Democracy Gone Astray

Democracy, being a human construct, needs to be thought of as directionality rather than an object. As such, to understand it requires not so much a description of existing structures and/or other related phenomena but a declaration of intentionality.
This blog aims at creating labeled lists of published infringements of such intentionality, of points in time where democracy strays from its intended directionality. In addition to outright infringements, this blog also collects important contemporary information and/or discussions that impact our socio-political landscape.

All the posts here were published in the electronic media – main-stream as well as fringe, and maintain links to the original texts.

[NOTE: Due to changes I haven't caught on time in the blogging software, all of the 'Original Article' links were nullified between September 11, 2012 and December 11, 2012. My apologies.]

Saturday, November 03, 2012

Alberta awash in health dollars

OTTAWA — As Alberta awaits a massive windfall of extra health cash from Ottawa, a new report shows the province is already best able to pay for its health-care system.

Alberta will receive an extra $1 billion per year from Ottawa starting in 2014-15, shrinking the pot for the other provinces. But Alberta already has the lowest health-costs-to-GDP ratio in the country, a new report by the Canadian Institute for Health Information shows.

Alberta spent the equivalent of 8.6 per cent of its gross domestic prodeuct on health costs last year, according to the report issued this week. That’s drastically lower than Prince Edward Island, which leads the country with a health-care bill worth 17.4 per cent of its GDP.

Nova Scotia had the second-highest ratio, spending the equivalent of 16 per cent of its GDP on health care.

It’s not like Alberta was skimping on health care. The province spends the most money in the country on doctors and the second-most on health care per capita after Newfoundland and Labrador.

It seems to be getting good results for that investment. While there are various ways to measure health systems, a review of CIHI data shows that Alberta has the second-best health outcomes in the country after British Columbia.

Things are about to get even better for Alberta, while several other provinces are facing a looming cash crunch.

Atlantic provinces were pushing for Ottawa to factor the cost of providing services into health transfers because they have older populations that are more expensive to care for.

Instead, Ottawa shocked the provinces last December by announcing it was going in the opposite direction. Starting in 2014-15, Canada Health Transfers will be doled out on a strictly per capita basis. This will mean a windfall of over $1 billion extra cash for Alberta in Year 1, and more every following year.

All other provinces will see their share of the pie either stay about the same or go down. The actual dollar amounts cannot decrease, and the federal government has committed to growing the pot each year.

“It’s going to make life a little easier for the rich provinces and a little more difficult for the poor provinces,” said Carleton University public policy professor Allan Maslove.

“It’s not an order of magnitude shift, but it certainly is an appreciable shift.”

NDP health critic Libby Davies said the government was sowing discord among the provinces by unilaterally switching to a system that greatly benefits one province. She said she understands why other premiers would not feel like they’re on a level playing field.

The government argues it’s a matter of fairness.

The change was made “to ensure all Canadians get the same health-care support from the federal government, regardless of where they live,” said Kathleen Perchaluk, press secretary for Finance Minister Jim Flaherty.

“Additionally, to ensure fairness, we ensured that no province or territory will see no decline to their per capita health transfers with the move to equal per capita cash.”

Lakehead University professor of health economics Livio Di Matteo says the argument that per capita funding treats everyone fairly doesn’t consider the broader picture.

“Equality is not always the same as equity,” said Di Matteo. “It is unfair in that it does not recognize differences in need and tax base across the provinces.

“The cash transfer should be broken into two components — an equal per capita amount for core funding of health systems and a portion tied to demographics and needs indicators.”

But experts are split on what system is most fair. Maslove agrees the old system was more fair, but says there are also problems with Atlantic Canada’s preferred system. If you bring age into the equation, you may also have to consider other cost drivers like rural and aboriginal populations, he said.

“There’s sort of a never-ending train of factors that you could put in. You could see it becoming very contentious very quickly,” said Maslove.

The CIHI report shows Nova Scotia spends 48 per cent of all program spending on health care, well above the national average of 38 per cent. It also has the highest private-sector spending per capita, and the highest per capita spending on drugs. (Alberta spends the second-lowest.)

Atlantic Canada also has worse-than-average health outcomes and a higher share of citizens entering old age.

Original Article
Source: the chronicle herald
Author: PAUL McLEOD

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