Over time he can marry fiscal conservatism and social tolerance into a kind of libertarianism of convenience, or those that believe opportunity and choice are the precursors to a vibrant dynamic society and government can play a moderating role. At present it would contrast him to a spectrum to the left (all 4) all the way to the antique relic in the NDP.

You are woefully ill-informed.

Except for the US as the major outlier, almost all large first-word countries spend between 8% and 11% of GDP on health.

“Canada clearly places a low importance on healthcare and consequently it consumes a relatively small fraction of GDP (compared to most European countries, as well as the US for mostly different reasons). ”

Wrong again. Canada spends comparatively more than most, so if that’s your metric, Canada places a high importance on healthcare, not low. However, it places importance on maintaining the incumbent system at any cost, not actual health outcomes.

Health Spending, Portion of GDP, 2007:
Canada – 10.6%
OECD average – 9.4%
Source: WHO

And we’re rising faster than the OECD too. In fact, we’re swiftly returning to the point we were at 10 years ago: spending more than anyone else (except the US), with mediocre results to show for it.

“This is a political choice. If you believe you/your family should have received prompter care then what you’d want is more spending allocated to health (or perhaps a different prioritization scheme),”

Wrong again. Returning to OECD comparisons, more spending at the macro level by itself does not equal better health outcomes. Those countries spending 8% have the same (or better) outcomes as those paying 11%.

What DOES make a difference is the structure of health care spending and delivery – and our system scrapes the bottom of the barrel. Spending more on a centrally-planned bad system just leads to a more expensive system, not a better one.

In each of my family’s cases, it would have cost markedly less to provide swifter care. Spending more on health care was not the issue – it is management, incentive, and actors. In our system, patients are treated as invisible non-actors, which is utterly obtuse.

It is ridiculous that if my cat and I require medical attention, I can pay to save my cat, but it’s ILLEGAL to do so to save my own life.

Until that is remedied, we cannot call our system moral, much less ideal.

Ignatieff was a shoe-in in 2006, but he still lost. It was obvious that a large part of the Liberal party (the anti-Americans) were allergic to Ignatieff. In 2006 Ignatieff had the largest support from Quebec Liberals – the LPC is Quebec is now in ruins. The party itself has gone more to his rival Bob Rae’s way of thinking, rather than his way.

Reading Ignatieff’s foreign policy books (Virtual War, The Warrior’s Code, Blood and Belonging, etc) I was always mystified as to why Ignatieff would be attracted to the pacifist, protectionist, anti-American, socialist Liberal party. It sems to me it is a nostalgic attraction – he longs for the Liberal party of Pearson (his fathers’ boss), not for the party of Chretien, Martin and now Dion.

The people who will be left in the rubble of the Liberal party are not Ignatieff’s kind of people. So, unless he returns to academia, I wouldn’t be surprised if he takes on Foreign Affairs under Harper, or takes up the PM’s offer of a senior diplomatic posting like Ambassador to the UN. Any of those would be terrific uses of his talents and intellect IMHO.

While I never say anything is impossible, it would seem to me that Ignatieff would have to believe that he would be a shoe-in for the Liberal leadership, especially after seeing how the Conservatives unleashed on Bob Rae when he had the unmitigated gall to pronounce on the state of the economy, after what he did to Ontario in the early 90′s.

Emerson was never a partisan Liberal; he was/is just a competent guy who wanted to serve his country in government, so he initially picked the Liberals as the best vehicle for him to achieve that. When the Liberals lost, he continued on with the Conservatives.

The Liberals might be in bad shape after Oct. 14th, but their brand is still strong. I’m sure Ignatieff could resurrect their brand quite easily. He wouldn’t get spanked in a campaign, that’s for sure. His first election might be a close-run thing, but I’m sure if he didn’t win, he’d live to fight another day, and would likely win on the second try.

Stephen Harper and 51 other Reform MPs were elected in 1993; that same election saw Lucien Bouchard and 53 MPs elected for the Bloc Quebecois. Since then federal politics has suffered an unprecedented distortion. The sovereignist/federalist dichotomy in francophone Quebec masked the latent pool of conservative bleus for whom a conservative mantra would have appeal. The Meech Lake crisis which exploded to destroy PC support, smash the taditionally dominant Liberal party and raise up the Bloc in Quebec from nothing almost smothered the conservative voice in francophone Quebec – Harper, against great odds and to the derision and ridicule of many (including many who participate in this Blog – recall the reaction to Harper’s “Belgium” speech where he rolled out federalisme d’ouverture) began to listen and speak to that conservative voice – faint and weak to begin with, but later more forceful and confident.

I have always contended that the Liberals were not Harper’s prime target – it is the Bloc. He has benefited from an unexpected but very lucky development – Paul Martin resigned on Election Night 2006 (Martin was still popular in Quebec and his organization was still formidable). Martin in opposition would have attracted support for the Liberals as the Bloc support decayed. But he left the scene and into the void came a new Liberal leader with near-zero appeal in Quebec (esp among francophones)and zero organization in that province. So nothing stood in Harper’s may as he appealed to traditional bleus to abandon the Bloc and come home to the Conservative party.

Gilles Duceppe’s shrieks to stop the Conservative wave by voting Bloc shows he knows what is happening. What happens next in Quebec will be the most interesting thing about this election as it was the last one, except this one will be interesting as well as we witness the final collapse of the Liberals as a pan-national party.

Harper’s recent comments about arts cuts in Quebec are interesting. By pointing out the absurdity of the separatist-leaning artistic/cultural elites whining for federal subsidies he is speaking to the larger majority of francophone Quebeckers who already feel partonized by the Montreal intellectual elite and who are struggling with real-life problems such as jobs and crime. Hopefully during the debates he will remind Duceppe that if Quebec was independent there would be no federal subsidies, for the arts or for anything else for that matter. Many heads will nod “c’est vrai” in Quebec.

Speaking of the debates, I will definitely watch the French debate on Oct 1. I want to watch the Duceppe versus Harper match-up. Should be good. I have no interest in what will be a dull English debate on Oct 2 because so little is at stake. Instead I will watch the Palin-Biden debate.

On a totally unrelated matter, I agree with the poster above who said after Oct 14 Ignatieff might pull an Emerson and become Foreign Minister in the Harper cabinet. Ignatieff has been very, very quiet in this campaign especially after Rae took centre stage. Maybe there are already feelers out?

It will have the twofold effect of being one less instance of talking about poop, and one more instance of educating a journalist and the public about another viewpoint in the country.

http://www.macleans.ca/canada/opinions/article.jsp?content=20080917_10717_10717&page=2

Canada clearly places a low importance on healthcare and consequently it consumes a relatively small fraction of GDP (compared to most European countries, as well as the US for mostly different reasons). This is a political choice. If you believe you/your family should have received prompter care then what you’d want is more spending allocated to health (or perhaps a different prioritization scheme), but this of course comes at the expense of everything else we consume.

In essence, there’s no such thing as a free lunch. Whether healthcare is consumed inside or outside of the public system it has an equivalent societal cost. Since we can always have better healthcare by spending more a line has to be drawn somewhere, and in Canada that line is drawn in the political arena.

In those few sentences lie the entire problem with single-payer medicine.

First, nowhere does healthcare eat the entire GDP, that’s ridiculous. It eats anywhere from 6-17%, with most on the lower half of the scale, no matter what the system. And to suggest that a single-payer model “rations in the most rational way (by need)” is completely indefensible. How can any system so large, complex – but most importantly, centrally controlled – optimize anything, much less by ‘need’? Unless ‘need’ is defined as institutional need, rather than, say, health outcomes.

Our health system IS far more allocation efficient than the US system, but it also aims low, and it sucks compared to many others in the first world. To keep ours hobbling along, we depend greatly upon the US as an escape valve when our system fails. Others manage by ‘knowing someone’ in our system.

Each of the four adult members of my family have faced severe life-theatening medical problems within the past decade. Unfortunately, our top-down single-payer ‘needs-optimizing’ system didn’t deem *any* of us worthy of timely attention.

The fix in each case – sometimes after months or years of agony, income loss and emotional distress – was inexpensive treatment at private facilities in the US or Quebec. Usually far less expensive, by the way, than the income lost while waiting for your ‘efficient’ single-payer model.

Why? It’s not for lack of money spent on our system – any comparative analysis will show you that. It’s because any such rigid system is bound to fail to allocate well. Failure in this case means unnecessary human deaths. How anyone can describe this as moral or efficient or even remotely IDEAL is incomprehensible to me.

I will not die for your utopia.

Just finished your How Journalists Get In The Way … column and I thought it was excellent. Many of your points were spot on, as far as I am concerned. Nice to read something in the msm that points out some of our reporters are a bit ridiculous and do far too much navel gazing.

Private PURCHASE (as I explained above) is a whole other can of worms however.

Re: a ‘mixed’ system, layering a system of private purchase on top of the public system simply leads to damaging inflation and over-consumption.

In particular, queues are a necessary and desirably part of the current healthcare system: we would never want no lines! (since we’d end up treating people it isn’t cost-effective to treat). Allowing people to avoid those queues (which serve to prioritize rationing) through private purchasing would not only lead to general healthcare inflation, but it would cause healthcare to consume more of the national product than deemed desirable, since individuals simply don’t make rational decisions about their own healthcare consumption.

I’ve not said whether I support universal healthcare on ‘moralistic’ grounds or not… to be honest I’m not sure (depends what mood you catch me in). But that it’s the clear winner in terms of objective efficiency according to very orthodox economics I have no doubt, for more reasons than I could think to list at once.

I’m not sure why the healthcare debate gets narrowly divided into public-only or private-only models. A number of European countries have a mixture and seem to be providing better care at lower costs, according the OECD.

I support public health care but there is something wrong with a system when my pets can recieve better healthcare (including MRIs, surgeries) than we can provide ourselves.

While many people seem to ‘expect’ private health insurance to function like other forms of private insurance (fire insurance, theft insurance, etc.) insofar as it’s a mechanism for distributing risk/cost, allowing everyone to have coverage for catastrophic events at an affordable price, in reality it does quite the opposite. While fire, theft, etc. are random events, a person’s health is overwhelmingly non-random. Some people will use a lot of healthcare, some very little, and by profiling people (looking at their age, lifestyle, socio-economic factors, family history, DNA, etc.) insurance providers can do an ever-improving job of determining the expected ‘cost’ of an insured individual. So the paradox is that the smarter the insurance industry gets, the more insurance premiums converge on costs for individuals, and anyone who’s likely to need health insurance gets priced out of the market (and anyone who can afford insurance probably doesn’t need it). The market is going what it’s supposed to (price insurance correctly)… it’s just not what we want it to do.

Private insurance only worked in the US in the past due to irreversible historical circumstances. Primarily, companies purchased bulk insurance for their employees, so each worker paid in essence the average cost of everyone at their job. As increasingly individuals have to buy their own insurance, and the insurance industry (with the help of computer technology especially) has become so good at data collection and processing, anyone in need of health insurance can no longer afford it.

I’m very much laissez faire oriented, but I would consider Canada’s single payer model the IDEAL from an efficiency standpoint. It rations healthcare (helthcare must be rationed to not eat up all out GDP) in the most rational way (by need) with the least overhead while keeping inflation in check. Other countries would love to have our system but can’t because it’s so politically difficult (it’s a wonder it was ever adopted).

Anyone supporting fully private healthcare is a market ideologue not an economist. I love laissez faire economics 80% of the time, but healthcare is one of those places where it just comes apart.

Are you happy that John Maccallum is using your name (and John Williamson) to support their claims that they are prudent managers of the economy?

Listen to the tapes:

http://stevejanke.com/archives/273961.php

So, in essence, you’re both wrong.

Few people can be their own heart surgeon.

The problem with completely market based medical services is that medical services do not adhere to the standard supply and demand curve. No matter how good the sale is, you’re not going to get a heart transplant if you don’t need one, and if you do need one, it doesn’t matter what the price is, you’ll find a way to pay it — or die. In addition, the supply of doctors is extremely limited. The competition in heart surgeons really isn’t there, and because it’s a profession which takes several years to build up the skillset required, it’s not going to suddenly appear just because the market demands it.

Combine these two factors and wholly private medical service is simply a recipe for rich people to receive service, and poor people not to. Yet even if you’re a full on objectivist who thinks that poor people deserve what they get (the lazy bums) this isn’t an ideal state of affairs, because people who are sick can infect you. Thus it’s in your own interest to ensure that people get adequate medical treatment as early as possible.

I’ve personally grown to like the public-payer, private-provider type of system for medical services, where the payer, with access to various statistics, can assign payment appropriately for specific areas of medical service based on overall demand, rather than the individual trying to decide based on their immediate demand.

The point is that Mr. Harper does have principles. He just realizes that perhaps the best way to implement them is to first become the natural governing party. I don’t think that many Canadians of the day knew how far to the left Mr. Pearson and Mr. Trudeau would take this country.

I also think that the single Canadian leader who had the most influence on Harper was Mr. Chretien – the master of winning with no real vision. He embodied the status quo and pragmatism. But it worked. The difference here is that Mr. Harper has a bigger dream for changing this country than did Mr. Chretien.

Interesting.

As for the efficacy of markets versus governments – would you want the state running, say, all of the grocery stores or the whole food distribution system? Would we have the range of high quality reasonably priced food we enjoy today if there was ‘foodcare’ instead of ‘medicare’? I don’t think so.

Finally the sea of ignorance is starting to abate. Ordinary people fought back to include Elizabeth May in the debates. The Greens’ numbers are steadily improving. People are tired of being manipulated and lied to. Those politicians and journalists whose fortunes depend on public support better watch out because the slumbering giant of public wrath is starting to stir thanks to alternative media on the internet. The cynical calculations of politicians like Stephen Harper and the political pundits who cheer them on will be punished. Witness the popularity of Obama south of the border.

No need to debate or analyze what PM Harper’s plan is – he takes his script from chapter 9 of “Harper’s Team” by Tom Flanagan. You and Mr. Wells hit the nail on the head in saying he has a long term goal and the way to achieve the goal is by winning elections – even if it means sacrificing true conservative doctrine in the short term to achieve that (remember the first principle of politics is to get elected). As you say, Mr. Coyne, PM Harper wants to be around long enough to become the status quo, then he can implement his vision as described by Mr. Wells. Tom Flanagan wrote all this down in 2007 in his book. PM Harper’s behaviour in the past Parliament and this election campaign is word for word out of that book. I just finished the book this morning and then reread your posts. Deja vu all over again as they say. Perhaps Feschuk has an explanation on how Tom Flanagan wired his plan directly to your brains. :)

Cheers

The troubling part is that, apparently, he’s pegged the Canadian everyman correctly….I am astounded that more of us aren’t absolutely insulted by his presumption that we can all be compartmentalized and massaged by targeted marketing.

“so intent on his long-term goal that he will not let mere principle get in the way of reaching that goal…”

That is Machiavelli in a nutshell. Long term vision takes complete priority and short term actions are not bound by any ethics or ideology so long as they lead to long term goals. Consequently you seem to be suggesting that Harper is “Machiavellian” in the truest sense of the word. What concerns me is that I happen to hate both his short term AND long term goals!

-conversely, oppositions defeat themselves on their platforms and leaders, while incumbents say or do little, campaign in a bubble (think Stanfield versus Trudeau or Trudeau versus Clark 80) (or McGuinty versus Tory 07)

-the “nice honest guy” politician gets his ass handed to him by the Machiavellian politician every time. Chretien did it to all comers. Kinsella has founded a reputation on it. Reform tried to do things differently, and never progressed beyond Western Canada. The Conservatives and Harper have now copied the Liberal playbook note and verse.

-I think it was Wells who said that if you were expecting a different, more principled government with the Conservatives, you were out of luck. Agreed. The nature of politics is spiralling downward as a result: blame both parties. Watch the Greens profit by it a the new fresh alternative. It won’t all be left of centre voters casting ballots for them.

How absurd. People vote Liberal, don’t forget.

“It isn’t that he has suddenly been transformed into a moderate, in the mold of the party’s hapless past leaders, but he has been converted to incrementalism.

Whatever his ideological objectives, Mr. Harper has as his first goal to make his party into a permanent contender for power: to end one-and-a-half party rule, forever. That is a matter not only of building a lasting electoral coalition, but given Canada’s peculiar political history, of reforming its institutions. Conservative predecessors had won smashing victories, only to be overwhelmed in office by the vested interests of Liberaldom.

Previous Conservative prime ministers aspired only to run the Liberal machine for themselves, leaving the motor running for the Liberals when they returned. Mr. Harper wants to dismantle it, piece by piece.”

And who wrote that? Well…it was a certain Andrew Coyne. So why are you so surprised that your 2006 predictions have come true?

http://www.nytimes.com/2006/01/23/opinion/23coyne.html

Harper isn’t interested in persuading the public to come round to his point of view, or in behaving in a principled or ideologically consistent fashion. All he wants to do is win. (The Coyne thesis.)”

You’ve nailed modern politics, and Harper quite well.

Trudeau says one thing and does another. Coyne Onanizes himself to the point of risking injury.

Harper says one thing and does another. Coyne rends garments, ululates and bemoans the country.

At least your cousin was honest about her Trudeau lust, go see Justin and get rid of that tension.

Hmm … that scheme that basically stole from the National Treasury to puff up their party’s electoral warchest, that gave them an unfair advantage in ’97 and ’00, might have had something to do with it? Just perhaps.

T. Thwim, give it up. That listeriosis outbreak would’ve happened had there been 100x the normal complement of inspectors. They only found the cause a month later, after cleaning the whole place top to bottom a few times!

Just like Walkerton was all down to cuts at the MoE, and nothing at all to do with the moronic PUC boys the Koebels, eh? Nevermind that it was the private labs that initially caught the problem. Myths take on a life of their own …

When Martin and then Dion transformed the Liberals into the NDP part deux.

Yeah, you’ve got a point there. I’ll have to think about that one.

————————————–

“Harper has no plan/ Harper has plan”

Certainly interesting take on the subject. We’ll see how it plays out.

But a short note on inconsistency here: I have noticed that some in the media seem to insert the importance and/or irrelevance of past and present in at will. Sometimes the past counts, sometimes it doesn’t. Which is it?

Trying to be objective here. If the past is fair game to bring out an example for one leader then it should be fair game to bring out the past for all leaders.

Harper has openly expressed this ambition. From Wells 12Feb08: “You know, the longer I’m Prime Minister… the longer I’m Prime Minister.”

One other point I’d like to make is that “green” and environmentalism seem to have a leftist perception. To me this is absolute craziness. Conservatives need to be just as concerned about these issues as leftists, but I don’t think that is happening.