Fates and musings

Issue: BCMJ, vol. 46 , No. 7 , September 2004 , Pages 318 Editorials

Fate often has a nasty habit of biting you in the nether regions when you least expect it. Recently, on a rainy weekend day with a clear head and heavily encumbered with an air of ass-bite indifference, I picked up a badminton racquet and started chasing a little plastic bird. The Fates were obviously watching with gleeful anticipation because just as the four of us were going to abandon our private little arena of stupidity I slipped on a piece of wet wood that was marking out-of-bounds. The fact that my position was something south of awkward introduced some nasty torquing forces into a soft tissue catastrophe-equation, the result of which was a tear of my left deltoid ligament, interosseous ligament, and spiraled the proximal fibula. The so-called Maisonneuve injury requires a close watch of the ankle mortise, but can be treated with non-weight bearing for a couple of weeks and then a boot-brace. As a result I’m sitting here with lots of time to write an editorial and trying to pick the juiciest of a bunch of current hot-button topics. The final selection ended up being between a couple of topics and both of them scored a 9.5 out of 10 on my personal rant-meter. The first of these was my escalating level of irritability and eventual anger at the federal Liberal campaign strategists who wasted so much time and money attempting to convince me that the other guys were going to trample all over the rights of non-traditional couples and women. As we all know, this would be totally contrary to basic Canadian values and would be political suicide, especially in a minority government where your coalition choices are social libertarians or nothing. The second topic, “how bad will publicly funded medical care get with a minority government in Ottawa?,” was at first equally interesting, but on further reflection I found the questions it raised more perplexing, the answers more difficult to predict, and much more fun to write about. 

It is now several days after the federal election and I have to take my hat off to the Liberal campaign strategists in Ottawa. They obviously were in touch with the right fear buttons and were able to save their political asses by convincing a gullible electorate in the Maritimes and Ontario to stay with the devil you know rather than switching to one you don’t. At any rate, the prioritization and implementation of health care promises by the Liberal minority is going to make interesting watching over the next 8 to 16 months (average life span of minority governments). My guess is that very little will happen as the Liberals, NDP, and Chuck Cadman argue over where, when, how and how much until the whole thing comes crashing down and the Governor General calls another election. 

In the interim the Chaouli case ruling will come down from the Supreme Court and the smart money is currently on the success of the applicants. If that is the case, the Canada Health Act will have to be amended in order to allow Canadians to purchase private medical care in this country and at the same time allow third party co-insurers to sell their product to Canadians for private Canadian health care. If that is the directive from the Supreme Court I can’t see the NDP or the Bloc allowing the Liberal minority to pass amending legislation to the Canada Health Act and the whole thing will likely languish in committee until another government is formed. What a prolonged amendment delay means as far as the legal status of the Act is concerned is a question for constitutional legal experts, but it will be an interesting question to have answered.

The other interesting scenario is Ralph Klein’s intention to radically redesign the Alberta health care system and challenge the Canada Health Act. Klein was originally going to reveal the “Alberta Plan” prior to 28 June but decided to delay the announcement because the potential implications of the announcement were being used negatively by the federal Liberals. In fact, political writers are now suggesting that Ralph Klein’s portrayal by the Liberals as a western boogey man may have played a major role in the success of the Liberal’s “fear the West” campaign. Premier Klein has in recent days announced that he will proceed with his plans to totally redesign health care for Albertans but will call an election in the fall and ask the electorate for another mandate before proceeding. There is no doubt that Mr Klein will win an easy victory and the rest of the country will be treated to health care reform, western style. I can hardly wait. 

Finally, I have to wonder if Mr Klein’s decision to wait had more to do with the Chaouli Supreme Court decision than anything else. If the challenge to the Act is successful and the required amendment process is underway (or more likely stalled), an Act challenge from our federal minority/coalition government as the Klein government implements its made-in-Alberta health care plan is unlikely to be successful. Probably more importantly, such a challenge could very well further damage an already very shaky piece of legislation, and I doubt the weakened Liberals would be willing to take that chance and be blamed for destroying the Canada Health Act. I suspect that the very cagey Ralph Klein figured this out long before I did.

Notwithstanding the above, I hope you all enjoyed Canada Day. What a great country! 

—JAW 
1 July 2004

James A. Wilson, MD. Fates and musings. BCMJ, Vol. 46, No. 7, September, 2004, Page(s) 318 - Editorials.



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