🧵Today @SPHERUsask hosted a wrap-up luncheon for our community partners in the @RuralDementiaSK initiative that we began nearly 5yrs ago. I've never worked on a more meaningful research & evaluation project in my nearly 30 year career. I want to tell you a bit about it ... 1 Armed w $$ from ESDC (aka the feds) we set out to fund community-based organizations (CBOs) in Yorkton, Melville & surrounding rural communities to deliver interventions aimed at reducing stigma & increasing social inclusion of people living w dementia & their care partners ... 2

By refusing to end it's private-pay MRI scheme [scam?] in the face of federal transfer deductions, #skpoli has become the first province to declare that it effectively no longer supports the principles of the Canada Health Act. 1/7 The CHA explicitly forbids provinces either directly or indirectly allowing patients to be charged for insured services and allows Ottawa to deduct such charges from a province's allocation under the Canada Health Transfer. 2/7

Saturday thoughts on a week in Cdn health care: Money, Reform & Politics. Let’s start with the $$. Whether you believe the health care system is woefully underfunded or whether it needs more reform than cash, it is undebatable that the feds have not been stingy w the cash. 1/20 From 2004-17 the CHT grew 6%/yr (2-3 X inflation rate). The 2004 Health Accord also gave additional billions for wait times reductions, human resources, home care, drug coverage, primary care reform and a host of other reforms promised by the provs. 2/20

As premiers intensify demands for increases to the health care transfer from the federal government, provincial publics need to make it clear that they too have demands. I can think of at least three things that should come out of the FPT negotiations: 1/8 First, provinces should provide clear plans as to how and where the money will be spent. These have to go beyond things like "we'll fix primary care" and clearly outline HOW they'll fix primary care (or wait times or whatever is their priority) 2/8

There's an old joke in politics that when someone says, "It isn't about the money", you know it's ALL about the money. So what does it mean when a premier describes the health care situation in Canada as being "all about the money" as BC Premier @jjhorgan did the other day? 1/9 First off, it shows that Horgan doesn't understand the situation with the health care systems in Canada very well at all. Yes, COVID threw the systems a series of curve balls that have done real damage. But simply opening the spending tap won't solve them. 2/9

The SK premier insists that the Lib-NDP confidence and supply agreement will increase western Canadian alienation. Presumably because it further weakens western voices in the federal government. Once again, the Premier’s arithmetic seems to be off … 1/X If we assume by “the west” the Premier means AB, SK and MB then there are 6 Liberal MPs from “the west” (and 21 if you include BC). By including the NDP in agenda setting that number increases to 11 (and to 39 if you include BC). 2/X

A thread 🧵on the Sask govt’s plan to reduce our surgery backlog. The plan is to contract private surgical facilities (some of which may need to created or expanded) to provide these services which would be paid for by the province. 1/20 These surgeries would presumably be the “easy” ones. Those that are relatively low risk and carry less need for post-op care. This leaves the more complicated, riskier and more care intensive surgeries to be done by the public system. 2/20

1/x Possibly a long thread: While @SLangeneggerCBC's interview w the premier this a.m. was great, there was another aspect of @CBCSask's recent coverage that is more problematic, namely the request that the govt release Dr. Shahab's specific advice to the govt on the pandemic 2/x This is a problem because Dr. Shahab is a civil servant (as was I many moons ago) and the idea that the government would release the advice of a specific civil servant goes against the very bargain that underpins the govt/public-service relationship.

While getting a flu shot a few days ago I had an interesting conversation with a colleague. He is a conservative voter (yes, they exist in the academy & are not nearly as rare as other conservatives would have you believe). Yet he told me he was "done" with the SaskParty 1/8 Since its inception he had gladly donated regularly to the SaskParty and consistently voted for SaskParty candidates. He was, generally, happy with the accomplishments of the Wall and Moe governments. But he can no longer abide their handling of the COVID-19 pandemic 2/8

As First Ministers meet to discuss health care financing, let's explore the demand from the premiers that the feds raise their share of the cost of medicare from 22% to 35% (abt $28B/yr). The demand fundamentally rewrites & misunderstands the history of health financing 1/20 The premise of the demand is simple. Once upon a time the federal gov't contributed 50% of the cost of medicare, now it contributes only 22%. The provinces, it seems, are being generous by requesting that the feds need only raise their share to 35%. 2/20