Mechanisms of Health Care Reform

On Tuesday June 7th, Maclean’s magazine, the Canadian Medical Association and CPAC hosted an open dialogue on health care at the National Gallery of Canada in Ottawa. It was entitled: Health Care in Canada: Time to Rebuild Medicare.

The two-hour, video-taped conversation demonstrated how passionately many Canadians feel about health care and that the delivery of health care in Canada isn’t meeting their needs and ought to be changed. One participant referred to the health care budget in Ontario, for instance, that now represents 40% of the Province’s overall budget and is beginning to crowd out other concerns like education, social and correctional services. CIHI estimates that health care spending in Canada was $191 billion in 2010 or 12% of GDP and that by 2031 this should rise to 19% of total GDP -- a rate of growth that seems unsustainable. So the question was posed: what would a reformed health care system look like?

Despite the obvious lack of political appetite for change, participants at the Macleans event were much more pragmatic about the prospect of change and suggested that we focus on how to make things better given the existing legislation. “Could we make use of an amending formula to make adjustments to the Canada Health Act like they do with US Constitution?”, asked one participant. If the major outlines won’t change, then are there smaller, less controversial avenues we can pursue?

To this I would say that there are. In fact, there are several things that might be done to begin shifting the system in a new, more responsive and sustainable direction. I offer three such mechanisms for change below. They include adding a preamble to the Canada Health Act; moving to incentivize change through the application of flat fees for services; and the institution of individual health accounts. (more...)

Scandals piling up in world of Canadian business

Source: Derek Abma, Postmedia News, 2 July 2011

This country has long benefited from a strong corporate reputation abroad — a "halo effect," as some call it, from being seen as a kinder, gentler version of our American neighbours. But some might question whether that's still the case, as the country gains attention, and sometimes notoriety, for everything from the oilsands pollution; to Bear Creek Mining Corp.’s loss of its mining rights in Peru; to Niko Resources Ltd.’s recent $9.5-million fine for influence peddling; and to the now re-jailed former media baron Conrad Black.

“… Christopher Wilson, a lecturer and researcher at the University of Ottawa's school of management, says some scandals involving Canadian business interests are indicative of a corporate culture that puts its emphasis on the immediate appeasement of shareholders, often at the expense of other stakeholders, such as workers, customers and affected communities.

"The orientation is to see the profits in the next quarter as opposed to the long-term health of the organization and the long-term value addition to society," he says. Wilson says English-speaking countries tend to have a business culture that emphasizes short-term needs of shareholders over other considerations. Canada, he says, is perhaps even more so this way than the United States, because the relatively small pool of significant shareholders in Canadian companies limits the diversity of opinion that goes into shaping corporate policies.

"It makes it really, really difficult for Canadian companies to make a change because everybody sort of thinks the same way," Wilson says. "Whereas in the more diverse, less closely held environment of the United States, there's so many other perspectives that come into play." (more..)