Consolidating health care

I am delighted C.N. Ghent has point-ed out in response to my article¹ the folly of fragmentation that consumes so much energy for so little gain. About a year ago, I drafted an op-ed piece entitled “time to punt.” I sent it to a number of newspapers urging the provinces to give up constitutional responsibility for health care and allow Ottawa to create a unitary system. All declined to publish it; perhaps they thought I was kidding and their satire quota had been filled for that month.

If we were just now assigning federal and provincial constitutional powers, would we toss health care into Section 92 (as did the Fathers of Confederation when negotiating the British North America Act) knowing what we know about how big and complicated the sector would grow? I'd suggest no. If we did not have to amend the Constitution to transfer the powers back, perhaps it would be an idea worth pursuing. Unfortunately, there is no chance of amending the Constitution to give Ottawa more power rather than less, even if this would be prudent from the standpoint of the provinces. But if Ghent would like to establish an advocacy group for a truly national and nationally governed health system, I could probably be signed up as a charter member.

Steven Lewis Centre for Health and Policy Studies University of Calgary Calgary, Alta.