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Lynn Hu: No, China is not a high-functioning democracy, despite what propagandists may say

Commentary

Over the years, Zhang Weiwei has emerged, both domestically and internationally, as one of the most vocal and faithful advocates of the “China Model”. Notorious for his debate with Francis Fukuyama back in 2011, Zhang has written numerous books and hosts his own political talk show produced by Chinese state media. He was even invited to address top leaders in the Politburo earlier this year on how to “improve the Chinese narrative”, a euphemism for its ideological propaganda. The party’s approval meant that his views are unchallengeable in China (in academia or beyond), and Western media often falsely equate the monopolized party perspective Zhang presents as truly representative, despite the diversity of Chinese perspectives that actually exist.

While his political agenda is clear, Zhang’s polemical arguments and tactics do warrant a closer examination. In a recent interview, Zhang grounded the superiority of the Chinese system of governance in three key areas: 1) China as a unique “civilizational state” with historical and cultural traditions which are incompatible with Western political and economic models; 2) the Chinese political system as a meritocracy in its leadership selection that is also a distinct form of democracy more advanced than that of the West; and 3) China’s unprecedented economic growth as a peaceful nation tolerant of religious and cultural differences. Rebuttals to each of these assertions are easily made.

Describing China as a civilizational state is common among defenders of the China Model. In his bookThe China Wave: Rise of a Civilizational State”, Zhang justifies the Chinese Communist Party’s autocratic rule as a continuation of China’s historical tradition of a unified ruling entity. He asserts that China is the only state in the world with a continuous civilization, and by virtue of its long history and unique culture the country will follow its own historical logic and develop its unique path to modernity—one that is distinctively different from the Western model.

However, civilizational exceptionalism is often an artificial construct that flattens the complexities of history to a singular narrative. It was used extensively by conservative literati in China and Japan in the late 19th century to resist political reform. The use of civilizational rhetoric is not limited to non-Western countries either. Some proponents of American exceptionalism like to invoke what they refer to as the country’s distinctive cultural traits to justify claims of superiority. In that sense, Zhang’s insistence on calling China a civilizational state is best understood as a veiled attempt to boost Chinese nationalism. Despite a nominal rejection of the nation-state, his definition of a civilizational state, including “unique language, politics, society and economy” is taken straight out of a nationalist’s toolbox.

Even if we take the concept at face value, we will soon encounter difficulties. Invoking China as a civilizational state has been used repeatedly to reject universal human rights and democratic values, but Taiwan, which shares similar civilizational traditions with China, has successfully transitioned to a thriving democracy.

Zhang himself likens Rome to a civilizational state, but the Roman Republic degenerated into an empire and eventually fell apart. ISIS can be regarded as a contemporary attempt to revive the Caliphate, the Islamic civilizational state, but it has proven to be a disaster for humanity. At the end of the day, apart from stating the obvious fact that every country is different, the civilizational state excuse cannot explain how and why a country chooses a particular path, nor can it offer the basis for justifying a country’s political system. In fact, it cannot really explain anything.

Nevertheless, Zhang extends from this argument of cultural distinctiveness and makes a second set of bold assertions labeling the Chinese model as better governed, more meritocratic, and more advanced than what he calls the “U.S. model of democracy from the pre-industrial era”. Not only did Zhang reject the term “authoritarianism” used by political scientists, but he goes further in claiming that it is a high-functioning form of democracy called “democratic centralism”. While it sounds ludicrous to most Westerners, it is in fact echoed by the CCP as the official position in its latest white paper entitled “China: Democracy That Works”.

There are three common tactics used by CCP apologists to defend the impossible, and Zhang has used combinations of all three. Firstly, they can define democracy narrowly as “one person one vote”, rather than the whole package of civil liberties and constitutional institutions such as the separation of powers and the rule of law. This line of reasoning is also used by others like Eric Li, making it easy to discredit electoral democracy as outdated and ineffective. Alternatively, they can also use Orwellian doublespeak to obscure and subvert the meaning of democracy by performing various definitional sleight of hands and providing alternative definitions. Lastly, if all fails, they can always reject the term altogether, in favor of other standards such as popular support, economic achievements, or political meritocracy.

Even by these alternative standards, the Chinese model’s superiority over liberal democracies remains highly contested. Popular support in China is largely a product of “manufactured consent” through decades of propaganda and censorship. Imagine if every single person in America grew up with only Fox News and pro-Trump messages permeated throughout society with no alternative voices allowed to exist. It wouldn’t come as a surprise that the vast majority of Americans would be supportive of Trump, regardless of his actual performance.

Likewise, the economic progress China has made in the past 40 years since Deng’s market reform was undoubtedly remarkable, but it is not as “miraculous” as Zhang would like us to believe. China’s GDP per capita remains only one-sixth that of the U.S., and, far from poverty elimination, more than 40 percent of Chinese people (roughly 600 million people) still live on a monthly income of merely 1,000 yuan ($140 USD). Other countries, such as South Korea, have achieved similar feats within a generation while also transitioning to a democratic system.

Attributing all economic gains to China’s political arrangement is a gross over-simplification. For every “miracle” that Zhang claims, we can find an equally disastrous episode in modern Chinese history: is the Great Famine or the decade-long chaos of the Cultural Revolution also part of the great success story of China’s authoritarian system?

The conflation of the Chinese political system with meritocracy is not new either. Other proponents of the China Model like Daniel Bell and Kishore Mahbubani also claim that China enjoys meritocratic leadership. But this is a false dichotomy. Western democracies also have strong elements of meritocracy, as most politicians need proven track records to be electorally successful. The fact that Chinese national leaders must first serve as county and provincial chiefs is no proof of meritocracy either. It is merely a prerequisite to the top position and barely reflects competence. Most China specialists would agree that a variety of factors such as patronage, factional in-fighting, corruption, and ideological alliance play critical roles in leadership selection, and the domination of the so-called “princelings” in Chinese politics is well-documented.

Finally, Zhang assures us that China intends a peaceful rise focused on economic development. Did he forget to update his talking points from 10 years ago? China has pushed for an aggressive foreign policy under Xi’s leadership since 2013, abandoning Deng’s guiding philosophy of “hide your strength, bide your time”. Having engaged in over a dozen border disputes on land and sea, its neighbours certainly don’t view China’s rise as very peaceful. Furthermore, China has repeatedly used its political and economic power to bully other nations and international companies to fall in line with its political directives, Canada itself being a victim of CCP’s hostage diplomacy with the arrest of the two Michaels.

Confronted with questions on China’s domestic human rights or issues relating to Hong Kong, Xinjiang, or Tibet, the classic rhetoric is to deny or to deflect by engaging in whataboutism (U.S. bashing being Zhang’s favourite hobby). While some of his criticisms of the U.S. are apt, his blatant double standard is telling.

Zhang can shamelessly tell these half-truths and lies with a calm smile because he knows the real audience for his message is not Western viewers, but the nationalistic crowds at home and his top priority is to win brownie points with the CCP. If he fails to convince the foreign audience, he can always blame it on anti-China bias and Western arrogance.

Sean Speer: In 2022, can we finally be honest about our health system’s failures?

Commentary

As we enter 2022, it’s still hard to see beyond the COVID-19 pandemic. The rise of the omicron variant and a new round of public health restrictions are a vivid reminder that the virus and its economic and social consequences are still with us.

Yet even when the once-in-a-century pandemic is finally over, it will still take some time to discern its lasting effects on various aspects of individual life and the broader society, including the persistence of remote work, the prospect of industrial reshoring, and the unknown consequences of more than two years of online education, economic and financial uncertainty, and state-mandated social distancing. Yale sociologist Nicholas Christakis describes these lagging outcomes as “aftershocks” in his book, Apollo’s Arrow: The Profound and Enduring Impact of Coronavirus on the Way We Live.

Although we don’t fully know the magnitude at this stage, one consequence that can we anticipate for certain in Canada is massive pandemic-induced backlogs for medical testing and surgeries. They are the result of necessary yet fraught decisions to suspend various tests and procedures at different times during the pandemic in order to free up capacity for the steady caseloads of COVID-19 patients. These pandemic-induced backlogs will ensure that the pandemic is with us for a long time even after its worst effects are over.

Take Ontario for instance. The Financial Accountability Office of Ontario estimated last spring that the province’s backlogs could reach nearly 420,000 for surgical procedures and 2.5 million for diagnostic tests. It’s projected to cost billions of dollars and take more than 3 years to fully eliminate. Some observers have described these pandemic-induced backlogs as the “crisis behind the crisis.”

But even these numbers don’t begin to tell the full story. There are two main problems with the FAO’s estimates. The first is it underestimates the magnitude of the problem. As the pandemic subsides and people return to normal health care consumption patterns, we’re bound to discover that the backlogs are actually much larger than projected. There’s currently an “invisible waitlist” that’s been concealed during this sustained period of delayed diagnoses, testing, and treatments. Consider, for instance, that the Quebec government has reported a 24 percent drop in requests to be placed on a surgical waitlist during the pandemic compared to a non-pandemic year.

The second problem with the FAO’s estimates for eliminating Ontario’s pandemic-induced backlog is it assumes that hospitals and front-line health staff will work beyond their current capacity for an extended period. Yet in light of the intensity of the past 22 months, it’s wishful thinking to expect greater productivity levels over a sustained period from an already burnt-out sector.

It’s far likelier therefore that the pandemic-induced backlogs are both bigger and slower to eliminate than is widely assumed. The consequences for the health and well-being of Canadians could be significant. Massive backlogs will invariably lead to ongoing delays in diagnoses and treatments and in turn protracted suffering and even deaths.

This is already happening of course. Different organizations have produced estimates of “excess deaths” which refers to the number of overall deaths that wouldn’t have occurred if the pandemic hadn’t happened. In a November 2021 study, for instance, the Canadian Medical Association estimated that there were more than 4,000 excess deaths between August and December 2020 alone. A more, up-to-date report from Statistics Canada has found that the pandemic had resulted in 5.2 percent more deaths, or nearly 19,500 in overall terms, as of August 2021.

Yet both studies also recognize the limits of their analysis due to the undercounting of the “invisible waitlists.” The CMA report, for instance, estimated that even after cancer screenings in Ontario were resumed after the early waves of the pandemic, they remained 20 to 35 percent below pre-pandemic levels as of last January. The full scale of excess mortality caused by the pandemic will therefore only become known over the long run and even then it may never be wholly knowable.

These problems with lengthy wait times are hardly new to Canada’s health care system. Even prior to the pandemic, the Canadian Institute for Health Information reported that provincial health care systems could not meet as much as 33 percent of patient needs according to governments’ own benchmarks for certain procedures such as joint replacements or cataract surgeries.

This is important to remember because even if governments could expeditiously eliminate the pandemic-induced backlogs, we’ll still have large and growing waitlists structural parts of provincial health care systems. An inexorable combination of aging demographics and unsustainable provincial finances will all but ensure it.

The underlying source of the problem here isn’t health care per se. It can instead be found in the realm of political ideas. It’s not just that we’ve collectively decided to prohibit most forms of private health care delivery in the misguided pursuit of egalitarian goals. It’s that we’ve seemingly extended the prohibition to policy and political debates about our current health care system and its failings.

The 2021 federal election campaign is a good (or bad) example. The major political parties essentially colluded to avoid discussing the structural problems facing Canadian health care. No political leader raised that Canada has the second-fewest hospital beds per capita among OECD countries. No one addressed that Canada’s pre-pandemic occupancy rate for hospital beds was 90 percent compared to less than two-thirds in the United States. No one spoke to the need for health care reform at all.

Instead, the Conservatives promised to throw more federal dollars at the problem, and the Liberals committed to further restrictions on the minimal amount of private delivery currently present in the system. There was, in other words, a multi-partisan consensus in favour of perpetuating the status quo even as the pandemic exposed the system’s fundamental failings.

Yet we know that the status quo amounts to accepting massive and ongoing waitlists which can result in significant human costs. As former Supreme Court Chief Justice Beverley McLachlin wrote in the 2005 Chaoulli decision: “The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care.”

The situation has only worsened in the subsequent decade and a half. Yet these waitlists are neither inadvertent nor unforeseen. They’re a logical and predictable consequence of the design and structure of Canada’s health care system. Federal and provincial policy choices have created system-wide scarcity that necessitates the kind of rationing that’s generally present in the system and even more marked during the pandemic. Rationing in the form of backlogs and waitlists is ultimately what holds the system together.

If the pandemic has demonstrated the need for serious reform, the main challenge will be overcoming the Medicare dogmatists who in spite of the mounting evidence still seem reluctant to cede the health care system’s structural shortcomings as if doing so would necessarily put at risk its egalitarian goals. This, of course, fails to recognize that various other jurisdictions are able to deliver on similar goals with greater affordability, efficiency, and equity. Canada isn’t the only country with universal health care after all. We just have the dubious distinction of being among the most expensive and having the longest wait times.

The good news is that one gets the sense that Canadians themselves are growing impatient with the status quo. They instinctively understand the axiom that “access to a waiting list is not access to health care.”

One of the consequences of COVID-19 therefore may be more room for sensible debate about how to address the pandemic-induced backlogs and better position provincial health care systems for the coming demographic-induced pressures, including a greater role for private health care delivery to augment public provision. If so, 2022 may be remembered as the year in which Canada modernized its health care system. It couldn’t come soon enough.