It is awfully tempting — painfully so — to feel superior to the United States over its national debate, and I use the term irresponsibly, on health-care reform. Angry men bring handguns to meetings that drop from holsters to floor. Sarah Palin says the Obama plan would let a “death panel” decide if she could keep her child with Down syndrome — and the Republican senator who inserted the clause in question says her version is “nuts”; an aged citizen warns, “Keep your government hands off my [government-run] Medicare!” This has become urban legend: It’s been reported at many meetings.

I know a Canadian 10-year-old who wonders: “Who wouldn’t want that?” I believe this is pretty much the global reaction to the spectacle.

But give Americans their due. They, too, want public “Canadian-style” health care. Polls have shown this for decades. In February, a New York Times-CBS News poll found, again, that “59 per cent say the government should provide national health insurance,” with only 32 per cent saying it should be left to private enterprise. In this, Americans are like people everywhere, usually far more “left” and socially “progressive” than elites and leaders. A recent poll of 19 countries found that majorities in 15 thought their governments should put higher priority on climate change. This included the biggest emitters. A poll by the same respectable U.S. pollster found the public in 17 of 19 countries feel their governments aren’t active enough in addressing the economic crisis. In India and China, which have been very active, most felt the response was “about right.”

But basic impulses cloud up when a specific plan such as “Obamacare” is on the table and the health industry, media elites and politicos, plus the normal hysteria in human nature, get to refocus discussion. Suddenly, it’s about “the dismantling of this country.” Those who feel their white privilege menaced by a black president say it “isn’t just about health care, it’s about … a means to regain political power.” The special role of fear in U.S. culture reinforces fables about death panels deciding who’ll “pull the plug on grandma.” The President doesn’t help when, fearful himself, he cuts a secret deal with drug companies for their qualified support, then has to admit it.

The result is ambivalence: a growing sense that the majority want Canadian-style health care but maybe the government needn’t run it — much as many Quebeckers want an independent Quebec in a united Canada.

Let me zoom out briefly to say our political system makes this kind of policy debate chancy. What we mean by democracy is really elections. The sovereignty of the people is basically about choosing representatives and leaders, not policies. We choose them; they choose policies. Then, a while later, we get to re-elect or depose them. So the election of Barack Obama was a meaty, significant political event. It showed the electoral kind of politics at its best. But it’s far less satisfying on issues such as health care.

Major social reforms tend to be formulated outside the electoral system. That was true of abolishing slavery and expanding U.S. civil rights, extending the vote to women and abortion reform. Eventually, these causes elbow their way onto the electoral agenda, but first they were extra-electoral movements, where they seem to breathe better. The Obama campaign had a movement quality, which it’s trying to deploy in the health-care context, but it’s having its problems.

At any rate, I don’t think only Americans get perplexed and say things like, Keep the government out of Medicare. Years ago, an NDP convention voted to nationalize lots of things such as banks. They stayed around afterward, to watch the CBC report their brave plan. The news noted nothing. Dismal silence. Then someone shouted, “Nationalize the CBC!”


Rick Salutin

Rick Salutin is a Canadian novelist, playwright and critic. He is a strong advocate of left wing causes and writes a regular column in the Toronto Star.