A strategy against strategies
Apparently what this country needs right now is a new national strategy for immunization. At least that's the view of "public health leaders" quoted in Monday's Globe and Mail. I personally think we need to be immunized against national strategies, if I could just figure out how.
I'm not against vaccination. But what has the federal government to do with it? There's a surprisingly common reflex in Canadian public debate to suggest bureaucratic centralization as the solution to various problems that don't seem remotely likely to respond well to it.
The general problem with centralization is that, by ensuring that everyone does the same thing in the same way, it makes it far too likely that we will all make the same mistake at the same time, and it would be very hard to fix it if we do. Decentralized systems, by contrast, begin by experimenting with different approaches, so it's almost impossible for everyone to make the same mistake, very likely that someone will get it right early on, and easy for people to discover and switch quickly to the superior approach. True, a command-and-control approach might get lucky, but it is not a rational gamble given the rapid self-correcting properties of decentralized systems. Also, getting lucky is no "strategy."
On vaccination, for example, the Globe quoted one proponent's ideal that "every kid has the same access to the same vaccines all the time." But even if we could do such a thing, which I doubt, why would we want to?
If it's clear what the best vaccination approach is, we don't need a centralized strategy because sensible doctors will already know what to do. If it's not clear, a national strategy only makes sense if the federal government reliably knows best and if it has the administrative capacity to act on its superior wisdom. Theory and experience alike, including with flu vaccines, suggest that both those "ifs" are extremely iffy.
Mind you, I'm not against all national strategies. I think we should have one for defending the country. But I want a national security strategy because only the federal government can do defence, not because I consider it unusually likely to do it well.
Unfortunately, too many people in public life call for national strategies without any attempt to explain why the particular matter at hand is one where the general hazards of excessive centralization are worth running. For instance, in late 2008 two Liberal critics were hyping a "Towards a Comprehensive Food Policy for Canada" summit. Yet if there's one thing that clearly should not be centralized it's eating food, with growing it a close second.
Likewise, the April 2, 2009 NDP press release saying, "Debate begins today on a New Democrat bill to bring in a National Housing Strategy." So there's food and shelter; anyone for a national clothing strategy?
Not yet. But on April 22, 2009 a press release told me the NDP wanted a "national forestry strategy." Why? How did cutting down a tree become a national enterprise?
Putting aside other notes in my files about calls for national strategies on various causes, (often worthy, but not logically connected to the proposed method), let me note federal Liberal demands in 2009 for a "national water strategy". It is actually not a foolish proposal given the geographically extensive nature of rivers, water basins and coastlines, and the federal responsibility for the environment. But when the chair of the national Liberal water caucus asked in the Commons on Earth Day, "Why is the government having so much trouble making it happen?" it was a far better question than he apparently realized. You see, the federal government has lots of national strategies -- most of which aren't working very well. Forget 2003's effort to develop one to combat bullying defined to include "putting down another teenager, leaving them out of a conversation or mocking their choice of clothing."
Just consider the famous national strategy to reduce surgical wait times which, the Fraser Institute reports, hit their second-highest level ever this year. It is also now 12 years since then-federal health minister Allan Rock promised a national strategy to confront the shortage of nurses. And who could forget the National Energy Program and official bilingualism? And at the risk of seeming to quibble, the government already has a national immunization strategy (or two; they put aside $300 million for one in 2003 and the same amount for another one in 2007).
As a rhetorical device, creating a national strategy has some merits. It deflects criticism by conveying simultaneously that you are neither ignoring the problem nor panicking over it. Maybe we need a national strategy on national strategies. It wouldn't work, but it would reassure us that it's all under control so we could go think about something more useful.
[First published in the Ottawa Citizen]