This is time of great ferment in the non-profit sector. Every week or so a new organization pops up that stretches the boundaries of charity, blends altruism with entrepreneurship or shows that community work can be self-financing.

Toronto is the hotbed of this activity. To those in the vanguard, it is exciting and creative. To those steeped in the tradition of selfless giving, it is unsettling, even threatening. To the rest of the population, it’s a blur.

The social enterprise movement wants to have a voice in the development of the city. It wants to put progressive ideas back on the agenda. And it wants to show political and business leaders that innovation isn’t confined to laboratories, universities and high-tech companies.

To highlight what’s happening and talk about what is possible, the Centre for Social Innovation — the nucleus of the city’s social enterprise culture — is hosting a brainstorming session this month. It will bring together the leaders of the movement — its own executive director, Tonya Surman; Tim Draimin of Social Innovation Generation; Anne Jamieson of the Toronto Enterprise Fund; Assaf Weisz of Venture Deli, and a delegation from a national group called Start-Up Canada — to “create a loud voice for social ventures in Canada’s entrepreneurial landscape.”

Unfortunately, the May 14 event is sold out. All the tickets were snapped up — mostly by insiders — within 12 hours of the announcement.

And there’s really nowhere else for those outside the tent to go for information. The proponents of social enterprise speak in abstruse language. (Here is an example: “Social innovation generation is about intentional exploration of the social innovation dynamic and the possibilities inherent in a deeply generative collaboration with the commitment to action outcomes.”) There are no clear guidebooks or user-friendly websites.

For Torontonians who want to understand what’s going on and why it matters, here is a journalist’s simple primer:

Social enterprises are business-charity hybrids. They aim to do well in the marketplace in order to do good in the community.

The concept is not new. Long before anyone was theorizing about it, Maritimers were doing it. Dairy famers built co-op creameries to cut their costs and stabilize their communities. Fruit growers organized co-operatives to break the grip of exploitative middlemen. Townsfolk pooled their earnings to set up co-op stores. These grassroots initiatives were one of the best anti-poverty programs ever conceived.

In the 1920s, a group of visionary priests at St. Francis Xavier University added adult education to the mix, travelling from village to village teaching people crop management and literacy. Over the next 30 years, the Antigonish movement spread from Nova Scotia to New Brunswick and Prince Edward Island, then moved westward, incorporating the ideas of Quebec’s caisses populaires. In the ’60s, it petered out.

Today’s social enterprise movement is a digital, secular, urban renaissance of that tradition.

It is hard to pinpoint when it began, but the founding of Toronto’s Centre for Social Innovation (CSI) is as good a date as any. In 2004, architect and community activist Margie Zeidler took a 91-year-old plumbing equipment warehouse on Spadina Ave. and transformed it into a headquarters for 85 social fledgling social enterprises. (Two more followed; a CSI annex on Bathurst St. and a third site at Regent Park.)

Although today’s social entrepreneurs follow the same principles as the co-ops and credit unions of yesteryear, they operate differently — in a very different landscape.

• Now, unlike then, governments have primary responsibility for social and economic development. They pay non-profit organizations — there are 160,000 of them employing two million people — to deliver their programs. This has insulated these organizations from the grubby economics of the marketplace, leading many of their leaders to believe they are above that.

• Now, unlike then, social enterprises are hidden and often misunderstood. They talk among themselves and make room in the movement for other progressive people who want to turn their ideas into business, but they don’t reach out to the rest of the population.

• Now, unlike then, there is no crusader like Father Moses Coady of the Antigonish movement to spread the message and cut through “the pessimism that has so benumbed everyone that nothing has been attempted to break the spell.”

His modern-day heirs might have the right formula. But they need an articulate leader who can explain social entrepreneurship to Canadians and give them a stake in its success.

< http://www.thestar.com/opinion/editorialopinion/article/1171357–toronto-incubates-new-brand-of-business-charity-hybrids >

They’re just whispers in the wind, but they’re getting louder and more frequent.

In the beginning, a few isolated voices — left-wing economists, academics, social activists, labour organizers, church leaders and corporate renegades — warned that Canada was becoming a highly inequitable nation.

They wrote earnest policy papers, produced credible statistics and occasionally attracted media attention. But they were ignored, dismissed or ridiculed in the corridors of power.

The volume went up a couple of notches last fall when thousands of young people took to the streets chanting: “We are the 99 per cent.” With one simple slogan, the protesters crystallized the issue: The top 1 per cent of the population was skimming off most of the economy’s gains, leaving everybody else to scramble for the remains.

The Occupy Movement got the nation — including a few corporate executives and public figures — talking about inequality. It convinced Canadians that something was wrong.

But it had no solutions — not even any suggestions — to offer. Gradually it petered out.

There was another flurry of interest in early April when theBroadbent Institute, an Ottawa think-tank devoted to creating a more equal society, released a poll showing 64 per cent of Canadians were willing to pay higher taxes to preserve social programs and reduce poverty.

But the source — a research body created by New Democratic Party — caused many observers, even those sympathetic to the cause, to question the poll’s credibility.

Last week brought two developments that couldn’t be shrugged off or attributed to left-wing agitation.

The first was a shareholders’ revolt at one of Wall Street’s biggest banks. To the surprise — and dread — of corporate America, shareholders rejected the pay package awarded toVikram Pandit, CEO of Citigroup.

The vote was not binding. But it would be folly for the bank’s board to ignore a rebuff from institutional investors (pension and mutual fund managers) whose clients are fed up with excessive executive compensation.

“This is a shot across the bow of every corporate boardroom in America,” said Robert Reich, former U.S. Secretary of Labor.

The reverberations were felt in Canada, too. Pandit’s $15 million pay package is in the same ballpark as those routinely approved by the boards of Canada’s top banks. Ed Clark, CEO of Toronto-Dominion, for instance, took home $11.3 million for the same period. His Scotiabank counterpart, Richard Waugh, pocketed $10.6 million and Gordon Nixon at the Royal Bank got $10.1 million.

Political strategists got a surprise of their own the next day. A survey of 1,084 Ontarians — with no partisan or ideological links — found 78 per cent backed NDP Leader Andrea Horwath’s call to impose a surtax on individuals with incomes above $500,000. “It’s hugely popular,” said Lorne Bozinoff, president of Forum Research, the country’s largest polling firm.

This undermined the long-standing assumption that voters were dead set against any tax increase and would punish any politician who raised the possibility.

None of this means a change of direction is imminent.

There is still strong resistance at all levels of government to raising taxes. Premier Dalton McGuinty, who acquiesced to Horwath’s demand this week to keep his minority alive, made his reluctance clear. He vowed to get rid of the surtax within five years.

Likewise, there is strong resistance in corporate boardrooms to reining in executive compensation. High-flying CEOs and their hitherto compliant boards will be watching nervously to see what shareholders do at the Bank of America’s annual meeting on May 9.

But restive stirring is in the air. Once-passive investors are beginning to challenge the notion that corporate CEOs deserve 300 times as much pay as the average worker. Once-tractable voters are beginning to question the notion that raising taxes is unthinkable.

The pendulum, stuck at the far right for a decade, is beginning to shift.

< http://www.thestar.com/opinion/editorialopinion/article/1167476–greed-loses-its-glamour-even-on-wall-street >

Their last hope is Frances Lankin. And they’re no longer sure whether she’s a friend or a foe.

Two months from now Lankin and Munir Sheik, co-chairs of Ontario’s social assistance review will release their blueprint. Their aim is to turn the province’s threadbare, demeaning welfare system into a modern income security system.

Initially, the 880,000 people who depend on social assistance — which includes welfare and disability support — regarded Lankin, former president of the United Way of Greater Toronto, as their champion in the corridors of power. She knew they couldn’t live on the province’s meagre allowance. She knew they needed affordable housing and child care. She knew the system stripped them of their privacy and their dignity.

But in recent months, doubts have set in. The commission’s discussion paper in February was vague and unsettling. Last month’s provincial budgetwas ominous. And the rumours they’re hearing scare them.

Last week, three Torontonians who live on Ontario Disability Support (ODSP) met at a supportive housing agency to share their concerns. All have mental disorders. All agreed to use their real names regardless of the stigma or the possibility of reprisals.

“I used to think the goal (of the review) was poverty reduction,” said Youssef Camara. “Now I think it will produce the reverse. I truly believe people will be worse off a year from now.”

Camara has severe clinical depression. Until last month he was working for a non-profit agency. Then his contract expired. He is looking for a new job but it’s hard to find an employer who will take a risk on a worker whose illness could flare up anytime and last for months.

That unpredictability, he explained, is why people with psychiatric disorders worry about the commission’s suggestion that disability support recipients deemed capable of working should be required to look for employment.

Sandra Smith, who has schizophrenia, figures she could work two days a week. Her medication, Risperidone, saps her energy and has other side-effects (insomnia, muscle stiffness, irritability).

Michael Koo puts his limit at 20 hours. And they might not be weekly. His disease, bipolar disorder, is cyclical.

“If the government wants us to work, why doesn’t it hire us to work with mentally disabled clients? It’s already paying us,” he pointed out. (ODSP recipients get a monthly benefit of $1,064.)

Camara wants to know who will decide which ODSP recipients are capable of working. “We don’t need another layer of bureaucracy.”

Last month’s budget heightened their fears. It froze welfare rates and halved this year’s promised increase in the Ontario Child Benefit.

(Last Friday, Premier Dalton McGuinty, hoping to win the support of the New Democratic Party, proposed an amendment that would give disability support recipients a 1 per cent increase in November. With inflation running at 2.2 per cent, this would still mean a drop in their buying power.)

“Why does this government consider it progress to move a person from severe deprivation to working poverty?” Camara asked rhetorically. His answer: “The intent of everything they do is to shrink funding.”

“It’s not just us,” Smith stressed. “More and more families are falling into poverty. It’s scary.”

Now they’re hearing speculation that Lankin and Sheik will propose that Ontario Works (basic welfare: $599 a month) and Ontario Disability Support ($1,064) be collapsed into a single program. That alarms them. They need the extra money for medications, supportive housing and transportation to hospitals, clinics and doctors’ offices.

Oppressive and unfair as the current system is, they can’t afford to lose what they have. And they don’t trust Lankin — or anyone else — to keep them whole.

As the conversation ended, they tried to explain what it’s like to be poor and disabled in Ontario. “It’s like you’re always being judged and found guilty of some crime,” Koo said. Smith gave it a name: “the crime of being sick.”

< http://www.thestar.com/opinion/editorialopinion/article/1166017–hopes-fade-for-humane-welfare-system-in-ontario >

The recession hit Canada’s non-profit sector hard. Demand surged. Donations shrank. Foundations suspended grants to protect their endowments. Government support held up for a time as Ottawa and the provinces poured money into the moribund economy, then it too was cut.

Some charities folded. Others hunkered down, laid off dedicated workers and placed a heavy load on their volunteers. They served their clients as well as they could, but had to turn away people who came seeking help.

Innovative non-profit organizations shelved groundbreaking projects and went into survival mode.

Nora Sobolov, who was chief executive of the Canadian Lung Association at the time, remembers receiving a distraught phone call from a colleague in 2009. He was worried about making his organization’s payroll because the money he was expecting for a government contract had been delayed. When he asked his bank of 15 years for a bridge loan, he was turned down flat.

Then she got a call from another friend. Her arts organization had found an interested corporate sponsor, but it needed a bit of capital to get artists started. No one would give her a loan.

Sobolov kept hearing similar stories, watching the growth of non-profit lending in the United States and Britain and brainstorming with others who shared her concern — at credit unions, co-operatives, social enterprises and other non-profit organizations — about creating a funding mechanism that would link Canadians willing to make a modest investment in their community with non-profit organizations that needed short-term help.

It wouldn’t — couldn’t — provide a sustainable income to chronically troubled charities. Its purpose would be to prevent temporary financial shortfalls from becoming life-threatening crises.

“We were just trying to fill one gap,” Sobolov says. “The (non-profit) sector needs a whole range of financing alternatives.”

She had the vision, the contacts and the qualifications (a law degree and social work degree) but Sobolov stresses that it was a collective effort. She sought help from bankers, securities experts, community leaders, the directors of the Nonprofit Finance Fund in the U.S. and CAF Venturesome in Britain. She tapped into the experience of Vancity and the Edmonton Social Enterprise Fund, which make non-profit loans on a regional basis. And she worked with Imagine Canada

The first step from blueprint to reality was a feasibility study to make sure there was a demand for the service. Sobolov and researcher Arlene Wortsman met the leaders of 100 non-profit organizations and confirmed that the need was real. The second step was to approach foundations looking for creative ways to use their endowments and other potential investors.

In 2010, the Community Forward Fund (CFF) was born.

It took another two years of work — painstaking legal work — to build Canada’s first non-profit lending institution. This spring the last hurdle was cleared. CCF won the approval of the Ontario Security Commission.

To celebrate, the CFF invited everyone who had been involved in its creation to a kickoff in Toronto. The event didn’t attract much public attention but for the voluntary community it was a breakthrough; one Sobolov hopes will mark the beginning of a “rethinking of the way we finance the non-profit sector.”

There will always be a need for government support, individual and corporate donations and grants from foundations, she says. But there have to be other options: fee for service activities, revenue-generating acquisitions, partnerships with private financiers and many more.

Since the launch, the CFF has approved two loans; one to an environmental organization that wanted to cut costs by installing a solar panel, the other to an artists’ group that needed exhibit space. Thirty-three applications are in the pipeline.

To qualify for a loan, a non-profit organization must be registered with the Canada Revenue Agency, have a strong business plan, share its financial records and have a substantial stream ($350,000 annually).

At the moment, there is $7 million in the fund. The goal is $20 million.

“Some people would call it a drop in the bucket,” Sobolov says. “But what a drop.”

< http://www.thestar.com/opinion/editorialopinion/article/1164808–canada-s-non-profit-sector-invents-a-solution-to-gaps-in-funding >

It was a throwaway line in Jim Flaherty’s budget; a throwaway institution in Stephen Harper’s Ottawa.

Deeply buried in an attachment to the 2012 budget was a one-sentence announcement that the National Council of Welfarehad been axed.

For a few days anti-poverty activists thought low-income Canadians had been spared. By the time they discovered the truth, all they could do was mourn the demise of another once-proud social agency.

Since 1962, the National Council of Welfare had held up a mirror to the nation, highlighting the pockets of poverty and warning policy-makers of the consequences of neglecting those in need. It gave non-profit groups the facts they needed to speak credibly about hardship in a land of plenty. It tracked the emergence and growth of a crack in society between the comfortably well-off and the struggling. And it brought together social policy thinkers to find solutions to poverty — or at least keep the debate alive.

Now it’s gone. Kellie Leitch, parliamentary secretary to the minister of human resources, dismissed the loss offhandedly. “We are putting our policy resources to best use and reducing duplication,” she said, pointing to Campaign 2000 and Canada Without Poverty as high-profile non-profit organizations serving the same role.

Actually they don’t. They don’t have a government mandate “to advise the (human resources) minister on matters concerning poverty and the realities of low-income Canadians.” They don’t have the resources to buy Statistics Canada’s unpublished data. They don’t have the statutory authority to create opportunities for the poor to participate in the national decision-making process.

But Leitch’s rationale scarcely mattered. Everybody working in the field knew the real reason the Conservatives dumped the agency was that it was an unwanted piece of Liberal baggage. They hadn’t listened to it in years. They didn’t want to be nagged about poverty, inequality or social responsibility.

Scrapping the council saved an easy $1.1 million.

Only one MP, New Democrat Carol Hughes, challenged the decision in Parliament.

There was no outcry from the provinces. They were happy to keep their own actions out of the spotlight. Ontario just froze its welfare rate at $599 per month and halved this year’s increase in the provincial child benefit.

The Star was the only media outlet that reported the death of the National Council of Welfare. Other newspapers and broadcast outlets — even the publicly owned CBC — didn’t consider it newsworthy.

That left the churches, food banks and social agencies to protest. But most of them are so overwhelmed coping with surging demand in the face of dwindling donations that they can’t afford to engage in advocacy.

Moreover, they’re weary.

They fought to save the long-form census, the best source of information on living conditions in Canada, and lost.

They fought for decent social assistance rates and lost.

They fought for the 60 per cent of jobless workers excluded from the employment insurance system, only to be told by Human Resources Minister Diane Finley: “We do not want to make it lucrative for them to stay home and get paid.”

There are still reasons — albeit tenuous ones — for hope.

Last week, Opposition Leader Thomas Mulcair told business leaders face-to-face: “The NDP is going to do everything it can to create a Canada that is more prosperous, as long as it is more prosperous for everybody.” Liberal Leader Bob Rae affirmed his party’s commitment to reverse the “stunning growth” of income inequality. And the courts drew a line in the sand. Judge Sandra Simpson of the Federal Court issued an injunction preventing the government from proceeding with one of the measures in its budget: a drastic reduction in social assistance to First Nations communities. The move would cause “emotional and psychological stress amounting to irreparable harm for some recipients,” she said.

The Conservatives can keep tossing away the fixtures of a compassionate Canada. But they can’t turn this into a nation of throwaway values. Only Canadians can do that.

< http://www.thestar.com/opinion/editorialopinion/article/1160732–harper-throws-national-council-of-welfare-on-the-scrap-heap >

In principle, Finance Minister Jim Flaherty is right. Canada must adjust to the demographic reality that it is an aging nation with a shrinking workforce.

In practice, his government has begun the process badly. It sprang a series of upsetting surprises on Canadians, disrupting their plans and pitting generations against each other.

The finance minister rectified some of the damage with Thursday’s budget. He provided a rationale and a road map for some the changes that will unfold in the next few years.

He also put an end to the debilitating speculation caused by Prime Minister Stephen Harper’s vague announcement in January that the government was poised to constrain the growth of Old Age Security (OAS), the country’s basic retirement support program. Canadians know that, starting in 2023, the retirement age will be pushed back to 67. They’ll either have to work longer or save more to finance their non-earning years.

Finally — and most importantly — Flaherty confirmed what has been hanging in the air for months. Deficit-cutting is no longer the Conservatives’ real goal. The Prime Minister intends to use his parliamentary majority to redefine the role of government and rewrite Canada’s social contract.

It would have helped to know all this before last year’s election. But Harper never said a word about reducing the government’s commitment to Old Age Security, capping Ottawa’s contribution to medicare or loosening environmental regulations. He never told Canadians a Conservative government would keep paring public services after the budget was balanced.

All of this, according to Flaherty, is necessary to promote economic growth, create jobs and “make sure our social programs are sustainable in the long-term.”

His budget provides the first comprehensive look at the Harper government’s long-term agenda:

• Ottawa will no longer invest in scientific discovery. It will require government labs to switch to commercial research aimed at improving business productivity. Science and Technology Minister Gary Goodyear has hinted at this shift in priorities for some time. Now it is official.

• At the same time, the government will move from tax credits — popular but ineffective — to direct grants to business that invest in economically productive innovation.

•  It will cut off environmental reviews of major resource projects after 24 months of hearings. This formalizes Energy Minister Joe Oliver’s vow not to let “radical groups” block crude from Canada’s oilsands.

• It will become much more selective about the immigrants it admits, picking newcomers who are young, adaptable and already have the skills to help transform Canada into an “energy superpower.” Those already in the backlog will be removed if they don’t qualify. Minister Jason Kenney has been telling Canadians that the “system is broken” for some time, without saying how far he intends to go to fix it. Now his objective is clear.

• The federal government will cap its share of health spending in 2017, forcing the provinces to either rein in costs or come up with more money themselves. Flaherty stunned his provincial counterparts in December when he announced Ottawa’s intention to reduce the growth of federal health transfers from 6 per cent to about 3 to 4 per cent (the new rate will be pegged to inflation and economic growth). Now he has locked it into Ottawa’s financial plan.

• And the role of government in people’s lives will continue to shrink. They’ll have to lower their expectations, save more, demand less and stop looking to Ottawa to shield them from the rigours of the marketplace.

Is this the realization of the Harper vision?

It certainly has elements of that, although it falls short of the hard-right agenda he articulated before he became Prime Minister.

Is it a pragmatic response to the challenges Canada faces?

It has elements of that, too. Curtailing the escalation of health spending was necessary. So was getting government-funded research out of the lab and onto the shop floor.

Is it a blueprint to remake the economically diversified, socially progressive Canada that past generations have built?

Categorically yes. That is the real story

< http://www.thestar.com/opinion/editorialopinion/article/1153728–more-than-a-budget-this-a-blueprint-to-make-over-canada >

Ontarians can scrap Dalton McGuinty’s job description — Premier Dad — right now.

No father would withhold funds from a disabled child, while giving a stronger child a tuition rebate for university or college, as McGuinty did in Tuesday’s provincial budget.

No father would deprive any child of the necessities of life, without making a significant sacrifice himself.

Ontario has fallen on hard times to be sure. But the government is still in a position to make choices about the $112 billion in revenues it expects to collect in the year ahead.

The numbers in Tuesday’s budget leave little doubt that deep spending cuts are required in light of Ontario’s status as a have-not province with a deteriorating manufacturing sector and a rapidly swelling debt.

Here are the key figures: Interest payments on Ontario’s $258 billion debt eat up $10.6 billion — 8.4 cents out of every dollar of revenue. That is more than the province spends on post-secondary education, children and youth services or public safety.

Each year the province runs a deficit, the debt goes up and there is less available for everything else. Even if McGuinty meets his target of balancing the budget by 2017-18, Ontario’s debt-to GDP ratio, which now stands at an uncomfortably high 37.2 per cent — the highest in the country — will rise to 41.6 per cent before going down. That is unsustainable.

Most Ontarians accept the need for belt-tightening. What they don’t accept — at least not yet — is that this province can no longer afford to support the vulnerable.

That is the premise on which Tuesday’s budget — delivered by Finance Minister Dwight Duncan but devised by McGuinty on the advice of economist Don Drummond — is built.

• It freezes welfare payments, currently $599 per month for a destitute individual, for a year, despite the fact that food prices in Ontario are going up by 4.6 per cent a year and electricity costs are rising by a staggering 8.9 per cent. These people have nothing to spare. They are already living far below the poverty line. Yet McGuinty is asking them to “share the burden” of restraint.

• Disability support payments, currently $1,064 per month — barely enough to sustain a poverty-level existence — are also being frozen.

• The Ontario Child Benefit, scheduled to increase to $109 per month in July, will rise instead to $100, forcing the poorest parents to wait a year for the financial relief they were promised.

• Children’s Aid Societies, which take care of kids no one wants, are expected to pare $16 million from their budgets.

On the other side of the ledger, here is what the government chose not to do:

• Cancel or revamp its 3-month-old tuition rebate that goes to post-secondary students with family incomes as high $160,000. Parents earning more than $100,000 like the 30 per cent rebate. But losing it would not be a financial hardship.

• Raise personal or corporate taxes (although it is deferring a couple of planned business tax reductions and boosting a handful of user fees.)

• Reduce the six-figure salaries paid to senior executives — hospital and university CEOs, and heads of provincial boards and agencies (their pay is being frozen for two years).

• Lift the 20-student cap on elementary classes, although there is no evidence that putting three or four more students in the classroom would compromise the quality of education.

The big-ticket savings in Tuesday’s budget are, for the most part, sensible and balanced, although they will hurt most Ontarians in some way.

It is the small items — the cutbacks imposed on those eking out a precarious existence — that raise questions about McGuinty’s values.

Although the premier enacted a poverty reduction plan in 2009, he has now effectively renounced it.

Although he insisted this week, “We are not prepared to balance this budget on the backs of families who may find themselves in difficult circumstances,” he did exactly that.

After nine years in power, McGuinty may have found his backbone. He is staking his government’s fate on a risky, bad-news budget.

But he has lost his compassion.

< http://www.thestar.com/opinion/editorialopinion/article/1152784–ontario-budget-is-a-requiem-for-a-caring-province >

Ontario has 82 taxpayer-funded health agencies. A handful, such as Cancer Care Ontario and the Trillium Gift of Life Network, are widely known. A couple — ehealth Ontario and ORNGE — broke into the public consciousness because of scandal. But most operate in obscurity.

These agencies are often where trouble breeds.

Even when they’re benign, they diffuse health decisions over so many different bodies that it’s impossible for Ontarians to keep track.

And they’re expensive. Many are headed by well-paid executives and provide jobs for hundreds of government appointees.

Is this a smart way to use public funds? Is it a good way to deliver health care? Is it a responsible way to spend taxpayers’ money?

Surprisingly, banker Don Drummond, who just conducted a year-long review of Ontario’s public spending, said very little about this issue. As chair of the province’s Commission on Reform of Ontario’s Public Services, he talked about the need to streamline health-care services. But his only suggestion on the profusion of government satellites was: Consolidation of health service agencies and/or their boards should occur where appropriate while establishing any new consolidated agencies as separate legal entities to limit major labour harmonization and adjustment costs.”

There was nothing about scrapping any of them, reducing their allocation or folding them into the health ministry.

It would be reckless, of course, to take an axe to these agencies without a thorough investigation of what they do and how effectively they do it. But at a time of austerity, Ontarians need to know why the government needs so many stand-alone health agencies. Do patients benefit? Do taxpayers get value for their money?

To weigh this question, some basic information is needed.

All health agencies are not equal. Some, such as Cancer Care Ontario, organize services and deliver treatment. Some, such as the Health Professions Appeal and Review Board, adjudicate disputes between health-care providers and patients. And some are purely advisory. They conduct studies and surveys designed to influence government policy.

Nor are the members of all agencies compensated equally. Some get up to $188,950 a year. Others are merely reimbursed for their out-of-pocket expenses.

Each type of agency needs to be considered separately:

• Those that bring together health specialists in a sprawling field such as cancer research and treatment make sense. A separate agency gives the government a way to allocate a specific amount and let those best qualified decide how to distribute it.

• Similarly, agencies that adjudicate disputes within the health-care sector clearly need to be independent of government.

• For advisory agencies, the rationale is less clear. Does the government really need 20 councils representing every health-care profession from dental hygienists to respiratory therapists? Does it need 25 district health unit boards as well as 14 Local Health Integration Networks (LHINs)? Does it need arms-length expert committees to guide its choices on autistic spectrum disorders, HIV/AIDS and rabies? Does it need an external recruiting agency to hire health-care workers?

There isn’t likely to be a better time than now to cull these agencies (plus the 526 that report to other ministers). The premier is determined to cut provincial expenditures. Health Minister Deb Matthews has just embarked on a comprehensive overhaul of the health-care system. And the public is primed for belt-tightening.

Surely some of these agencies have outlived their purpose; some are maintained for reasons of political expediency and some exist chiefly to lobby the government.

By winnowing down the list, ministers could differentiate between agencies that do valuable work and those that make government more opaque, less accountable and more costly. They could simplify the maze that has developed at and around Queen’s Park.

It’s not just a matter of efficiency, it’s a question of fairness. At a time when Ontarians are being asked to sacrifice, it would unconscionable to deprive kids living in poverty, families warehoused in homeless shelters and struggling legal aid clinics of provincial support to perpetuate unnecessary government agencies.

(A complete list of provincial government agencies is on the website of Ontario’s Public Appointments Secretariat.)

< http://www.thestar.com/opinion/editorialopinion/article/1143399–too-many-needless-government-agencies-in-ontario >

It took six years, 60 researchers and $4.3 million.

Finally, the most comprehensive study of women’s health ever done in Ontario — possibly anywhere — is complete. The concluding chapter — a 10-point road map to health equity — was released last week at St. Michael’s Hospital at a celebration featuring speeches, congratulations and assurances by Ontario Health Minister Deb Matthews that the information in the massive tome would be put to good use.

There’s one problem: The POWER (Project for an Ontario Women’s Health Evidence-Based Report) study has received so little attention that most women don’t know it exists. Neither do their doctors.

That means too many women who suffer heart attacks will be misdiagnosed. Unlike men, they don’t typically experience chest pains or numbness. The most common symptoms of cardiac arrest in women are nausea, vomiting, shortness of breath and intense fatigue.

It means too many expectant mothers will undergo C-sections for low-risk births and unnecessary episiotomies for vaginal deliveries.

It means too many medical practitioners will ignore the strong connection between poverty and chronic ailments, such as obesity, hypertension, diabetes, arthritis and obstructive lung disease, which lead to foreshortened lives.

One of the reasons the 12-volume study hasn’t received much coverage is its heavy use of jargon. Here is an excerpt from last week’s release: “Health equity cannot be achieved without moving upstream and addressing the root causes of disease in the social determinants of health. A multi-faceted approach is required to tackle the many complex problems which contribute to greater chronic disease prevalence and poorer health outcomes in some groups.”

A second reason is that it has been released, chapter by chapter, over so many years that health reporters have lost track of the thread or moved on.

These problems could easily be rectified. The Ontario health ministry, which funded the project through one of its satellite agencies, ECHO, could assign a communications team to produce a user-friendly version of the report and develop an outreach plan. Or it could hire a public relations firm.

But Premier Dalton McGuinty is poised to cut spending and his budget adviser Don Drummond is urging the health ministry to streamline its operations. Both suggest that follow-up is unlikely.

This leaves women who want to take charge of their health with three options. They can read the 1,800-page report. With patience and persistence, they’ll get the gist of it. They can cherry-pick the topics that matter to them. Or they can lobby the government to finish the job.

For those willing to download the report, here are a couple of tips:

Some chapters are aimed chiefly at women, others at policy-makers. The written-for-bureaucrats chapters are distinguishable by their reliance on health/sociological jargon.

The most useful chapters for women seeking practical guidance are: cardiovascular disease, diabetes, depression, reproductive health and older women’s health. The chapters on cancer and musculoskeletal conditions (arthritis, osteoporosis) identify gender disparities, regional disparities and socioeconomic parities, but they don’t tell women much about how to improve their odds.

There is no question the study is a gold mine of information. Its website has attracted online visitors from 132 countries, 49 of the 50 U.S. states and 675 Canadian cities.

Taken seriously, it could be a catalyst for change. Its research team estimates that if Ontario had a truly equitable health-care system, there would be 230,000 fewer people with disabilities and 3,373 fewer premature deaths in the province’s big cities.

“We have more than enough evidence to make health equity a priority and more forward,” said chief investigator Arlene Bierman, a physician at St. Michael’s Hospital.

But the report could have done so much more. It could have alerted women to factors that raise their risk factor for various diseases. It could have helped them ask their doctors more informed questions. It could have led to public pressure for change.

< http://www.thestar.com/opinion/editorialopinion/article/1142057–women-in-the-dark-about-massive-ontario-study-of-female-health >

Two decades after its introduction, Canadians still resent the GST. They no longer take out their anger on store clerks and restaurant servers. But every time they pay the hefty tax — 13 per cent in Ontario, where it’s combined with the provincial sales tax — there’s a spark of irritation.

A few items are exempt: basic groceries, prescription drugs, rent, medical devices, health and dental services, child care, legal aid and financial services. That mitigates the ire.

Now Michael Smart, an economist at the University of Toronto, is proposing these exemptions be scrapped. He is backed by Jack Mintz, chair of the School of Public Policy at the University of Calgary, one of Stephen Harper’s most trusted advisers.

Smart released his paper, commissioned by the Calgary school, at a news conference on Parliament Hill. Mintz was by his side.

Both men argued that eliminating all GST exemptions would benefit the government and the public. “I’m not saying it’s politically easy,” Smart allowed. “I’m saying it’s economically sensible and I don’t think it’s impossible by any means.”

Mintz concurred. “Taxing food makes sense,” he said, daring any politician to refute his logic.

Here is the rationale put forward by Smart, who has taught at U of T for 17 years.

By charging a uniform value-added tax on everything, Ottawa would reap $39 billion annually, more than doubling the $32 billion produced by the current, inefficient, exemption-ridden GST/HST.

The government could use this revenue to reduce income taxes, improve social services, give low-income Canadians larger GST rebates or cut the consumption tax rate by 40 per cent. In addition, Smart pointed out, a pure VAT would give the economy a boost, make life easier for business and reduce tax evasion.

Politically, this proposal looks dead-on-arrival.

It would trigger a fierce backlash, uniting rich and poor, left and right, westerners and easterners, in protest. It would contradict everything Harper and his ministers have said about taxation: “We will not raise taxes on Canadian consumers and families” (2011 Conservative election platform). And it would cost the Tories millions of votes.

But before dismissing it entirely, consider the following:

• Four years ago with corporate pensions heading for insolvency and retirement savings hard hit by the global financial meltdown, there was a strong consensus that public pensions had to be strengthened. The provinces were on-board. So were workers, seniors and pension experts. Finance Minister Jim Flaherty seemed to be on-board, too.

Then he commissioned Mintz to take a second look. The Calgary economist saw no need for major reform. Shortly thereafter, Flaherty pulled the plug.

• Sixteen years ago Mintz urged then-finance minister Paul Martin to reduce corporate taxes. Politically, the idea seemed unthinkable. Four years later, Martin did it. And Flaherty kept doing it. Today, Canada has one of the lowest corporate tax rates in the industrial world.

• Finally, there’s Harper’s background. The University of Calgary, home of the 3-year-old School of Public Policy, is his alma mater. He earned two economics degrees and lectured there. The logic of tax simplification would appeal to him.

Superficially, it is appealing.

Ottawa could use the $39 billion gained by implementing a pure value-added tax to improve the poor. But would Harper use the windfall that way?

Bolstering social programs would be antithetical to everything he has said and done since taking office. Reducing income taxes might tempt him, but it wouldn’t do the poor much good — most don’t pay income taxes. Likewise, he might be willing to increase GST rebates, but they are sent out quarterly. Families buy food weekly.

As an economic theory, Smart’s scheme may be defensible.

But outside the safety of academe, it is a prescription for more hardship and more hunger.

< http://www.thestar.com/opinion/editorialopinion/article/1139689–tax-food-toronto-economist-advocates >