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Showing posts from October, 2011

Attacks on arbitrators and arbitration

The failure of their advocate in the provincial election, Tim Hudak, has not stopped critics of interest arbitrators.

Today the Windsor Star (a long time critic of public sector unions) attacked not just interest arbitrators, but also Dalton McGuinty (who opposed 'finagling' with the arbitration process during the election).

The Star said arbitrators "might as well be senators" and suggested an arbitrator "thumbed his nose" at the government.

A hospital boss also got in on it.  Annoyed about an interest arbitration award, David Musyj, the boss of the Windsor Regional Hospital said, "Something has to be done to fix the system. The arbitration system is broke and continues to be broke."

The Star adds "Of course it is. That goes without saying. It's been broken for years."

In fact, this was a significant point of dispute during the election. Hudak's Progressive Conservatives advocated policies on public sector bargaining and in…

P3 hospitals in decline (but Ontario keeps at 'em)

The British Construction Products Association (CPA) is forecasting a 30 per cent fall in health sector construction work this year, followed by a 15 per cent fall next year, with further declines in 2013 and 2014.   Health construction work is expected to fall from a peak of around £5.2 billion in 2008, down to £2.4 billion in 2014, even adjusted for inflation, industry paper H&V News reports. Kelly Forrest, CPA senior economist, put the collapse down to uncertainty over public private partnerships (P3s or, as the British refer to them, private finance initiative or PFI) . P3s have been harshly criticized in recent months in Britain, with the National Audit Office and Parliament’s Treasury Select Committee calling them out, among others “We think it will be a while before PFI returns to the health sector,” said Kelly. Ontario, meanwhile is still officially planning to expand its use of P3s for hospitals.

Occupy Wall Street takes on health care for the 99%

Occupy Wall Street has taken on privatized U.S. health care.  Here is a short clip on work leading up to an October 26 Occupy Wall Street march "Get Wall Street Out of Our Health Care."

The Occupy movement is changing the terms of the debate in the USA and Canada.  And it is great to see them take on the mess of privatized U.S. health care and building health care for the 99%.  To keep abreast of the Occupy Wall Street work on public health care and to see videos from the October 26 Occupy Wall Street health care protest, check out this blog: Healthcare for the 99% – Occupy Wall St Working Group

Are hospitals investing in support services to fight superbugs?

"The cuts in the 1990s certainly had something to do with the decision to cut support staff because they were not a priority and cuts had to be made. I think we now know it was a mistake and we are starting to reinvest in those basic services."

This is taken from recent comments on hospital acquired infections to the the Standing Senate Committee on Social Affairs, Science and Technology by Senior Scientist, Dr. Michael Schull. Dr. Schull was representing the the Institute for Clinical Evaluative Sciences. ICES is an independent non-profit corporation that uses information derived from health administrative records to assess the performance of the Ontario health system. They are, however, funded by the Ministry of Health and LTC.

While there has been some signs of reinvestment, it is far from clear what the ongoing trend will actuallybe.  The government plans to squeeze hospital funding and it would be far from surprising if support services are not sacrificed once again.

If 83% bed occupancy is too high what about 98%?

A leading Welsh doctor has warned of hospital bed cuts. Dr Richard Lewis, Welsh secretary of the British Medical Association, said the bed cuts could put patients at greater risk of catching a serious hospital infection.

Dr Lewis told the Daily Post, “we know patients are still waiting on trolleys to find beds; elective surgery is being cancelled because of pressure on beds." Calling the cuts "unacceptable," Dr Lewis added, “There’s a clear link between hospital-acquired infections, the overcrowding of beds and high bed occupancy rates.”

According to the most recent government figures, Welsh hospital bed occupancy is 82.5%. The government reports 13,116 hospital beds in Wales,  or one bed for every 229 people in the nation of just over 3 million.

That however is far, FAR better than in Ontario, which is running at an astronomical 97.9% bed occupancy (after the elimination of about 18,500 beds, one-third of the total, since 1991). With 30,810 beds and 13,210,600 popu…

One more failure of privatized health care

Many older people in Ontario are not getting adequate oral health care according to a new study on older women's health:
"Close to half of older adults (45%) did not visit a dentist in the past 12 months. This percentage rose in the older age group to more than half (55% of women and 54% of men aged 80 and older).  This is particularly important because dental services are not funded within our health care system. Accordingly, access can be related to socioeconomic status." The study  adds: "Good oral health is a prerequisite for good nutrition and poor oral health is associated with an increased risk of a number of chronic conditions."

It concludes: "Access to preventive dental care is important for maintaining health and nutrition. Dental care is an example of a service that is not universally accessible in our existing health care system. Those without private insurance or those with lower socioeconomic status may not be able to afford this service. Po…

Free collective bargaining: Posties win first step

An important victory for workers (like Ontario hospital workers) who are required by law to resolve contract disputes through interest arbitration rather than strikes or lockouts.
Following the lock-out of postal workers by Canada Post earlier this year, the Harper federal government introduced legislation that unilaterally appointed the arbitrator. However, the arbitration process only works if both employer and union agree on the arbitrator. The Harper government appointed a judge without any experience in arbitration.
This is similar to what the Mike Harris government tried to impose on Ontario hospital workers in the 1990s. OCHU/CUPE had to fight this off for four years, before getting an experienced arbitrator acceptable to both parties.
A federal court judge has granted the Canadian Union of Postal Workers (CUPW) a stay of proceedings. The arbitration will now stop until the union's challenge to the hand-picked arbitrator is heard in January.
CUPW is also challe…

Private sector bosses getting twice the pay increase of public sector workers

The Conference Board of Canada predicts that non-unionized salaried employees will get 3.1% salary increases in 2012, despite our economic troubles.  This is up from 2.7% in 2010 and 3% in 2011.

Private sector salaried personnel are leading the way, with projected increases of 3.2%, while salaried public sector employees can look forward to only 2.6% increases.

In contrast unionized workers can expect just 2% in 2012, according to the Conference Board.  Private sector increases will be a little higher at 2.3%, while public sector increases will be lower at 1.5%.    Union increases were also well below what the non-union, salaried class got in 2010 and 2011.  Public sector union settlements were especially low, averaging 1.6% in 2010 and 2011.

While the salaried class are predicted to get an (uncompounded) increase of 8.8% in 2010 through 2012, public sector wage settlements are predicted to get just over half of that (and well less than inflation).

But many right wing commentators dogg…

$50 million superbug law suit claims hospital not properly cleaned

A $50-million class action lawsuit has been certified over a deadly outbreak of C. Difficile at Joseph Brant Memorial Hospital in Burlington, the Hamilton Spectator  reports.

"That's a positive step in the process," said Hamilton lawyer Stanley M. Tick, who represents the claimants with Windsor lawyer Harvey Strosberg.

The lawsuit alleges that Joseph Brant Memorial Hospital was not properly cleaned, maintained and disinfected. None of the allegations have been proved in court. The Spectator notes that "in the years since the outbreak, the hospital has significantly changed procedures and cleaning protocols, invested heavily in infection control, and made other changes recommended by experts."

The superbug overran the hospital from May 2006 to December 2007. But the full extent of the infection was not known, or made public, until the spring of 2008, after a review by expert outsiders.  The hospital announced that 91 infected people had died. About 225 caught C. Di…

Niagara Hospital superbug protection: $1 million annually

Health Minister Deb Matthews has told the Niagara Falls Review that although the C. Difficile outbreak at the St. Catharines General hospital has (finally) ended, not much is going to change at Niagara's hospitals. Many of the changes introduced to cope with the outbreak -- from restricted visiting hours, increased cleaning and hand washing, and daily staff meetings -- will remain in place. "This is the new normal," Matthews said.

Matthews added that it cost the Niagara Health System approximately $1.5 to $2 million to cope with the outbreak.  Maintaining the outbreak measures going forward will cost about $1 million annually, she said.

More on the costs of not improving hospital housekeeping tomorrow.

Wal-Mart increases health care premiums 36%, cuts part-time coverage

The rolling disaster of privatized health care in the USA was borne out again, this time with Wal-Mart.  Market Watch reports Wal Mart is increasing its health care premiums by about 36 percent and will stop offering health care benefits for new part-time employees. 

Reuters adds that Wal-Mart is also cutting its employees' health care expense accounts by 50%, providing just $250 for single employees for uninsured expenses, down from $500 (and $500 for families, down from $1,000).
Wal-Mart currently insures 1,000,000 employees.  
Wal-Mart spokesperson said,  "Our country needs to find the way to reduce the cost of health care particularly in this economy. The current health-care system is unsustainable for everyone. Like other businesses, we’ve had to make some tough choices.”
Large increases in premiums for employer-based health care plans is the norm in the USA, as is shrinking coverage and a shrinking number of people covered.  Privatized health care is no solution for Canad…

Windsor hospital bed backlog: the wages of P3s

An ongoing shortage of acute-care beds in Windsor forced 22 patients to wait in the emergency room at Windsor Regional Hospital on Thursday and threatened to cancel elective surgeries, the Windsor Star reports.  The hospital is running at 103 per cent bed capacity, according to hospital CEO David Musyj.

"For hospitals to run at their best they should be at 90 per cent capacity. Anything over that and the staff burn out" Musyj noted.

The Local Health Integration Network claims it has added extra beds to deal with the long standing bed shortages in Windsor, citing 26 new complex-care beds at Windsor Regional, 60 interim long-term care beds at Leamington Court Retirement Home, and 16 new short-stay beds at Hotel-Dieu hospital.

MPP Taras Natyshak (NDP-Essex), said the Liberal government should have moved faster to redevelop the former Grace Hospital site into a longterm care facility. 

 A long term care public private partnership (P3) on the old Grace hospital site failed after long…

Government passes buck for private clinic infections

Ontario Health Minister Deb Matthews has refused the suggestion by a health expert that the province should take on responsibility for overseeing private clinics. Her comments to the Ottawa Citizen follow the disclosure that 6,800 patients would have to be notified that faulty infection control procedures at a private clinic in Ottawa could have exposed them to HIV or hepatitis.

 Matthews said she was not planning on taking over that responsibility through her ministry, the Citizen reports. "Government can't do everything.  A professional (regulating body) like the College of Physicians and Surgeons, they take responsibility for their members."

 "At this point I am delighted the College is taking that responsibility seriously and has found a problem that we need to fix." 
The Citizen reports that roughly 270 private clinics in Ontario exist without being subject to the same sanitation and infection-control standards as hospitals.  However, following the 2007 de…

Nova Scotia is cutting hospital spending 3%

Nova Scotia has told its district health authorities (DHAs) that it will cut their budgets three per cent next year.   The government already flat-lined DHA budget this year.

The DHAs deliver health services in Nova Scotia, including hospital, community health, mental health, and public health services.

Health and Wellness Minister Maureen MacDonald believes the budget cut presents an opportunity for the DHAs to improve efficiency through collaboration, reports. "We have to do things differently and ask whether duplicating programs and services across the province still makes sense.”

The DHAs are less enthusiastic.  “We can never promise absolute lack of disruption to our patients, to our staff, services, and so on,” says Amanda Whitewood, the chief financial officer of the Capital Health District in Halifax. Her DHA has had to reduce its spending by $11.3 million or 1.4 per cent this year to compensate for the budget freeze and inflationary pressures. With …

C. Difficile: outbreaks went up but cases went down?

As reported earlier here, the publicly reported incidence of C. Difficile in Ontario hospitals hit a 22 month high in May.  

But it was not until June and July that we saw a surge in reports of outbreaks of C. Difficile.   One outbreak was declared at the St. Catharines General Hospital May 28 with twelve cases confirmed.  Another nine hospitals declared outbreaks in June and July.

So it is, perhaps, odd that the rates reported to the public by hospitals in June and July were lower than in May.  According to the reports from the hospitals, the rate of infection was not much higher than average, even while ten hospitals reported C. Difficile outbreaks.

The reported rate went down again in August to 0.32 cases per 1,000 patient days, with 266 cases reported.

Are private clinics well versed in sanitization?

"When you get into the private clinics and facilities of that nature, it appears we don't have the same kind of oversight and regulatory environment as hospitals," Douglas Angus, a health economist and professor at the University of Ottawa's school of management told the CBC.
Infection concerns were raised this past week when 6,800 people were sent registered letters informing them a private clinic in ottawa didn't always follow infection prevention and cleaning protocols for endoscopic equipment.
"I look at this [the Ottawa clinic situation] as a wakeup call and I would think governments across the country should be saying that this is something we should be taking a careful look at," says Angus.
Dr. Michael Gardam, director of infection prevention and control with Toronto's University Health Network, told the broadcaster that "if you're opening a clinic, the onus is on the owner of the clinic to make sure they follow proper sanitation pract…

Two peas in a pod? Hudak calls for Drummond's unvarnished opinion.

Progressive Conservative leader Tim Hudak has weighed in on the upcoming report on public services from Bay Street "1 percenter"  Don Drummond: "Here's a concern I have: I want it unfiltered. I want his direct honest advice on how to control spending so we don't keep doubling the debt. I worry if we don't get it directly, it might get edited. I want the unfiltered facts."

"I worry the government may not like everything in Mr. Drummond's report. The government will ultimately control how this report is released."

Hudak (who spent time during the election calling for the privatization of public services while also attacking unions, public sector wage settlements, and interest arbitration) apparently believes that Drummond's unvarnished opinions will serve his ends. 
That does not sound good.  But given Drummond's long Bay Street background, it is probably just about right.
Hudak has written Drummond and asked for a meeting, QMIrepor…

Top 10% take ALL income growth 1971-2008

The Economic Policy Institute has put together an amazing, interactive chart on American incomes, which allows you to see who got what over different time periods from 1917 until 2008.

For the period before the rise of the US industrial labour movement (1917-1936), the top 10% took all of the average income increase.

But during the rise of the U.S. industrial labour movement from 1936 to 1971 the top 10% of income earners got 29% of total income growth, while the bottom 90% got 71% of income growth.  Still far from fair, but better than before -- and after.

From1971 to 2008, a period coinciding with the decline of the US labour movement, the top 10% of income earners got 100% of income growth, while the bottom 90% saw a decline in their income!  

The decline in income wasn't because the economy got worse from 1971 to 2008 -- far from it.  Average income actually went up $9,965 per year.  It was just that the top 10% got ALL of the growth in income.

Even over the period 1998-200…

Private finance: transfering the risk (to the public)

A week ago, it became apparent western business and political elites were contemplating a €1 trillion bail out for the mess in the European banking system.  Then, by late last week, Bank of Canada president Mark Carney urged €1 trillion in funds or "a little bit more";  he was shortly followed by the British Chancellor who called for €2 trillion. Over the weekend the proposals began stretching up to €3 trillion.  Here is a report from London's Telegraph:  
Germany and France have now agreed the principles of a €2 trillion to €3 trillion rescue plan. Mr Osborne said they had just seven days to come up with “something quite impressive”.   Details will be thrashed out this week but there now appears to be consensus around the core measures – to increase the firepower of the eurozone bail-out fund (EFSF) from €440bn to around €2 trillion, to recapitalise the banks with €100bn-€200bn, and to devise a credible programme for Greece, including losses for private sector creditors…

Up to 6 P3 hospitals "not viable under any scenario"

With public sector austerity in Britain, the National Audit Office has reported 20 hospitals "are not financially or clinically viable in their current form." 

The report also indicates that British Department of Health advisers have found that  up to 6 of the 22 hospitals with public private partnerships (P3s) "were not viable under any of the tested scenarios" because of the scale of their P3 (or as the British refer to them "PFI") payments and other financial problems. 

The Audit Office reports that "tackling the financial problems faced by some of the most challenged (hospital) trusts will require direct intervention" by the government, including "addressing the affordability of PFI  schemes."  The Audit Office notes that the Department of Health now "acknowledges that external financial support may be needed for a small number of trusts with large PFI schemes." Conservative Health Secretary, Andrew Lansley, commented: “This…

Home care cuts in Durham, Scarborough, Northumberland, etc.

The Central East Community Care Access Centre (covering Durham, Northumberland, Peterborough, Haliburton, and Scarborough) reports a drastic decline in the amount of services it provided in its most recent annual report.

There was 199,000 fewer "units" of personal support provided than in the previous year. The personal support budget was cut almost $4 million.  Nursing was harder hit. Nursing visits were reduced by 250,000 "units" and  2,000 fewer clients were served.  The visiting nurse budget was cut by over $8 million -- a 19% cut. Physiotherapy service units were cut 28%.

Overall, Central East CCAC expenditures were cut almost $12 million, while its revenue actually increased over $7 million. In 2009-10 there was a significant deficit, so these cuts may have been made to make up for CCAC's debt.

With no guarantee of home care, the care you receive is driven by budget rather than need.

€1 trillion euros to ward off private finance crisis

Now even Canadian Finance Minister Jim Flaherty and Bank of Canada president Mark Carney are flagging the peril of a bank crisis in Europe (or, more accurately, a bank crisis starting in Europe).

The CBC reports "Flaherty has been pressuring his European colleagues to move faster on measures to shore up the cash reserves of the biggest European banks. Carney has warned the region is "extremely vulnerable" to recession if bank cash isn't adequate.  Those banks hold large numbers of loans made to Greece and other troubled governments, and the value of those assets could drop substantially should Greece default."

But, the CBC adds,  recent moves by credit rating agencies have underscored the need for action soon to prevent a loss of confidence from undermining the governments and banks of larger European economies:
On Thursday, Standard & Poor’s cut Spain’s credit rating for the third time in three years.Moody's Investors Service has warned Belgium its rat…

Failed P3: workers forced to take repeated wage cuts

The failure of a public private partnership (P3) long term care home in BC is driving down its workers wages once again. Our sister union, the Hospital Employees' Union (HEU) states:
At Parksville’s Stanford Place, more than 200 health care workers were told by an arbitrator that they must accept significant wage rollbacks and benefit cuts in order to keep the facility’s private operator financially viable.  The rollbacks take more than $1.25 million out of wages and benefits in each of the next two years and will leave some of the workers among the lowest-paid health care workers on the Island with wage cuts as deep as $3 an hour. The HEU opposed the rollbacks arguing workers should not have to shoulder the costs for the operator’s failed business plan or the Vancouver Island Health Authority’s (VIHA's) failure to recognize that the public-private partnership (P3) was not viable.

Stanford Place was approved for construction by VIHA in 2006 as a P3 and opened in 2008. The Ah…

Radical changes in Ontario home care service

The Community Care Access Centre (CCAC) annual reports are beginning to roll out for 2010-11. While the reports are not exactly filled with informative facts, the Central CCAC report does contain at least one useful chart (p. 5) which provides a partial update on home care trends.

Personal Support
The chart notes that the number of hours of personal support work declined by 100,000 hours in 2010-11 compared with 2009-10.  In terms of total hours, that is a modest decline, but the number of clients assigned personal support declined much more sharply, from 22,049 to 16,884 -- a 23.4% decline.

This breaks with recent provincial trends.  Province-wide data to 2009-10 indicates a 19.3% increase in the hours of personal support over 2007-8. Is this a new trend for the province? We'll see.

Out of this data, the Central CCAC highlights the increase in the number of hours of personal support per patient. (This, I might add, is only a result of the large decrease in the number of patients w…

Troubled bank unit involved in Ontario P3s

A large part of the troubled assets of Dexia (the failing Franco-Belgian bank) are on the balance sheet of Dexia Credit Local, a French unit of the bank. Bloomberg reports the unit has €21 billion of Greek, Italian, Portuguese, Spanish and Irish sovereign debt.

Dexia Credit Local is also the unit of the bank involved in all four of the bank's public private partnership (P3) projects in Ontario. The Ontario P3s include three hospitals and a highway.

Standard & Poor's downgraded the credit ratings on three Dexia units, including Dexia Credit Local, on Thursday, citing the group's limited access to wholesale funding markets. The ratings are on credit watch with "developing implications", S&P said.

The French, Belgian, and Luxembourg governments stepped in over the weekend. Belgium will nationalize the healthy Belgian part of the bank and other parts will be sold off (e.g. Canada's RBC is in very advanced talks to buy out Dexia from their jointly owned c…

Britain moves to privatize health care services

Public health care is under serious attack in Britain, with the Conservative-Liberal Democrat government's "The Health and Social Care Bill".

Health unions vociferously oppose the Bill. UNISON, a major public sector union in Britain, says the Bill will: Lead to a far larger role for private (for-profit) providers,Allow 'private' patients to jump the queueMake the Health Secretary (like our Minister of Health) and the National Health Service (NHS) less accountable to the publicCreate significant threats to staff jobs (20,000 redundancies are expected) and staff wages, andCreate a health care system based on wholesale competition (in contrast with the original NHS which was based much more on cooperation, collaboration, and integration). If implemented, such changes in Britain will create more pressure for more private, for-profit care in Canada. Already, British health care businesses are playing a leading role in privatizing Canadian health care services.
The Prim…

P3 bank to receive up to $120 billion in public handouts

Update: Earlier today the board of the failing bank Dexia approved a rescue plan drawn up over the weekend by the governments of France, Belgium and Luxembourg. The bank's Belgian unit will be nationalized and its other divisions sold. Dexia will receive up to €90 billion ($120 billion) in taxpayer guarantees, mainly from Belgium, to shore up its funding, according to the Wall Street Journal. Dexia is involved in numerous public private partnerships, including four in Ontario.

A second European bank, Erste, has now put out a profit warning.  Erste now expects a loss of nearly €1 billion this year (instead of an expected €1 billion profit).  Erste has shelved for at least a year a plan to repay 1.2 billion euros of aid from the Austrian government. There is speculation that more banks may fess up to such losses later.

European governments have now postponed the planned European Union summit one week (until October 23) to allow more time to develop a response to the new banking cr…

Private nursing home chain collapse - and now more?

Southern Cross, the giant, for-profit British nursing home chain that failed in July, has now begun to transfer its homes to other operators as it winds up its own operations.

It announced in late September that the first 250 of its 752 homes were being transferred to new operators and that it hoped to transfer more in October and November. It claims that it has entered unconditional business purchase agreements for 70% of its homes, with the remaining 30% still in progress.

But another for-profit corporation, Four Seasons, which hopes to take over 140 of the 752 homes, is now itself having to refinance its operations. It's currently in discussions to refinance hundreds of millions of pounds in debt.
The union, GMB, has called on the Care Quality Council to investigate, arguing that "Four Seasons Healthcare is saddled with debts of £790m and has no other income except money to care for residents to pay them."
The Independent reports Justin Bowden, national officer of t…

Failing bank involved in 3 Ontario hospital P3s

Europe's latest failing bank, Dexia, is involved in at least three hospital public private partnership (P3) projects in Ontario: Halton Healthcare, Bridgepoint and CAMH, as well as the Windsor Essex Parkway P3 project.
The British government has said it does not expect Dexia's situation to affect the viability of P3 projects in Britain. So far, there is no word from the Ontario government on this point.
Will the financial crisis spread? Quite a few banks were downgraded by credit rating agencies late this week, following the crisis at Dexia and declining confidence in the financial system. Ominously, the New York Times reports "European banks are reluctant to lend to one another, and United States lenders are reluctant to lend to European institutions. Banks have been unable to sell bonds to raise money."
Dexia has, however, held on to an investment grade credit rating due to the financial commitments from the French and Belgian governments to backstop the bank.

Get the F out of infrastructure

The 'F' in question is, of course, 'Finance'. As in the Design, Build, andFinance(“DBF”) ofpublic infrastructure projects by the private sector (as is common nowadays for Ontario hospital projects).

Europe is wobbling towards another financial crisis as the banks begin to show signs that they are afraid to lend to each other. Governments are already spending billions to prop up banks in one way or another, but a trillion dollars or more may be needed, some suggest. The Economisthas called for "simultaneous injections of capital into the region’s banks" as soon as possible.
As with the last go around (just three years ago) no one knows which businesses will make good on their promises, and which will fail. That drives up the cost to finance infrastructure through private finance relative to public finance. As a result, a financial crisis will drive up the costs of public private partnerships (P3s) -- aka "DBF" projects.
Of all the attempts to escap…

What's best for health care: competition or collaboration?

The head of the Ontario association of for-profit home care corporations, claims, "As a direct result of competition today's home care system is more accountable, has better client service indicators and has greater transparency than it did in the past."

Which is news to many of us. Not least because there has not been any real competition in Ontario home care since the Ontario government was forced to suspend the compulsory competitive bidding process years ago, due to complaints from the community.
In fact it is now almost seven years since the process was first suspended.
So... competition delivers results -- even when there is no competition?
It is, however, interesting that the Home Care Association is publicly advocating for the old system: it sounds a bit like they hope to get competitive bidding back once the election is out of the way. If so, the failure of the PCs won't help them, especially if the Liberals fail to get their majority, as it seems now (11…

Lifespan shorter in USA than other developed countries

World Bank data suggests that the United States has a lower life expectancy compared to the other major developed economies. Canadian life expectancy is now (2009) 2.5 years longer than in the USA. In 1960, before the development of Canada's public medicare system, the difference was a little less, 1.3 years.
Indeed, the USA has fallen behind its long term nemesis, Cuba. Cubans now live 78.9 years, a couple of ticks more than the U.S. lifespan of 78.7 years.
In 1960 (at the beginning of the Cuban revolution) Cuban's lived 5.9 years less than Americans.

The good, the bad, and the ugly: three approaches to bargaining

In the past week the leaders of the three largest Ontario parties have all weighed in on collective bargaining in the public sector. Here's the summary (with a little commentary):Liberal leader Dalton McGuinty called for medical doctors to accept a 'pay' freeze for their contract -- although it does not even expire until March . A crafty move, McGunity is simply reiterating his public sector wage policy, but without specifically attacking any of his supporters in the mainstream labour movement. Moreover, there may be a lot more in a deal with the doctors than a simple freeze to their fee schedule, even if that's what gets talked about in the media releases. New Democrat Andrea Horwath defended collective bargaining, responding to McGuinty's comments on the doctors by saying she was surprised the Liberals would begin contract talks in such a way. ``We know that that's a bad way to start negotiations and it's a way that doesn't work.I think we need to hav…

Will new banking crisis drive up P3 costs?

Dexia, one of Europe's larger banks, is also one of the larger backers of public private partnerships. The Guardian reports it has been involved in about $9.36 billion worth of P3 projects in Britain. Dexia has also been involved in three P3s in British Columbia, two hospitals and a bridge.

As of today, the bank has fallen on hard times, connected to fears about its potential loses in Greece. So it is now on the verge of receiving a bail out from (who else?) the public.

This is the second time around for Dexia in just three years: the bank had to be bailed out by France and Belgium during the 2008 banking crisis with $6.92 billion of taxpayers' money.
( Apparently these guys truly do believe in PUBLIC private partnerships.)

Dexia may be just the first to go if there is a new round of bank crises. If so, more P3 financiers may need a public bailout before it is over.
“Dexia is by no means alone in terms of being at risk here,” said Simon Maughan, head of sales and distribution a…

Moving surgeries from public hospitals to for-profit clinics

An Ottawa Citizenstory on the push by the Ontario Medical Association (OMA) to take surgeries out of hospitals and move them to private clinics claims that the McGuinty Liberals have already signalled their intention, if re-elected, to pay hospitals less for some publicly insured medical services.

The report adds: "That raises the possibility that some hospitals could simply stop providing procedures with high overhead costs and low demand, resulting in more of that work being transferred to specialized clinics."

The Liberal Health Minister responded positively when the OMA raised the idea of moving work out of hospitals and into private clinics in July. She stated: "We're not opposed...We support the need to deliver services in the community. That's why we have a lot more dialysis, for example, out of hospitals. It's really all about getting the right balance."
The right balance? The Liberals have already increased funding for these private clinics (f…

Ontario Police weigh in on Hudak and PCPO plans

The Police Association of Ontario has released several documents on Tim Hudak and the the Progressive Conservatives. And they appear decidedly not pleased: "The PAO remains very concerned about comments made by the Progressive Conservative Party Leader Tim Hudak in relation to the Arbitration System. We simply cannot sit on the sidelines – there’s too much at stake."This is unusual territory for the Police Association, but they feel compelled to speak out: "It is very unusual for the PAO to side with one Party over another, or take a position during an election, as we recognize that we need to work with whichever political party is elected. The PAO desires to remain nonartisan. However, our concern is so great that the PAO’s Board of Directors feels compelled to inform our membership of what is very likely to occur if Tim Hudak’s PC Party is elected."Some other election materials prepared by the PAO on arbitration (Just the Facts Maam and Election 911) als…

A plea from the heart of the Establishment: Make the Rich Pay!?!

Our ruling circles must really be getting in a tizzy -- here's the solution suggested from a front page column by Eric Reguly in yesterday's Report on Business of the Globe and Mail:

"To fund debt restructurings in Greece, Spain, Portugal, Italy, Ireland, and perhaps France, governments will have to shake down the rich, who are the holders of the last largely intact store of money."In Canada, our rulers are much more content, for now, to blame working people and demand they pay for the economic problems. 
But, who knows what crisis might require? In Canada, just as in these other countries, most of the wealth created over the last few decades has gone to the well to do.