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Govind Rao

How B.C. balanced its books by controlling health-care costs - Infomart - 0 views

  • The Globe and Mail Wed Feb 18 2015
  • When B.C. Premier Christy Clark made debt reduction an early priority of her government, it was understood the job would be all but impossible unless health-care costs - escalating at alarming and unsustainable rates - could be contained. On Tuesday, Ms. Clark's government tabled its 2015-16 budget, where the increase in the Ministry of Health was again kept under 3 per cent - not that much greater than the rate of inflation. It is the fourth consecutive budget in which the B.C. government has been able to achieve this goal, which has helped put it in a position to not only balance its books - for the third straight year - but also begin paying down overall debt.
  • B.C. has put itself in an enviable position. The estimated surplus for the current fiscal year ending March 31 is nearly $1-billion. The government is projecting surpluses in the next two budgets as well. The province's debt to gross domestic product ratio - the number credit rating agencies really keep an eye on - will hit 17.4 per cent this fiscal year and is forecast to decline to 16.6 per cent by 201718. This compares to a debt-toGDP ratio of 54.3 per cent for Quebec and 39 per cent for Ontario. It would appear there are no immediate threats to B.C.'s plum Triple-A credit rating.
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  • Meantime, other important measurements of debt are also in retreat, including debt to revenue, direct operating debt and overall growth of debt. When you talk to people in the Clark administration, there is near-unanimous agreement that one of the key factors in the government's ability to begin getting its fiscal house in order was its single-minded focus on health care. "Addressing health-care costs is one essential prerequisite [to balancing budgets]," Finance Minister Mike de Jong said. "And I think the other is addressing costs around your overall labour costs. They both accumulate and aggregate and continue to build year over year."
  • From 2001-02 to 2011-12, Health Ministry costs grew at an average of just over 5 per cent annually. But the last three years of that period - from 2009 to 2012 - department accounts grew at rates of 5.7, 4.9 and 6.3 per cent respectively. When Ms. Clark became Premier in 2011 and made balanced budgets a priority, pressure built inside government to find ways to start containing those costs. Government bargained tough new agreements with nurses and doctors and also drove better deals with medical laboratories throughout the province. It urged greater collaboration among health authorities in an effort to find efficiencies that would save cash. It introduced patientfocused health care, a change from the block-funding model in which hospitals were given a set amount of money each year. Under the new formula, the funding moved with patients; consequently, the more patients a hospital handled, the more money it received. This set up a competition among hospitals for customers, which helped drive further cost savings. The other major price escalator was Pharmacare - drugs are expensive.
  • Again, B.C. began driving harder bargains with drug manufacturers. It joined with other Western provinces to make bulk buys, which also helped lower costs. It looked more often at generics. Between 2007-08 and 2010-11, Pharmacare costs increased an average of 5.6 per cent annually. From 2011-12 to 2013-14, that number fell to an average of just 1 per cent, according to the Ministry of Finance. Mr. de Jong believes that containing health-care costs is getting harder, with the province set to receive less in health transfer payments from Ottawa in 201718, under a new funding model linked to nominal GDP and population. "To the extent there was ever low-hanging fruit - generic drugs, laboratory costs, etc. - I think we've dealt with most of those," Mr. de Jong said. "But with a [Health Ministry] budget of $18billion, I'd like to think there are other efficiencies that can be found." He believes rate increases that hover near or slightly above the rate of inflation could become the new normal. "I believe it is sustainable," he said, "and when you look around the country, more and more jurisdictions are coming to the same conclusion, mostly out of necessity."
Govind Rao

Banker's budget benefits Bay Street - Infomart - 0 views

  • Thu Feb 25 2016
  • TORONTO, ONTARIO--(Marketwired - Feb. 25, 2016) - The provincial budget tabled today at Queen's Park looks like it was written by former TD Bank Executive Ed Clark for the benefit of Bay Street, not for the people of Ontario, says the president of Ontario's largest union. "On every major file, given the choice between benefiting Ontarians and benefiting Bay Street, the Liberals have chosen Bay Street," said CUPE Ontario President Fred Hahn. "It's not what Kathleen Wynne campaigned on; it's not what the people of Ontario need." This year's budget will hurt communities across the province as programs and services are cut in order to balance the budget by an arbitrary date.
  • "Maybe the Liberals missed the memo. Both their federal cousins and the people of Ontario clearly are less concerned about deficit than they are about investing in the economy to create the good jobs and public services we all need," said Hahn. Successive austerity budgets have left Ontario with the lowest per-capita program spending in Canada and serious cuts to front-line public services such as health care, schools, universities and social services. North Bay has seen more than 300 jobs cut from its hospital, Hamilton lost more than 70 child protection workers and the Toronto Catholic District School Board is looking at eliminating 100 educational assistants - cuts similar to those being seen in every community across the province. To make matters worse, he said, the budget continues the Liberal plan to privatize services and sell assets we all own in common. This includes the sale of 60 percent of Hydro One, which government watchdogs and economists warn will ultimately cost Ontario hundreds of millions of dollars annually. Continuing the privatization agenda flies in the face of AG's finding that P3 schemes have needlessly funnelled more than $8 billion into the pockets of private corporations.
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  • This government needs to stop letting bankers like Ed Clark drive the bus. They don't have the best interest of Ontarians at heart," said Hahn. Instead, he said, the government should restore corporate tax cuts, which former Premier Dalton McGuinty bragged amount to $8 billion a year. They should invest in public services that create good jobs and stimulate the economy in every community across the province. "The Liberals have a choice to make," said Hahn. "Stop the cuts that are dragging our economy down, or face the thousands of people they've left unemployed during the next election." CUPE is Ontario's community union, with more than 250,000 members providing quality public services we all rely on, in every part of the province, every day. CUPE Ontario members are proud to work in social services, health care, municipalities, school boards, universities and airlines.
  • Craig Saunders (416) 576-7316
healthcare88

The topsy-turvy world of hospital budgets; MUHC's plight shows activity-based... - 0 views

  • Montreal Gazette Tue Nov 1 2016
  • Imagine a business providing a service so popular that demand is 30 per cent higher than anticipated. That would be good news, right? Admittedly, there might be an adjustment period as more equipment is purchased and additional staffis hired. But still, you would expect more demand to be a positive thing. Now imagine this business complaining about having too many clients. And not just complaining, but reducing the use of new equipment and firing staff. Sounds crazy? Welcome to the topsy-turvy world of public health care in Canada, where patients are a source of additional expenses for a hospital instead of being a source of revenue.
  • The latest instance of this madness is the Quebec government telling the McGill University Health Centre (MUHC) that it is taking on too many cancer and emergency-room patients, according to a report in Monday's Gazette. In particular, ER admissions at the new superhospital that opened in April 2015 are 30 per cent higher than expected. The government is refusing to fund these "volume overruns," with the result being that the MUHC will have a $10-million shortfall for this fiscal year. The MUHC is apparently responding by mothballing some cutting-edge medical equipment, closing new operating rooms, postponing elective surgeries, and possibly cutting 750 full-time and part-time jobs.
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  • The main reason for these counter-intuitive reactions to increased demand is the way hospitals are funded. As in most of the rest of Canada, hospitals in Quebec currently receive their funding in the form of global budgets based essentially on the amounts they spent in the past. This kind of lump-sum funding leaves hospitals with a tough choice: Limit admissions or go over budget. There is no incentive for hospital administrators to innovate and become more efficient, since an innovation that reduced expenditures would lead to an equivalent decrease in the hospital's next budget. On the other hand, an innovation allowing wait times to be reduced and more patients to be treated entails increased pressure on the fixed budget.
  • Almost all other industrialized OECD countries fund their hospitals to a large extent based on services rendered. With such activitybased funding, hospitals receive a fixed payment for each medical procedure, adjusted to take into account a series of factors like geographic location and the severity of cases. The more patients a hospital treats, the more funding it receives. Generally speaking, in countries where activity-based funding is widely used, there is more competition between medical facilities and quicker access to care. Health Minister Gaétan Barrette has said that the Quebec government wants to adopt activity-based funding for medical facilities in the health network. This would make a lot more sense than demanding that MUHC doctors refer oncology and ER patients to other hospitals, as the Health Ministry is currently doing.
  • But getting rid of Quebec's anachronistic funding of its hospitals through global budgets, while a step in the right direction, should be accompanied by other, complementary measures such as mandatory quality reporting for hospitals. Giving patients and referring doctors access to the information they need in order to determine the best hospital for each case would allow for some healthy competition, leading to quality improvements throughout the system, as has happened in Germany in recent years.
  • If Brian Day's constitutional challenge now being considered by the British Columbia Supreme Court is successful, two other European measures could also come to Canada: allowing a market for private insurance to develop, and allowing doctors to practise both in the public sector and in the private sector.
  • International experience confirms that the presence of a mixed health care system is not incompatible with health care services that are accessible to all. Indeed, such measures could improve access to health care by encouraging entrepreneurship without undermining the principles of equality and universality that Canadians hold dear. Jasmin Guénette is vice-president of the Montreal Economic Institute.
Heather Farrow

Socialist Action will stand up for the people - Infomart - 0 views

  • The Telegram (St. John's) Tue May 24 2016
  • Socialist Action is gaining a foothold in Newfoundland Labrador and it is needed now more than ever. The provincial government has tabled an austerity budget that will have drastically regressive effects on public services, seniors, women, youth, those most vulnerable, and the provincial economy as a whole. The provincial government's budget is a stark contrast to Alberta's budget, where low commodity prices have also taken a big bite and the NDP government has taken a different course than that of the Liberal government in N.L. There is nothing in our b
  • udget about creating jobs, eradicating poverty, improving literacy, providing opportunities for young Newfoundlanders and Labradorians, enhancing life in rural communities and for seniors, eliminating the gender wage gap, and improving mental health programs.
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  • Socialist Action participated in the NL Rising! rally on May 5 at the Confederation Building. The event was organized by the Newfoundland and Labrador Federation of Labour and was attended by public and private sector unions, social justice groups, women and youth rights groups, and all those affected by the cuts to services, axed jobs and unfair tax measures. There were about 2,500 in attendance and a Socialist Action member held an SA banner on the main stage with the help of a member of Anonymous.
  • Socialist Action also has participated in town halls to rally support against the austerity budget. "This is the most miserable budget I've ever seen, except for Greece, and Greece's was forced on them" is how one CUPE economist put it.
  • Socialist Action is also involved in starting a local NDP socialist caucus within the ranks of the provincial NDP modelled after the socialist caucus in the federal NDP. The finance minister has made some of her money thanks to temporary foreign workers working at her fast-food restaurants. She was previously the biggest cheerleader for the Muskrat Falls project when sitting on the board of directors for Nalcor, the provincial utility and energy company. Now she says she has to implement this budget because of the cost overruns on the dam project. It is a project lacking transparency and accountability, and making a lot of people from outside Newfoundland and Labrador wealthier, including foreign construction companies that have never done jobs like this in Canada, a Canadian engineering company that was involved in a bribery scandal with Libya when Moammar Gadhafi was still in power, and foreign banks, bond holders and credit rating agencies. Her goal seems to be to obey the credit rating agencies and please them.
  • Newfoundland and Labrador is in a more precarious position now than in 1933, when Newfoundland was bankrupt and Canada and Britain were worried about their own credit ratings. The British and Canadian governments appointed a Commission of Government which was controlled by two private bankers. This was the start of a 15-year political breach which eventually led to the Crown selling off Newfoundland and Labrador to the Canadian bourgeois wolves to pay off their war debt in 1949.
  • Socialist Action NL has unanswered questions about Don Dunphy, an injured worker who was seemingly killed for a tweet when an RNC officer on the then premier's security detail showed up at his home on an Easter Sunday. What is happening to the pensions of iron ore miners from Labrador who have provided raw material to Hamilton Steel Mills for years? We still have foreign multinational corporations willing to exploit our fishery resources. Those corporations and the provincial government are stomping on indigenous peoples' rights in Labrador.
  • Socialist Action is on the ground in Newfoundland and Labrador, active in the labour movement, social justice, international solidarity, feminist and environmental campaigns. We will continue to make the socialist caucus visible in the NDP provincial party, to be at the table at the N.L. independence debate, to actively support indigenous peoples' struggles, as well as in anti-war, anti-poverty and the human rights movements. Socialist Action NL is in solidarity with the Fourth International worldwide. Chris Gosse St. John's
Heather Farrow

NL budget 2016: missed opportunity to boost the economy | Canadian Union of Public Empl... - 0 views

  • Apr 14, 2016
  • Reacting to the provincial budget, CUPE NL President Wayne Lucas says, “The budget tabled by Finance Minister Cathy Bennett cuts hundreds of jobs, makes the tax system less fair, and is a missed opportunity to boost our economy.”
  • The budget could have invested in measures like child care, to grow the province’s economy, says Lucas.
Heather Farrow

CUPE NL delegates join town hall resisting 'miserable' budget | Canadian Union of Publi... - 0 views

  • May 3, 2016
  • CUPE NL convention delegates and community members came together in Gander to fight austerity and build an economy that works for everyone.
  • The Gander town hall was organized by the Common Front NL, and is part of a province-wide mobilization to resist the Liberal government budget. CUPE economist Toby Sanger compared the recent provincial budget to Alberta’s budget, which was unveiled on the same day. Both provinces have been hit hard by plummeting resource revenues. And the difference in their response is stark.
Irene Jansen

Health transfer data shows Alberta wins at other provinces' expense - Winnipeg Free Press - 1 views

  • Ottawa is moving toward a pure per-capita system of calculating how much each province should receive in federal health-care funding, starting in 2014. The new system means the existing equalization component in health transfers — intended to even things out among have and have-not provinces — will disappear.
  • the change means Alberta will receive $1.1 billion extra each year, on average
  • Redford added that Alberta got the short end of the stick for years and this finally evens the playing field.
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  • As a of the change, the other provinces — especially Ontario, British Columbia and Quebec — will all receive less than they otherwise would have. Ontario will be losing out on $382 million annually, British Columbia will be down $351 million and Quebec will see $210 million less each year.
  • A separate calculation by researchers at the Library of Parliament shows that on a per capita basis, the change in health funding penalizes Newfoundland and Labrador the most.
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    Quebec 2012 Budget http://www.budget.finances.gouv.qc.ca/Budget/2012-2013/en/documents/budgetplan.pdf Section E pp 273 - 98. See in particular: P 281 P 290 P 297
Govind Rao

Prime Minister Harper could trigger early election after 2015 budget | hilltimes.com - 0 views

  • Thursday, April 17, 2014
  • The next election is supposed to take place on Oct. 19, 2015, but some Tory insiders and opposition parties say Prime Minister Stephen Harper could decide to trigger it earlier to take advantage of momentum generated from next year’s expected balanced federal budget with billions of dollars of surplus. “If he’s got a budget and it’s balanced and he wants to sprinkle some goodies, this is a good opportunity to do it [call an election] and then go, and rather than sit there and lose all that momentum that the budget will give you,” said Keith Beardsley, former deputy chief of staff to Prime Minister Harper (Calgary Southwest, Alta.) who now is a partner at True North Public Affairs.  Next year’s budget is also likely to announce a number of tax breaks for Canadians, including income-splitting. 
Govind Rao

NDP aims to shake spendthrift image - Infomart - 0 views

  • Toronto Star Thu Aug 27 2015
  • Tom Mulcair has made the deficit fetish his own. The New Democratic Party leader has vowed that, no matter what happens, he will balance the federal budget if his party wins government. Even Conservative Leader Stephen Harper hasn't gone that far. He says governments may have to run deficits during recessions. Coming at a time of a wobbly world economy and falling oil prices, Mulcair's promise is almost certainly bad economics.
  • But for a party saddled with the (largely undeserved) reputation of wasting public money, it is probably good politics. The reason Mulcair's promise is bad economics is that deficits are sometimes necessary. In times of recession, for example, efforts to balance government budgets by raising taxes or cutting spending can make matters worse. The NDP understood this in late 2008 when, as part of an ill-fated coalition attempt, it said Ottawa should spend billions and endure at least four years of deficits in order to fight the worst economic slump since the 1930s.
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  • Ultimately, Harper obliged. At the time, New Democrats didn't complain about the massive deficits that the Conservative stimulus plan would entail. Rather, as Mulcair told the Commons in early 2009, the NDP worried that Harper would renege on the billions in spending that he promised. Is Canada in a recession now? Experts differ, but Mulcair seems to think so. At least that was the impression he gave in a televised debate earlier this month. But even if the country is not technically in recession, an ironclad commitment to balanced budgets can be counterproductive. Governments have only two methods to steer a sluggish economy in the right direction. One is to have the central bank cut interest rates. The Bank of Canada has tried this.
  • But with interest rates close to zero, Bank of Canada governor Stephen Poloz is running out of room. The other is to have Ottawa pump money into the economy, either by cutting taxes or spending more. This is not a radical idea. Mainstream economists say that in this low-inflation environment, the government can run deficits without putting the economy at risk. Writing in the Globe and Mail, former deputy minister of finance Kevin Lynch argues Ottawa should borrow money to fund necessary infrastructure projects even if this results in deficits. The NDP has already announced bold spending plans worth billions of dollars, ranging from daycare to health care. Given these commitments, it seems odd that the party would imprison itself in the balanced-budget straitjacket. At least it seems odd until the politics are taken into account.
  • Politically, the NDP faces a stereotype problem. Voters tend to believe that New Democrats are overly casual with public money. In fact, NDP provincial governments have pretty much the same fiscal record as those of other parties. They try to nickel and dime public servants in order to keep costs down. They fret about credit ratings. Their finances get whacked when the overall economy turns south. But New Democrats never get any fiscal respect. In Saskatchewan, former premier Allan Blakeney's NDP government regularly balanced the budget. His Conservative successor rarely did. Yet when polled, Saskatchewan voters tended to view Blakeney as the spendthrift. Mulcair's aim is to break the stereotype.
  • Hence the hard-line position on deficits. The New Democrats are even using lines from Conservative attack ads to bolster their case. Toronto NDP candidate Andrew Thomson, a former Saskatchewan finance minister, has taken to mocking Liberal Leader Justin Trudeau for saying that growth is more important than slavish attention to deficits and that, if the economy grows - and tax revenues grow with it - the budget will balance itself. The odd thing is that, in this instance, Trudeau was right. The odder thing is that the NDP used to take the same position. Thomas Walkom's column appears Wednesday, Thursday and Saturday.
Govind Rao

Harper, Trudeau, Mulcair clash on budgets, deficits - Infomart - 0 views

  • The Telegram (St. John's) Thu Sep 3 2015
  • Stephen Harper, Justin Trudeau and Tom Mulcair duelled over deficits today in the wake of Statistics Canada's recession pronouncement. The three leaders offered sharp differences of opinion on the economic way forward after the agency reported on Tuesday that the economy contracted for a second straight quarter _ the technical definition of a recession. Trudeau said that both Harper and Mulcair will have to cut spending to honour their pledges of a balanced budget. "They want to cut programs and they hope in vain that the same plan that has been in place for the last 10 years will still work and will kick-start the economy," the Liberal leader said in Trois-Rivieres, Que.
  • Trudeau says only his plan to run deficits to 2019 and increase infrastructure spending will spur real growth in a slackening economy. "Mr. Harper doesn't understand that in order to grow the economy in the 21st century we need to invest in people and give them the tools they need to succeed," he said. "Confident, optimistic countries are always willing to invest in their own future rather than believe that cutting is somehow the path to growth and success."
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  • Harper said the economy is not doing badly and will grow later this year, so the budget must be balanced. "Proposing a deficit right now with economic growth is a recipe for permanent deficits," the prime minister said in North Bay, Ont. "It's why we're not going to do it and why I think the country will reject that proposal from the other parties." But Mulcair insisted his New Democrats won't run deficits either if they win power.
  • He reiterated that the NDP will be able to deliver on its various spending promises by cutting some Conservative initiatives. "We have a plan for investing in infrastructure and housing, but it's all done within the framework of a balanced budget," Mulcair said in Kamloops, B.C. "Tommy Douglas balanced the budget 17 times in Saskatchewan and still brought in medicare in Canada for the first time." © 2015 Transcontinental Media G.P. All rights reserved. Illustration: • NDP Leader Tom Mulcair plays street hockey during a federal election campaign stop in Kamloops, B.C., on Wednesday.
Govind Rao

CUPE Alberta's pre-budget submission | Canadian Union of Public Employees - 0 views

  • Sep 15, 2015
  • CUPE Alberta’s pre-budget submission for the historic 2015 provincial budget, the first to be brought down by the new NDP government. In the few short months that Premier Rachel Notley and the NDP have been in power, they have already brought forward substantial and progressive legislation. We commend them for moving so quickly to enact real change that brings more fairness in Alberta’s highly regressive taxation system, increases the minimum wage and reduces user fees for public services. We applaud these and other swift changes that show the NDP government understands and values the importance of dignity in all workplaces. Still, there is much more to be done during these difficult economic times. CUPE Alberta’s position is that the government can deal with its deficit while still having room to increase investment in quality public services. Specifically, our budget recommendations include:
Govind Rao

Health care, infrastructure top budget priorities for Canadians: Nanos survey | CTV News - 0 views

  • Thursday, March 3, 2016
  • Canadians want health care and infrastructure to be the top priorities in the Liberals' first federal budget this spring, according to results of a survey from Nanos Research. In a survey asking respondents to rank their top two budget priorities, 43 per cent of respondents said health care should be the No. 1 priority in the budget, while 28 per cent said infrastructure spending should be prioritized above all else. Eight per cent of respondents said the economy/jobs/stimulus efforts should be the top priority, while seven per cent chose public safety spending. The military and the environment were each ranked No. 1 by only four per cent of respondents, respectively.
Heather Farrow

Health-care costs need more haggling; Must study how public funds flow through system -... - 0 views

  • National Post Sat Aug 20 2016
  • The whole idea of a doctors' union is, on its face, preposterous. Doctors are not typically to be found among society's downtrodden, lacking marketable skills or bargaining power: on the contrary, they are among the highest-paid professionals in the country, and would be with or without a medical association to negotiate on their behalf.
  • More to the point, doctors are not civil servants. While some are paid a salary or per-patient "capitation" fee, most are in private practice, and charge for each treatment they perform. They are small business operators, really. And yet they are entitled to bargain collectively, like coal miners or factory workers, their fees set not by competition in the marketplace but in marathon negotiations with the government.
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  • Just now in Ontario this arrangement would appear to have hit a wall. Having negotiated a four-year deal offering average annual fee increases of 2.5 per cent, the Ontario Medical Association executive was dismayed to find it rejected by nearly two-thirds of its members, who complain it does not make up for cuts in fees imposed last year. How things should have broken down to this extent need not detain us here. But it does perhaps point to the need to find another way.
  • Because doctors' fees, as such, are not the issue. To be sure, they are part of the puzzle: at $11.5 billion annually, they are roughly one-fifth of Ontario's health-care budget. But all the hard bargaining in the world isn't going to rescue Canada's health-care system from the fiscal cliff to which it is headed. Much more important than doctors' fees are doctors' decisions, as the gatekeepers dictating how resources are allocated within the system: how many tests are ordered, what procedures are done, and so on.
  • The problem is that decisions about treatment are too often divorced from decisions about budgets. Governments set a budget constraint at the macro level, which filters down through the various regional health authorities and local health networks the provinces have seen fit to establish. But doctors typically do not: they make whatever they can bill. And the incentives of feefor-service are to perform as many surgeries and other treatments as they can. Absent changes in those incentives, simply capping fees isn't going to change much.
  • You can see why doctors felt the need to organize. Governments had set themselves up as sole purchasers of medical services. The idea was supposed to be that they could exploit that monopoly power to drive down costs. But it didn't quite work out that way: politicians in need of re-election, it seems, do not make terribly tough negotiators (who knew?). It was always easier to pass the problem on to the next government, or the next generation - or, as federal governments got in on the act, Ottawa. In consequence, health-care spending skyrocketed through much of the 1970s and 1980s.
  • Only with the onset of the early 1990s recession, and particularly the sharp cut in federal transfers as Ottawa tried to stabilize its finances, was there the first serious effort at retrenchment. But as the fiscal crisis eased, and particularly after the 2004 health-care accord, with its massive 10-year increase in federal transfers, whatever impetus for reform there might have been dissipated. Rather than "buying change," most of the new money went to increases in provider compensation.
  • Even in the more recent wave of cuts following the last recession, these have been largely untouched. As documented in a new study by the C. D. Howe Institute
  • ("Hold the Applause: Why Provincial Restraint on Healthcare Spending Might Not Last"), governments have largely resorted to the familiar public-sector strategy of starving the capital account to feed the operating account: while capital spending has been sharply curtailed, physicians' fees have not.
  • This is not sustainable in the long run - as new doctors enter the profession, and most of all, as the population ages. As it is, provinces are now spending more than 40 per cent of their budgets on health care; by 2030, a recent Fraser Institute paper projects the number will have risen to nearly 50 per cent. Yet wait times continue to mount: at more than 18 weeks, on average, from GP referral to treatment, they are nearly twice what they were 20 years ago.
  • Clearly the answer does not lie in more money, least of all more federal money: for every additional dollar in federal transfers the Howe study's authors find that provincial health spending increases by 36 cents. But neither is the answer ever stricter doses of austerity - any more than one would improve a car's mileage by putting less gas in the tank. Rather, what's needed is systemic reform, altering the way that public funds flow through the system, and how the different players within it are remunerated.
  • Traditionally, doctors have been paid per service, while hospitals have been funded on a block grant basis. The key to reform is to turn this around: giving groups of doctors a fixed amount per patient, with which to purchase services from hospitals, clinics and other providers, that is on a per-treatment basis. Paying doctors a lump sum localizes the budget constraint, forcing doctors to take account of costs in decisions on treatment; paying hospitals per service makes it possible for lower-cost competitors to undercut them.
  • In sum, rather than doctors and governments negotiating with each other at one gigantic bargaining table, what we need are lots of little bargaining tables, at which providers can haggle with each other.
Govind Rao

Assembly of First Nations - News & Media - Latest News - 16/3/22 AFN National Chief Say... - 0 views

  • March 22, 2016 
  • Today’s federal budget is a significant step in closing the gap in the quality of life between First Nations peoples and Canadians and beginning the process of reconciliation, Assembly of First Nations (AFN) National Chief Perry Bellegarde says. 
  • The 2016 federal budget unveiled today is an historic $8.4 billion over 5 years in investments in Indigenous issues
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  • Health;
Govind Rao

Missing In Action: CUPE Federal Budget 2014 Response < Budget, Economics | CUPE - 0 views

  • Feb 11, 2014
  • Conservatives ignore Canadians pressing economic needs with a do-nothing budget
  • The federal government should negotiate a new Health Accord with provinces that sets federal health transfer increases by taking into account the real health needs of Canadians and an aging population. Federal leadership to build a comprehensive public health care safety net for Canadians is the most efficient way to cover all Canadians with high-quality care at the lowest overall cost. For example, a national formulary for a core set of drugs and single-desk bulk purchasing would save Canadians more than 40% from total drug costs, almost $15 billion. The federal government should also reinstate the pre-2012 scope of coverage for refugees’ health care at a cost of $20 million per year.Federal leadership is also needed to create a national continuing care program covering both home and residential care beds. With the correct training and a proper staff complement, such a program would provide better care to seniors and save money through the significant reduction in accidents and complications from the inadequate care conditions that exists as part of a patchwork private-public system.
Govind Rao

Budget 2014 triggers Harper's plan to dismantle national health care « Canadi... - 0 views

  • Budget 2014 triggers Harper’s plan to dismantle national health care By Michael McBane, The Hill Times, February 17, 2014
  • Federal transfer payments to provinces were first used in order to establish national standards in health care delivery across Canada. On Tuesday, February 11th, Prime Minister Harper turned this on its head by tabling a budget that will use federal transfers in order to eliminate national standards in health care.
Govind Rao

Ontario Budget Will Result in Devastating Hospital Cuts If Funding is Not Improved - 0 views

  • April 23, 2015
  • TORONTO, ONTARIO--(Marketwired - April 23, 2015) - For the fourth consecutive year Ontario's hospitals will suffer real-dollar budget cuts according to today's Ontario Budget. This is the longest unbroken period of real-dollar public hospital cuts in Ontario's history. Already, Ontario has cut hospital beds more drastically than virtually anywhere else in Canada, or the industrialized world. Maternity units, entire wards, even entire hospitals are threatened with closure. Despite all rhetoric and false claims, these are not services that are being replaced in community care. The hospital cuts are resulting in accelerated privatization, hardship for patients and unsafe hospital overcrowding that now ranks among the worst in the developed world.
Govind Rao

Budget does little for long term care residents - Erie Media | Erie Media - 0 views

  • April 24, 2015
  • Ontario’s budget will do little to improve care levels for residents living in long term care homes, said Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS). In the months leading up to the budget, OANHSS urged the provincial government to put more money into front-line staff — primarily nurses and personal support workers — to meet the growing and increasingly complex needs of residents.
Govind Rao

CUPE Alberta's pre-budget submissions | CUPE Alberta - 0 views

  • September 15, 2015
  • I am pleased to share with you CUPE Alberta’s pre-budget submissions for the historic 2015 provincial budget, the first to be brought down by the new NDP government.
  • Implementing major initiatives from the NDP platform, including a greater public investment in child care and increasing supports to the Family and Community Support Services. This is also a good time to call a commission to look at how to phase-out coal-generated electricity while investing more in green energy. CUPE specifically recommends the commission include the principle of Just Transition, to make sure workers and communities dependent on these legacy industries are treated properly.
Govind Rao

NDP plan calls for increase in corporate taxes; Voters face starkly different choices a... - 0 views

  • The Globe and Mail Thu Sep 17 2015
  • The New Democratic Party unveiled its economic plan Wednesday, relying on corporate tax increases to pay for a suite of spending programs and promising four years of budgetary surpluses if it forms government next month. The plan, however, came under fire as critics say the party overestimates how much new revenue the corporate tax hike would actually bring in, given the potential for companies to shift profit elsewhere. There were also questions over why the NDP is relying heavily on April's budget numbers as economists have since lowered their forecasts for economic growth and federal revenue.
  • With the release of the NDP numbers, all three major parties have now outlined in broad strokes how they would govern if elected - and their visions are starkly different. The economic plans will be put to the test Thursday evening as the three major party leaders take part in a debate in Calgary on the economy hosted by The Globe and Mail that can be seen online or on the Cable Public Affairs Channel.
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  • The NDP plan to hike corporate taxes could be a flashpoint in the debate as both the Conservatives and Liberals oppose it, saying it would be bad for the economy. The Conservatives are campaigning on their April budget, which cut taxes and promised balanced budgets and more infrastructure spending over the coming years. The NDP say they would balance the books as well, but would fund new programs with roughly $7-billion a year in tax increases, including raising the corporate tax rate to 17 per cent from 15 per cent.
  • On taxation, an NDP government led by Mr. Mulcair says it expects $3.7-billion a year from the corporate tax increase, making it the single biggest source of new revenue in the party's costing plan. "The NDP's fiscal plan that we have announced today is balanced and it is progressive," Andrew Thomson, a former Saskatchewan finance minister who is running for the NDP against Conservative candidate Joe Oliver in the Toronto riding of Eglinton-Lawrence, told reporters at an afternoon news conference. Mr. Oliver is the Finance Minister in the Tory government. But questions quickly emerged Wednesday as to whether the corporate-tax estimate may prove optimistic, given that corporations could shift profit to countries with lower rates.
  • The Liberals are planning to run deficits for three years to fund major investments in infrastructure, but have not released specific spending and revenue figures for each year. The New Democrats are locked in a tight three-way battle with both the Conservatives and the Liberals as the election campaign enters its final month.
  • In the document, the NDP says it will rely heavily on a twopoint increase to the corporate tax rate on Jan. 1 as a key source of revenue to pay for billions in new spending on health transfers, daycare spaces and new infrastructure. The party says it can do all of this while planning for surpluses of at least $3-billion a year in each year of a fouryear mandate. The NDP says the document is not the party's full platform, as it still plans to make more detailed announcements throughout the campaign. Critics questioned the New Democrats' reliance on the April budget numbers to project surpluses given that forecasts for economic growth have since been lowered substantially, which will lead to less federal revenue.
  • With the economy at the top of the list of issues on the minds of voters, NDP Leader Thomas Mulcair hopes to persuade Canadians that he is a prudent fiscal manager, and someone who can chart a course to prosperity without driving up debt. The seven-page document released Wednesday in Ottawa includes a chart titled "A balanced plan," but total new spending and total new revenue are not in balance. The chart lists seven sources of new revenue, which add up to $7.2-billion in 2016-17 and increase to $7.5-billion in 2019-20. The chart also lists eight categories of new spending, which add up to $5.8billion in the first year and rise to $11.3-billion in the fourth year.
  • Over all, the lack of detailed information provided by the New Democrats made it difficult to determine whether their numbers add up. But, it was clear that some of the promises being made by the NDP Leader have had to be modified to meet his commitment of a balanced budget. Since late 2011, NDP politicians have accused the Conservative government of planning to cut $36-billion over 10 years from health care, starting in 2017-18, by replacing the annual 6-percent increases in health transfers to the provinces with increases based on the growth in nominal gross domestic product.
  • The New Democrats have said they would reverse that decision. And Peggy Nash, the party's industry critic, told reporters on Wednesday that the 6-percent increases to transfers would be restored. But, she said, they would be used to pay for the slate of new health-care initiatives included in the NDP campaign platform such as a mental-health innovation fund, a half-billion dollars over four years for new clinics and to hire doctors and nurses, an Alzheimer's strategy, a seniors-care strategy and whatever other health announcements Mr. Mulcair has yet to make. Ontario Health Minister Eric Hoskins said the Conservative decision to slash the Canada Health Transfer would result in $8-billion less for health care for Ontario over 10 years and accused the New Democrats of making health-care decisions without provincial input. Absent from the NDP document is a major pledge to increase foreign aid. Mr. Mulcair had promised in May to set a multiyear target to increase foreign aid to 0.7 per cent of GDP, a pledge that could cost more than $8-billion a year if fully implemented. The party confirmed Wednesday that the foreign-aid target will not be met during the first mandate of an NDP government.
  • Canada's federal corporate tax rate had declined to 21 per cent between 2000 and 2007 from 30 per cent in 1980. It has since declined gradually under the Conservatives to 15 per cent as of 2012.
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