We all have Alzheimer’s when it comes to health care

Each time I go to a medical clinic, it’s like they don’t recognize me and have never seen me before.  And the hilarious part is I don’t know them either.   This is not a huge problem as I’m an extravert and make friends easily.  However, I really do feel strange asking someone I don’t know to give me a prostate exam but that’s your life when you don’t have a family doctor.

Today, I can’t say the health system is working for me.

The documentary by Michael Moore entitled “Sicko” compares the health systems of the US, Canada, the UK, Cuba and France.   Moore’s analysis makes for good entertainment and perhaps opens the eyes of a few American viewers on the deficiencies of their health system.  His portrayal of the Canadian system is generally on the mark although there are inaccuracies with emergency room wait times and access to primary care.

Statscan figures show that 8.2% or 61,500 New Brunswickers don’t have a family doctor.  We presently have 700 family doctors or 1 for every 983 people.

The Minister of Health Mike Murphy plans to hire another 15 doctors, which would be 1 doctor for each 4100 of the 61,500 citizens presently without medical representation.  Hey, what’s wrong with the math here?  Are we hiring enough to solve the shortage or just enough to lower the political heat?

The annual health budget for New Brunswick is $2,933 per person or $2.2 billion.  As a country, we spend about 9.8% of the Gross Domestic Product (GDP) on health care (NB is 8.8%).  We’re in the middle of the pack when looking at what some countries spend; Ireland –7.2%, France – 11.1%, Germany – 10.7%, with the US being considerably higher at 15.3%.

What has concerned all national governments over the years has been the continual increase in the cost of health care above the rate of inflation.  In other words, the health budget chews up more of the government revenue leaving less for other departments.  The US system is trending towards 20% in coming years and I don’t think that country or New Brunswick can or will accept costs of that magnitude.

The increase in costs comes from more high technology (MRI’s, etc) and what is often called “mission creep.”  That’s a change in our expectations of what the system can provide.  Only a number of years ago, open-heart surgery or hip replacement wasn’t that common.   Longevity of people is on the rise and a significant portion of the budget is spent on people who will live less than a year.

Even though the Canadian system has a lower cost due to reduced administration, it is encouraging to see the Health Departments 2008 – 2012 plan.  It’s a road map for providing better health care with less cost.  A notable initiative is the use of computer technology to manage patient care (one patient, one electronic record).
Consolidation of regions and non-clinical services should provide less back office cost and focus money back on patient care.  This saving is approximately 1% of the total health budget or $20 million per year.

It appears that efficiencies can give us some respite in increasing costs, but it will not be enough.  Are we prepared to set an upper limit on our health costs to perhaps 11% of GDP?  That would be another $550 million per year in New Brunswick.  It might eliminate wait times for surgery, provide more MRI’s and the like, but what else in the overall provincial budget would we cut?  Or would we be prepared to raise taxes to live longer, healthier lives?

But perhaps our future won’t be increasing budgets for health care but cutting them.  The fragility of our financial system to something as ridiculous as sub-prime mortgages shows that the economist’s assumptions of perpetual growth is not entirely certain.  The decline of the world’s commodities like oil production in the near future will have a profound effect on GDP.  It will shrink the tax base that supports the health care system we so cherish.

Should we be planning for a future that is less rosy than the optimists of this world predict?   As an aside, there are 45 million Americans who could be looking for a family doctor in Obama’s insured world.  Maybe I’ll get a doctor before they come looking for 45,000 doctors north of the border.  I doubt they’ll be talking to Raoul Castro about Cuba’s surplus medical talent.


Why the Green Party is out-greening the NDP

I didn’t know jack about Jack Layton and that’s not right.  A citizen should make an informed decision on who’s right for them.  At least that’s the theory.  But I float over the surface of life because there is so much information to absorb.  Jack, I did like your “new kind of strong” advertisements.  It brought me back down to earth and I’m listening.

The 2008 NDP platform proposes the development of high-speed train links in the populated corridors like Quebec to Windsor and Edmonton-Calgary.  Wonderful!   He also supports better public transport through a 1-cent gas tax.  Sounds like a carbon tax to me.  Not that there’s anything wrong with that.

Jack suggests that a Canadian Renewable Energy Agency would promote 35% renewable energy by 2020.  This includes “new financial incentives for clean power, including from solar, wind, water, biomass and other renewable sources for electricity production and from industrial co-generation and small-scale, sustainable community facilities.”  Also, the NDP suggests promoting the zero emission and high efficiency cars by working with manufacturers.

Another interest of the NDP is energy security and environmental considerations being number one priorities in any new trade negotiations.  They also want to slow down development of new tar sand projects until the environmental problems and CO2 considerations are dealt with.  The New Democrats would promote the processing, refining and petrochemical development of oil in Canada for job development.

From their platform comes a remarkable statement. “We must plan now for a future where our energy consumption is drastically reduced and where all our energy comes from renewable sources.”  This is a politician telling you the truth about your energy future – oil will decline and we need to adapt.

Of course, it makes perfect sense that non-renewable sources will eventually decline.  But few politicians want to be the bearer of bad news or to utter that incendiary four-letter word “peak” when describing oil.  Jack Layton gets a “B+” rating for his energy platform that confronts directly the challenges we will see in coming years.  Jack said no to a carbon tax in favour of a cap and trade system.  Some call it an opportunistic approach to vote getting.

Can you identify what party makes this statement?  “We acknowledge that human society depends on the ecological resources of the planet, and must ensure the integrity of ecosystems and preserve biodiversity and the resilience of life supporting systems.”  If you thought Green Party, you would be right.

The Green party, in 70 countries around the world, has some similarities with the NDP but the Greens go back to the basics of life and develop policy through a number of basic principles (Social justice, ecological wisdom, non-violence, participatory democracy, sustainability, and respect for diversity).

The leader since 2006 is Elizabeth May, a longtime environmentalist, writer and lawyer. On energy, the Greens favour a carbon tax like the Liberal plan. The green vision includes cuts in income, payroll taxes and provides rebates to make the tax shift fair to various sectors.  Corporate tax is reduced when companies reduce carbon emissions, which provides them a double benefit. A cap and trade system is implemented for large emitters.

She supports increased rail and green urban transport, promotes local agriculture and the 200-kilometer diet as well as community gardens.  Her party would “launch a plan for Canada’s Green Century, with a commitment to make Canada one of the most energy-efficient, sustainably powered nations in the world.”

All buildings in Canada would have an energy retrofit by 2025 and new buildings would net zero energy construction after that date.

The Green party positions itself as being fiscally conservative with a goal to eliminate the national debt.  According to May, it is the only party that “grasps the future… at the end of the Fossil Fuel Era, we are emerging to a new reality….that the greatest threat to our security does not come from foreign terror cells and criminal elements, serious as they may be, but from our addiction to fossil fuels and the clear and present danger presented by the climate crisis.”

Elizabeth May’s straight honest approach attracts me.  I would give her an “A” rating for the very detailed Green energy platform.  Although I may not agree with every item they propose, the website makes fascinating reading.  Her rise to prominence has been due to her performance in the debates and is an indicator of dissatisfaction with the present government.

Polls show only a little better than a third of Canadians want Stephen Harper, which means a clear majority of Canadians do not want Stephen Harper.  Together the Greens and the NDP have almost a third of the voters.  Our electoral system ensures that the split among the opposition is of advantage to the Conservatives in the same way that the PC’s and Alliance split the right wing vote in years prior to the 2003 merger.

As difficult as it may be to contemplate, there are some ridings (closely contested in 2006) where voters, who want a better energy policy than the Conservatives offer, may vote strategically.  This include Tobique-Mactaquac, Fredericton, Madawaska-Restigouche, and Miramichi.

The people of Canada have several credible choices this year with respect to solving our energy problems.  Recent events in the financial world indicate how fragile our global economy is.  It’s evident that different policies are required to make our system more resilient and stable.  Review the platforms.  Your vote on October 14 is important to your future.  Can you afford to miss it?

How do the Liberals rate on Energy Policy?

Looking back in history to December 1979, Joe Clark was the leader who introduced a tax of 4 cents a litre as a measure to balance the budget.  His minority government lost on a non-confidence vote and the Tories are defeated in the 1980 general election.  The lesson is burned into the political brain trust of all parties … must not have tax increase just before election.  And sometimes, smart governments cut taxes to win votes.

Fast forward to 1996, when Stephane Dion transitions from university professor to minister of intergovernmental affairs.  One of his accomplishments was the “clarity bill” setting the conditions for Quebec referendum questions and separation negotiations in clear and unambiguous terms.    From 2004 to 2006, he was environment minister and from accounts of independent observers, did a credible job.    Recently, he became leader of the Liberal party.

The 2008 Liberal platform consists of some interesting energy commitments – to retrofit 50% of all homes by 2020 and 100% by 2030.  Provisions for doubling financial incentives and a zero interest $10,000 green mortgage for major energy improvements like geothermal and solar are all good steps.  They want higher energy standards for the National building code and for all appliances to ensure that “all new builds are green builds.”

A Stephane Dion government also proposes strong enforcement of the post 2010 fuel efficiency standards and improvements in car-scrapping programs to increase efficiency of existing cars.  $250 million is suggested for a Green fisheries and Transport fund encouraging public transport initiatives.  In addition, he proposes a 10% reduction in the carbon content of fuel by next generation bio-fuels.  Unfortunately, this part of the program to be weaker and less defined than I would have liked.

The amount of electricity generated by low impact renewables would rise from 5% to 10% by 2015 and to 15% by 2020 causing large investments and 10’s of thousands of green energy jobs.  But these items have not been getting as much attention in the media as the “greenshift”.

The leader of the Liberal party has suggested a remarkable change in the way that Canada views pollution. This is proposed by a reform of tax policy – increasing taxes on carbon energy sources and lowering income taxes.

In the past, companies have caused pollution without penalty or in the worst cases, were ordered to install pollution abatement equipment.  With this change, a stronger link is made between corporations and the environment.  Pollute with carbon energy and you will pay a fee.  The fee is then rebated to citizens and this makes alternative renewable energy more competitive.

The Conservatives have been accused of confusing Canadians about Stephane Dion’s “green shift” which transfers taxation from income to carbon.   The Tory “tax grab” attack seems unusual in light of the plan’s promise, “ putting it into law that every dollar raised in pollution taxes be returned to citizens in tax cuts.  The Auditor General will ensure the Green shift’s revenue neutrality.”

A second Tory theme, that the plan will destroy the economy, seems exaggerated as well. One blogger humorously notes that if the “greenshift” plan would destroy the economy, then the opposite, to raise income taxes and lower carbon taxes, should create a boom.

Lowering corporate and personal taxes, as the “greenshift” suggests, is similar to the Conservative mantra.   Taxes on fuel in Europe are $1 a liter higher than here without serious harm to the economy.  This plan leaves the gasoline tax without change.  Furnace oil would increase gradually and be a total of 8.5% higher by the fourth year. Diesel would increase 7 cents by the fourth year, a 5% increase.   Finally, it is likely that a world cap and trade system will eventually surface with all countries participating.  Trade sanctions will ensure that all play their part.

Canadians seem to want leadership to reduce global warming and to adjust to higher energy prices as peak oil arrives.  But is reality different from the perception?  The Liberal plan is actually quite modest in comparison to the size of the economy or the government’s operating budget.  Are Canadians ready to accept real change, however gentle it may be?  Stephane Dion has proposed wide-ranging solutions that rate a “B” on my energy scale.  The plan is incomplete in terms of national energy security, but it is courageous and forward-looking.

There are real differences being offered to Canadians this election.  Voters can easily compare the platform of all parties directly off the Internet and should do so.  Stephane Dion’s clarity in energy policy is one of his advantages in this campaign.

His refusal to follow Harper’s lead and spend huge sums on Arctic patrol vessels is an example of the different thought process among leaders.  As he noted “We can’t win against the Americans, we can’t win against the Russians, and we’re too civilized to shoot the Danes.”

Prior to George W. Bush’s tenure, the United Nations was the primary arena for discussion or international arbitration of differences.  When common sense returns, the UN will regain an important role in meeting the challenges to come.  World co-operation on adapting to declining energy supplies and carbon reduction steps are the answer.