Friday, May 28, 2004

Politicians' decisions - and ours - do bring death

VICTORIA - Paul Martin rolled into Victoria this week, planning to talk about health care but ending up defending himself from Jack Layton's charge that he'd caused 100 people to die in Toronto.
A low blow, Martin called it, and the kind of politics that discourages young voters.
And inaccurate, he added.
The accuracy takes some sorting out. Layton, the NDP leader, said Martin had cut social housing spending when he was finance minister in order to balance the budget. In the aftermath, more people were forced on to the streets and 100 more people died in Toronto.
Martin says the Liberal government spent lots of money on housing. It was the Mulroney government that made cuts, the Liberals added.
The bottom line is that it's tough to prove or disprove Layton's charge. Since it's such a serious - and specific - accusation, that makes it reckless.
But the notion that somehow we shouldn't raise such issues, or use such language, is wrong.
There are real consequences to many political decisions, and we need to be able to acknowledge them.
When governments decide against spending enough money to bring down surgical wait lists, some people will die while they are waiting. Even if urgent cases are dealt with quickly, it's a statistical certainty that misjudgments will be made or unexpected complications will strike. People will die because of the decision not to pay for needed surgery.
That's why government is important, and difficult. In some ministries - health, children and families, human resources - many choices involve life and death decisions, with no easy answers.
Take child protection. Place a priority on keeping children with their families and you will likely have greater overall success than if you take children into government care at the first sign of problems. But some children will suffer, even die, as a result. The choice is difficult because some of the children taken into government care will also suffer and die - their death rate is much higher than the norm.
These are all tough choices. Fund a first-rate counselling team for every high school in the province and you'll save lives, keeping at least some youths from drug abuse or suicide. Triple the number of addiction treatment beds and fewer people will die of drug overdoses and health problems related to a dangerous life. Upgrade military equipment and you'll avoid deadly accidents.
The challenge for government is to reflect our views about how far we're prepared to go and how much we're prepared to spend in saving lives, and where the most effective efforts can be made.
It's unrealistic to argue there should be no limit to our efforts. People don't want to hand all their money over to government so that every possible measure to save lives can be taken.
But it's dangerous to claim that even a discussion of the reality - as Martin suggests - is somehow off limits.
Of course if we're going to impose this kind of disciplined honesty on politicians, we need to hold ourselves up to the same kind of scrutiny. You could go out to a movie this weekend with the family and drop $50, or you could send a cheque for the same amount to one of a number of effective charities and aid organizations - and save lives. Your individual choice is no different than the politicians' choice on your behalf.
It's a favorite rhetorical question - "How many more must die before. . . ."
But we'd have a better public debate, and better public policy, if we made more of an effort to answer the question in some specific way.
It shouldn't be off limits to suggest that politicians' decisions carry consequences, and those consequences include death.
It's simply an acknowledgment of reality. And an election campaign based on reality will produce much better results than one based on a fantasy world where everything is possible, and no decision carries negative consequences.

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