In 1987, Robert Gilpin spoke about the crisis of national welfare capitalism in a non-welfare international capitalist world [1987, 60-64]. That crisis is only in part a logical consequence of the integration of global markets. It is also a result of a relentless and successful campaign to shape the ideas of the people of the world. Karl Polanyi had already spoken in 1945 of a situation similar to the current one, where "groups are pushing that which is falling . . . and may even be perverting the trend to make it serve their aims" [1957, 28]. Today's "perversion of the trend" has reached epic proportions.
My objective in this paper is twofold: to chronicle the undermining of universal social programs, health care among them, that were virtually a defining characteristic of Canada among the countries of the Western Hemisphere and to reflect on the fortunes to date of the counter-movement to preserve those programs. For years, many Americans pointed to the Canadian universal health care system as a model to be adapted for their country. Now it appears that the reverse is more likely to be the case. The deficit reduction mania and the attack on the active state, both part of a concerted ideological campaign, offer the real prospect that an American-style medical system may take root in Canada.
Sharing a border with the foremost proponent of free markets has its political consequences. The Great Capitalist Restoration in the United States spread very quickly to Canada. In 1970, Kari Polanyi Levitt wrote The Silent Surrender: The Multinational Corporation in Canada to call attention to the threat to Canada posed by the influx of mainly American firms:
The "continentalist" orientation is fundamentally destructive of Canadian unity because it rejects the maintenance of a national community as an end in itself. The value system by which a nation is ultimately defined is put up for sale. In every "cost benefit" calculation concerning the gains and losses from the continued U.S. presence within the Canadian economy there is an implicit price tag on national values and beliefs [Levitt 1970, 149].
Levitt and others can hardly take much satisfaction in having sounded a largely unheeded alarm. The Canadian trajectory of the Great Capitalist Restoration has recently been chronicled by Tony Clarke as the Silent Coup: Confronting the Big Business Takeover of Canada , a title which brings to mind that used by Levitt 27 years earlier. Clarke speaks of
. . . the way in which large corporations - most of them transnational - -have been able to seize political as well as economic power in this country, and in the process substitute corporate rule for true democracy. . . . What we are addressing here are the new political and economic realities of corporate rule, and the radically different kind of society they are creating in this country [1997, 8].
An End to Universality?
While many academics were busy with intellectual deconstruction, the vested interests were busy with a wider project of deconstruction, with far greater near-term impact: the public good, collective responsibility, society itself, and more were all consigned to the trash. The Vancouver-based Fraser Institute (founded in 1974 "to redirect public attention to the role markets can play in providing for the economic and social well-being of Canadians") and the Ottawa-based Business Council on National Issues (formed in 1976 by corporate leaders "to contribute personally to the development of public policy and the shaping of national priorities" [Clarke 1997, 249]) were among the entities that worked overtime to spread the gospel of economic liberalism.
Canada's universal citizenship entitlements, independent of labor force participation, included family allowances (established in 1944), old age security benefits (in 1951), and insurance coveting hospital fees (in 1957), which extended to physician fees and related services in 1966 [Myles 1996, 126]. Although the areas of health care and education are both constitutionally designated as provincial domains in Canada, the willingness of the federal government to provide financial support to the provinces allowed for the shaping of nationwide standards for access to health benefits. The key conditions for provincial receipt of these transfers (a case of...