example, in 2003, a more detailed examination of health care-related polling revealled that 17% of Canadians were "very dissatisfied" with the availability of health care, 24% of Canadians were "somewhat dissatisfied", 41% were "somewhat satisfied", and only 16% of Canadians were "very satisfied".

The same study found 44%, 28%, 19% and 6% results for the same issues in the United States.

The same study found that 22% of Canadians were "very dissatisfied" with the quality of health care, 26% were "somewhat dissatisfied", 39% were "somewhat satisfied" and 13% were "very satisfied".

Respectively, the same study found 26%, 24%, 31% and 17% margins in the United States.

Those numbers are not nearly so resounding as the numbers that Mang cites, finding that only six years ago, and with no extremely public American debate to frame these issues against, up to 48% of Canadians were dissatisfied with the quality of their health care, and 41% were dissatisfied with the availability of that health care.

Once again, the comparisons to the American system -- 72% of Americans were dissatisfied with the availability of health care, and 50% were dissatisfied with its quality -- are flattering. But perhaps that's the reason why individuals such as Mang insist that the American health care system be treated as the only alternative model to Canada's.

The French and German health care systems are being discussed as alternative to Canadian-style health care in the United States -- this aside from the fact that Barack Obama's proposed reforms are actually very different from the Canadian system.

If Americans are willing to look away from the 49th parallel as their basis of comparison for health care models, why is it that Eric Mang and the Golden Lake Institute -- and so many of their cohorts -- cannot?

It's also very worth discussing that the allegedly-damaging examples of dissent on the health care issue uttered by Stephen Harper were spoken in 2000 and 2002. Times when the Gallup poll cited here revealed that there were some very real problems with Canadian health care -- and the experiences of Shona Holmes (who, despite Mang's mendacious insistence that her claims have been "largely debunked", had every reason to believe the growth in her brain may take her life) are merely one example of why such discontent was detectable at the time.

Even now, the overwhelming contentment that Mang alludes to is best addressed as a comparative contentment. And while it's clear that Canadians have many reasons to be contented with their health care system in comparison to the American model, it's clear that many of the problems that led to this discontent remain.

Eric Mang would certainly like to pretend that he and the Golden Lake Institute are merely acting in the best public interest of Canadians. But the truth is rather different.

It's Mang and individuals like him who have done so much to discourage open and honest debate about health care in Canada. Now that some conservative leaders have decided they would like to spare themselves the aggravation of opening themselves up to attack in a foreign country, they still want to use this as evidence of some kind of "hidden agenda" on health care.

What they forget to mention to anyone -- or likely simply choose not to -- is that "hidden agenda" arguments enjoy the advantage of not needing any evidence in order to support them. In fact, any lack of evidence is seen as in and of itself, evidence.

In other words, Stephen Harper was fucked if he spoke out on health care, and he's still fucked if he doesn't.

Individuals like Eric Mang rather enjoy this particular rhetorical luxury they've afforded themselves. Unfortunately, it suppresses debate on a crucial issue, and is very much contradictory to the public interest.