, 01.05.2022 11:49 AM

My latest: pay up, Trudeau

As the pandemic grinds on, as more and more of us get infected, there’s lots of blame to go around.

Anti-vaccination spreadnecks, for making a bad situation much worse. Inept politicians, who falsely claimed that the pandemic was coming to an end, or that it was nothing to worry about. Canada’s federal government, for mishandling everything from vaccine procurement to border crossings.

The framers of Canada’s Constitution deserve some blame, too, even though it’s arriving more than a century late. Let us explain.

Responsibility for health care — and, critically, responsibility for the financing of health care — isn’t clearly addressed in our Constitution. Hard to believe, but it isn’t.

Federal responsibilities are listed in Section 91. Provincial responsibilities are detailed in Section 92.

But as no less than the Supreme Court of Canada ruled in 1982: “Health is not a matter which is subject to specific constitutional assignment but instead is an amorphous topic which can be addressed by valid federal or provincial legislation, depending (on) the circumstances.”

“Amorphous?” And: “Depending on the circumstances?”

You don’t need to be a constitutional scholar to recognize the problem created by this constitutional fuzziness. It is a sure-fire formula for federal-provincial squabbling over the funding of health care. And, in the intervening 155 years, there’s been plenty of squabbling — because, on average, health care costs more than any other program.

In Ontario alone, the biggest program areas are hospitals ($25.8 billion) and the Ontario Health Insurance Plan (which is made up of physicians and health practitioners, at $17 billion). Taken together, those two expenditures alone account for 58% of the health ministry spending planned for this year. Nearly 60%, and growing every year.

And in the decade leading up to the pandemic, provincial health-care spending grew by nearly 120%. That’s a formula for bankruptcy.

Throw in a pandemic, then, and you’ve got a fiscal crisis that defies description. COVID-19 has overwhelmed our doctors, nurses and hospitals — and has completely gutted provincial health budgets, and budgetary planning.

Because constitutional responsibility for providing health care, you see, has fallen mainly to the provinces. And responsibility for funding much of it is the role of the Justin Trudeau government.

The Trudeau regime repeatedly claims to “have Canadians’ backs” during the pandemic. But it simply doesn’t.

In September, the premiers and the prime minister met to discuss the health funding catastrophe. The premiers of the two biggest provinces, Doug Ford and Francois Legault, were quite specific: They told Trudeau the provinces need the federal government to do more.

Ford and Legault and others wanted Trudeau to increase health-care transfers to the provinces by $28 billion this year. That would boost the $42-billion transfer the provinces receive to $70 billion.

“We’re here to ask the federal government: Step up to the plate,” Ford said. Legault, meanwhile, issued a warning to the federal Liberal leader: “Don’t come and invent all sorts of new programs and new spending when the priority of Canadians is to properly finance health care. And right now it is not well financed.”

And it isn’t. Anyone on a waiting list, anyone seeking a vaccination or a booster, anyone who has tried to see a doctor or get a hospital bed knows that the Canadian health system isn’t at a cliched “breaking point” anymore. It’s broken.

The pandemic is the biggest personal, political, cultural, and economic event of our collective lifetimes. None of the other fetishes of the Trudeau government — like approving hefty pay hikes for its MPs — come close to being as important.

More than perhaps at any other time in our 155-year history, we need to properly fund health care. We need to dramatically step up our efforts to fight and beat COVID.

Our Constitution may not have addressed that.

But Canada needs to, now, if we are ever to be free of the prison that is the COVID-19 pandemic.

— Warren Kinsella is a lawyer and former Chief of Staff to a federal Liberal Minister of Health

23 Comments


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    PJH says:

    Spreadnecks!…….That is indeed a keeper……along with two other favourites: Covidiots and BranchCovidians…If the shoe fits, etc…..

    Keep spreadin’ the truth, Mr. K…..


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    Ronald O'Dowd says:

    Warren,

    This is precisely what you get when the collective of village idiots — federal, provincial and territorial — refuse to open up this joke of a constitution. So…everyone finally gets to pay the piper, at least those who haven’t dropped dead yet.


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      Pipes says:

      Mr. O’Dowd: I was playing with my grandchildren today, and for a particle of a moment I suddenly felt inconsolable about their future, and it’s not just healthcare. Flashing signs of a leaderless apocalypse caught me by surprise in the middle of a good old fashioned foam sword fight….


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        Warren says:

        That’s some good writing there, Pipes.


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        Ronald O'Dowd says:

        Pipes,

        For those of us who choose to believe in a higher power, God in my case, believe in the love, power and grace of an extraordinary being. The young are always the future — and the better part of humanity. I trust that the divine plan continues to assure a better future collectively for them than for those who came before them. Humanity is ever progressing and becoming better both collectively and individually. I choose to embrace hope and optimism. The light still shines to guide the way forward no matter how many obstacles and challenges are put in front of humanity’s path. The young will push this planet forward and make it an even better world than it has ever been before. Don’t despair.


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          Pipes says:

          Mr. O’Dowd, you may be right. Yesterday, my grandchildren were in their on-line learning class. I really wasn’t paying too much attention until one of the students ( Grade 1) asked her teacher, what would happen to Canada if the US lost their democracy? The teacher was taken by surprise and my thoughts began to surge like the chaos at the beginning of the creation of a new universe, until my head exploded. That student may re-animate a lifeless planet. So I think I will join you in your hope and optimism . Thank you.


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            Ronald O'Dowd says:

            Pipes,

            I also try in my modest way to infuse a sense of patriotism into our American cousins. When I speak to our American clients, as soon as they start complaining about the other “side”, I remind them that they are first, last and always Americans! Then I go into my routine about how the United States saved freedom and democracy in WWI and WWII and how JFK saved all of our lives in the Cuban Missile Crisis. It generally works and makes them think again. Hopefully, they become a little less Republican or Democrat and a lot more patriot. We desperately need America now more than ever — otherwise it’s world domination by totalitarians à la Putin, Xi, etc.


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    Sean says:

    What’s with the gong show distribution of test kits?! Why didn’t they just use Canada Post to deliver across the country?! Why the hell do we even have a postal service if not for this?!

    As a taxpayer I don’t think anyone involved in “planning” or “managing” any of this should ever be employed again.


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    Miles Westbrook Lunn says:

    Real problem is anytime a politician talks about health reforms, people freak out claiming American style health care. Fact is our current system is not working and it needs to change. We spend more per capita than most OECD countries yet deliver worst results. This doesn’t mean more privatization, far from it. There are many different types of public health care systems that deliver superior results so why not learn from places that deliver better results.

    Yes they all involve some private provision, but so does ours. No system is fully public or fully private and most that deliver better outcomes than ours may allow some private involvement in areas we ban, but also have more public involvement in areas we largely leave to private sector like prescription drugs.

    But this means politicians willing to have a grown up discussion with Canadians which I fear they are not.


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      Sean says:

      People don’t freak out. Lobbyists freak out… and they tell politicians to freak out. The public is then bombarded with too much contradictory information (GASP! “American Style!” or double GASP! “private!”) Average voters don’t have the time or inclination to sort it all out… and they settle with whatever side transmits the most safe / comfortable common sentiment / popularly accepted platitude. And on and on it goes.


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      Steve T says:

      You wrote basically exactly what I was going to write.

      Canada’s healthcare system has mediocre outcomes when compared to other countries, and virtually every country that does better than Canada has a parallel private/public system. Yet, as you point out, any attempt to adopt those beneficial measures is met with the phony cry of “American style!”. Even though that is fundamentally untrue.

      People are indoctrinated into parroting the line “we have the world’s best healthcare”, and they dutifully repeat it back at every opportunity. It’s pathetic, and its untruth now is being laid bare by COVID.


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        Sean says:

        it’s all so fucking stupid…. the vaccines were created by private companies… the P.M. got his at a private pharmacy. Which is all fine! That said, I’m all for public healthcare. 100%. But pretending it’s one option or the other and that there there isn’t already substantial private involvement is just fake… fake… fake…. HS on top of HS

        Just speaking for myself – I have a pretty average joe income but a good benefits package etc… I spend WAAAYYY more time with private healthcare (Dentist, Physio) and pretty darn close to ZERO time with the public system in the last 5 years or so.


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          Miles Lunn says:

          What’s ironic is most OECD countries actually overall have less private involvement than Canada does, just structured much differently. Canada is basically near government monopoly for basic health care, while predominately private for supplemental. Most other developed countries allow more private involvement in basic health care than we do, but cover a lot more procedures under public purse than we do.

          Still we need to look at what delivers best results and as long as universality is maintained, all options should be on the table. Only those that don’t involve universality off the table.

          In fact Canada and US are outliers in OECD. Canada as only one that tries to ban private competition in basic health care (I say try as you do have some private clinics you can pay for faster service and ironically the places with most of these is none other than Trudeau’s home town of Montreal, not Alberta or Saskatchewan as Liberals would have you believe) while US is only industrialized country that does not have universal health care.

          Heck why not amend the CHA to give provinces more flexibility. One of the great things about being a federation is different provinces can try to different approaches and we can learn what works best and what doesn’t. After all universal health care didn’t start nationally; it started in Saskatchewan and was so popular and worked better all others jumped aboard. Quebec has had universal child care for almost a quarter of a century before others have. For education, we don’t have an equivalent of CHA yet our educational rankings are quite high compared to others unlike with health care.


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    Joseph says:

    the Supreme Court of Canada ruled in 1982: “Health is not a matter which is subject to specific constitutional assignment but instead is an amorphous topic which can be addressed by valid federal or provincial legislation, depending (on) the circumstances.”

    Well if you put it that way then it appears part of the problem is a court that has a bad habit of reading into the constitution instead of just reading it.
    The other part of the problem that has become evident from the number of critics that seem to find issues with the document in question is that it needs a rewrite.
    On the second point you will need government at both the federal and provincial level that are honest good faith brokers and that this time (unlike in 82 and every unsuccessful attempt thereafter) not use it as an opportunity to cement a political legacy or as leverage to extort power or privilege.
    Good luck with that.
    On a closing note, what would be the reaction from the punditry if someone claimed our healthcare act couldn’t deliver and it was a feature not a flaw?


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    Historical_Pedant says:

    I have to take issue with R. O’Dowd’s comment: “…and how JFK saved all of our lives in the Cuban Missile Crisis. ” JFK was the one who nearly killed us all through his reckless brinkmanship, as egged on by Curtis “The mad bomber” LeMay. LeMay had to go, and unfortunately there was only one way to do that.


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      Ronald O'Dowd says:

      HP,

      Two sides to every coin. But JFK did the job, he got the missiles out of Cuba and gave up missiles in Turkey that were already obsolete, just so Khrushchev could save face. No Soviet invasion of West Berlin. Nice piece of statecraft, I’d say.


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    Kenny Blankenship says:

    Spreadnecks?

    https://covid-19.ontario.ca/data/case-numbers-and-spread

    (change from yesterday)
    In hospital but not the ICU
    Unvaccinated cases: 457 (+16)
    Partially vaccinated cases: 115 (+15)
    Fully vaccinated cases: 1353 (+26)

    In ICU
    Unvaccinated cases: 123 (+4)
    Partially vaccinated cases: 18 (+1)
    Fully vaccinated cases: 137 (+31)

    Vaccination status
    Fully vaccinated: 82%
    Partially vaccinated: 6%
    Unvaccinated: 12%

    12% (unvaccinated) account for 23% of hospitalizations
    82% (fully vaccinated) account for 71% of hospitalizations
    57 new hospitalizations (not ICU) out of 13 362 new cases is a hospitalization rate of 0.43%
    36 new in ICU out of 13 362 new cases is an ICU rate of 0.27% (though there is no info suggesting these are people were new patients admitted directly to the ICU. They are only recorded as new to ICU units)

    Those numbers are skewing even more daily, so perhaps it’s time to stop pointing fingers at your fellow citizens. Mandates and vaccines aren’t working. You’re on the right path looking into spending. If this government was as loose with the purse strings as they were with the CBC, maybe our system wouldn’t be as strained. That’s wishful thinking though since they haven’t made a right step yet


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      Ronald O'Dowd says:

      Kenny,

      Your points are eye-opening but vaccines need to be tweaked to address new strains such as DELTACRON. I’m not God so could be wrong but I prefer a world where we tweak vaccines than one where we do nothing and stop vaccinating as necessary. But that’s just me.


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      Sean says:

      Fake news. According to the website provided…

      ICU cases:

      Unvaxxed + partially vaxxed = 141 = 50%

      Fully vaxxed = 137. = 49 %

      Fully vaxxed in Ontario = 77%. The pandemic is therefore obviously hitting the unvaxxed harder according to the website provided by Kenny. If people want to fight against reality, go ahead. No one can stop you. But don’t pretend that the numbers are on your side.


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    Max Heiliger says:

    As I wrote last week (and wasn’t published): the curve is reversing this week, and the entire pandemic ends in February.


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      Sean says:

      I’m going to hazard a wild guess and *predict* that you didn’t listen to Kinsellacast Episode 192.


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        Max Heiliger says:

        1. I already have a near-monopoly on the Truth, so I don’t need to hear other people’s opinions
        2. If I was agreed with, I was first to think it anyway
        3. Justin Trudeau is starting to sound like Julius Streicher


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    Ronald O'Dowd says:

    Quebec Anti-Vax Tax: Here It Comes!

    This thing will be like Trump — they’ll be no happy medium and no one who’s indifferent. It’s fraught with political disaster, or political nirvana, depending on your point of view. Sure, the unvaccinated in hospitals, in ERs and ICUs roughly cost government the same but not all of them have the same paying capacity…so there’s the rub and potential land mine. Sure, it’s legal but is it the right way to go? Maybe.

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