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CUPE is raising serious concerns about the future of social programs in Canada as the Harper Conservative government pushes for more private sector involvement. The union is calling for an open public discussion on the use of for-profit business models to finance and deliver public social services.

In November 2012, Diane Finley, Minister of Human Resources and Skills Development Canada (HRSDC), announced that the Conservative government was looking for ideas which use for-profit private financing to address social and environmental initiatives. This approach - known as the social financing model or a social impact bond - allows corporations to profit from financing privatized social programs at public expense.

CUPE points out several major issues with the social financing model that have been experienced throughout the world, including concerns about the economic sustainability, fairness and risks associated with this model.

CMAJ April 19, 2016 vol. 188 no. 7 First published February 29, 2016, doi: 10.1503/cmaj.150964

The disparity between supply and demand for transplantable solid organs has resulted in strategies to drive increased organ donation, including public solicitations for living donors. Public organ solicitation occurs when a recipient or their representative solicits an organ for transplantation by public broadcast (e.g., social media or a public notice). The intended donor and recipient may not have a prior relationship. Lack of regulation of public solicitations for organ donation in Canada is a cause for concern. We call for careful screening of altruistic donors within a well-organized system that links willing donors with a maximum number of beneficiaries.

Public solicitation for organs offers an opportunity to find a living donor for potential recipients who do not have one within their social or familial network. Thus, solicitations are a way to redress a somewhat natural injustice, whereby some people have more friends or family members who are willing to donate than others. Accepting these donations does not discriminate1 nor does it disadvantage those on the waiting list.2 Solicitation leads to access to an organ that would not otherwise have been available for donation.3 In addition to being a benefit to the direct recipient, every transplant reduces the demand on the waiting list.2 Solicitation can also increase the awareness of organ shortages and may elicit more donors for other recipients.3

March 23, 2015

by DAVE LINDORFF

it’s time for an aggressive mass movement built around defending and expanding both those critical public funding programs.

The Province Sun Oct 30 2016

Despite a 95-year age difference, five-year-old Tony Han Junior and centenarian Alice Clark enjoy each other's company. After decorating Halloween cookies together, Han brings his own masterpiece, smothered in smarties and sprinkles, to Clark and encourages her to try it. Few words are exchanged, but smiles and giggles are constant at the intergenerational program at Youville Residence, a long-term care facility for seniors in Vancouver. Han Jr. is among a half dozen children visiting this day from the Montessori Children's Community - a daycare located on the same site as Youville, at 33rd and Heather.

Despite a 95-year age difference, five-year-old Tony Han Junior and centenarian Alice Clark enjoy each other's company.

program members identify that a major contributor to happiness, which traditional economics ignores, is the sense of identity that comes from belonging to groups and from having control over one’s outcomes and surroundings

employees become more productive and satisfied when they have greater input into the design of their workspace; senior citizens adapt more effectively to moves to long-term care facilities if they maintain memberships in formal clubs or informal groups of friends

In long-term care facilities, changes such as aging and declining health are a threat to residents’ sense of self and well-being. A range of studies known collectively as “The Social Cure” use theory, experimentation and field trials to show how well-being can be improved simply by helping people engage with each other more. Studies of identity loss among seniors when they move from their homes to long-term care facilities found that those who remain engaged in social groups and clubs fare better. This study and others demonstrate that health care interventions that get people involved with social networks can foster new social identities that can buffer adverse effects of aging, promote recovery from heart surgery and stroke, and delay the onset of degenerative diseases.

Guelph Mercury Thu Oct 15 2015

It's time to tackle root causes of health inequities As Canadians, we are justifiably proud of our publicly funded health-care system. It is, arguably, the single-most powerful expression of our collective will as a nation to support each other. It recognizes that meeting shared needs and aspirations is the foundation on which prosperity and human development rests. We can all agree that failing to treat a broken leg can result in serious health problems and threats to a person's ability to function. Yet, we accept huge inequities in access to dental care and prescription drugs based on insurance coverage and income. Although the impacts can be just as significant, dental care isn't accessible like other types of health care, and many Canadians don't receive regular or even emergency dental care. Many others have no insurance coverage for urgently needed prescription medications and may delay or dilute required doses due to financial hardship.

Demand for dental care among adults and seniors will only increase as the population continues to grow in Ontario. From 2013 to 2036, Ontario's population aged 65 and over is projected to increase to more than four million people from 2.1 million. It is time all Canadians had access to dental care. This necessitates federal and provincial leadership in putting a framework together to make this possible. Dental health problems are largely preventable and require a comprehensive approach for all ages that includes treatment, prevention, and oral health promotion.

The Globe and Mail Sat May 23 2015

It's 4:30 on a Friday afternoon at her Sherbrooke, Que., clinic and Marie Hayes takes a deep breath before opening the door to her final patient of the day, who has arrived without an appointment. The 32-year-old mother immediately lists her complaints: She feels dizzy. She has abdominal pain. "It is always physical and always catastrophic," Dr. Hayes will later tell me. In the exam room, she runs through the standard checkup, pressing on the patient's abdomen, recording her symptoms, just as she has done almost every week for months. "There's something wrong with me," the patient says, with a look of panic. Dr. Hayes tries to reassure her, to no avail. In any case, the doctor has already reached her diagnosis: severe anxiety. Dr. Hayes prescribed medication during a previous visit, but the woman stopped taking it after two days because it made her nauseated and dizzy. She needs structured psychotherapy - a licensed therapist trained to bring her anxiety under control. But the wait list for public care is about a year, says Dr. Hayes, and the patient can't afford the cost of private sessions.

Meanwhile, the woman is paying a steep personal price: At home, she says, she spends most days in bed. She is managing to care for her two young children - for now - but her husband also suffers from anxiety, and the situation is far from ideal. Dr. Hayes does her best, spending a full hour trying to calm her down, and the woman is less agitated when she leaves. But the doctor knows she will be back next week. And that their meeting will go much the same as it did today. In its broad strokes, this is a scene that repeats itself in thousands of doctors' offices every day, right across the country. It is part and parcel of a system that denies patients the best scientific-based care, and comes with a massive price tag, to the economy, families and the health care system. Canadian physicians bill provincial governments $1-billion a year for "counselling and psychotherapy" - one third of which goes to family doctors - a service many of them acknowledge they are not best suited to provide, and that doesn't come close to covering patient need. Meanwhile, psychologists and social workers are largely left out of the publicly funded health-care system, their expertise available only to Canadians with the resources to pay for them.

The Globe and Mail Mon Aug 31 2015

Four-year-old Eddie Hopkins is focused on a game of I spy. The object of his attention is a tube of lipstick in a picture. Can he say what it is? "Lipstick," he says, but it sounds more like "lit-git." Maybe lipstick is too hard. Can he say stick?

"Sti-ck," he says, hesitating before the k sound. One more try. "Sti-ick!" he shouts confidently, dividing the word into two. It seems like a small accomplishment, but for Eddie, it's the first and major step toward speaking normally. Like tens of thousands of children in Ontario, Eddie is in need of speech therapy. He has problems pronouncing the hard k sound, known as an unvoiced velar stop. He often switches it with the voiced velar stop, which most people know as the soft g sound, bringing him from "stick" to "stig." He also switches his sh and s sounds, and has issues with pronouncing two consonants together, such as the "cl" in "clown."

National Post Fri Mar 13 2015

Gaetan Barrette, Quebec's Minister of Health, recently announced proposed legislation that would change how the province funds in vitro fertilization (IVF) for women unable to conceive without medical assistance. Women would have to sign a declaration stating that they had been sexually active for a sustained period, and were still unable to become pregnant. Women over the age of 42 would not be eligible for IVF at all. Minister Barrette, I would like to introduce you to Mikey, my little boy. I had him when I was 43 and I am not alone. The trend toward later motherhood is significant in most Western countries today. The proportion of Canadian women giving birth in their early forties has doubled since 1988, and in the U.S., it has quadrupled. The decision when to have a child is very personal. It is also widely acknowledged that women today are under tremendous social pressures to "be responsible," complete their education and establish financial and relationship stability prior to starting a family. Having a child later in life is not always a mere preference; often it is the result of how our current social structure limits the choices open to women. But by the time it is "socially responsible" to have a child, it may become biologically challenging. Our fertility declines and we are racing against our biological clocks. This is precisely when some need the assistance of IVF to conceive.

I am not certain why you chose 42 as a threshold (perhaps you are relying on policy advice from Douglas Adams' Hitch Hiker's Guide to the Galaxy, that suggested "42" is the answer to the meaning life). But this age threshold discriminates between women who are lucky enough to conceive spontaneously in their forties, and those who need assistance. It also discriminates between me and my husband, for whom there is no age limit in your Bill. Is it medically riskier to have a baby after 40? Yes, it is. Does the risk justify not having a baby? In most cases, it does not. And in almost all cases, this is a decision that a woman should have the liberty to make for herself. Women are making much riskier decisions without government intrusion, such as undergoing plastic surgery. They are making them for more trivial reasons than the desire to bring a child into the world.

This work reminds me of the words of activist/musician Bernice Johnson Reagon, of Sweet Honey in the Rock: “If you are in a coalition and you are comfortable, that coalition is not broad enough.”

February 6, 2015

Immediately following Act 10, Walker and the Republican-dominated state legislature made the largest cuts to public education of any state in the nation and gerrymandered state legislative districts to privilege conservative, white-populated areas of the state.

Peter Hicks April 9, 2015

According to Hicks, the welfare state’s approach of addressing the broadly defined needs of broadly defined groups of beneficiaries in a broadly uniform manner at a single point in time is simply no longer adequate.

The evidence base generated by the system of big statistics

Toronto Star Sun Apr 26 2015

The powerful relationship between poverty and health has been documented for nearly two centuries. We have long known that a person's economic position is the strongest predictor of their health status. Being poor means dying sooner and dying sicker. A Toronto Public Health report released earlier this week concludes that poverty is literally imprinting itself on the lives of Torontonians. The findings presented in the report are grim. Over the past decade, health inequalities between the rich and the poor have persisted. In some cases, they have grown wider. Opportunities to be healthy in Toronto remain as unequally distributed as ever. The report rightfully attributes these inequalities to the social determinants of health - a diverse range of factors including income, education, employment and housing.

We live in a divided city and the deepening of economic cleavages has become a defining feature of our civic landscape. Income inequality is on the rise. Housing is becoming less affordable. Neighbourhoods are becoming more polarized. And the cost of living has far outpaced individual earnings. In Toronto, as elsewhere, the social determinants of health have suffered significant decline. As the report makes clear, the poorest among our city's residents have borne the greatest part of this burden. These trends have affected the health of the poor in countless ways. They have constrained access to quality health care. They have increased susceptibility to harmful behaviours, such as smoking. They have compromised the adequacy and stability of housing conditions. They have restricted access to nutritious foods. They have heightened exposures to daily stress and adversity that get under our skin and harm not only our minds but our bodies as well. In fact, research has shown that economic conditions underlie almost every pathway leading to almost every health outcome.

Pamela Fralick, President and Chief Executive Officer, Canadian Healthcare Association

I will therefore be speaking of home care as just one pillar of continuing care, which is interconnected with long-term care, palliative care and respite care.

The short-term acute community mental health home care services for individuals with mental health diagnoses are not currently included in the mandate of most home care programs. What ended up happening is that most jurisdictions flowed the funding to ministries or other government departments that provided services through established mental health organizations. There were few provinces — as a matter of fact, Saskatchewan being one of the unique ones — that actually flowed the services through home care.

Last week, the Canadian Institute for Health Information (CIHI) released the latest figures on the country’s health spending.

Health costs are not out of control.

Health spending was fairly steady at 33 per cent of program spending during the early and mid-1990s. After 1997, it rose rapidly to 39 per cent of program spending in 2003 before plateauing there until 2008. It has been falling since.

Join a live Q&A at 11:30 this morning with Steven Lewis, an academic and public policy consultant, on the erosion of social programs in Canada and what future is in store for the country.

The Globe and Mail Thu Sep 3 2015

Economic Insight Prime Minister Stephen Harper's economic record since taking office in 2006 is at the centre of debate in the current federal election campaign. Arguably his signature achievement is to have radically reduced the fiscal capacity of the federal government, and with it, the broader role of government in advancing the economic and social welfare of Canadians. As labour economists Jim Stanford and Jordan Brennan have shown, the Harper economic record is the worst of any postwar federal government when judged by 16 key macro-economic variables including per capita GDP growth, job creation, unemployment and under-employment, business investment, exports and productivity growth.

To which the government responds that it has had to deal with many factors outside of its control, including a global recession and the recent collapse of commodity prices. But the government can be fairly judged by its own discretionary fiscal actions, including decisions whether to raise or lower spending and taxes, and whether to run deficits.

our theme today is health and human resources

Dr. Andrew Padmos, Chief Executive Officer, Royal College of Physicians and Surgeons of Canada

The first is to continue and augment investments in patient-centred medical education and training programs that support lifelong learning.

Winnipeg Free Press Fri Aug 28 2015

CANADIANS spend more on taxes than on food, clothing and shelter combined, according to a study released Thursday. The study by the Fraser Institute shows the average Canadian family spent 42.1 per cent of its income on taxes while 36.6 per cent went to the combined basic necessities of food, clothing and shelter. In its study, the non-partisan, public policy think-tank looked at an average family in Canada earning $79,010 in 2014. While 42.1 per cent of that income went to taxes, just 21 per cent was spent on shelter, 11 per cent on food and five per cent on clothing.

That translated to $33,272 in total taxes compared to $28,887 on food, clothing and shelter combined. "With growth in the total tax bill outpacing the cost of basic necessities, taxes now eat up more family income, so families have less money available to spend, save or pay down household debt," Charles Lammam, director of fiscal studies at the Fraser Institute and co-author of the study, said in a statement. However, a community advocate cautions people should remember taxes cover programs such as health care that would have to be paid by families as necessities if those programs didn't exist. "There's no question we're paying far more in taxes, but what tends to be really misleading is to state that we are paying more in taxes than we are paying in necessities in life when you take into account medicare because that's part of the reasons taxes went up after 1961," said Harold Dyck, a community social-assistance advocate with Winnipeg Harvest, referring to Canada establishing its universal health-care program. A key focus of the study was a comparison of taxes paid in 2014 by families with taxes paid by families in 1961. It found an average family's tax bill has risen 1,886 per cent in the past 53 years while average income increased by 1,480 per cent, a slower rate than taxes.

Today, at Anishnawbe Mushkiki Aboriginal Health Access Centre in Thunder Bay, Ontario Minister of Health and Long-Term Care Dr. Eric Hoskins, alongside his colleagues David Zimmer, Minister of Aboriginal Affairs, Michael Gravelle, Minister of Northern Development and Mines, and Ontario Regional Chief Isadore Day, made a ground-breaking announcement of the largest investment in Indigenous health care in Ontario’s history. This investment includes the establishment of up to 10 new or expanded Indigenous-centred primary health care teams that include traditional healing to serve Indigenous communities across the province, similar to the existing network of 10 Aboriginal Health Access Centres (AHACs).

Unique in Canada and made in Ontario, AHACs are Indigenous community-led primary health care organizations that embed Indigenous cultural practices and teachings at the heart of everything they do. They provide a comprehensive array of health and social services to Indigenous communities across Ontario. These services include primary care, traditional healing, mental wellness, addictions services, cultural programs, health promotion programs, early years programs, oral health care, community development initiatives, home and community care and social support services. Importantly, they work on healing the impacts of intergenerational trauma. Being community-governed, AHACs are able to respond to the specific geographic, socioeconomic and cultural needs of the diverse Indigenous communities they serve.

Canadian Press Mon Jul 20 2015

NEW YORK, N.Y. - Doris Ranzman had followed the expert advice, planning ahead in case she wound up unable to care for herself one day. But when a nursing-home bill tops $14,000 a month, the best-laid plans get tossed aside. Even with insurance and her Social Security check, Ranzman still had to come up with around $4,000 every month to cover her care in the Amsterdam Nursing Home in Manhattan. "An awful situation," said her daughter, Sharon Goldblum. Like others faced with the stunning cost of elderly care in the U.S., Goldblum did the math and realized that her mother could easily outlive her savings. So she pulled her out of the home. For the two-thirds of Americans over 65 who are expected to need some long-term care, the costs are increasingly beyond reach. The median bill for a private room in a U.S. nursing home now runs $91,000 a year, according to a report from the insurer Genworth Financial. One year of visits from home-health aides runs $45,760.

Goldblum estimates that she and her mother spent at least $300,000 over the last two years for care that insurance didn't cover. "If you have any money, you're going to use all of that money," Goldblum said. "Just watch how fast it goes." How do people manage the widening gap between their savings and the high cost of caring for the elderly? Medicare doesn't cover long-term stays, so a large swath of elderly people wind up on the government's health insurance program for the poor, Medicaid. For those solidly in the middle class, however, the answer isn't so simple. They have too much money to apply for Medicaid but not enough to cover the typical three years of care. Some 60 per cent of Americans nearing retirement - those between the ages of 55 and 64 - have retirement accounts, according to the Employee Benefit Research Institute. The median balance is $104,000.