Last Thursday night, as three Canadian federal party leaders jousted with a vacant lectern, 10 candidates for the U.S. Democratic Party’s presidential nomination were on a different stage, going toe-to-toe. The United States campaign is still in the pre-season, with the election more than a year off, but this was already the Democrats’ third debate. And the issues they’re hotly contesting – health care, guns, immigration, taxes – could have a big impact on Canada’s future.
Our politics, and its possibilities, are circumscribed by what happens next door. Everything from the political terms Canadians use, to our sense of what’s doable or impossible, politically mainstream or extreme, is influenced by the American signals Canadians receive and often absorb as if they were their own.
When U.S. politics change hue, its light refracts through our political spectrum. The southern invention of neo-conservatism two generations ago is still colouring politics north of the 49th parallel. But it’s a very different movement that is today animating the Democrats.
The United States is an outlier in a lot of unfortunate ways. Compared to other rich countries, including Canada, it has less social mobility, more wealth among the rich and deeper poverty among the poor; more violence, worse health, shorter lives – Americans can expect to live three-and-a-half years less than Canadians – and it is the one developed country without universal health insurance.
That last issue is the biggest one Democratic candidates are arguing over.
They all agree that U.S. health care is broken. The debate is what to do about it. America spends more than any other country on medical care, yet in 2018, according to the Commonwealth Fund health-care think tank, only 55 per cent of Americans aged 19 to 64 were fully insured. The other 45 per cent were underinsured, went at least part of the year without health insurance or were uninsured. No other developed country has such a dismal record.
For Senators Elizabeth Warren and Bernie Sanders, the solution is simple: copy Canada. They favour a plan known as Medicare-for-all, which would replace the current system of largely private coverage and enormous coverage gaps with a universal, publicly funded insurance plan.
But Democrats such as former vice-president Joe Biden, the race’s current leader, don’t think that’s politically realistic. Mr. Biden proposes expanding the Affordable Care Act, a.k.a. Obamacare, a public-private hybrid scheme. Passed under the previous president, and still constantly beset by Republican roadblocks, it has nevertheless improved coverage for low- and middle-income people, without taking away anybody else’s private insurance.
A decade ago, Mr. Obama promised people that, under his plan, those who liked their private insurance could keep it. Mr. Biden and others fear that the Warren-Sanders plan will be seen by many voters as a promise that, even if you like your private health insurance, you’re going to lose it. But the Warren-Sanders duo argue that the private health-care system is so broken, and so gamed by private insurers, that only a root-and-branch transformation can pull up the rot.
Democrats want to insure all Americans, as Canada does. Still to be settled is whether they’ll aim to do that by directly copying Canada, or choosing a different path. (Republicans for their part have no real health-care ideas, other than to deride all Democratic proposals as too expensive, or communist.) Whatever answer Americans settle on, it will have an impact on Canada.
Other subjects the Democrats are debating include stronger gun control, which all candidates favour to some degree. Canada’s murder rate is one third the U.S. rate, and our rate of gun deaths is even lower. Those statistics are not unrelated to our tighter gun rules.
However, though Canadian gun control works, this country isn’t an island. A fair number of the guns used in the commission of crimes in Canada, particularly handguns, are believed to be smuggled from down south. If the United States had less of a gun problem to export, we’d import less of it.
In these and other areas, Democrats are talking about growing the size and scope of American government – and the country’s levels of social spending and taxes, both of which are currently low compared to the rest of the developed world. Any change to that American status quo will have a big impact on Canadian economics and politics. It’s a subject we’ll come back to later this week.