They should learn from us

EDITORIAL

ONE OF THE STRANGEST differences between the political systems of Canada and the United States is in the area of policy-making.

Here, all the parties work out their platforms and choose their leaders well before a scheduled election, with no need for the selections to be made simultaneously.

South of the border, as we are currently seeing, all the attention is devoted to the candidates for presidential nominations and the particular stances they have on policies.

In the case of the Democrats, the field of candidates has finally narrowed to the point where only four of the once 20-plus remain following this week's ‘Super Tuesday' primaries in 14 states. They are centrists Joe Biden and Michael Bloomberg and leftists Bernie Sanders and Elizabeth Warren.

Of all the issues between them, none is more prominent than their differing approaches to health care, with Mr. Sanders and Ms. Warren wanting “medicare for all” and the Biden and Bloomberg camps wanting to preserve private health insurance, at least in the area of employer-assisted group insurance.

At present, many millions of Americans have either no health insurance or insurance that offers far less protection than Canadians have enjoyed for more than half a century and Britons for even longer.

On top of that, the situation varies widely among the 50 U.S. states, with Medicaid available in only some states and no state currently claiming to have universal coverage, although Massachusetts is close to it at about 99 per cent of its population having some form of coverage.

In the circumstances, it's passing strange that in an era when the Republicans have been unable to kill or replace the Obama-era Affordable Care Act (‘Obamacare'), the Democrats haven't come up with a platform beyond agreeing that more work needs to be done.

Thus it remains to be seen whether the Democrats'  presidential nominating convention to be held in Milwaukee, Wisconsin in mid-July will result in a candidate for the highest office in the land who has a health-care policy supported by both Democrats and the roughly 40 per cent of Americans that describe themselves as independents.

It will be interesting to see whether any of the candidates, let alone the party as a whole, examines in any detail how it was that Canada managed to come up with a solution that came to be supported by all its national parties, the only current disagreement being over the need to shorten waiting lists and extend coverage to include pharmacare and denticare.

There's little doubt that Canadians owe a huge debt of gratitude to the late Tommy Douglas, father-in-law of actor Donald Sutherland, whose son Keifer ironically has portrayed a centrist U.S. president in the television series Designated Survivor. It was as premier of Saskatchewan from 1944 to 1961 that he introduced universal medicare in that province and as federal New Democratic Party leader from 1961 to 1971 pushed successfully for its adoption nationally.

As is so often the case, the federal Liberal Party eventually came aboard and by October 1969 even Ontario's Progressive Conservative government had replaced a mixed public-private system of the sort advocated by the Biden and Bloomberg camps in the U.S. with a single-payer regime dubbed the Ontario Health Insurance Plan (OHIP).

Although Mr. Sanders likes to suggest that his ‘Medicare for All' would be modelled on the Canadian system, he seems to ignore the fact that in both Canada and the U.S. health care is primarily a responsibility of the states and provinces.

Accordingly, what the Democrats (both presidential candidate and the party as a whole) should be looking at is the same approach used in Canada, with it being left to each state to decide whether to have a single-payer system, a mixed public-private program or perhaps a single private insurance firm chosen to manage a form of universal medicare.

Under such an approach, the role of the federal government would be limited to sharing in the cost of each state's medicare program and settling minimum rules as to the breadth of coverage and ‘portability' of the programs for those who become ill outside their own state.

Such an approach could still be seen as a form of universal medicare, although it would not be as dramatic a change as the Sanders approach, and would strike most independents as vastly better than the do-nothing approach adopted by the Republicans and the Donald Trump administration.