"Doesn't anybody deserve a government that works?" Lou Dobbs asked this over and over again in an advertisement on CNN. The answer is yes, Mr. Dobbs, for anybody who respects government and is not so quick to put it down.
We get the government we deserve. If we vote for empty promises, we should expect empty actions. If we vote out of anger, we will find ourselves with angry politicians who are mean. If we expect little from government, in the belief that it is rotten, then they should not be surprised to get rotten government that does little. And vice versa.
Americans don't much believe in government. Many think it incapable of doing most everything. (Ronald Reagan, as U.S. President, claimed that "The ten most dangerous words in the English language are 'Hi, I'm from the government, and I'm here to help!'" He, of course, was there to help.) As a consequence, many capable people hesitate to work for government, while some who do function under a cloud of inadequacy. Hence there is a lot of inept government in America, which of course only makes people even more suspicious of government. If ever there was a self-fulfilling prophecy, this is it. And that, of course, plays into the hands of corporate executives and others that don't want to be bothered by government.
I was at a dinner party in Virginia recently, where people were railing against government. I got nowhere trying to make the case that they need government, let alone better government, so I asked: "How about the military? Do you respect that?" Sure, came the reply. "But is that not government?" ("here to help," I might have added) Hm... they never thought about that.
In the great condemnation of American government, the military is somehow exempt. It is perceived as highly competent; in fact, it is revered by many Americans. Two of the most vociferous people at that party were retired from the military, which means that their salaries before and their pensions since have come straight from the government -- from the taxpayers. Surprise!
Now if so much in American government is so bad, then the public service has to be marginalized: its top ranks, several layers into each department, have to be reserved for political appointees, ostensibly to keep those civil servants in their place. For example, FEMA, the Federal Emergency Management Agency, was headed in the George W. Bush administration by a good Republican who had previously been supervising the judges of horse shows. He presided over the debacle in New Orleans. (Contrast this with the recent effort in Chile to save those miners: it was orchestrated by government.) Bush's Secretary of the Army was a businessman who announced on arrival that he was going to bring in "sound business practice." He came from Enron.
In the military, however, political appointments are taboo. The generals -- one, two, three, and four stars -- are not removed en mass every time there's a new government. But why not? Shouldn't they too be replaced by people who ran horse shows and failing companies?
"We can't do that," came the reply at the party. After all, the military is so important, the experience of the generals so critical. Unlike education? Health care? Emergency relief?
In Canada, we believe in government. As soon as a serious problem arises, most of us expect the government to deal with it. One consequence of this is that we too get the government we deserve, at least at the civil service level: competent. Not faultless, but is business faultless? Over the years, I have been struck time and again by how thoughtful, concerned, and capable are so many of the senior civil servants I have met in Ottawa.
We barely have political appointments in Canada. The "deputy ministers," who report directly to the ministers and advise them as well as run the departments, are usually career civil servants, or else people appointed for their competencies, not their connections. And so too are the people who report to them.
To appreciate how Canadians feel about government, consider this. In 2004, CBC television (itself government owned, with a radio network that has to be one of the best in the world) held a contest to elect "the greatest Canadian". And the winner: Tommy Douglas.
If you are an American who has never heard of Tommy Douglas, don't worry: he is hardly a household name in America. If CBS ran such a contest, with Abraham Lincoln or Thomas Jefferson the likely winner, believe me, we would know those names in Canada. We could have picked Wayne Gretsky or Pierre Elliott Trudeau -- you probably heard of them. But we picked Tommy Douglas. Who is he?
Tommy Douglas's highest post in life was the leadership of a marginal opposition party in the Canadian parliament, and before that, the premiership of the province of Saskatchewan (population at the time: less than a million). He was obviously chosen for another reason: Tommy Douglas was the father of Medicare, Canada's system of health care that covers all medical and hospital costs for every Canadian, with the money coming straight out of general taxation.
Douglas brought Medicare to Saskatchewan in 1961, against the fierce opposition of the American Medical Association, which saw it as a foothold for socialized health care in North America. And then in federal politics in 1966, he led his party to vote with the minority Liberal government to pass Medicare for the entire country.
When Americans debate changes in their system of health care, as they do regularly, the opponents point to Canadian Medicare as a disaster. So why do Canadians think so highly of Tommy Douglas? Because Canadian Medicare is not a disaster at all: health care in Canada costs much less than it does in the United States while its outcomes are consistently better. (The two countries had comparable costs before Medicare came to Canada.)
Of course, we never stop complaining about our health care services in Canada. But neither do people in every country I have ever visited. A few years ago, after listening to some Italians in this field go on and on about their health care, I asked "So how did Italy come out in the last WHO rankings?" Their reply: "Oh, second best in the world." Apparently second best is not good enough.
In fact, anything to do with health care is never good enough. At a party in Montreal, a young physician was going on and on about the dire state of health care in Quebec. Finally I interrupted her and asked: "You did your residency in the U.S. What about that?" She threw her hands in the air and blurted out: "Don't get me started on the American system!" Paraphrasing Churchill, I guess Canada has the worst health care system in North America -- except for all the alternatives.
There are, however, bright spots in American health care. One is the Veterans Administration. There you go again -- government. Michael Porter, Harvard Business School's strategy star, has co-authored a popular article and book about redefining health care in America. On government-controlled regulations, the book states that it is "never a real solution" (2006: 382); on the unsatisfactory performance of American health care over many years, it claims that "while this may be expected in a state-controlled sector, it is nearly unimaginable in a competitive market" (2004: 21). How about the opposite, Professor Porter -- a few facts? There was not a mention at this place in the book about the Veterans Administration (although a search in its index revealed three brief references to it elsewhere, two of them favorable, the third neutral).
Most Canadians revere Medicare as a pillar of the country's collective democracy, much as Americans revere business as a pillar of the country's individualistic democracy. But in a world that requires a decent if not dominant public sector, it is the Americans who get the government they deserve, not the one they need.
Henry Mintzberg is Cleghorn Professor of Management Studies in the Desautels Faculty of Management at McGill University in Montreal and Faculty Director of its International Masters for Health Leadership (www.mcgill.ca/imhl).
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