Prime Minister Stephen Harper peers through a PET scanner during a campaign stop at the Thunder Bay Regional Health Sciences Centre on April 19, 2011. THE CANADIAN PRESS/Frank Gunn

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It was almost like an ambush in a John Wayne movie. No public announcement, no explanation, no accountability. Just a single shot ringing out from the sagebrush, a puff of smoke, and a body going backwards off its horse. Another one.

The shooter was one Stephen Harper, former top hombre at the National Citizens Coalition, now prime minister. On page 260 of Stephen Harper and the Future of Canada, author William Johnson notes that the NCC was founded by insurance millionaire Colin Brown as a personal advertising campaign against medicare.

So it’s not totally surprising that this time the bushwhacker’s victim was the Health Council of Canada. HCC was created back in 2003, a time in our national life when independent oversight was seen as a virtue, rather than an irritating restraint on the unbridled exercise of power. The HCC’s mandate was to produce evidence-based reports on Canada’s health care system, to identify ‘best practices’ and figure out how the nation was doing on the job of ‘renewing’ medicare.

The HCC, created through a recommendation out of the Romanow Report, may never have become everything it was intended to be — a national leader on achieving the best health outcomes in Canada. From the beginning, provinces like Alberta resisted unwanted oversight at the national level.

But HCC’s work has never been more important, as evidenced by the dour conclusions of the Mar. 27, 2012 Senate committee report on health care. Among other things, the committee found that after ten years of special government commitment and increased funding, real systemic transformation of the health system simply hadn’t happened.

The HCC was one of the better tools legislators had to find out why not. That’s because it reported in detail on the issues casting the longest shadows over the future of medicare: access to physicians, wait-times for essential procedures, pharmaceuticals management, aboriginal health and primary health care reform.

Even more important, the HCC was the only independent national body acting as a watchdog on how health care dollars were spent once they gushed from tax spigots in Ottawa to the tune of $35 billion a year. The federal government itself was once the custodian of national standards — always holding in reserve the power of the purse if it detected violations of the Canada Health Act.

All that changed with the government of Stephen Harper. He adopted a policy of cut-and-run on medicare — cut the cheque and run from any responsibility for ensuring it is spent in ways that are consistent with a national health care program. Finance Minister Jim Flaherty made that obvious in his ‘meeting’ with his provincial counterparts in Victoria. You know those kind of meetings — the ones you had with the principal before he gave you the strap. Flaherty handed over the cash and let it be known that it was not his problem how the provinces decided to spend it. Devolution is always the first step in dismantling.

As one senior health care executive put it to me, ‘It was about the feds getting the medicare gum off their shoe.’ Stephen Harper isn’t the only federal politician who has tried to do that … but he has been by far the sneakiest.

Some might call cash without strings a good thing. But as one senior health care executive put it to me, “It wasn’t about generosity or respecting provincial jurisdiction. It was about the feds getting the medicare gum off their shoe.”

By a long shot, Stephen Harper isn’t the only federal politician who has tried to do that (remember Pierre Trudeau’s block grants?) but he has been by far the sneakiest. He used the dense fog of omnibus legislation to dump the responsibility for RCMP health care on the provinces, cut funding for the Interim Federal Health Program for recent immigrants and slash support for aboriginal health organizations. About the only thing the PM has been up front about is that he has no plans to get in the way of privatized medicine.

There is much more to this story, though, than the termination of funding for an organization which just ten years ago was unanimously viewed by both federal and provincial political leaders as a vitally important way forward on the perennial chestnut of how to preserve, even enhance, medicare.

In a speech he gave in June 2012, the chair of the HCC, Dr. Jack Kitts, may inadvertently have written his outfit’s epitaph. In reporting on government progress on improving medicare, he gave good grades to Ottawa and the provinces on some things like telehealth. But he gave a big fat D on a very important subject: Both levels of government had failed to come up with “common health indicators” crucial to being able to measure the performance of any truly national health care system.

Worse, he gave advice in his speech that was pure anathema to the federal government. He extolled the virtues of independent monitoring agencies, greater transparency, and more use of data collectors like StatsCan.

As the members of the National Round Table on the Environment and the Economy found out, thanks to a lapse into frankness by John Baird, there are two things the Harper government hates: criticism, and sources of information other than those ministerial manure machines that go by the name of government communications. Who would have thought that spinning gold into straw could ever be so big?

So far, the Harper government has managed to rid itself of a great many obstacles to its practice of decision-based evidence to support an agenda that is rarely declared. So many evidence-based riders — experts, knowledge-lovers, rationalists — have been shot off their horses.

The long form census died, (even though its replacement cost $30 million more) because it professionally gathered nuanced information that got in the way of governing by ideology.

The Experimental Lakes Area was erased because its scientists might have come up with irrefutable reasons to reconsider the breakneck development of the tar sands at all costs.

The Law Reform Commission was put out of business because some of the brightest legal minds in the country thought too much about constitutional and legal considerations that might create inescapable restraints for political bullies.

And now the Health Council of Canada.

But there’s a difference this time. To paraphrase Robert Frost, “Something there is that doesn’t love a firewall.” That something is Canadians. Medicare is seen as a public good, a national symbol, and a defining characteristic of citizenship. According to a January 2013 Ipsos-Reid report, it is still the number one issue in this country.

Why wouldn’t it be? What would you rather have — rented panda bears at a cool $10 million, or a knee replacement as you limp towards eternity hoping someone still cares?

Michael Harris is a writer, journalist, and documentary filmmaker. He was awarded a Doctor of Laws for his “unceasing pursuit of justice for the less fortunate among us.” His eight books include Justice Denied, Unholy Orders, Rare ambition, Lament for an Ocean, and Con Game. His work has sparked four commissions of inquiry, and three of his books have been made into movies. He is currently working on a book about the Harper majority government to be published in the autumn of 2014 by Penguin Canada.

Readers can reach the author at [email protected]. Click here to view other columns by Michael Harris.

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