The Written Word
for September 23, 2001

In addition to the usual problems all governments must face, Premier Gordon Campbell has two special ones – his huge caucus and how to control health care costs.

There’s no way, as the years pass, the premier can prevent a backbench of 50 from getting into serious mischief. He’s the victim of his own success – not only did he wipe out the opposition he wound up with a virtually "dud-less" caucus. There being no safe NDP seats in the last election, every Liberal nomination was contested by people who really expected to get elected; people used to responsibility and success who won’t long be content lobbing soft pitches to ministers in question period and doing "make work". Last week the seams in the ship of state showed their first leak when the Premier "retired" Val Roddick from her job as Chair of the Core Services Review Task Force. (She can’t say I didn’t warn her! When she beat Bill Vander Zalm in that by-election she told me that her voice, admittedly loud, would be heard. "Val", I said, "you’ll learn!" She just did.)

Mr Campbell doesn’t need all his backbench – in fact keeping it happy will start to occupy too much of his time. He will pander to it a bit with some "free votes" but sooner or later members will tire of kissing the government’s ass and, goaded on by their constituents, will start to ask real questions. I predict that by 2003 at the latest there will be an identifiable "rump" group of right wing Liberals who may even break away to form their own party. This won’t bother Mr Campbell a bit. Far better that he go into the 2005 election, which will be a slam dunk, with a nice, tight group of, say 50.

But Mr Campbell, on the more serious issue of governing, faces a problem of huge proportions inherited from all previous governments back to the days of W.A.C. Bennett - the healthcare system is wildly out of control. And, unlike his predecessors, Campbell can’t postpone the solutions.

The problem breaks down into two basic areas – the need for large sums for capital expenditure and for more cash to run the system. And the two problems intertwine.

Because no government in the past 50 years faced the reality of the baby boom, which now needs more and more long term care, we’re woefully lacking in long term care facilities. In the result, highly expensive acute care beds, badly needed for acute care, are occupied with extended care patients who have nowhere else to go, resulting in unacceptably long lineups for even critical surgery.

In short, the system is not producing and its costs are now well past the ability of the treasury to pay.

What to do?

There are two broad solutions – cut back some services forcing the public to insure against their need and bring in more private capital to help fund long term care facilities. Neither solution carries with it the political risks it once did when there was a viable NDP around ready, ever ready to bellow like bulls while intoning the sacred name of Tommy Douglas at the very sniff of what they saw as the "Americanization" of the system. The debate has rocketed past that rhetoric, in no little measure due to the unwillingness and inability of the NDP to come to grips with the problem when they ruled this province. Private insurance and extensive private capital are part of most health systems in the world and must come to B.C. It’s really a question of accepting much more private involvement on our terms now, or on its terms later. (This brings the province into direct confrontation with the feds but, since they only pay about 14 cents on the dollar of health costs Ottawa is becoming little more than a noisy, near irrelevancy, reducing the political risks substantially).

What about the government itself tackling the massive short term costs of creating the necessary long term care facilities? There are no funds available unless, of course, they’re found by breaking campaign pledges and cashing in crown assets like, say, Hydro and ICBC.

W.A.C. Bennett once campaigned on the promise not to nationalize the B.C. Electric then promptly did. Bennett Sr, is one of Mr Campbell’s heroes, so watch for it!

Necessity is not only the mother of invention but a famous breaker of campaign promises.