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Bob Rae (Fred Lum/The Globe and Mail)

Bob Rae

(Fred Lum/The Globe and Mail)

BOB RAE

Three issues in desperate need of long-term thinking Add to ...

The shorter news cycle is contributing to even shorter-term thinking both by us as individuals and by all institutions as well.

Let’s think about three big issues – ageing and health; the future of First Nations people; and immigration into Canada – and see why it’s so important for us to think longer term.

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The news last week about a man dying of a heart attack at his front door on a freezing night in Winnipeg naturally aroused all our sympathy and anger. How could a bureaucracy be so thoughtless? A hospital spokesman dutifully announced that “policy will be changed,” and that from now on the hospital and the taxi driver will make sure you get through your front door.

This really misses the point. People (and read, older people), are being pushed out of hospital more quickly because there’s no beds and no place for them in hospital. This is happening because too many patients are stuck in hospital beds when they should be in longer-term care, either at home or in a facility. Emergency room care, and corridors chock full of people needing a real bed, are not the exceptions in Canada today, they have become the rule.

Universal care is coming unravelled as the most important costs of getting older – where to live and how to get the appropriate level of care and attention – are mainly private, not public, costs. Drug care is not universal either, and neither are dental costs. Mental health costs are also largely borne by individuals and their families. The 1960’s medicare deal is not just frayed at the edges – every year it covers less of the real cost to families.

The Harper government couldn’t care less about these issues, so the burden of doing, or not doing, something falls on provinces, cities, and above all, on families.

The First Nations’ demographic is quite the opposite – the birth rate is high, and as children finish primary school the exodus to larger cities picks up. The federal government is not worried about that, because each departure from reserve means less for it to worry about. This trend will only grow, and the education, social service, and health costs are, again taken up by “someone else” – people, provinces, and cities.

The implications of this population boom were widely discussed by the Royal Commission on Aboriginal Peoples in the 1990’s, and then largely ignored. The one emphatic response of the last decade – Paul Martin’s Kelowna Accord – was scrapped. Its replacement has been to dramatically increase the incarceration rate among aboriginal people.

The legal, permanent, immigration tap is capped at about 200,000 a year, and here, again, there is precious little discussion about whether this number should be higher or lower. We are steadily becoming a more diverse population, but thus far the only province which is really reacting to this is Quebec, whose government has decided to embrace the worst aspects of small-minded chauvinism as its hallmark, and make it clear that differences are to be smothered instead of celebrated. Atlantic Canada suffers from a lack of immigration, and yet there are few voices embracing the advantages of both a younger and more diverse society.

There is a strong argument to increase levels and flows of permanent immigration, rather than to rely, as the Conservatives have done, on temporary foreign worker programs which build-in European style marginalization. But one rarely hears real arguments about how and why this needs to change. From the latest headlines it appears the Harperites have chosen the course of least resistance and will continue beefing up the temporary programs.

These are not issues that make it to the lineup in Question Period, or even the headlines of newspapers. Journalists are being laid off. Sensationalism rules the day. Policies to deal with deep, long-term issues are only improvised when they reach a truly critical point.

We can do better than this.

Bob Rae is a former member of Parliament and former premier of Ontario.

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