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In that vein, Enoch said in the report that accountability and transparency have been the first victims of privatization in Saskatchewan. "What it also means is that hard-working Saskatchewan people are losing good jobs," Hubich said. The report argues that in many instances, privatization has not delivered on the promises of "lower-cost, yet also higher-quality and more responsive services than the public sector." NDP MLA Trent Wotherspoon agreed the government seems to "use privatization at every turn," which he called short-term thinking that is not in the best interest of the province, driving up the cost of living and giving away quality jobs. "There's a large and growing concern across Saskatchewan about what's next," he said.

Deputy premier Don Mc-Morris dismissed the report as "fearmongering." "The basis of their argument is all around fear, trying to scare people to think that nobody else can deliver these services except government employees," he said. "That just isn't the record here in Saskatchewan or really anywhere else in North America." McMorris touted the growth Saskatchewan has seen under his party. "We'd never want to go back to the type of thinking that this organization is trying to profess," he said, referring to the idea that "privatization is an absolutely terrible word." He emphasized as one example how surgical wait lists have decreased with privatization. "They would have rather had people languish on long wait-lists than actually do something about it by using the private sector," McMorris said of the centre.

Privatization hasn't "necessarily" accelerated under the Saskatchewan Party, and future moves will be dictated by a common-sense approach, he said. While the report noted that several jurisdictions in Canada and around the world are bringing privatized sectors back into the public realm, McMorris pointed to the growing popularity of public-private partnerships in North America. "I wouldn't say jurisdictions are backing away," he said. McMorris was hesitant to say whether privatization would figure large in the 2016 provincial election, but Hubich and Wotherspoon said they think it will be a lightening rod. "I actually think it will define the next election," Enoch said. nlypny@leaderpost.com twitter.com/wordpuddle

WRHA spokeswoman Heidi Graham said the study measures physician perceptions rather than tracking actual wait times.

According to the Fraser Institute, the wait for cataract removal in Manitoba is 27.3 weeks after a patient first sees a specialist. According to the government website, the wait for cataract surgery is 13 weeks in Winnipeg and as long as 20 weeks at the Portage District General Hospital.

Canute, seated at the sea's edge, was making a witty point to flattering courtiers, showing he could do nothing at all to prevent the waters from rising. One might well gain the impression, however, that our present rulers are responsible for making the waters ebb and flow. Take that Economic Action Plan. We taxpayers have forked over well above $100 million just for ads touting the wing of bat and eye of newt that were supposed to work their magic for us and, of course, for the Harper administration as well. But the economy is presently on a serious downturn, largely thanks to the recent precipitous drop in the price of oil, and in the value of our loonie. We shouldn't blame Harper for all that, of course, even if his emphasis on oilsands development has made us somewhat vulnerable to this sort of thing. But let's be consistent. Why should he then reap unqualified praise when the economy is doing well? Not that our leaders are completely helpless, of course. Within limits, they can moderate the harmful effects of downturns, if they so choose. The question really becomes, whose harm should they address? That's what these federal budgets are all about. They aren't mere balance-sheets, but a statement of values and priorities. And here there are real choices to be made.

Reflecting those conflicting moral options, some think-tanks have demanded low corporate taxes, to improve profit margins and encourage investment. Others, currently being audited by the Canada Revenue Agency, want taxes to rise, to pay for quality public services such as food inspection and post-Lac-Mégantic rail safety and a national child care program and the increased demands upon medicare and Canada Pension Plan reform. It's fair to say that this government has chosen its path, and it's not one leading to the door of that "ordinary Canadian." The new budget maintains that direction.

It's a pre-election document, with the flash and dazzle of deficit elimination. But to accomplish that, the government announced spending that won't come fully into force for years, and also made off with two-thirds of the contingency fund - intended for real national emergencies, not political manoeuvring. The much-ballyhooed family income-splitting measure, already making its way through Parliament, stands to benefit the very richest 15 per cent of Canadian families. Now the Tax-Free Savings Account will have the maximum contribution nearly doubled, to $10,000 per year - once again disproportionately benefiting the well-to-do who can afford such contributions, while costing the government billions in revenue losses. Under Prime Minister Stephen Harper, we've seen fewer unemployed workers than ever before able to qualify for employment insurance benefits. There is nothing in the budget to remedy this, and no serious job-creation measures to ease unemployment.

Given the current poor health of the economy, the burden of inequality continues to be borne by those Canadians least able to withstand it. The budget, like its predecessors, doesn't even pretend to address that fundamental issue. The "ordinary Canadian," once again, has been left on the sidelines. Nothing new here: move along. John Baglow is an Ottawa writer, researcher and consultant.

La Presse published a follow-up story the next day with a response from the Government of Quebec’s health ministry, saying the minister does not agree with the numbers in the study. The health ministry pointed to their own statistics, which showed a much shorter average wait time for surgery – 8.5 weeks instead of 19.9.

“I don’t think the report has much value because it’s a survey with a small sample size and questionable methodology,” Picard wrote in an email.

“At the very least I think media reports should have explained the limitations,” Picard said.

The La Presse story didn’t mention that Quebec’s health ministry starts calculating wait times from the moment the doctor decides the patient needs surgery. The Fraser Institute’s 19.9 weeks of waiting is calculated from the time the patient gets a referral to a specialist from their GP – a vital piece of information that would have explained some of the discrepancy.

“When wait times are measured in a scientific fashion using a common definition – such as in the Health Council of Canada annual report – the data are valuable,” Picard said.

And dozens of occupations, some that you've never even heard of, are exempt from basic rights entirely. "Keepers of fur-bearing mammals" have no right to minimum wage. Sod layers have no limits on their daily hours of work. Shrub growers don't get a lunch break. The system is so complicated that the Ministry of Labour has developed a special online tool to help decipher who's entitled to what. But as the province reviews its antiquated Employment Standards Act, critics argue that its confusing web of exemptions makes it harder for the so-called precariously employed to defend their rights - and easier for bosses to ignore them.

"When you distil it down to what these exemptions are seeking to achieve, really they are to give employers more control over work and more control over wages," says Mary Gellatly of Parkdale Community Legal Services. "It sends the message to employers that they can get away without complying." The Act was first introduced in Ontario in 1968 to set basic work standards, especially for non-unionized employees who don't have a collective agreement to provide extra protections. But there are at least 45 occupations in Ontario that are exempt from a variety of its fundamental entitlements, many of them low-wage jobs in industries where precarious work is rife.

The Ministry of Labour says many of the exemptions are "long standing" and related to "the nature of the work performed." But York University professor Leah Vosko, who leads research into employment standards protections for the precariously employed, says exemptions have come at least in part from industry pressure, leaving the Act a "complex patchwork that is difficult for workers and even officials to comprehend." Even when there are clear violations, speaking out can come at a cost. Reprisal is illegal under the Act, meaning bosses can't penalize employees for exercising their workplace rights. But the Act gives workers no protection against wrongful dismissal. Employers do not have to give cause for firing someone.

Unionized employees are generally protected by their collective agreements, and workers can sue employers if they think they have been unfairly terminated. But most precarious, low-income employees are not unionized, and most do not have the money to take legal action against an employer, says Parkdale's Gellatly. "It's the big reason why many people can't do anything if they're in a workplace with substandard conditions, because they can get fired without cause." Linda Wang, who worked at a Toronto cosmetics manufacturer for four years, was fired less than two weeks after asking her employer for the extra pay she was owed for working a public holiday. She says no reason was given for her termination. Wang, a mother of two, claims her employer repeatedly bullied her and her colleagues, and says she believes she was dismissed for asking for the wages.

She has filed a reprisal complaint with the Ministry of Labour, but Wang cannot afford to take her employer to court. "I feel the system is against workers," she says. "It's in favour of employers." "Whatever job you have, you put so much of yourself into it," adds Gellatly. "The fact that employers can just fire you without a reason is incredibly devastating for folks." The Act also contains significant gaps when it comes to sick leave and overtime. The legislation provides most workers with 10 unpaid days of job-protected emergency leave, which means they can't be fired for taking a day off due to illness or family crisis. Critics call this measure subpar by most standards, since it still causes many workers to lose a day's income for being ill. An estimated 145 countries give employees some form of paid sick leave.

"Unfortunately, we stand out for our inadequacy," says Brock University professor Kendra Coulter. But the 10-day protected leave doesn't apply to almost one in three of the province's most vulnerable workers. An exemption that excludes employees in workplaces of fewer than 50 people from that right means 1.6 million workers in Ontario are not even entitled to a single, unpaid, job-protected sick day. Fast-growing, low-wage sectors such as retail, food services and health care are most likely to be exempt according to a recent report by the Workers' Action Centre. While many small businesses voluntarily give their employees paid sick days, the loophole leaves many workers - especially the precariously employed - exposed.

Toronto resident Gordon Butler asked his employer, a small construction company in Markham, for one day off work after he sliced his thumb open on the job. He says his boss told him not to come back. "I didn't believe him," says Butler, 44, who has an 8-month-old child. "I tried to plead with him, and he said 'No, too bad.'" "The way it's stacked up right now is there are very few options for people who are in low-wage and precarious work to actually take sick leave when they're sick," says Steve Barnes, director of policy at Toronto's Wellesley Institute, a health-policy think-tank. "They not only have to worry about lost income, but the potential for losing their jobs," adds Brock's Coulter. "It's unkind and unnecessary." The stress caused by the province's meagre sick-leave provisions is compounded by exemptions to overtime pay, to which around 1.5 million don't have full access.

As a rule, employees should get paid time and a half after 44 hours a week on the job, according to the Employment Standards Act. But in 2014, more than one million people in the province worked overtime, and 59 per cent of them did not get any pay whatsoever for it, Statistics Canada data shows. This, experts say, is partly because enforcement is poor. But in Ontario, a variety of occupations don't even have the right to overtime pay, including farmworkers, flower growers, IT workers, fishers and accountants. Managers are also not entitled to overtime. Vladimir Sanchez Rivera, a 45-year-old seasonal farmworker in the Niagara region, says he has worked 96-hour weeks doing back-breaking labour picking cucumbers and other produce.

We don't have access to protections when we are working in agriculture," he says. "And our employers tell us that." Low-wage workers are even more likely to be excluded from full overtime pay coverage, according to the Workers' Action Centre's research. Less than one third of low-income employees are fully covered by the Act's overtime provisions, compared to around 70 per cent of higher earners, because they are more likely to work in jobs that aren't eligible. Workplaces can also sign so-called "averaging provisions" with their employees, which allow bosses to average a worker's overtime over a period of up to four weeks. That means an employee could work 60 hours one week and 50 the next, but not receive any overtime as long as they don't work more than a total of 176 hours a month.

Critics say the measure means more work for less pay, and paves the way to erratic, unpredictable schedules. "That's a huge impact on workers and their families in terms of lost income and having to work extra hours," says Parkdale's Gellatly. "It's certainly not good for workers, for their families, and it's not good for creating decent jobs in terms of rebooting our economy," she adds. For many of the precariously employed, falling through the gaps ruins lives. "Even now, when I think about the working environment, I feel very depressed," says Wang, who, 10 months later, is still waiting for the Ministry of Labour to issue a ruling on her complaint. "I feel panic."

Sara Mojtehedzadeh can be reached at 416-869-4195 or smojtehedzadeh@thestar.ca. By the numbers 1.6 million non-unionized Ontario employees with no right to an unpaid, job-protected sick day 59%

of Ontario workers who worked overtime in 2014 did not get any pay whatsoever for it 71% of low-wage, non-unionized Ontario employees don't have full access to overtime pay 29%

of high-income employees don't have full access to overtime pay Sources: Workers' Action Centre, Statistics Canada Proposed solutions A recent report by the Workers' Action Centre makes a number of recommendations to rebuild the basic floor of rights for workers. The proposed reforms include: Amending the ESA to include protection from wrongful dismissal

Eliminating all occupational exemptions to ESA rights Repealing overtime exemptions and special rules Repealing overtime averaging provisions Repealing the emergency leave exemption for workplaces with less than 50 people Requiring employers to provide up to seven days of paid sick leave

The justices in Washington are expected to deliver their ruling in the next 10 days, a decision that could have a serious impact on Obama's re-election hopes as well as the healthcare of the millions of Americans who currently have inadequate coverage or none at all.

moves that are under way everywhere to improve the co-ordination and quality of care as the Act requires, he says. Doctors and hospitals are exploring different relationships. Accountable care organisations (ACOs) are springing up to provide the entire network of care many people need – specialist, primary care doctor and home health care as well, instead of just the separate parts

"Medicaid is more vulnerable than Medicare because it serves a less vocal population and it's a state/federal partnership

Medicare is so big and so important that you really can't get the whole system to move without Medicare's involvement, but Medicare can lead or it can follow.

Berwick's downfall was considered to be his praise for Britain's universal national health service

He warns that increasing the role of the private sector in the NHS, as the British government is now doing, is risky. "I would be cautious – very cautious," he said. "When you invite entrepreneurial private sector investors into the delivery of care, under most payment systems, they will be very interested in volume. They will be very interested in doing more things to people and you may find that you lose control of that level of discipline to the disadvantage of patients. When more things are done, more unnecessary things get done and more hazard enters the system – not just cost.

"You want hospitals that seek to be empty, doctors that seek to be idle, machines that are few. In healthcare you want to find the way to help that is the least invasive of the person's life and body. A volume-based system does not have that incentive structure."

I am speaking here of the fact that instead of the Canadian government borrowing money from its own bank, our bank -- the Bank of Canada (BoC) -- it has, since 1974, chosen instead to borrow exclusively from private international and domestic financial institutions providing them with enormous, absolutely risk-free profits for almost four decades

By 2012, the government had paid C$1 trillion in interest -- twice its national debt. Interest on the debt is now the government's single largest budget expenditure -- larger than health care, senior entitlements or national defense.

In the early 1990s, at the height of the media's deficit hysteria and rhetorical nonsense about hitting a "debt wall," 91 per cent of the $423-billion debt was due to interest charges. Our real debt -- revenue minus expenditures -- was just $37 billion.

But if you think having squandered a trillion dollars that could have been spent on the public good is a side issue, feel free.

"We are dealing with programs or structures that are 50 years old and haven't been modernized very much over that entire time," said the P.E.I. native and former Ontario Hospital Association president. Yet even as MacKinnon pens worthy articles and reports for Policy Options magazine, the Fraser Institute and the Ontario Chamber of Commerce, he is mindful that such weighty issues get little traction before, during and after election campaigns.

And that, said the senior fellow at the Atlantic Institute for Market Studies think-tank, shortchanges voters - especially in Ontario. "What I don't think is yet understood in Ottawa is that Ontario has the least accessible provincial programming of all provinces. Fewer doctors in relation to population, fewer nurses, fewer judges - a whole range of issues when you go into education, into long-term care spaces."

MacKinnon said subsidizing Atlantic Canada - and to a lesser extent Quebec - "has done incalculable harm. "The system we've got makes sure that the part of the world where I come from is always going to be an economic disaster," he said. "How do we compete in the world with that nonsense going on? This is profoundly damaging Canada's productivity and its ability to compete in the world."

Wages are "about flat" if you adjust for inflation, Jackson said.

Jackson said his research found a third of new jobs are in the lowest- paid occupations, such as sales and service, and a third of new jobs are part time.

"I think the key point I'm making is they're overhyping the quality of the jobs they've created. And 2009 is not the appropriate starting point," Jackson said. In comparison with 2006, when the Harper government was first elected, unemployment is higher for all age groups and both genders, the institute notes, based on data supplied by Statistics Canada.

Among 25 to 54 year olds, for example, the unemployment rate in 2006 was 5.3 per cent. The rate rose in 2009, during the Great Recession, to 7.1 per cent. By the end of 2014, it had fallen to 5.8 per cent but remained above pre-recession levels, the data shows. The number of part-time jobs rose at twice the rate of full-time jobs and was concentrated among older workers over age 55, the report says. In terms of job quality, the public sector has produced most of the good paying jobs while the private sector has provided more low-wage work, the report says.

Sales and service jobs, which pay $16.40 an hour on average, grew. Health-care jobs, which pay $35.50 an hour, also rose. While manufacturing work, which pays roughly $20.68 an hour, declined, the report said.

"It's far from being back where we were in 2006 in terms of the proportion of Canadians with jobs, and particularly full-time jobs," Jackson said. "The tilt of job creation has been to part-time, low-paid service jobs. "What it tends to show is this theme of the eroding middle-wage job," Jackson said.

The federal government should stabilize or even reduce the value of the Canada Health Transfer

the federal government should allow the provinces the maximum amount of flexibility to design, regulate and provide health care

- Jason Clemens is the director of research at the Macdonald-Laurier Institute and author of the recently released Reforming the Canada Health Transfer.

Tax swaps, whereby the federal government takes over corporate income tax and the provinces take in all sales tax revenue, are another alternative worthy of consideration.

Australia does all-in transfers, bundling federal health and social payments into a single funding package, that are then equalized according to each state’s need.

An opinion poll commissioned by the Mowat Centre for Policy Innovation shows that, in every province except Quebec (where sentiment is almost evenly split), people feel they’re not getting fair treatment when it comes to federal transfers.

Mowat Centre for Policy Innovation