Decentralization Is Key to Canada's Health Care Reform

Despite high levels of public spending, Canada’s health-care system consistently performs more poorly than a number of peer jurisdictions with universal health-care systems. 

Governments across the country must address this policy challenge in a context of constrained resources, as the federal government and a number of provinces currently face increasing debt loads and other significant fiscal challenges. 

During the 1990's, the federal government transformed its approach to providing financial assistance to the provinces to support their welfare and social assistance programs. Specifically, the federal government reduced transfers to the provinces but, in exchange, removed a number of “strings” previously attached to federal funding that prohibited certain types of policy reform. 

For example, the provinces were permitted to create work requirements for receipt of welfare payments, which previously would have triggered the withholding of federal transfers. The reform of federal transfers to the provinces led immediately to a wave of policy innovation and reform at the provincial level, as governments across the country pursued various policy paths designed to improve their welfare programs, create solutions that actually addressed local problems, and reduce program costs. 

Many of these reforms had the intended effects, as there was a marked decline in welfare dependency and government spending on public assistance in subsequent years. However, no similar wave of policy innovation occurred following the 1990's transfer reforms in Canadian health care. This is largely because the government maintained the various “strings” that were attached to health spending transfers and, specifically, the terms and conditions of the Canada Health Act. 

As a result, health-care policy in the Canadian provinces has since the 1990's generally been largely characterized by policy inertia while spending on health care has increased considerably. 

Canada’s experience with welfare reform provides a model with important implications for how to begin reforming and improving Canadian health care. By reducing transfers in real terms while amending specific provisions of the Canada Health Act that inhibit reform, the federal government can partially address the fiscal challenges it faces today while providing provinces with the freedom to innovate and pursue policy reforms to improve their health-care systems. 

Such changes would allow for greater experimentation by each province as they seek out what policy arrangements have the best possibility of improving health-care performance. 

For instance, provinces would be well served to examine the introduction of cost-sharing arrangements (co-insurance, deductibles, and co-payments) used in most other universal health-care countries to ensure more efficient use of the health-care system by patients. 

Provinces might also look at removing regulations that currently prevent a greater supply of needed health-care professionals and investment within the health-care sector. 

It is uncertain exactly what reforms different provinces would choose and the paper does not weigh the advantages and risks of specific reform options in detail. Instead, based on Canada’s experience with welfare reform, this paper recommends a crucial change, the devolvement of decision-making powers to the provinces, with the federal government permitting each province maximum flexibility (within a portable and universal system) to provide and regulate health-care provision as they see fit.

Read full article by by Ben Eisen, Bacchus Barua, Jason Clemens, and Steve Lafleur  @ https://www.fraserinstitute.org/sites/default/files/devolvement-initiative-post.pdf

Greater economic growth requires Productivity NOT political deficit financed public spending

As fall approaches, all levels of government will begin preparing their budgets. Expect the usual grandstanding by special interest groups seeking new spending and tax cuts. The one not at the table will be the Future Taxpayer who will be stuck with any debt piled up by today’s deficit-happy politicians. Our existing deficits already total three per cent of GDP for all levels of government.

Actually, more than public deficits are being called for. Politicians want to expand government in the belief that the biggest economic bang is through public spending. What’s not getting a big push are tax cuts, which can be quick to implement and create better incentives for the investment, work effort and risk-taking needed for growth.

I have been warning for some time of a coming Canadian debt bomb. All government debt is now over 110 per cent of GDP compared to 90 per cent in 2007 (although below a peak of 135 per cent in 1995). Household debt now exceeds GDP. Corporate indebtedness has been climbing since 2011.

Governments are fooling themselves that Canada has substantially more room for more debt by looking only at “net debt” figures. These underestimate the size of our debt bomb since pension assets (CPP, QPP and employee pensions) are subtracted from debt while future pension liabilities are ignored. If we add back these liabilities, then all-government net debt is close to 70 per cent of GDP, far higher than the 44 per cent politicians tout to make Canada look prudent.

None of these calculations include the tsunami of liabilities associated with unfunded health care and other age-related spending. Meanwhile, the unfunded liability from Old Age Security just got bigger, after the Trudeau government’s reversal of the eligibility age to 65 from 67 years.

Obviously, the current public debt is more tolerable at today’s ultra-low interest rates. Maybe these rates will continue for years, as we seem stuck in a Japan-like funk of low growth and low inflation. Nevertheless, even at today’s values, these low debt charges cost taxpayers considerably. Total public debt charges in Canada are over $60 billion (eight per cent of public spending), money that could be used for health care, education and a less onerous tax system. Interest costs will balloon if governments take their feet off the money-supply accelerator, as recently seen in the EU and U.S.

With monetary policy failing to jolt economic growth, Keynesian economists argue for looser fiscal policy instead, meaning bigger deficits and public spending. Will fiscal expansion and deficits work? Japan’s recent, fruitless attempts suggests it won’t.

Governments are fooling themselves by thinking Canada has plenty of room for more debt

There may be good reason for that. The Keynesian model assumes people are myopic, ignoring the consequences of deficits on future tax liabilities. It is hard to believe, though, that smart traders would ignore excessive debt build-ups that ultimately lead to economic stress, higher taxes and currency devaluations.

Nor does it seem that fiscal stimulus works well in open economies. An expansion of public deficits creates a capital inflow, pushing up the dollar, reducing international demand for exports and increasing domestic demand for cheaper imports. When the federal government announced $30 billion deficits last winter, the Canadian dollar rose despite a continuing decline in commodity prices.

But maybe I am wrong. People can be myopic and currency shifts can happen for a variety of reasons. So even if we believe that deficits can grow the economy, is it better to increase public spending or reduce taxes?

Keynesian's argue that spending increases are more powerful than tax cuts, which might be saved rather than spent. This assumes that government spends only on consumption (which is never the case) while tax cuts create savings “leakage.”

However, tax cuts work through an economy faster in the short run compared to spending programs like infrastructure. Moreover, if the economy is to grow faster, we need higher productivity, since growth is simply the combined growth in the working population and growth in productivity (in Canada, the two are expected to be little better than 1.5 per cent). Infrastructure spending creates capacity for long-term growth but is a poor short-run stimulus, while tax cuts can generate growth both in the short and long run.

Currently, Canada’s reliance on income taxes impairs incentives for investment, entrepreneurship and the adoption of technology — all critical to growth. Some countries have clearly figured this out. The U.K. and Ireland, with low corporate taxes and some personal tax relief, have recently achieved better growth rates than the U.S., Canada and other European countries.

Canada has been doing the opposite. Federal and provincial governments have pushed up marginal income tax rates, whether at the top end or through higher claw-back rates for income-tested programs. Effective corporate tax rates on new investment have increased by almost 15 per cent through fewer incentives, higher transfer and property taxes, and increased tax rates in some provinces. Small businesses have gotten breaks, but they face a wall of taxes and regulations if they grow. 

If we want to see better economic growth, we need to get back to the productivity agenda — not the Keynesian agenda of deficit-financed public spending.

Jack M. Mintz | September 22, 2016 5:13 PM ET

Jack M. Mintz is the president’s fellow at the University of Calgary’s School of Public Policy.

Humanity EmptyTop Down to Bottom Up

Today's politician and political parties are more corrupt than the citizens from the biblical city of Babylon days. (https://bible.org/seriespage/5-rise-and-fall-babylon)

We the people have allowed ourselves to be governed Not by “the people for the people”, rather by political parties for political parties for Corporations, Bankers and Unions.

Our governments have become corrupt with absolute power by controlling the appointments of supreme court judges through the political party in power at the time such appointment are made solely based on political preference for the expedience of a political ideology of the political party in power at the time of such appointment. 

They (Political Parties) further control who their people puppets shall be as their party's mouthpiece to be put forward for a political party for the voters to elect to represent them, NOT the voter, Rather the various political party these party agents truly represent and seek office under.

Global trade agreements do not benefit the middle class or poor within countries rather the political elite and their money backers’; international corporations; bankers; labour unions and political party leaders.

Do not believe me? Then look at the facts over the past 30 or 50 year. What affects the cost of homes for example. Simply put it’s PLR. Products, Labour and Regulations. 

Products of course representing material, labour basically wages and regulations government building and fire codes etc. 

With all these regulations by government the peoples (purchasers) cost for insurance has Not decreased, rather greatly increased. Multinational insurance companies of course control those costs. 

Products also for the most part are now under the control of large international corporations while labour costs are controlled by, you guessed it, international unions.

In Toronto for example the average house cost in 1985 was $109,094. The median family income at that time was $31,965.(http://business.financialpost.com/personal-finance/mortgages-real-estate/now-and-then-do-canadian-homes-really-cost-that-much-more-than-30-years-ago)

Representing a 3.4 times income in 1985. Today the Toronto median family income is $68,110 as per  Statistics Canada with the average house price in May 2016 within Toronto for all homes was $782,051 as per TREB.(http://www.citynews.ca/2016/06/03/average-house-price-in-toronto-continues-to-rise-to-1-28m-in-may/)

Today in 2016 this represents a 11.48 times income. Keep in mind that the family median income in 1985 adjusted for inflation today represents $65,091 or 12.01 times that 1985 income adjusted for today. Thus a family’s median income since 1985 has in fact DECREASED by $3,019.

So much for free trade, political parties and your elected party puppets looking after the interest of you the voter for these past 30 plus years!

An article by Bill Bennett re: Trump

Written by the distinguished Bill Bennett PHD - Secretary of Education under Ronald Reagan Cultural studies at the distinguished and renown Heritage Foundation

 What I See Happening In a Trump Presidency

By Bill Bennett
"They will kill him before they let him be president.  It could be a Republican or a Democrat that instigates the shutting up of Trump.
Don’t be surprised if Trump has an accident.  Some people are getting very nervous:  Barack Obama, Valerie Jarrett, Eric Holder, Hillary Clinton and Jon Corzine, to name just a few.
It's about the unholy dynamics between big government, big business, and big media.  They all benefit by the billions of dollars from this partnership, and it's in all of their interests to protect one another. It's one for all and all for one.  It’s a heck of a filthy relationship that makes everyone filthy rich, everyone except the American people.  We get ripped off.  We’re the patsies.  But for once, the powerful socialist cabal and the corrupt crony capitalists are scared.  The over-the-top reaction to Trump by politicians of both parties, the media, and the biggest corporations of America has been so swift and insanely angry that it suggests they are all threatened and frightened.
Donald Trump can self-fund.  No matter how much they say to the contrary, the media, business, and political elite understand that Trump is no joke.  He could actually win and upset their nice cozy apple cart.
It's no coincidence that everyone has gotten together to destroy The Donald.  It's because most of the other politicians are part of the a good old boys club.  They talk big, but they won’t change a thing.  They are all beholden to big-money donors.  They are all owned by lobbyists, unions, lawyers, gigantic environmental organizations, and multinational corporations – like Big Pharmacy or Big Oil.  Or they are owned lock, stock, and barrel by foreigners like George Soros owns Obama or foreign governments own Hillary and their Clinton Foundation donations.
These run-of-the-mill establishment politicians are all puppets owned by big money.  But there's one man who isn't beholden to anyone.  There's one man who doesn't need foreigners, or foreign governments, or George Soros, or the United Auto Workers, or the teacher's union, or the Service Employees International Union, or the Bar Association to fund his campaign.
Billionaire tycoon and maverick Donald Trump doesn’t need anyone’s help.  That means he doesn’t care what the media says.  He doesn’t care what the corporate elites think.  That makes him very dangerous to the entrenched interests.  That makes Trump a huge threat to those people.  Trump can ruin everything for the bribed politicians and their spoiled slave masters.
Don’t you ever wonder why the GOP has never tried to impeach Obama?  Don’t you wonder why John Boehner and Mitch McConnell talk a big game, but never actually try to stop Obama?  Don’t you wonder why Congress holds the purse strings, yet has never tried to de-fund Obamacare or Obama’s clearly illegal executive action on amnesty for illegal aliens?  Bizarre, right?  It defies logic, right?
First, I'd guess many key Republicans are being bribed.  Secondly, I believe many key Republicans are being blackmailed.  Whether they are having affairs, or secretly gay, or stealing taxpayer money, the National Security Agency knows everything.
Ask former House Speaker Dennis Hastert about that.  The government even knew he was withdrawing large sums of his own money from his own bank account.  The NSA, the SEC, the IRS, and all the other three-letter government agencies are watching every Republican political leader.  They surveil everything.  Thirdly, many Republicans are petrified of being called racists, so they are scared to ever criticize Obama or call out his crimes, let alone demand his impeachment.  Fourth , why rock the boat?  After defeat or retirement, if you’re a good old boy, you’ve got a $5 million-per-year lobbying job waiting.  The big-money interests have the system gamed.  Win or lose, they win.
But Trump doesn’t play by any of these rules.  Trump breaks up this nice, cozy relationship between big government, big media, and big business.  All the rules are out the window if Trump wins the Presidency.  The other politicians will protect Obama and his aides but not Trump.  Remember:  Trump is the guy who publicly questioned Obama's birth certificate.  He questioned Obama's college records and how a mediocre student got into an Ivy League university.  Now, he's doing something no Republican has the chutzpah to do.  He's questioning our relationship with Mexico; he's questioning why the border is wide open; he's questioning why no wall has been built across the border; he's questioning if allowing millions of illegal aliens into America is in our best interests; he's questioning why so many illegal aliens commit violent crimes, yet are not deported; and he's questioning why our trade deals with Mexico, Russia and China are so bad.
Trump has the audacity to ask out loud why American workers always get the short end of the stick.  Good question!  I'm certain Trump will question what happened to the almost billion dollars given in a rigged no-bid contract to college friends of Michelle Obama at foreign companies to build the defective Obamacare website.  By the way, that tab is now up to $5 billion.  Trump will ask if Obamacare's architects can be charged with fraud for selling it by lying.  Trump will investigate Obama's widespread IRS conspiracy, not to mention Obama's college records.  Trump will prosecute Clinton and Obama for fraud committed to cover up Benghazi before the election.  How about the fraud committed by employees of the Labor Department when they made up dramatic job numbers in the last jobs report before the 2012 election?
Obama, the multinational corporations and the media need to stop Trump.  They recognize this could get out of control.  If left unchecked, telling the raw truth and asking questions everyone else is afraid to ask, Trump could wake a sleeping giant.  Trump's election would be a nightmare.  Obama has committed many crimes.  No one else but Trump would dare to prosecute.  He will not hesitate.  Once Trump gets in and gets a look at the cooked books and Obama's records, the game is over.  The goose is cooked.  Holder could wind up in prison.  Jarrett could wind up in prison.  Obama bundler Corzine could wind up in prison for losing $1.5 billion of customer money.  Clinton could wind up in jail for deleting 32,000 emails or for accepting bribes from foreign governments while Secretary of State, or for misplacing $6 billion as the head of the State Department, or for lying about Benghazi.  The entire upper level management of the IRS could wind up in prison.
Obamacare will be de-funded and dismantled.  Obama himself could wind up ruined, his legacy in tatters.  Trump will investigate.  Trump will prosecute.  Trump will go after everyone involved.  That’s why the dogs of hell have been unleashed on Donald Trump.
Yes, it's become open season on Donald Trump.  The left and the right are determined to attack his policies, harm his businesses, and, if possible, even keep him out of the coming debates.  But they can't silence him.  And they sure can't intimidate him.  The more they try, the more the public will realize that he's the one telling the truth".

Hydro One sell-off a BIG CON JOB?

By: Keith M. Summers

I am not an expert on whether or not Hydro One needs new management or if we would all be better served if Hydro One were not 100 per cent owned by the people of Ontario. But I do know that for $9 billion, the new shareholders should get somewhere around 30 per cent of the company, not 60 per cent.

Why is this a bad deal?

Because it is a bad price.

Investment people — like the people who have agreed to help Queen’s Park unload its majority stake in Hydro One — value companies based upon a couple of different factors. Sometimes the value of a company is based on the value of its assets: land, factories, intellectual property, and brand name recognition. The thinking being that better management of those assets might generate higher profits. Sometimes the value of a company is based on its profitability. A stable stream of income is worth paying good money for. Some companies are valued on their assets, others are valued on their earnings; sometimes it’s a little of both.

Hydro One is a stable generator of profits. It has been profitable since it was created out of the breakup of Ontario Hydro. Its profits have grown 6.3 per cent per year for the last 14 years. It reported earnings of $749 million for 2014 — all of which belong to the people of Ontario. You and me.

Now, we all know that the province is in debt. $284 billion. That’s the bad news. The good news is that investors love to buy government bonds. Investors are so eager to buy Ontario bonds that they compete as to who will accept the lowest interest rate. In March, bond investors lent Ontario money for 10 years at a rate of 2.1 per cent. Our average interest rate on all our existing debt is only 3.8 per cent (and falling).

So, we have some numbers to work with: 1) Hydro One earns $749 million. 2) The province pays, on average, a 3.8-per-cent interest rate on its outstanding debt and 3) the province can borrow new money at rates as low as 2.1 per cent for 10 years. So here’s the question: how much should we, as Ontarians, receive for selling this $749-million income stream?

One way to calculate it is to say that $749 million pays all of the interest on $20 billion in existing government debt at a rate of 3.8 per cent. So, to accept anything less than $20 billion in cash is a bad deal.

Another way is to say that $749 million will pay all of the interest on $36 billion of new government debt at a rate of 2.1 per cent. So, to accept anything less than $36 billion in cash is a bad deal.

The number that doesn’t make sense is $15 billion. That’s the value that the premier has put on Hydro One. (If 60 per cent is worth $9 billion then 100 per cent is worth $15 billion). That is the number that Bay Street has convinced the Premier to accept for selling a profitable and growing business that earns $749 million with an earnings growth rate in excess of 6 per cent.

Why is she doing this?

I don’t know. But I can tell you why Bay Street is pushing this deal.

Greed. In addition to buying a blue-chip electricity monopoly at a rock-bottom price they hope to make money by “underwriting” the deal. They intend to charge us a fee for selling our Hydro One to themselves at a terrible price. And a deal of this size could be worth hundreds of millions of dollars in fees.

I have a lot of respect for investment bankers. They are the guys (mostly guys, anyway) who help companies “go public” by convincing ordinary Main Street investors to buy shares in newly public companies. That takes a lot of work and is not without some risk.

What will not take a lot of work for them and involves no risk is selling Hydro One at a ridiculous, giveaway price.

This deal is the biggest con I’ve ever seen.

Source:

Keith M. Summers is a former hedge fund manager and was convicted of fraud in 2014. He is currently serving a three-year sentence. His book, Conned: How Wall Street rips you off and How to Fight Back will be published this fall.

http://www.thestar.com/news/queenspark/2015/05/18/why-kathleen-wynnes-hydro-one-sell-off-is-a-sellout-cohn.html

Carding, itself, can be defined as a valued public safety reason.

In any day or age and especially in these times of world-wide terrorism, coupled with the disrespect for the life, law, order and discipline, a civil society’s overall public safety through policing which involves prevention and protection of all communities is not best served through a policy of speech precondition statement (you have the right to walk away) for interaction by the police with the public within the Toronto is the wrong choice for overall public safety and policing on our streets or within our communities.

Toronto's former police chief Blair should be congratulated, not bullied and harassed by the media, for standing firm on behalf of the majority of law abiding citizens against the demands of media activists and others who continually advocate against carding and other police polices that are valuable public safety measures used in protecting the public at large in these precarious times.

Watering down by strangling the public’s essential rights to public safety by restricting the policy of carding for all, through a policy of speech precondition interaction by police, is wrong.

We all enjoy the right to remain silent after being arrested for a crime. And in a civil and free society it is also our civic duty to openly cooperate and respect a non-confrontational link between police officers doing their duty as members of the community to serve and protect us all.

No individual or groups has the right to claim ownership of a city or community as Shawn Micallef of the Toronto Star would have you believe. Crimes of murder, theft, sexual assault, robbery, break and enter, stolen vehicles, drug charges etc are hourly reported throughout the city and communities. 

These daily occurrences of breaking laws by individuals, regardless if their skin colour is red, white, blue, purple, black, green or yellow, necessitates the occasional arbitrary stops and sometimes intrusive questions of residents on our streets. And remains a very valid policy of public safety in protecting and serving citizens, residents and tourists within Toronto.

Toronto’s pressure group activists vows of going to court if THEIR reforms for police carding practices are not implemented by duly elected officials should be a clear indication to law abiding citizens just who is attempting to be the puppet master of policing and public safety in our communities!

Watering down by dismissing the public’s essential rights to public safety with a policy of speech precondition interaction by police is wrong.

Source:

http://www.thestar.com/life/2015/04/17/police-carding-policy-has-made-this-column-a-sham-micallef.html

http://www.thestar.com/opinion/editorials/2015/04/15/carding-reform-should-be-left-to-torontos-next-police-chief-editorial.html

Sanctions a Cowards Declaration of War and Insincere Approach to Diplomacy

Should the USA supply arms to the Ukraine government in addition to sanctions already applied against Russia, which is itself a form of a declaration of war, could lead not only Europe but the US itself into a nuclear WW3.

The U.S. has imposed sanctions, unilaterally or with other nations, far more frequently than any other nation in the world, or any multinational body in the world, including the United Nations.

Economic sanctions violate Just War principles and do not affect a country's military power but rather directly affect a nations citizens.

Sanctions do NOT protect the innocent life of civilians or preserve conditions necessary for decent human existence and definitely do not secure the basic human rights of a nations people.

Further on the basis of proportionality the damage inflicted by sanctions is far greater to the populace of a nation than questionable offenses being avenged . And in no way do sanctions present any probability of success when the outcome of sanctions not being known shall be futile.

The EU by joining following the Americas and British sanctions against Russia have in effect declared an economic war against Russia.

Sanctions as a means of peacekeeping and international governance, effectively escape ethical analysis as we do not judge them by the same standards we judge other kinds of harm done to innocents.

Yet, concretely, the hunger, sickness, and poverty which are ostensibly inflicted for benign purposes affect individuals no differently than hunger, sickness, and poverty inflicted out of malevolence.

Using or describing sanctions as a means of "peacekeeping" or "enforcing human rights" is an ideological move, which, from the perspective of concrete national experiences throughout history, is simply counter factual.

Sanctions are, at bottom, a bureaucratized, internationally organized form of siege warfare, and should be seen, and judged, as such.

The EU and indeed the Americans perhaps have awakened the Russian sleeping bear and the world not just Europe this time is in grave danger of an all out nuclear war, thanks to sanctions and the arming of Ukraine with USA weapons.

Additional Info 

http://www.publications.parliament.uk/pa/ld201415/ldselect/ldeucom/115/11502.htm

http://www.publications.parliament.uk/pa/ld201415/ldselect/ldeucom/115/115.pdf