Tag Archives: health care

How a fiscal leopard changes spots


New Brunswick’s former Finance Minister Blaine Higgs, God love him, has always been a straight shooter. Except when he hasn’t.

Whilst in Tory office for all of four years, he inveighed against the provincial government’s tendency towards profligacy, calling for deep and painful cuts in the public service.

He suggested that everything “must be on the table”, and that included a serious review of his government’s tax policies – even going as far as intimating, off the script, that a prudent hike in the HST might save New Brunswick years of unnecessary fiscal pain at the hands of international bond holders who held – and continue to hold the province’s $12-billlion long-term debt in abeyance.

He talked darkly about streamlining the educational system; about cutting services to rural citizens; about rationalizing the way we pay for basic infrastructure, like roads, highways, sewer systems and pubic meeting spaces.

Apart from a few trims to the fiscal petticoat that hides a multitude of sins in this province, he largely failed and largely through no fault of his commitment or character. The political winds within his own party of silos and principalities were simply not in his favour. (Have they ever been for any sitting provincial finance minister in any province of this country)?

Still, now that the man is drifting freely in the soft winds of a durable New Brunswick spring – far from from the tethers of Cabinet discipline that once constrained him – one must wonder at the temerity of his latest proposal, a proposal that he must know has no chance of finding purchase in Canada’s only bilingual province.

Conflate New Brunswick’s two health authorities, he says, into one fully bilingual one. Why? “Because,” he told the Saint John Telegraph-Journal last week, “we don’t have a choice. In order to provide the quality of health care we need in the province, we need to look at how we can work more closely together, not further apart.”

Leaving aside, for the moment, just how breathtakingly ambitious – both politically and administratively – such a move would prove, the obvious question arises: If Mr. Higgs feels this strongly now, having prowled the perimeters of the political wilderness for seven months, why didn’t he speak up (as he did about public service cuts, education and infrastructure) just as forcefully when he had a better chance to use his position to win friends and influence people on an important matter of public policy?

Answer: Because, on this file alone, he would have been burned like a bad bagel, kicked to the backbenches and consigned to vacant seat in the “independent” section of the legislative gallery by the whips and goons of his own party. And he knows it.

Of course, on the face of it, his proposition to merge the province’s health authorities is fatally flawed, if only because it can’t work. The law stipulates in excruciating detail that health, like education, is a central plank in the Equal Opportunity platform that has guided New Brunswick politics since the late 1960s. Dismantling this apparatus would be tantamount to declaring war (real or imagined) on the rights of Francophones.

Beyond this, though, Mr. Higgs’ late-game candor conveniently ignores the real problem with health care in this province, which is not linguistic “duality” but service “duplication” and the fact that nobody in government or health authorities seems to know (or, perhaps more accurately, cares to think) about how to both profitably privatize and regulate certain elements of geriatric and long-term care and, in so doing, remove huge costs from critical-care facilities.

Methinks, politics will always win out when its erstwhile gunmen aim low and shoot from the lip.

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The fault is not in our “stars”; it’s in ourselves


The mind of a Canadian premier is a terrible thing to waste.

Its life can be as short as four years, but never longer than 12. And during that midge-like span, it must muster all the mental and physical resources – intellectual flexibility, empathy, focus, judgement, courage, energy – necessary to the task of not utterly failing the electorate that enshrined it.

The voters (it goes without saying) expect nothing of their government leaders, if “nothing” means everything.

As balloteers grudgingly mark their election-day cards, they flee back into their workaday lives, sure of the disappointments that are about to mount, insensate to the absurdity of their standards for political representation.

We, the people, demand that our roads be paved, our potholes be filled, our educational facilities be matchless, our health care system be the best in the world. But when a government flies the rare kite, suggesting tentatively that to pay for these things, it might actually have to raise a highway toll, or increase a sales tax, or (gasp!) actually tighten its belt, out come the placards and the picket lines.

It’s worse in the United States, where they, the people, have managed to transform the poor slobs who run for public office into mewling supplicants of populous fashion. That’s the leadership they’ve come to expect; the leadership they ultimately deserve: unfocused, apologetic, tremulous, and, ultimately, ineffective.

Still, there there was a time in this fair land when democratic imperatives intersected neatly with political ambitions. It didn’t last long, but for as long as it did, women got the vote and all Canadians got a minimum standard of universal health care.

Since then, however, women have served in our parliaments and assemblies with decreasing frequency and increasingly shorter duration. Meanwhile, our health care system has devolved into a multi-jurisdictional hodgepodge that serves some people superbly well, but most of us poorly and without even the semblance of discernment.

All of which may only lend credence to the notion that true democracies are extraordinarily fragile, as likely to wither from neglect as crumble from abuse. And those who we authorize to guard them, for however long a period, should be given every opportunity to muster their resources, especially at the beginning of their mandates.

New Brunswick’s incoming Liberal Premier Brian Gallant faces a terrifically challenging four years. And that’s to say nothing of the several hundred wish lists voters and their organizational proxies will dispense with nauseating regularity.

The most monumental of his tasks, however, will not be grappling with one particular issue or another. It will be applying the considerable faculties of his nimble and educated mind to urgent questions of the common good, even as broad swaths of New Brunswickers stubbornly refuse to recognize those matters that constitute their shared cause.

Surely, chief among these must be resuscitating an economy that’s been beached for some time.

Does Mr. Gallant soften his position on hydraulic fracturing in the nascent shale gas industry and clear the way for commercial exploitation of the resource, a move that could one day generate tens-of-millions-of-dollars in taxes and royalties for this fiscally bereft province?

Or does he stick to his guns and slap a moratorium on the controversial practice, as he has vowed to do, until such time as he believes it sufficiently safe and manageable? And then what?

If he is, as he has intimated, the “education premier”, will he make literacy, numeracy and higher learning tools for economic development now and in the future? Does the road to prosperity wind its way through vistas of human capital, as yet unexplored, or the all too familiar terrain of natural resources and the raw labour they require, often only seasonally?

Campaign rhetoric aside, what, in fact, is Mr. Gallant’s endgame for New Brunswick, and will he be permitted to pursue it in relative calm, free of the cacophony the vested, the specially interested, the lightly knowledgeable, and the constitutionally loud-mouthed among us are so good at raising?

Or, perhaps, knowing that there is no time to waste in New Brunswick, he will let none of it stand in his way.

That, in itself, would be an achievement worthy of note.

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Canadians say ‘ho hum’ to federal priorities


Sleeping giants, like the electorate, wake up...don't they?

Sleeping giants, like the electorate, wake up…don’t they?

Certain enclaves of the federal government have long suspected that Canadians are far less enamoured of their cherished policies than they have otherwise propagandized. 

Their buoyant rhetoric about the nation’s proud military tradition, bolstered by tens of millions of dollars for war memorials and stagy commemorations, have struck many citizens as crass testimonials to a certain prime minister’s preoccupation with battlefield derring do. 

Meanwhile, thousands of veterans needlessly do without – victims of red tape, official neglect and outright disinterest among corps of bureaucrats whose members have never, and likely never will, lace up an army boot.

Equally, Canadians are, in increasing numbers, dissatisfied with Ottawa’s leadership (or lack, thereof) on education – both pre-school and K through 12. Public school is properly the purview of the provinces, but a sense of national purpose is sorely lacking – a fact manifested in the hodgepodge of early education, primary and secondary programs across the country.

And then there’s health care, another provincial responsibility that could use some sage advice from federal policy makers and office holders. Still, Ottawa’s diffidence regarding long wait times for several medical procedures and widely divergent catastrophic coverage regimes virtually guarantees the nation’s mediocrity in this crucial service on the developed world stage.

In fact, in almost every way, the Government of Canada’s ‘jails and jobs’ agenda has failed to impress the general public. 

The wholesale flight of the feds away from things Canadians actually care about – the environment, hard science, and, of course, the social safety net – to things that merely bewilder them – fighting crime at a time when crime rates are at historic lows; taking credit for creating jobs while repeatedly reminding everyone that only the private sector can and should generate new employment opportunities – has conjured an atmosphere of ennui from coast to coast.

Now, some research commissioned by the federal Department of Finance confirms officialdom’s worst suspicions. 

According to a Canadian Press story this week, public opinion surveys conducted last winter, “suggest key government policies are out of step with Canadians’ priorities, including the Northern Gateway project. . .Members of focus groups. . .had ‘little enthusiasm’ for the proposed bitumen pipeline to the British Columbia coast – even those who said they support the controversial project. . .Rather the groups spontaneously raised education, health care, pensions, and veterans as their key issues.”

The operative word there is “spontaneously”. That indicates that participants weren’t prompted or even asked forthrightly about their feelings. They just blurted their concerns with a degree of unanimity that should truly worry a government that’s running second in the polls, behind the third-party Liberals, and preparing to head into a national election. 

As for western oil and gas, the report, itself – prepared by NRG Research Group – states that “detractors worry about the environmental consequences in the event of a spill, particularly as a result of a tanker accident off the B.C. coast. . .There is an appreciation that increased access to oil will be economically beneficial, but there is still a desire to do so in a more environmentally safe manner.”

A report like this is, of course, exactly why governments employ professional spin doctors. When I was one, back before the federal Grits suffered their political Waterloo at the hands of Stephen Harper’s bayonetted storm troopers, I might have prepared a statement that read something like this: “Naturally, Canadians care about the environment. So does this government. To suggest otherwise shamefully underestimates the intelligence of the electorate, which, need it be said, gave this government the mandate it now takes with great seriousness.”

See how that works? Wait for it; we’ve still got it in store.

In the meantime, however, we might do well to ruminate on what it means to live in a democracy where the government of the day – Conservative, Liberal, NDP, Green, Republican, Democratic, Rhinoceronian – brooks no criticism, takes no advice, considers no alternatives to its various hobby horses, and prosecutes its “mandate” with a perpetual scowl on its face. 

We might legitimately question whether this political machinery constitutes a democracy at all.

Then again, if we have decided that our rage against the machine will keep us home on voting day, we already have our answer.


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New Brunswick gets it right on drug plan

Maybe it, like health, will recover

Maybe it, like health, will recover

Three years ago, David Alward made catastrophic drug coverage one of the linchpins of his election campaign. The other was capping the Harmonized Sales Tax at 13 per cent. Thus began, perhaps, the premier’s complicated relationship with what economists term “inputs and outputs.”

Specifically, one actually needs to raise revenue before one increases spending or one tends to go broke pretty darn quickly.

Most householders in New Brunswick get this simple arithmetic. A $500-million annual deficit and a $11-billion long-term debt against the province’s accounts suggest that our elected lawmakers are not as perspicacious as the people they represent.

Still, every so often, a case can be made for a spending program in the absence of a new and ready source of revenue to cover its costs – especially when the administration of such a program will likely prevent the state’s extensive financial hemorrhaging in the future.

Indeed, such a case can be made for the Tory government’s comprehensive drug plan, announced last week, and its specific codicils for catastrophic prescription coverage. Apart from opposition Liberals in the legislature, most interested groups in the province seem sanguine about what they observe in the fine print, which splits the cost of the $50-million (per annum) plan almost evenly between consumers and the Province.

“We’re pleased to see this happening – it’s a moment in history for New Brunswick health care,” Anne McTiernan, CEO of the Canadian Cancer Society in New Brunswick, told the Telegraph-Journal last week. “It will make a huge difference on a go-forward basis for New Brunswickers. It will address both the financial barriers for people accessing important drugs.”

Added Barbara MacKinnon, president and CEO of the New Brunswick Lung Association, for the same piece: “This is an excellent plan. Although it is going to cost, it is really going to keep people out of the hospital. . .If you can get the right diagnosis, the right prescription drug plan, then you are not going to have a stroke.”

In fact, this plan is not likely to financially hobble anyone – not the province which is, arguably, already on skid row, or individuals whose premiums have been scaled to their incomes.

According to the Department of Health, “For individuals earning a gross income of $26,360 or less and families earning a gross income of $49,389 or less, the premium will be approximately $67 per month per adult ($800 per year). For individuals earning a gross income between $26,361 and $50,000 and families earning a gross income of between $49,390 and $75,000, the premium will be approximately $117 per month per adult ($1,400 per year). For individuals earning a gross income between $50,001 and $75,000 and families earning a gross income of between $75,001 and $100,000, the premium will be $133 per month per adult ($1,600 per year). For individuals earning a gross income of more than $75,001 and families earning a gross income of more than $100,001, the premium will be $167 per month per adult ($2,000 per year).”

Meanwhile, “Children 18 and younger will not pay premiums but a parent will have to be enrolled in the plan.  All plan members will be required to pay a 30-per-cent co-pay at the pharmacy up to $30 per prescription.”

There’s even a bone or two tossed to the approximately 80 per cent of New Brusnwickers who hold private drug coverage, to wit: “From May 1, 2014, to March 31, 2015, some New Brunswickers who have private drug plans but still incur high drug costs or need access to a drug covered under the new plan but not through their private plan may join the New Brunswick Drug Plan.”

After that, the province mandates that all private group drug plans “must be at least as comprehensive as the New Brunswick Drug Plan.” That means they must provide comparable coverage in terms of prescriptions and costs.

It has taken three years to craft a program that make sense. But, as Health Minister Ted Flemming points out, if it’s the right plan, it’s worth the wait.

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