this post was submitted on 14 Jan 2024
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I think a lot of it boils down to the provinces being allowed to spend transfer payments however they want to, ie: healthcare/education payments from the feds are not restricted to being used for healthcare/education. Too often you see provincial gov'ts handing out tax credits when they should be increasing taxes instead. Even a 1% increase to provincial sales tax would help ... but politicians are focused on being re-elected vs caring for the needs of everyone in their province.
Managing healthcare should not be the job of a minister chosen every 4 years. It should be a non-partisan position, chosen maybe by the government but mainly based on competence and track record.
In the US, Powell and Yellen chaired the federal reserve under both Democratic and Republican governments, not because they were elected for this position, but because they have worked at various levels of government and industry.
On the other hand, this scenario cannot happen in Canada since the ministers are all elected, so unless economists and doctors are running and get elected, they would have to choose ministers without the right qualifications. Even if a doctor is elected, they would still need to spend a considerable amount of time to participate in MP duties, or would otherwise be replaced within 4 years; this time could have been spent on actually implementing useful policies.
Fortunately/unfortunately under Canada's Constitution the provinces hold a great deal of power over how transfer payments are spent. Up until fairly recently it wasn't a big issue, but the last few years have made it so.
My comment applies to provinces too. In Quebec, the health minister was solely educated in business, and worked exclusively in accounting and finance before joining politics. Based on that, I doubt he ever set foot in a hospital (unless as a patient), yet is expected to be making decisions impacting thousands of physicians across dozens of specialties?
Similarly, if I was a large company's CEO, I wouldn't hire a doctor who worked in a hospital their whole life to become the CFO of the company, where they would need to publish quarterly reports, draft financial statements, and submit accounting documents to government agencies. Maybe they can delegate those tasks to actual accountants, but would their decisions make sense long term? If not, why are we okay with the reverse?