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Mr. Day goes to Ottawa CMAJ 2000;163(5):596 See also: eLetters Can Stockwell Day win the next federal election? And if he does, what impact will he have on health care?
Surprise at Day's runaway victory in the race to head the Canadian Alliance quickly gave way to speculation about his impact on federal politics. His youthful looks and penchant for flexing his biceps at every photo op create the impression that he represents a new generation of Canadians. At 49, however, the former Alberta treasurer is no spring chicken, and his fundamentalist views he opposes abortion and believes every word of the Bible is true are out of step with those of most Canadians, especially younger ones. In politics, however, perception is everything, particularly when the present resident of 24 Sussex Drive is 66 and looking every year of it. As soon as Day's victory was announced, the tectonic plates of Canadian politics began to shift. Public support for the Alliance jumped, and the Tories slumped to the sad status of rump party. The Liberals maintained a comfortable lead nationally, but dissatisfaction with Jean Chrétien because of his determination to fight a third election was palpable. And if Finance Minister Paul Martin leaves, as has been rumoured, the Liberals will be left with an aging leader and without their most attractive selling point. So given all the changes on the political landscape, can the Day-led Alliance win the next federal election? Probably not, although the party will probably make the Ontario breakthrough it lusts for. In 1997 the Liberals swept Ontario because the right-wing vote was split between the Reform Party and Tories, but the Tory collapse means the Alliance might take 20 Ontario seats. It is unlikely to make any gains east of Ontario, however, and it can't increase its representation in the West enough to challenge the Liberals. So we will not see Stockwell Day leading the next government but we will probably see him wielding considerable power as party strategists start calculating the odds of a minority Liberal government. The Liberals may be reduced to 145 seats nationally, with the Alliance winning 105 seats and the Bloc Québécois holding the balance of power. That means the Alliance and Bloc will seek areas where they can challenge the Liberals, and the most obvious place for their agendas to meet is in areas involving the turnover of federal powers to the provinces. Although the parties have different goals, each sees in the other an opportunity to defeat the hated Grits. Stockwell Day wants to strip Ottawa of powers and responsibilities that he thinks would be better exercised provincially. He has endorsed a radical proposal to reverse the current fiscal system: he wants the provinces to collect all taxes and then allocate funds to the central government. The Bloc wants to transfer powers from Ottawa to an independent Quebec, and will happily go along with any policies proposed by Day that achieve that end by stealth rather than open secession. Such decentralization will destabilize health care, although it is not yet clear exactly how. "Day's public track record on health care is minimal in Alberta," says Ron Kustra, assistant executive director of public affairs at the Alberta Medical Association. "He was never health minister here, in Klein's government, and he wasn't treasurer when the provincial government cut health spending in the early '90s. But he was a key member of the Klein team and shared the view that there is nothing sacred in the status quo. He is open to new ideas and relationships." Day didn't say much about health care during the recent leadership race, even though there were plenty of opportunities: the future of the health care system is the number-one concern of most Canadians, and Dr. Keith Martin, another leadership candidate, tried to spark a debate on a two-tier system. Day wouldn't bite. However, the Alberta government's recent battle to pass Bill 11, which in its original form would have legalized private medical clinics, involved mass antigovernment demonstrations and sit-ins at the legislature. If this can happen in the province most sympathetic to free-market economics, what would happen if Day talked about similar proposals on the national stage? Day did endorse the 1998 Saskatoon Consensus, in which all provinces supported Quebec's argument that if Ottawa introduces a new social program, any province has the right to opt out and keep the cash. He does not think Ottawa should play the policing role assigned by the Canada Health Act, and his years in the Klein government (and the friends he made there) have left him sympathetic to two-tier health care. Day's arrival in federal politics at a time when there has never been such pressure on medicare can only make its preservation in any form more difficult. Charlotte Gray, Ottawa © 2000 Canadian Medical Association or its licensors |