Let’s have a real conversation about health care — minus the mudslinging

For a government that has made tackling online misinformation one of its key priorities, getting nailed with a warning label from Twitter is a particularly bad look. That’s what happened on the weekend to a pair of tweets from Chrystia Freeland, who was sharing an edited video of Erin O’Toole answering a question about private health-care delivery.

“It's disappointing to see the Liberals resort to American-style divisive politics,” said Mathew Clancy, the Conservatives' manager of media relations.

Irony is now officially dead in Canada, and Mr. Clancy’s statement ought to be listed as its cause of death. After all, American-style divisive politics are his party’s stock in trade, one that already saw it have a video of its own pulled down by Twitter. But Freeland’s unforced error here, and the online furor that it kicked up, is getting in the way of a conversation we really need to start having in Canada: What, exactly, do we want from our health-care system?

In the video in question, O’Toole was asked whether he would be “prepared to allow provinces to experiment with real health-care reform, including the provision of private for-profit and non-profit health-care options, inside of universal coverage?” His answer, an emphatic “yes,” is being pitched by Liberals as an admission of guilt — a window into the secret agenda they’ve been warning about for three election cycles now.

But while Canadians are understandably nervous about the private provision of public health-care services, we may be at risk of missing the forest for the trees here. According to a recent report from the Commonwealth Fund, Canada ranks second-last among 11 countries when it comes to the performance of our health-care system.

Yes, we’re better than the United States, which ranks last on things like access to care, administrative efficiency, and health-care outcomes despite spending a larger percentage of its GDP on health care than its peers. But being better than a raging tire fire isn’t exactly a ringing endorsement, and that becomes clear when you compare Canada to places like Australia, Norway, and the Netherlands. All three of those countries, for what it’s worth, allow private-sector activity in their public health-care systems.

Now would be a perfect time for us as Canadians to spend more time thinking about how we could improve our health-care system and get more value for the tax dollars we spend on it. Recoiling instinctively at the mere mention of private-sector involvement is almost surely a byproduct of our proximity to the United States and the clarity it offers us when comparing each country’s approach to providing health care. But that sort of binary thinking blinds us to the other options and opportunities that are out there — ones that could deliver better services at improved costs.

We could also be talking about the sorts of things that would make our health-care system more equitable and just, from pharmacare and the inclusion of dental services to greater support for lower-income populations. The Conservative position on “conscience rights” would almost certainly come in for considerable scrutiny here, given that it seems to put the moral qualms of certain doctors ahead of the best interests of their patients.

There is no shortage of opportunities, in other words, for the three major national parties to have robust disagreements around the same central goal of improving health-care outcomes.

I’m not betting on that conversation happening any time soon, though. As Kim Campbell famously said during the 1993 campaign, “This is not the time, I don’t think, to get involved in a debate on very, very serious issues.” The Liberals know they have an effective wedge with the Conservative position on health-care “experimentation,” and the Conservatives would much rather talk about Freeland’s tweet getting flagged as misleading content rather than the actual content in it.

Until both sides are willing to spend more time talking about the merits of their own ideas rather than dunking on their opponents, Canadians aren’t going to get the kind of political conversations they need — and deserve.

Our political parties need to spend less time clipping each other out of context or misrepresenting what their opponents are saying and more time telling Canadians what they would do differently. Politician, heal thyself.