Having a massive, publicly funded health infrastructure, with 2.1 million employees, helps recession-proof Canada.Nav Rahi/The Globe and Mail
As part of a flurry of activity in response to Donald Trump’s economic chaos, the Liberal government of Mark Carney has introduced legislation that would fast-track “nation-building” projects.
The bill, tabled Friday, defines a “major project” as one that contributes to national prosperity, strengthens economic resiliency, advances the interests of Indigenous people and meets climate change objectives. If a project meets these criteria, it would benefit from streamlined approval and, presumably, a whack of federal cash.
Let’s hope, however, that this isn’t all about pipelines, power plants and other bricks-and-mortar infrastructure projects. Because there’s something missing in the selection criteria: Values.
The most impactful nation-building projects are not things, but ideas – programs that focus on bettering the health of people, both physically and financially.
Case in point: Medicare.
The underlying philosophy of Canadian medicare is that no one should be denied essential care because of an inability to pay.
It results in big costs savings for individuals. In the U.S., suffocating medical bills are the top cause of personal bankruptcy; in Canada, that is almost unheard of.
Medicare is good for business – employers save a lot on insurance premiums. It’s also an economic stimulus and stabilizer. Having a massive, publicly funded health infrastructure, with 2.1 million employees, helps recession-proof Canada, as was demonstrated during both the 2008-09 financial market crisis, and the height of the COVID-19 pandemic.
Canada also has the Non-Insured Health Benefits (NIHB) program, a publicly funded type of health insurance specifically for Indigenous peoples that is more expansive than medicare.
But provincial and territorial medicare programs, and the NIHB, are outdated and struggling to meet the needs of a 21st-century population. Reforming medicare could be profoundly impactful on national scale.
What better nation-building project could there be than bolstering programs that are not only uniquely Canadian but distinguish us clearly from Americans? (Not to mention that a smart investment in medicare would meet all the criteria for a “nation-building” project worthy of fast-tracking.)
The other component of “nation building,” especially in these patriotic times, should be building pride, not just physical stuff.
What makes Canadians most proud is their values – fairness, kindness, generosity, humility.
We like to make a difference in the world. As Mr. Trump’s America slashes its contributions to global health initiatives in an orgy of self-centredness, there is tremendous opportunity for Canada to step up.
“If the U.S. no longer wants to lead, Canada will,” Prime Minister Carney said back in April. He was talking about the importance of international co-operation on trade, but that philosophy could and should apply to other areas of global policy.
There is currently a campaign to end the scourge of HIV-AIDS by 2030. In the wake of COVID-19, which sapped all public health resources for years, that goal was already in peril, and now U.S. cuts could bury it.
Imagine if Canada made this its cause.
HIV-AIDS has infected an estimated 88.4 million people, 39.9 million of whom are still alive. Thirty million of those survivors are currently taking antiretroviral drugs that suppress the virus.
If we could get the other 10 million on treatment, further infections would virtually disappear.
Treatment as prevention is a Canadian innovation in the fight against the virus, one that has already saved millions of lives.
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Ironically though, within Canada, only B.C. has embraced it, while other provinces have dithered. The greatest beneficiaries of a treatment-as-prevention strategy could be Indigenous communities, where HIV rates are soaring, especially in Manitoba and Saskatchewan.
Imagine a Canada without HIV, or AIDS. A world without either.
That could be a bold Canadian goal, one worthy of our ambitions. Soft power suits us better than hard power.
All this may seem fanciful, a far cry from our traditional view of nation-building projects.
But let’s not forget we have a Prime Minister who has spoken and written eloquently on the importance of socially motivated investing, on the importance of putting purpose before profit.
In his 2021 book, Value(s): Building A Better World For All, Mr. Carney reflects thoughtfully on the corrosive impact of inequality and unhealthiness, and how more equal societies are more resilient.
He also writes about seven key values that are essential for building a better world: solidarity, fairness, responsibility, resilience, sustainability, dynamism, and humility, all laced with compassion.
The way to embrace those values is to invest in programs that make people healthier and more equal, like medicare, and ending AIDS.
Economically, and otherwise, we should take that over a pipeline any day.