Wednesday, November 21, 2012

Two Cheers for Obamacare


{The following column will appear in the Anahim-Nimpo Lake Messenger in December}

On November 6, I breathed a sigh of relief when Barack Obama was re-elected for a second term as the President of the United States.  Although his victory carries no guarantee of either world peace or fiscal sanity, intransigent conservatives in Congress were at least not rewarded for their worst behavior.
Most importantly, the election means that the Patient Protection and Affordable Care Act —“Obamacare”—is here  to stay. This legislation addresses both of the most serious flaws in the American health care system: the huge number of uninsured (46 million people) and under-insured (25 million);  and runaway costs (two-thirds of personal bankruptcies in 2007 were due to illness or medical bills).  In recent years,  these twin issues of coverage and cost have reinforced each other in a vicious downward spiral. Coverage has declined because premiums and co-payments are rising; premiums and co-payments keep rising because of the lack of effective cost containment.  

A recent report comparing health prices said it all.  A routine doctor’s visit costs approximately $30 in Canada,  $22 in Germany and ranges between $59 and $148 in the U.S. , with the Medicare rate for seniors set at $72. A bottle of Lipitor  costs $31 in Canada, $78 in Germany, and an average of $134 in the U.S.  MRI scans cost $304 in Canada, $632 in Germany, and an average of $1009 in the U.S.  A normal childbirth in a hospital?  $3200 in Canada, $2200 in Germany, and a whopping average of $9280 in the U.S.

 Increasingly, it was not just poor people who could not afford to pay these inflated prices.  The push for reform was partly driven by the growing plight of middle-class Americans. And the rising unemployment rates that accompanied the recession that began in 2008 meant that even more individuals lost affordable coverage. Something had to be done.

Will Obamacare succeed?  The criticism has been made that the Affordable Care Act does not sufficiently attack  the power of special interests—insurance lobbies, drug companies, and the corporate health sector—who have a financial stake in the existing system.  It is true that the government had to jettison the ‘public option’ (offering public insurance at lower premiums for a standard care package) in order to get the Ac t through the Senate.  And to gain the cooperation of doctors and pharmaceutical companies, the government had to agree not to control the prices paid for products and services.

But much has been achieved. When fully implemented, 95 percent of U.S. citizens will have the same basic health security that Canadians have. And the Affordable Care Act contains several payment and delivery options  that will foster higher value, lower cost and patient-centred primary care .  In the not too distant future, Americans may even have a thing or two to teach us about how to do health care.
  
Mark Crawford is an Assistant Professor at Athabasca University. He can be reached at markcrawf@gmail.com .

Tuesday, November 20, 2012

Why is NDP the Best When it Comes to Fiscal Responsibility?

It is a common talking point of New Democrats, whenever they are playing defence on economic issues: the NDP has the best record of the three major parties when it comes to balancing budgets. 

During the time that there have been NDP governments in Canada since 1980, those governments have produced balanced budgets 50% of the time and deficit budgets 50% of the time. Conservatives managed to balance the books only 37% of years they were in government while Liberals could only manage 27% - which was roughly the same record as Socred and PQ administrations. (Sources - Canada Finance: fiscal reference tables October 2010, RBC Provincial Fiscal Tables April, 2011; Statistics Canada: Provincial and Territorial Economic Accounts Data Tables) .

It is important to go a little beyond the talking points and the statistics in order to understand WHY this should be the case. Put simply, conservative and neo-liberal politicians are attracted to tax cuts, whether for the wealthy and business  on the trickle down theory, or to everyone else on some kind of populist rationale.  They like to imagine that they can re-coup the lost revenue through a combination of fat-trimming and economic growth. In fact, they can only re-coup a faction of the revenue through either one of those means.

Internationally, George W. Bush was the poster-boy for such thinking; more generally the U.S. has been forced by a combination of populist conservative ideology and constant congressional electioneering into shifting its tax burden onto business. The ironic result: the heartland of global capitalism shifts too much of its tax burden and its health cost burden onto business!

More locally, the new Conservative premier Alison Redford is obviously a sensible person who understands the need for long-term planning and infrastructure in a province that is the hub of the Canadian economy and which is expected to grow by about a million people over the next 10--15 years. Her problem is that she has find a way to pay for this inside the conservative nut-house that is Alberta politics.  This is a place where an unexpected shortfall in oil and gas revenues ought to mean only that the Heritage Trust Fund doesn't grow that year; instead it is a place where deficits balloon, schools and hospital beds get closed and nurses get laid off, all because  Conservative politicians and their supporters  think it is a matter of principle to use revenue from a depleting non-renewable resource to subsidize  the current consumption of the current residents of Alberta instead of the long-term welfare of long-term residents.

New Democrats  are under no such fiscal illusions, and are not as prone to that kind of collective irrationality. They place their faith instead in the growth-enhancing properties of public investments in human capital (education) and infrastructure(which business benefits from). And--though they are often loathe to admit it during election campaigns--avoiding broad, across-the-board tax cuts.

Thursday, November 15, 2012

The Ideal MP for the Cariboo-Chilcotin

{The following article was also published in the November 2012 issue of the Anahim-Nimpo Lake Messenger--MC}



Have you ever thought about  what the ideal political representative for the Cariboo-Chilcotin would be like, or at least how the existing job that our MLAs and MPs are doing could be improved?  I have.   As a Parliamentary Intern working for Kamloops MP Nelson Riis in the 1980s, I saw that it was possible to be a successful politician without being  nasty toward others or having an exaggerated opinion of oneself. Nelson  was a decent and caring person who was widely respected  by people from  all parts of the political spectrum, which is part of the reason why he remained in office for 20 years .  As a Ministerial Assistant for David Zirnhelt in 1996-97 I came to appreciate  not only Zirnhelt’s knowledge of this region and its people and his extensive knowledge of forestry and land use issues, but also his incredible work ethic, as he strove to reach every corner of  Cariboo South  on weekends despite his busy schedule as a Cabinet Minister in the Harcourt and Clark NDP governments.  Those efforts clearly paid off, as he won three straight elections in what had been the most Socred riding in the province in Alex Fraser’s day.

 No doubt supporters of Donna Barnett could also sing her praises , based on her long history as mayor of 100 Mile House and her own deep roots in the area.   If Dick Harris  hasn’t done as much  as the others to earn his long tenure as  federal MP, it is probably because he hasn’t had to in a riding that is more solidly conservative than his former riding (Prince-George Bulkley Valley) had been . For him, the biggest challenge has been  winning his own party’s  nomination, as when  he narrowly staved off a challenge by Dr. Elmer Thiessen in 2004.

In a less partisan vein, I was encouraged  by Nathan Cullen’s attempt in last year’s federal NDP leadership contest to at least try to cooperate with other parties.   I gave my support to Nathan’s campaign largely because such an extraordinary strategy is necessary in order to shake up politics in the federal riding.  I even had a plan ready if Cullen had won the leadership:  to approach former Ulkatcho  chief Lynda Price to run as a candidate with the endorsement of both Liberal and New Democratic parties in the next federal election. (Having her run as an independent would neatly avoid the problem of persuading one party to support the other’s candidate).   As it turned out, Nathan lost the leadership bid and Lynda had just enrolled in law school, so I never found out whether the idea would have flown.

Mark Crawford is a political scientist at Athabasca University . He can be reached at markcrawf@gmail.com

Saturday, November 10, 2012

Remembering Billy McIntyre--and a Suggestion

I remember my father saying that he and a few other boys from the Prince Albert -Paddockwood area of Northern Saskatchewan had decided to sign up in 1941 , event hough they legally  weren't quite old enough yet. The following year they were off to Britain, where they were stationed and trained for a  year or so. Dad saw heavy fighting in Italy, including the battle of Monte Cassino, before his active duty was ended by a bout of malaria.

Another boy from the neighbourhood, I think he said his name was Billy McIntyre--wasn't so lucky.  I remember Dad saying "he was on the beach in  Normandy and got hit right between the eyes."  I think every Billy McIntyre deserves to be remembered  by name.


One way to ensure that people like Billy McIntyre are never forgotten is  to list them on a website. In addition, every school in Canada could adopt a certain number of fallen veterans for its remembrance.I believe that the number of fallen Canadian soldiers since 1914 is @ 117,000; divide that  among Canada's schools according to where they were born and/or attended  The average elementary school and secondary school would have 8 soldiers whose faces and names  could be displayed in a conspicuous place in the school.  


(According to Statistics Canada data, there are approximately 15,500 schools in Canada:
  • 10,100 elementary
  • 3,400 secondary
  • 2,000& mixed elementary and secondary
  • The overall average is 350 students per school
In 2004–05, provinces and territories reported that there were 5.3 million students enrolled in public elementary and secondary schools. )