By Richard Gwyn

A GIVEN IN Canadian politics is that health care is a “live rail.” Anyone who touches it, by calling openly for a two-tier health system, will die an instant, and horrible, political death.

All the polls make this plain as a pikestaff (whatever that is). Even the most ardent ideologues of American-style health care dare only to muse about it in public using code words, such as the need for “choice” and for “additional sources of funding.”

It’s quite another question whether Canadians are prepared to accept what could be called two-tier regionalism, with some parts of the country permanently poor and becoming poorer, comparatively, while others soar off into the global economy. There are some signs this may be happening.

This issue has been brought to the public agenda by the imputation by Alliance pollster John Mykytyshyn that Maritimers are lazy and the subsequent verbal volleying by several of the premiers, led by Newfoundland’s Brian Tobin and Alberta’s Ralph Klein.

Mykytyshyn has since resigned his post. It’s another matter whether he’s being punished for what he said or for his mistake in saying it, at a time when Conservative Leader Joe Clark is attempting to make it to the Commons, and there perhaps revive his party, via a by-election in Nova Scotia.

Mykytyshyn has brought out of the closet an attitude that is quite widespread, particularly in the Alliance party and in right-wing think tanks and right-wing media.

The contrast with the near-universal popularity of single-tier health care is instructive. The poor, whether in the regions or in the most affluent cities, are seen as a burden on better-off taxpayers.

The sick are also a burden on the health system. But all citizens benefit from it, unlike the minority that benefits from unemployment insurance, welfare and equalization payments.

In the instance of two-tier regionalism, two separate issues are intertwined. The first is that legitimate criticisms can be made of the existing system of subsidies and grants.

An excellent analysis of this is contained in the study “Retreat from Growth: Atlantic Canada and the Negative Sum Economy” published recently by the Halifax-based Atlantic Institute for Market Studies.

This study, by researcher Fred McMahon, describes how an influx of money from Ottawa has often substituted for local enterprise, has distorted provincial spending decisions, has seduced people into remaining in underdeveloped regions rather than ranging out in search of jobs across the country, and has artificially pushed up local wage rates, thereby discouraging new industries from locating in the region (or only for as long as their subsidies last).

McMahon’s essential policy recommendation is straightforward, and persuasive: “a normal policy regime” rather than the distortions of outside subsidies.

Persuasive only up to a point, though. Fiddling on unemployment insurance has been memorably described as the equivalent for the poor of fiddling on taxes by the well-off.

New industries need a “nurturing” period of assistance. And the subsidies are declining anyway. Federal transfers to Nova Scotia are down below 20 per cent of the provincial budget from 40 per cent a half-decade ago.

Here’s where the second issue gets entwined with the first. An attitude of, at best, indifference, at worst, meanness, is being legitimized by the smug, self-satisfied, “lazy” kinds of comments heard from those whose real agenda is to uphold today’s ever-widening income gaps and thereby justify their specific policy nostrums of deep tax cuts (Alliance’s 17-per-cent flat rate, as an example) and minimalist government.

This kind of meanness would be out of place at any time. It’s especially jarring at this time because many underdeveloped regions are suddenly scoring their first economic successes in years.

Newfoundland, for example, the poorest of the poor, has just recorded the fastest rate of economic growth in the country for the past two years.

Despite the closure of its historic cod fishery, the exploitation of crab and shrimp has pushed the value of marine exports higher than before the moratorium. Tourism revenues have increased by 50 per cent in four years. This despite an outward migration of 30,000 people in the past five years.

We are all Canadians, whether in relative poverty or affluence, in sickness or in health.

Everyone agrees with that. Or ought to. But not the Alliance’s Mykytyshyn, it turns out. Nor Alberta’s Klein, who told Tobin when they quarrelled over health-care funding at last week’s premiers’ conference, “Don’t give me that s—.” He should have eaten his words.