Meaningless law masks failure to act.
by Don Cayo
This column ran in The Telegraph Journal only.
“The law is a ass, a idiot,” said Charles Dickens. He meant the law in general as it stood in England when he wrote Oliver Twist, but his words still resonate. And they precisely describe a particular statute passed just last week in the New Brunswick legislature.
Despite the passage of 161 years of often asinine law-making in countries around the world since Dickens’ day, Premier Camille Theriault’s highly touted health care guarantee legislation still stands out as one of the silliest things ever to make it into the law books. Not just absurdly pointless in the sense of a law that would fine you for wearing a hat in a bar or some other innocuous affront, but goofy in the way of a parlour charade. It’s drivel masquerading as substance. It would be laughable if it didn’t divert attention from something so serious.
The law would tie, for all time, the percentage of annual increases in health care spending to not less than the percentage of annual increase in the GDP. As an ever-increasing number of analysts – everybody from economists to health care interest groups to Maude Barlow – have pointed out since the day it was announced in the Throne Speech, it’s a profoundly flawed and ultimately meaningless formula.
First, GDP growth has nothing whatever to do with the health of New Brunswickers. And its average growth has been less, on average, than the province added to the health care kitty during the lean, mean decade of McKenna “cutbacks.” Those years saw health spending virtually double.
Those two facts alone are enough to dismiss Mr. Theriault’s much touted bill as mere smoke and mirrors.
But it gets worse.
There’s no question that the New Brunswick health system is mired in a mess and getting in deeper. So, assuming that the economy continues to muddle along with fair-to-middling growth inspired by lack-lustre development policies, the size of the spending increases mandated by the act might reflect a reasonable balances of the province’s needs and means for the next few years.
But laws continue long into the future unless they’re deliberately removed. And tomorrow’s politicians are likely to be as reluctant as today’s to monkey with what is seen as motherhood legislation, no matter how perverse it can be shown to be. So what will happen if the economy really heats up and starts to grow like that of, say, Ireland, which used to be in even worse doldrums than ours is today? Growth of eight per cent a year or so would in a few short years put the health care budget irresponsibly out of sight.
And if our economy lags and starts to shrink – as it could when baby boomers start to retire, demanding more care while paying less in taxes – this “guarantee” would means nothing.
Or less than nothing. One detail that escaped notice until the legislation was tabled is an incredible fudging of language that could cause the health budget to fall far behind. The act says spending will go up by the percentage of “real” growth in GDP – in other words, growth after subtracting the amount of inflation. But increases to the health budget will be in “nominal” dollars – in other words, with no regard to inflation. That means that if, five or 10 or 20 years from now, we hit a period of 10 per cent inflation and two per cent growth, the formula would provide only a two per cent raise, despite a 10 per cent increase in costs. So Mr. Theriault and his government are, in this scenario, guaranteeing the system would lose no more than eight per cent of its revenue each year. And if we ever again hit the high-teen levels of inflation of the early 1980s or, as countless other countries have, percentages far higher than that, health care spending could wither from substantial to piddling in just a few years.
Yet this guarantee that guarantees nothing is being touted – and I fear being accepted by some people – as proof positive that the government is taking the health crisis seriously. It’s disguising the continuing need for and delaying effective action. It’s creating a mere illusion that something is positive being done.
The Theriault government is conducting a major review of the health system – a fact that makes me even more puzzled about why any act, especially this one, would be introduced now, before the study is complete. And our government is talking the talk of greater accountability and better management – things that, if they’re ever actually done, have the potential to make a real difference.
But if this is what they think it takes to walk the walk, be careful. Eat your apple every day and look both ways before you cross the street. You don’t want to get sick or injured while these guys are controlling the quality of care.