Provincial elections take precedence over federal politicking

One of the major fallacies commonly held about the Canadian healthcare "system" is that there is such a thing in the singular. The truth of the matter is that beyond providing funding and assessing some apparently arbitrary nominal fines for violations of the Canada Health Act, the federal government has little influence in creating or implementing the health policies that affect the majority of Canadians. Canada has health systems, plural. Counting each province's ministry of health plus Ottawa's administration of healthcare for First Nations, soldiers, veterans and prisoners, there are fourteen distinct systems.

Nevertheless, there is often much talk during federal election campaigns about threats to medicare or efforts to kickstart healthcare reform when instead those matters pertain to provincial politics. Perhaps because the characters are seen as more colourful or perhaps because the rhetoric is more inspiring, federal politicians tend to overshadow their provincial counterparts.

This is the case at the moment. While the chattering classes jaw about whether Liberal leader Michael Ignatieff will attempt to topple the government sooner rather than later and whether Prime Minister Stephen Harper will work with the NDP or the Bloc Québcécois to keep his Conservatives in power, two provincial elections of significant consequence are coming up.

British Columbia's campaign is in its last stages and voting ends next Tuesday, May 12. The NDP's numbers are surprisingly high considering where they were several months ago, but the incumbent Liberals still hold a small lead in the polls. The Liberals have had some tumultuous years in terms of health policy, what with the Insite safe-injection controversy and a recently begun battle against Canadian Medical Association past-president Dr Brian Day over the constitutionality of denying patients full rights to use private health facilities.

On the other coast, the writ was dropped earlier today in Nova Scotia, triggering a June 9 election in which the Progressive Conservatives will attempt to either hold on to their minority government status or gain a majority in the legislature, while the NDP will attempt to leapfrog past the Tories to become the governing party. During the campaign Canadian Medicine expects to see the Conservatives forced to defend their healthcare record, which consists of an ambitious review of the entire system ("transformational system-wide realignment" was the catchphrase) conducted over a year ago but little substantive progress made in practice so far. The Tories did, however, manage to successfully negotiate an interesting collective agreement with the province's physicians a year ago this month, which may help lay the groundwork for future reforms.

Stay tuned. Canadian Medicine will endeavour to bring you the most important news on the health-related aspects of the two election campaigns.

Meanwhile, tell us your opinions of the campaigns on the coasts. Will the Liberals prevail in BC? Will the NDP defeat the Conservatives in Nova Scotia? What results would be of the most benefit to doctors, their patients, and the province's healthcare systems as a whole?

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