The main findings of the research described here are not exactly a surprise, but are nevertheless disappointing and very concerning, on the eve of the general elections in Quebec.
Université de Montréal political scientists Olivier Jacques and Alain Noëlse examine what influences government choices in matters that require long-term effort. In this case, the researchers are particularly interested in investments in public health, but it could also have been about our efforts in the environment, education, disaster prevention or research and development. That is to say all these areas where the resources invested today have little immediate effect and whose potential impacts, although significant and very real, will be diffuse, less visible and spread over many years.
Our experts refer to them as “silent policies”, as opposed to “loud policies”, which attract attention because they have a more rapid, recognizable and quantifiable impact for citizens and interest groups. This is the case for universal measures, such as investments in hospitals, healthcare staff and medicines for the curative healthcare system. But the same is true of policies that benefit subgroups of society, such as the employment insurance program or tax cuts.
“Disaster prevention is the quintessence of a long-term investment because it reduces the probability of a natural disaster and diminishes the damage that it could cause”, illustrate Olivier Jacques and Alain Noël. But despite their “significantly superior return on investment”, these preventive measures are generally overlooked, unlike disaster relief, “which has an immediate and highly visible effect and will easily gain voter support”.
Priority to “noisy policies”
But because money is scarce, and choices have to be made, citizens, interest groups and politicians seeking voters often agree to prioritize “loud politics” over detriment of “silent politics”. In health, preventive measures “provide few short-term benefits to voters, and their effects take time to manifest themselves, whereas investments in curative health provide patients with immediately visible short-term services and generate income for practitioners and institutions.
In Quebec, this resulted, in 2021, in a government effort equivalent to $98 per person in preventive measures, compared to $2,360 for investments in curative health. It is true that Quebec is at the bottom of the pack in this area, admitted Olivier Jacques during a conference in March. But Ontario, which, on the contrary, is considered a leader, did not do much better, with a ratio of $300 to $3,000.
This phenomenon is not unique to Canada. It can be seen everywhere, specify our two researchers, who studied 25 member countries of the Organization for Economic Co-operation and Development (OECD) for the period from 1970 to 2018.
And things don’t get better when the economic and financial context becomes more difficult and budget cuts have to be made. Again, it is usually “silent policies”, with diffuse long-term effects, that pay the price first, with governments not only seeing their resources dwindle in times of austerity, but also falling behind noisy” grow hollow.
Left and right
Surprisingly, the differences in the political orientation of governments do not change anything. Whether on the right or on the left, they usually all bring down the budget ax in the same place when it comes time to make the tough decisions.
In terms of public health, there is perhaps hope that the COVID-19 pandemic has exceptionally brought the importance of this type of issue to the forefront and earned it greater attention from the voters, interest groups and governments, say our researchers.
In another research, Olivier Jacques explored the possibility that political parties whose election seems assured may have a better capacity to free themselves from the short-term demands of voters and to propose policies with a longer horizon. However, the results were not as conclusive as one would have liked.