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Neo-conservatives deserve to be known for their mastery of small-p politics. They are very deft at setting out tiny tidbits of policy that will emerge as the full-blown far-right agenda years down the road.
American political critic William Greider calls this strategy the “deep lobby” – and we’re seeing Stephen Harper turn it into a modus.
Take the May 12 Globe and Mail insert in celebration of Canada Health Day. Here, federal health agencies and departments served up six half-truths on as many pages. You can read it as the Tories’ opening shot to reposition chronic disease and public health as private responsibilities.
Sure, there’s some big-P politics in the insert. Health Minister Tony Clement uses the front page of the taxpayer-funded freebie to plug the Conservative agenda of reduced waiting times and increased tax writeoffs for hockey equipment.
But there’s no talk of privatizing medicare, already a proven loser for Alberta premier Ralph Klein. That doesn’t mean the Health Day insert isn’t signalling the shape of the emerging battle to define health care.
What we can gather from the insert is that health will be the ultimate download – not just from the flush federal government to under-financed provincial and municipal governments, but from governments as a whole to individuals and charitable health orgs, the most prominent and conservative of which are featured on the back page of the insert.
The first half-truth about privatized public health (and this is an area where half a truth is worse than none) is that individuals have considerable responsibility to maintain their own health. Of course, there’s personal responsibility for health, as there is for education, the environment, clean streets, safe driving and other areas where government is the key funder.
But what the insert does is re-imagine public health so it only includes areas where individual lifestyle choices can make a difference: heart disease, lung cancer, diabetes and osteoporosis, for example.
This leaves out quite a swath of what should be the domain of public health: damage to fetuses by petrochemical toxins cancers and their relation to hormone disrupters in the environment childhood leukemia and high-voltage power lines (subjected to rigorous study by the British Medical Journal last summer) workplace injuries and deaths pedestrian and cycling injuries and fatalities premature deaths from air pollution . The list goes on.
Mission accomplished if Conservatives can use a half-truth to sweep this long list of injuries and deaths off the medical chart of what a public health system should protect against.
More half-truth comes from an interview with Dr. David Butler-Jones, head of the Public Health Agency of Canada, who has a high profile in the Globe insert. The doctor’s orders for the most important things we can do to protect our health are to quit smoking, wash our hands, exercise and eat healthier.
This rather sickly list is inspired by his view, which permeates the entire insert, that “small changes can mean a lot.” Partly true, of course. But less of a whole lie is the fact that public health requires major redesign that only government or collective organizations have the means to accomplish.
Once small change becomes the only currency of public health, there’s no reason to worry about eliminating air pollution or reducing the impacts of global warming, neither of which figures in the Conservative health agenda.
Why would the good doctor raise the need for the government to control ads by junk food companies? Why would he raise the fact that Canada and Ireland are the only countries in the OECD (the Organization for Economic Co-operation and Development) not to provide school meals in national-government-financed programs? Why would he talk about the need for designated and protected bike lanes?
The good doctor certainly knows how to wash his hands of big and tough issues.
Butler-Jones offers that the “best piece of advice I think I can give parents is love and respect your children.” This is the family-values version of privatized public health.
His gratuitous advice is a sappy iteration of a major plank of progressive public health, which highlights the health value of personal esteem. The family is one, but only one, institution that provides support for healthy self-regard. Others include schools, workplaces and recreation centres.
Odd that a doctor would advise parents to overlook all these sources of support for their children’s health, simply because they require government intervention to implement. Interesting that racism, the most toxic assault on a healthy sense of self in a multi-racial society, doesn’t rate a mention.
Media ads are in the business of using self-esteem as a teaser. Regulating such ads is a hot item in many jurisdictions. In England, public health leaders are campaigning to ban junk-food ads aimed at youth. Similar efforts have already succeeded in Quebec and are about to get under way across North America.
But according to another half-truth in the Globe insert, parents have more influence on children’s self-concept than celebrities or ads. It’s been verified, the article claims, by a study done by none other than the Dove Self-Esteem Fund. If that’s true, I wonder why Dove is paying so much money for all those ads targeting zaftig women who need their skin touched up with Dove products.
Here’s another demi-truth: we need to learn how to prevent falls by seniors, which cost the medical care system about $2.4 billion a year. Such falls can surely be reduced in number and severity. The sin of omission comes from the failure to note the common sequence, which is not the obvious “fall, then break leg or hip,” but “leg or hip breaks, then fall.” Osteoporosis, the bone-wasting disease, is the silent killer of seniors, and will become epidemic when today’s youths, raised on soda pop and other calcium-poor foods, start losing calcium as they age. That’s the issue that public health, with its prevention mandate, needs to focus on.
Somewhat surprisingly, perhaps, there is a bit of class in one of the half-truths. One article in the insert has the headline “Social factors targeted” and argues that “people with lower income and social status have less control and fewer choices in their lives.” The wealthiest men live six years longer than the poorest, and wealthier women enjoy an extra three.
It’s half-true, at least, that income is linked to longevity and health. But the more important half is that inequality, in and of itself, is as important a health determinant as low income, as studies suggest. The wealthiest in Britain live longer than the poorest in Britain, for instance, but die younger than the poorest or wealthiest in Scandinavia.
There are many reasons for this reality. Work stress, pollution levels and social engagement all figure in, as do the stresses of status anxiety. Tagging inequality as toxic to the health of rich, middle-class and poor alike is precisely what makes public health public, a common concern of all people rather than a concern of one “interest group,” such as the poor.
It’s an index of how entrenched publicly financed medical care is in Canada that the Tories are easing up on campaigns to reverse it. But this leaves both hands free for a more crucial battle in the near future.
Once public health is privatized, at least in the public mind, privatization of medicare won’t be far behind. “Why, after all,” the pitch will go, “should hardworking taxpayers pay for medical expenditures that arise from individual lifestyle choices to drink, smoke and eat too much?”
The Harperites will be walking that talk soon enough.
news@nowtoronto.com
