The strategy of counterattack against the Romanow report is clear. “An ideological model from the sixties,” said Alliance leader Stephen Harper, choosing to pick a fight with a bygone decade.“ More of the same,” wrote The National Post’s Don Martin, and “all too familiar.” He said what’s missing is “the cornerstone of the system: the family doctor.” So Marcus Welby, if anyone recalls, would be his idea of fresh. B.C. Premier Gordon Campbell said it had “the smell of the status quo,” which is sheer rhetoric. The status quo is never an option because everything always changes. But even Roy Romanow says that the status quo is not an option, proving it’s a stick no one wants to be beaten with.

Nothing gets tired as quickly as the call for change, since it will always be followed by a call for change to itself. Same thing for newness; it gets old. So Roy Romanow can take the same tack as the advocates of privatized medicine: “These are not new,” he says, “they are old solutions. We’ve been there.” Which is true, if partial, like all truth. But in a sense, socialist values aren’t progressive either — they’re regressive, harking back to tribal models, just as capitalism had run through all its radical options by the mid-nineteenth century.

There is always fashion, which always gets old-fashioned. In the past fifteen years, the main fashion in politics has been anti-government and pro-business. This fashion swept the field. No one in public life fought it, including Roy Romanow as Saskatchewan’s premier. The only people who held out against this fashion, according to polls, were the people. But fashion shifts. Business takeovers in formerly public areas like water and electricity (in Ontario) or schools (in the United States) have gone badly. Even some right-wing people, like Ernie Eves, began to doubt their certainties, just as leftists had done, in the fashion’s heyday.

So never mind old or new or status quo. Ask what values or models should guide public policy on health care. Saying it’s public versus private merely states the categories. So try this: The debate is between those who feel health care should be dealt with on its own terms, as a basic and irreducible human right versus those who think health care should be treated essentially like one more good in the market, where it can be bought and sold, since that’s how everyone’s needs will ultimately be best served. The first position doesn’t exclude some role for private interests, but under the shadow of the general model. For instance, everyone always talks about the Shouldice facility in Toronto as a private hospital. But Shouldice was created by some fanatics who did hernia operations, and managed to turn their obsession into a business. They weren’t investors looking for the best return and willing to put their money into health care or cluster bombs. That’s the difference. The Shouldice people are basically into hernias. The Hospital Corporation of America is basically into profits.

Is it really necessary to choose a model, or set of values? Why not just be practical, as people on both sides claim they are being? The empirical results are rarely convincing to everyone and besides, human beings seem to like setting their course according to some moral compass. The realm of goals and ideals has less to do with getting verifiable results than with setting a marker for your course. Everything will always fail in part; socialism has, capitalism has; but they achieve some things, too. At least you can try to make a justifiable choice.

I once sat with Roy Romanow in his office in the Saskatchewan legislature at the start of a long winter night, and accused him of doing nothing as premier except cut programs to balance the books. He shot back that Tommy Douglas — his mentor and hero — called avoiding deficits a public duty. All I could think of to say was that Tommy Douglas talked about a few other things, too. Some time later I ran into Premier Romanow in the Toronto airport. He was returning from what he called his annual exercise in humiliation before Wall Street financiers. I was going to Regina to talk about privatization in the arts. He said his wife, an artist, and her friends weren’t speaking to him because of cuts he’d made in arts funding.

The real passion, when he met with the press yesterday, came when he spoke about the Douglas legacy and the privatizers who may destroy it. Maybe he feels he got a bit lost, wending his way in and out of power. Maybe Jean Chrétien, whose Tommy Douglas was Pierre Trudeau, feels it, too. Are they looking for redemption? Who isn’t?

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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.