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Maxed Out

With Max Fawcett
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January 24th 2024
Feature story

Our health-care system is crashing

The COVID-19 pandemic has already killed more than 50,000 Canadians and crippled our sense of national unity and cohesion. But its biggest casualty may be yet to come: Canada’s health-care system.

If you’ve spent even a moment trying to access critical care over the last few years, you know just how bad things have gotten. Wait times at emergency rooms often stretch into days rather than hours, surgeries and other necessary procedures are being delayed, and finding a family doctor just keeps getting more difficult. Doctors and nurses, many of whom are suffering from pandemic-related burnout and some low-grade PTSD, are retiring early. As a result, a system that’s supposed to provide universal coverage is becoming decidedly less equitable. As Dr. Tara Kiran noted in a new study published in the CMAJ, “What we have is a haves-and-have-nots situation. [There are] people who do have access to a family doctor and a health team, and then those who have nothing.”

In Alberta, where the UCP has made a point of undermining the morale of doctors and health-care workers with direct funding cuts and a refusal to take COVID-19 and other respiratory viruses seriously, the issue is particularly acute. According to a recent survey of family doctors in the province, 91 per cent are concerned about the financial viability of their practice, with 61 per cent considering leaving the province as a result. This is happening at a time when a record number of Albertans are looking for a family doctor or trying to avoid losing one they already have.

“Our entire health-care system is at stake,” Alberta Medical Association president Paul Parks told reporters at a press conference earlier this week. “Because if you don’t fix primary care, it’s impossible to address the issues in acute care or continuing care or mental health and addictions care.”

Case in point: Edmonton’s pediatric hospital was so short-staffed last month, and so overwhelmed with patients, that it cancelled and delayed surgeries for sick and injured kids. As a pair of doctors noted in a Dec. 25 letter to the provincial government, “Several children each week are having their treatment or surgery cancelled with no guarantee of urgent rescheduling… After the events of last week, we can tell you that we are failing, daily, and children are suffering and may die as a result.”

Things aren’t much better in other provinces, which all face the same dangerous combination of a depleted workforce, debt-focused governments and ever-expanding demand from an aging population. A recent Angus Reid Institute survey showed that fewer than two in five Canadians said their province was handling the health-care system well.

Ironically, the highest rating in the country came in Alberta, where 37 per cent of people said the government was doing a “good” or “very good” job of handling health care. That’s probably because the provincial government has made a big show out of its plan to revamp the health-care system. For some people, it seems, any change is better than the rapidly deteriorating status quo.

But tinkering with the organizational structure of Alberta’s health system or trying to scapegoat public servants for the province’s health-care problems isn’t going to work. If anything, it seems designed to sow further chaos and instability to break the system’s back so the government can then rebuild it in its own image.

The federal Liberal government would do well to make this far more of an issue than it has. It could remind voters that it’s the mostly Conservative provincial premiers who are responsible for managing and delivering health-care services, and who are failing abjectly at that crucial job.

And then, of course, there’s the man who’s poised to become prime minister — and who doesn’t seem like the type who would make the sort of necessary federal investments in repairing our most important safety net. As Pierre Poilievre told reporters back in March 2020 when the federal government was rolling out the financial aid programs that saved millions of businesses and households from ruin, “You might want to address it through big fat government programs — we’re Conservatives, so we don’t believe in that.”

Indeed, they don’t.

What’s needed now is a national effort to save the health-care system from those who want to break it. We have to move past the binary, two-dimensional arguments about “American-style health care” and realize the Canadian style of providing healthcare is increasingly unsatisfactory to most of us. We need a system that works in and for the 21st century, and can accommodate our ever-aging population. That’s probably going to mean more money. It almost certainly will mean more federal control and oversight over provinces that don’t always spend what they’re given and can’t co-ordinate and communicate effectively with each other.

This is a big ask of a federal government that already seems too tired to manage its own existing programs and problems, never mind adding a huge new one to the pile. But if they don’t do something dramatic here, the next federal government almost certainly will — and Canadians may all end up poorer for it.

The NDP needs to get its story straight on housing

By all rights, this should be the moment the federal NDP has been waiting for since Jack Layton stepped down as leader. The governing Liberals are badly wounded, the opposition Conservatives are led by a polarizing and ideologically strident leader, and the country is hungry for change and open to new ideas. So why is Jagmeet Singh’s party still polling in a distant fourth place?

The most recent answer came in the form of a video Singh recorded about a housing project in Edmonton’s Griesbach neighbourhood, one he suggested involved public housing being torn down by the federal government to build “luxury condos.” This will come as something of a surprise to the Métis Capital Housing Corporation, which is actually building the 127-unit low-rise apartment for low-income Indigenous families (with a particular focus on women and children). The units will be rented at a maximum of 80 per cent of average market rents, and the building includes a ceremony room, community kitchen and an early childhood learning centre.

The facts about these 127 new units didn’t seem to resonate with Singh, who suggested that “87 per cent of them could be luxury homes.” Not surprisingly, he pinned the blame here squarely on Justin Trudeau. “He’s building luxury condos you can’t afford. With his plan — developers get rich, you get gouged.”

Oh, but it gets worse. In an apparent effort to apply this economic illiteracy as even-handedly as possible, Singh took a run at Poilievre and his apparent influence over rents. “When Conservatives got into power in Ontario — they removed rent control for new developments,” Singh tweeted. “The result: $2,600+/month for a one-bedroom. Pierre Poilievre will do the same for his top donors.”

But, of course, rent control and related matters fall under provincial jurisdiction, as Singh’s own tweet implies. And Poilievre has been abundantly clear about his desire to see provinces and municipalities build more housing — and his own willingness to force their hand if necessary.

This conspicuous lack of economic literacy, and his habit of misunderstanding how our Constitution assigns responsibilities to different jurisdictions, have been consistent features of Singh’s leadership. This would be bad enough at the best of times, but when things like the cost of living and economic anxiety are at the top of the average voter’s list of concerns, being able to talk credibly and competently about kitchen table issues is table stakes stuff. Right now, the NDP can’t even ante up.

Canada’s courts deliver a timely reminder

Liberals are supposed to be gathering in Montreal for a cabinet retreat that will set the tone for the year ahead. Instead, they’re having to react to news that a Federal Court judge found that the invocation of the Emergency Measures Act in 2022 was “unreasonable” — and infringed on some of the protesters’ charter rights. "I conclude that there was no national emergency justifying the invocation of the Emergencies Act and the decision to do so was therefore unreasonable and ultra vires," Justice Richard Mosley wrote in his decision.

Deputy Prime Minister Chrystia Freeland has already announced the government will appeal the decision, but even if it’s overturned, it won’t entirely undo the damage done to an already reeling government’s reputation. Pierre Poilievre and Alberta Premier Danielle Smith have, of course, already taken their victory laps here.

The decision is already being picked apart by minds far more talented than mine, and I’ll leave the legal analysis to their learned pens. But I see some interesting political angles here that I want to explore briefly. First, there’s the fact that this decision presents Poilievre with a challenge: can he resist the temptation to dunk on this government when he knows the ball will probably rebound back into his face?

The occupation of Ottawa was not, after all, his finest moment as a party leader, and it’s one he and his team would surely like to leave in the past. Yes, there’s a slice of voters in this country that will feel vindicated by this court decision, but they’re already safely inside the Conservative camp. Most Canadians opposed the occupation and the people behind it, and looked poorly on Poilievre’s willingness to side with them and their crass and lawless invasion of Canada’s capital. Does he really want to remind voters of that side of him when he’s up 15 points in the polls?

There’s also the fact that as this court process unfolds, the convoy-curious will get an opportunity to learn more about a legal and judicial system so many of them clearly don’t understand. This decision will get appealed to the Federal Court of Appeal, and it stands to reason that the Supreme Court of Canada will ultimately have to weigh in given the important constitutional questions and charter issues at stake. If nothing else, it might help educate more Canadians about how our courts actually work.

The very fact that a judge appointed by a Liberal prime minister would rule against another Liberal prime minister should cause them some cognitive dissonance. Many of them seem to believe our courts are politicized in the same way as America’s, and that they’re incapable of delivering justice to anyone who isn’t a Liberal supporter. That the chief justice was originally a Harper appointee doesn’t seem to register with people making this argument, but maybe this case will help open their eyes just a bit to the reality of Canada’s courts. They exist to uphold our laws rather than serve the narrow partisan interests of the people who put them there, and nobody — not even the prime minister — is beyond their reproach.

The politics of property taxes

Few issues make people show their hand quite like property taxes, and they’re on full display right now in Calgary and Toronto. In both cities, the city councils are trying to pass significant increases in order to keep their budgets in the black — and fund basic services for their citizens. And in both cities, the conservative establishment is working itself into an entirely predictable lather.

Don Braid, the Calgary Herald’s eminence grise, described the elected officials supporting a proposed 7.8 per cent increase as the “tax crazed majority.” These “tax-lovers,” as he also calls them, apparently have the temerity to listen to radical socialists like the Calgary Chamber of Commerce, which has been pushing for many years to see local homeowners carry a bigger portion of their city’s tax burden. That’s because, as they wrote last year, “Calgary has one of the highest ratios of non-residential to residential property tax in Canada, across comparable jurisdictions. This means businesses in Calgary pay a significantly higher portion of municipal tax compared to residential properties in the city, even though residential properties far outnumber non-residential properties.”

You might think that the erstwhile pro-business representatives on council would back this argument, especially when the increase amounts to just $16 per month on a house assessed at $610,000. Fat chance. Instead, a group that Braid has dubbed “the sane six” is trying to make an issue out of the proposed hike, despite the fact they all voted in support of a new arena for the NHL’s Calgary Flames — one that clearly deprives the city of financial resources it could use to, say, keep property taxes lower.

That group, it’s worth emphasizing, includes Sean Chu, a councillor and former police officer who was elected despite a late-campaign revelation that he had been charged with two counts of discreditable conduct under the Police Act for having “inappropriate physical contact with a minor” when he was 34 years old and working as an undercover officer.

In Toronto, the politics are nearly as craven. The city is proposing a 10.5 per cent property tax increase, one that Mayor Olivia Chow describes as “the first step in the process of getting our city back on track.” The city’s conservative pundits and politicians are, of course, completely outraged that the new mayor — one who won a pretty convincing mandate — would try to address the problems she was elected to fix. Anthony Furey, the former Postmedia pundit who left his job as VP of editorial and content at True North to get trounced by Chow in the mayoral race, described her decision to raise taxes as “heartless.”

But as The Hub’s Steve Lafleur wrote, “It’s around $32 a month for the average homeowner. Certainly not welcome news, but it’s only historically large on a percentage basis because the last two mayors kept property taxes low, allowing basic services and amenities to fall into disrepair. If Toronto had a mascot (other than a raccoon), it would be an overflowing garbage can or a closed public toilet.”

And for all the concern over the fiscal plight of people who own million-dollar homes, it’s the city’s renters who clearly deserve sympathy. The average rent in Toronto spiked up more than 40 per cent between 2021 and 2023, which amounts to many hundreds of dollars a month in additional costs. Yes, homeowners are more numerous, and they tend to vote more often. But their troubles pale in comparison to those of the city’s renters, and it’s long past time to allocate more of the city’s property taxes to helping them out.

The way forward should be obvious: give cities the ability to raise money through methods and means other than property taxes. As Toronto’s current city manager has argued, “The property-tax base just cannot generate the kinds of resources that are required to adequately fund the infrastructure of cities, to adequately fund the full breadth and depth of programs that cities are now delivering.” A small local sales tax or the imposition of things like road tolls would be a more effective way of funding cities like Calgary and Toronto and their growing range of programs and services.

But that would require the provincial governments in Alberta and Ontario to devolve some powers to their local governments, and that seems highly unlikely for a bunch of different reasons. Never mind, for the moment, the irony of supposedly pro-freedom governments keeping cities and their democratically elected leaders shackled to their hip. For Conservative premiers like Danielle Smith and Doug Ford, freedom for me rarely translates to freedom for thee.

The Wrap Up

I’m not a big music guy, but the announcement that Conde Naste would be folding Pitchfork into GQ magazine caught my attention all the same. It’s one of those niche publications that should be successful in a digital world, given its scale and scope and the enduring popularity of new music. And yet, apparently, the numbers just didn’t work.

This, alongside the recent news that Sports Illustrated was essentially giving up the ghost and the Los Angeles Times was laying off more than 100 people, does not fill me with huge amounts of optimism about journalism’s future — not that I had much of that to spare to begin with. At some point, there has to be a reckoning between our interest in good content and our willingness to actually pay for it. I try to practise what I preach here, but I’m going to try harder going forward. I hope you’ll do the same.

After Alberta’s near-blackout experience, I watched the cold settle over Texas with particular interest. Texas, after all, has the same “energy-only” electricity market as Alberta, along with huge amounts of wind and solar. Would its grid survive the cold or would it buckle the way it did back in 2021?

Good news, folks: everything went well. Better still, the state’s wind and solar played a big part in that. On Tuesday, electricity demand topped out at 78,138 megawatts, one of the highest readings in the state’s history. That same day, solar generation set an all-time record with 14,835 megawatts flowing to the grid, or 20 per cent of overall power being generated. The previous evening, meanwhile, wind met 30 per cent of a similarly massive demand for electrons.

It would be nice if Alberta’s government could learn from that experience and stop pretending that wind and solar are the cause of their electricity grid’s problems rather than a potential solution. Alas, I’m not holding my breath there.

And finally, our favourite narcissistic psychologist was handed another defeat (or was it a victory?) in his ongoing quest to be the biggest victim in the country. An Ontario court upheld the decision of the provincial regulatory body governing registered psychologists that Jordan Peterson’s social media posts were “degrading, demeaning and unprofessional” and posed “moderate risks of harm to the public.” The provincial regulatory body said those harms include “undermining public trust in the profession of psychology.”

Peterson, who loves to claim his free speech rights are being infringed here, demonstrated that by penning a lengthy column in the National Post and offering comment in a variety of forums and formats. The hypocrisy here should be obvious, even to the good doctor and his more lucid fans. But the issue of free speech is more complicated than Peterson wants to let on, as Prof. Emmett Macfarlane pointed out in a more nuanced take on his Substack — one I think is well worth reading.

Either way, we can rest assured that we haven’t heard the last about this. If Peterson gets his way, we may never hear the last of it.

That’s all for this week. Please remember to share this newsletter on your socials and send a link to anyone who hasn’t heard about it yet. And if you want to find me on the non-terrible social media platform, I’m over at Bluesky at maxfawcett.bsky.social. I have a few invites to spare if you need one.