There has been an awful lot of worrying, hand-wringing, and doomsaying recently among the political class about the polarization and extremism that appears to have gripped our contemporary political debate. “Democracy is under attack!” they shout. Yes, indeed it has become a bit raucous lately, if not downright sinister. It comes from both edges of the political spectrum. The right-wing, anti-vax, freedom convoy cranks at one end, and at the opposite end we have the kooky, left-wing, woke crowd who rename schools, hate the police, and insert “colonialism” into every sentence.

Centrists and moderates on the Right and Left can bemoan it all. But here’s the thing: blame yourselves. 

Our political system must hold the trust and confidence of those who it claims to represent and serve. When the system is seen as dysfunctional because of the repeated failures of those who control it to solve politically difficult problems, then voters of all stripes will turn against it.

Full disclosure up front: I’m a moderate Conservative who ran for Parliament in Toronto in the 2021 federal election. I sit somewhere between Red Toryism and social conservatism. I’m appalled at the recklessness and shortsightedness of some in my party who cater to the fanatics. But I’m equally discouraged and disappointed by the unwillingness of moderates who fail to confront the unpleasant, hot-button issues for fear of giving offence to polite company.

People don’t talk about green energy tax credits, NATO, or energy policy when they’re having drinks after work. It’s too abstract. The problems they see every day, the ones they easily understand, the issues that get under their skin are the ones that rile and energize them. Many of these issues may be risky, politically incorrect ones that involve the unpleasant aspects of modern life. That’s more reason for right-minded, responsible, mature leaders to solve these nettlesome issues. If they don’t, they cede the ground to the extremists and fanatics on both sides. That’s what happened.

On the Right, the illogical Covid restrictions that went on for too long, wokeism, the destruction of statues and historical heroes, and our porous borders are a few of the aggravators. On the Left, it’s the police unions who block reform and protect bad cops, entrenched intergenerational poverty now largely delineated by race, mega-rich CEOs who lay off workers despite high profits, and perennially missed greenhouse gas targets. To name a few. 

Mainstream politicians have failed to solve these problems. When reasonable political leaders fail to address the high profile, unpleasant and tough issues, then party members and voters will find someone who will. And if that means electing some loudmouth screwballs, then they’ll do it. Be warned. 

Moderate party orthodoxies must address the prickly problems. Conservatives should accept that higher income and capital gains taxes on the super-wealthy are not an offence against capitalism or conservatism. Neither is lowering the boom on bad cops. Moderate liberals must stop being silent on the left-wing McCarthyism of cancel culture and the nihilism of critical race theory. 

Former President Obama and prominent Democratic strategist James Carville recently opined on the unwillingness of Democrats to confront the extremists that are dominating the Left. Said Carville, “I mean, this ‘defund the police’ lunacy, this take Abraham Lincoln’s name off of schools. I mean that —people see that.” He adds: “Some of these people need to go to a ‘woke’ detox centre or something. They’re expressing a language that people just don’t use, and there’s backlash and a frustration at that.”

Yet the problem runs deeper than simply choosing your electoral platform and communications strategy. It’s trite that the hardest part of solving a problem is admitting you have one. Conservatives and Liberals both need to admit to the gaps and shortcomings in their political performance. 

Why do left-wing extremists want to defund the police? Perhaps because we collectively failed to weed out bad cops over the decades. Why do right-wing extremists continue to bang on about “the elites”? Perhaps because we the elite have collectively ignored their needs and sneered at them for a generation now. 

Brokerage-style political parties like the Conservatives and Liberals are supposed to be broad, nimble, and flexible enough to capture and contain a vast array of political currents. Politicians are supposed to be brave enough to debate touchy issues and drive toward common-sense solutions. 

Moderates on the Right and Left need to stop tut-tutting and clutching their pearls. Get in the game, propose common sense solutions to these problems, and by doing so blunt the anger. Neutralize the fanatics by getting out there first and solving the problems that fuel extremism.

Moderates should get on it. Or someone else will. 

The recent federal and provincial health ministers’ meeting in Vancouver ended without an agreement on increasing health transfers, and negotiations appear to have broken down and taken an acrimonious turn. The provinces have been asking for increases to the Canada Health Transfer that would raise the federal share of provincial health spending from 22 percent to 35 percent.  Given that for 2022-23 the Canada Health Transfer to the provinces is expected to be 45.2 billion dollars, such an increase would amount to an additional cash transfer of over 25 billion dollars. This is a well-travelled road and the federal response to such requests usually begins with the mantra that if one includes the value of tax point transfers for health to the provinces brought in decades ago, then the federal share of provincial health spending is already at 35 percent—even though everyone knows the value of those tax points were incorporated into provincial own source revenues years ago.

However, the real bone of contention appears to be the federal insistence that any increase to the Canada Health Transfer be accompanied by the condition that a set of common national indicators be developed and applied to allow for monitoring of outcomes, and one expects measurement of whether the federal government is getting value for money and ultimately political credit. Predictably, the provinces, and Quebec particularly, have responded that this is an intrusion in their affairs given that they already have their own indicators. Given that health is a provincial jurisdiction, having the federal government set conditions to which the funding is tied is seen as an intrusion. 

Historically, the provinces have displayed an affinity for the federation from Star Trek; that is, a federal government that observes but does not intervene in provincial affairs. Conditions on funding are considered a form of intervention. Though it is curious that the provinces do not display a similar attitude when it comes to their municipal grants.

In the end, the federal end of the current round of negotiations is being led by a health minister trained as an economist. As Minister Duclos knows, economics is ultimately about how people respond to incentives and simply handing over money without any conditions creates a perverse set of incentives. Simply handing over more cash to a set of provincial health systems in a country that has one of the highest health spending-to-GDP ratios in the developed world means business as usual. The provinces can take the money and not necessarily fix health care and then still blame the federal government for insufficient funds.

After all, the enhanced transfers of the 2004 Health Accord with its 6 percent annual increase escalator that lasted until 2017 was supposed to buy fundamental reforms and transformative change. And yet, twenty years later here we are facing similar issues of physician and nurse shortages, crowded ERs, and lack of access to timely care. The pandemic and its aftermath have only worsened the situation but are not the cause.

The federal government is not going to simply hand over the cash. It realizes that health is ultimately a provincial responsibility and therefore any political fallout from increased wait times and lack of access will land at the feet of the provinces. The premiers can blame Ottawa all they want for the current crisis and claim that increasing transfers are needed to solve the health systems problems, but the public knows that health is a provincial responsibility given they provide provincial health cards when they seek medical services.

And Ottawa does have a point that if the provinces can send assorted cheques to their residents and run surpluses then they should be able to find the money for health care. Ontario is a case in point with rebates for vehicle registrations and a two-billion-dollar surplus. Then there is Quebec, which is providing cash payments of up to $600 to help Quebecers fight inflation. However, Ottawa is being somewhat disingenuous on this point given that they have provided more than their fair share of rebates and monetary enhancements to Canadians.

Is there a way ahead? Well, there is nothing preventing the federal government from coming up with its own indicators based on available provincial data and creating a new grant that would complement the existing Canada Health Transfer, which would remain operating as it has. Let’s call the new grant the Canadian Health Enhancement Transfer, or if we are feeling more whimsical, CHTPlus, and make it available to those provinces that are willing to comply with its terms. It could set the measurement indicators and set priorities for the money. We could add a new term to the Canadian federalism lexicon: incentives-based federalism. 

CHTPlus could for example set a target of so many physicians or nurses or hospital beds per 100,000 population or target increases in those indicators. It can tie the funding to increases in surgeries for specific procedures or reductions in wait times. It can base some of the enhanced funding on population indicators like share of population over age 65. In short, it can construct a formula and tie the amounts of a new block grant to the formula and tie future amounts and increases to fulfillment of the targets. Provinces will have an incentive to enact change and exhibit improvements and they can decide how to make those changes. 

The existing CHT would continue. This would be new money tied to improved outcomes. Provinces that feel they are being subjected to domineering federalism can decline the new grant and find their own way ahead. And, of course, the federal government needs to resist pressure by standing firm and not allowing provinces to lobby and opt-out from the conditions and still get the cash as a special case. Will this work? We won’t know until it has been tried. However, unless the federal government caves in and hands over more cash with few or no strings attached, this is probably the only way forward.