It is unfortunate that political agendas and ideology-driven policy dominate the healthcare debate in Canada. We can and should have better healthcare that is more accessible and more efficient. However, disingenuous arguments create obfuscation and make improvements harder.

1/
For instance, a significant amount of healthcare is already privately delivered. Most doctors’ practices are privately owned corporations. People don’t tend to debate whether or not this is the ideal structure. But it shows we can and do have some private delivery.

2/
Of course, this doesn’t mean that private delivery works in all areas. I don’t know. Perhaps if the funding model is designed properly, it will. Perhaps not. Each service has unique aspects. But the debate doesn’t touch on the underlying facts.

3/
There is also an entirely separate debate as to who pays — public or private. We see across the world that there are many differences as to which services are publicly funded and which are privately.

4/
Most of the debate in Canada regarding public funding centres on how large a portion of government budgets goes to healthcare. To me, this is very disingenuous. The goal should be how much *people* are paying for healthcare through taxes and privately funded care.

5/
The argument for pharmacare, for instance, is that the increase in government spending would be more than offset by reduced private spending. Taxes would go up, but not by as much as people would save from what they had previously spent on prescriptions.

6/
Unfortunately, the debate is rarely about what model delivers healthcare at the lowest overall cost to Canadians. Instead the public vs. private argument is ideologically driven and masked in political spin.

7/
Another major issue is equity, or access to healthcare. There is a significant demographic who have additional health and dental coverage (generally through their work) and can generally afford most health needs that come their way.

And then there are the less fortunate.

8/
The demographic least able to afford certain privately funded health services are often disproportionately in need of those same services. Mental health, for instance, is correlated with income.

9/
Publicly funding these services would mean that the “middle class” would likely see a tax rise greater than their current private health premiums as the taxes on the less fortunate would be much less than the costs of delivering that care to them.

10/
Politically, people like equity if they don’t have to pay for it. Yes, we will (almost) all *say* that we are willing to pay a bit more so that others can benefit. But when April 30 comes around, we grumble about how much our taxes are and how little we seem to get for it.

11/
The above is already a very simplified version of some of the key debates that needs to happen on healthcare.

But we aren’t even doing that. And because of this, we aren’t getting the healthcare we need and deserve.

12/
I cynically (realistically?) expect that the @Alberta_UCP policy will not further the debate that needs to happen. Instead, I fear that it will further that ideological fight, pitting those privileged with good health and incomes against the less fortunate.

13/
I hope that one day I will be wrong, that Canadians will increasingly be having a real conversation on the real issues regarding healthcare and do so without partisan spin, to the point where they demand politicians do the same.

/fin

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More from @tim4hire

17 Oct
By “sitting on it”, @jkenney presumably means “taking the time required to fulfill the duty to consult Indigenous peoples, which is more complicated to do during a global pandemic.”
The only way a pipeline is provincial jurisdiction is if it is entirely intraprovincial. Any pipeline that crosses a provincial border is federal jurisdiction and always has been. There is no ‘bringing it back to provincial jurisdiction’ unless you’re only shipping it to Airdrie.
Your perennial reminder that Alberta already had the lowest corporate income tax rates prior to the UCP tax cut and has the lowest overall taxes of all provinces (and no sales tax).
Read 12 tweets
29 Sep
@ChipPitfield @PierrePoilievre Debt is issued in other currencies de temps en temps because it allows governments to optimize its debt management strategy and keep interest costs as low as possible. This matters much more than having the option of inflating our way out of debt (which has some downsides).

1/
@ChipPitfield @PierrePoilievre Provided nominal GDP growth > the effective interest rate on the government debt, the government can run a (modest) primary deficit without increasing the debt/GDP ratio (which is the main determinant of how manageable the debt load is).

2/
@ChipPitfield @PierrePoilievre Note that even as the bank rate begins to rise, the interest charged on government debt will not rise as quickly because a significant portion of the debt is in longer-term bonds, which will not need to be refinanced until they mature.

3/
Read 5 tweets
28 Sep
This. The fact that people are even willing to consider a nomination right now tells me that the US is broken. Responsible government does not exist.

1/
By way of contrast, in Canada, the caretaker convention would apply. This close to an election day, no government would appoint a Supreme Court Justice. No one would propose such a thing. In short, it would literally be:

2/
Note that the caretaker convention, like all constitutional conventions, isn’t a law. No court would stop a government if it sought to break the convention.

Nevertheless, it is a principle that all politicians treat as binding.

3/
Read 5 tweets
27 Sep
Every infection is terrible. But the ripple effect is huge, and policy makers need to think beyond just the absolute number of cases.

1/
Assuming a 1% positivity rate is maintained, it means 99 children are tested and found negative for every child with COVID-19. Each case thus implies 100 more people at overcrowded testing sites.

2/
None of those 100 children can attend school or daycare until they have been tested and get a negative test result. It can be days before a parent can get that child tested, and only a minority of test results are available in 24 hours.

3/
Read 7 tweets
21 Sep
<thread>
As the situation in Nova Scotia escalates with settlers opposing Mi’gmaw engaging in a lobster fishery, I thought I might share a brief and limited overview of the Mi’gmaw rights determined by the Supreme Court of Canada.

1/
21 years and 4 days ago, that Court issued a landmark ruling in respect of a Mi’gmaw fishing for eel during the closed season (R. v. Marshall, [1999] 3 S.C.R. 456). The a Court confirmed that a treaty right to fish existed and this included a right to trade.

2/
Settlers not being any happier about that decision then they are about the current lobster fishery actually sought to have the Court reconsider its decision. The SCC clarified its original ruling (R. v. Marshall, [1999] 3 S.C.R. 533) two months later, but upheld its decision.

3/
Read 25 tweets
10 Sep
You’re right. Giving women the freedom to choose whether or not to be in the work force is not something that can just be measured in dollar and cent terms. The value of human dignity and right to make these self-determinations are worth much more.

1/
But recognizing that governments can not afford to do everything that everyone wants, it is useful to calculate the economic returns of investing in childcare and other measures that allow more women to participate in the labour force. And economists have done this.

2/
The good news is that these investments provide huge economic returns. Indeed, there is evidence that the net cost to the government is nothing as the returns from these investments result in higher taxes from higher incomes that more than offset the cost of the programs.

3/
Read 5 tweets

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