A brief history of health care

by politicalthing

Guest Post: Hassan Arif

In addition to being a dear friend of mine, Hassan Arif is a columnist for the Telegraph-Journal in New Brunswick. He is also a Phd candidate at the University of New Brunswick in Fredericton, Canada.

The opening ceremonies of the 2012 London Olympics was both spectacular and at times unusual. In all the ceremony, what was especially notable was a tribute to the National Health Service (NHS), Britain’s system of public and universal health care.

The NHS was established in 1948, a proud achievement of the government of Clement Attlee who led the first majority government of Britain’s Labour Party. The NHS was a major step forward in its time, even Sweden would not have a public and universal health care system until more than a decade later. The NHS would serve as an inspiration for other countries, including for our medicare system here in Canada.

The post-war Labour government of Clement Attlee was crucial in setting up the modern British welfare state – a welfare state which, including the National Health Service, largely followed the blue-print of Lord William Beveridge, a Liberal, from his 1942 Beveridge Report. Prime Minister Attlee was more low-key than his bombastic predecessor as Prime Minister, Winston Churchill, but his accomplishments were no less remarkable for it.

Given this history, it was surprising how in the 1990s Tony Blair and “New” Labour sought, in many ways, to distance the party from its past. Of course, the 1980s and 1990s brought new realities that forced a re-think of progressive politics – a global economy with greater capital mobility, the rise of the high-tech sector, the decline in Britain of the manufacturing working-class and the rise of a professional middle-class.

These new realities called for the adoption of a new progressive politics for the late 20th/early 21st century.

Enter Tony Blair and “New” Labour. After Labour’s fourth consecutive electoral defeat in 1992, there was a feeling among some that “modernization” had not gone far enough. However, in the process, accelerated upon Tony Blair’s ascension to the Labour Party leadership in 1994, seemed to go too far, running away from the party’s history, trying to hide any semblance of being a progressive party and being afraid to (assertively) contrast themselves with Thatcherite Conservatives. Tony Blair emphasized pledges to not increase taxes, to focus on deficit reduction and courted the conservative press. Labour faced accusations of focusing more on image and spin than on substance. The Blair government included some very progressive initiatives – a comprehensive poverty-reduction program and a strong focus on environmental sustainability. However, these progressive initiatives were often downplayed.

It was ultimately foreign policy that would overshadow much of the record of Tony Blair’s government, which solidified an image of him as betraying Labour’s progressive values; in particular, lining up with George W. Bush on the Iraq War. Cynicism increased and party membership plummeted. Labour managed to win re-election in 2005, but bled support to the Liberal Democrats and smaller parties such as the Greens. Idealism seemed lost.

The aftermath of the 2008 financial collapse has opened up greater space for progressive politics, as the abuses of the financial sector became too evident and demands for government intervention to help the unemployed increased. The emphasis of the Cameron government on austerity instead of job-creation has plunged Britain into a double-dip recession, increasing calls for a strong progressive alternative.

This is a call being heard in the post-Blair Labour Party with former leadership contender David Miliband taking up the cause of youth unemployment, establishing a progressive politics that seeks substantive policy solutions to real problems faced by the population. Current Labour leader Ed Miliband has attempted to broaden the party’s progressive base, drawing in social activist groups beyond the traditional base of labour union support.

Are there any lessons in this for Canada? While the Labour Party is the sister party of the NDP, many of the lessons are applicable to the broad spectrum of progressive parties including the Liberals. As Labour regularly forms government, it faces the pressures of governing similar to those traditionally faced by the federal Liberals and the provincial Liberals here in New Brunswick who are currently official opposition.

The Liberal Party has frequently faced accusations of being weak on principles and ideals. In New Brunswick, the last Liberal government lurched to the right on issues like taxation – advocating a flattening of tax-rates – ending up to the right of the Tories. Given the 2010 results, this “Out-Torying” of the Tories did not work out well.

We need a progressive politics that recognizes economic and demographic realities – that emphasizes jobs and entrepreneurship along with social justice, poverty-reduction and environmental sustainability, seeking to deal with the issues of the day, such as a Millennial generation faced with mounting student debts and an uncertain job market.

We need a politics where those who care about social and economic issues feel included and engaged. We need a politics that combines pragmatism and idealism – seeking substantive policy solutions. The NHS is a clear example of that in promoting accessible and guaranteed health care for all regardless of income or walk of life, making it a worthy accomplishment to be celebrated as an integral part of British history and society at the Olympic opening ceremonies.