Saskatchewan Premier Brad Wall is planning to push his provincial colleagues to band together and ask Ottawa for a health care innovation fund that would provide extra money for projects to improve patient care.

“What we’d like to focus on is, over and above the transfer, is the federal government going to be interested in partnering with provinces on outcomes-specific innovations that we propose?” Mr. Wall said in an interview on Friday.

He will take his proposal to the premiers’ meeting in Victoria next week, and told The Globe and Mail that he believes the federal government has left the door open to doing more on health care than it is currently offering.

“I am hopeful. I am hopeful,” he said. “This discussion can’t just be about cash… it’s got to be about how health care is going to get better… and more sustainable.”

Last December, Finance Minister Jim Flaherty shocked his provincial counterparts when he gave them a take-it-or-leave-it health accord. The 10-year deal gives the provinces a 6 per cent annual increase in the money Ottawa transfers to them for health care until 2017. After that the increase is tied to the nominal GDP.

More than 40 per cent of Saskatchewan’s budget goes to health care; other provinces’ budgets are similarly consumed. Mr. Wall noted the new accord has divided the premiers – MOST in the West like it and those in the East are not so happy. Nova Scotia’s Darrell Dexter, for example, believes the new funding formula will hurt smaller and less wealthy provinces such as his.

Mr. Wall said an innovation fund could be used to help finance projects such as Saskatchewan’s program to reduce waits for some kinds of surgery, such as orthopedic.

“Over and above the transfer, we would like the federal government to consider an innovation fund that would work with the provinces on these kinds of initiatives,” he said.

Mr. Wall said he doesn’t have a dollar figure in mind for the fund. Rather, he wants the premiers to discuss the concept, which he believes should be raised with the federal government.

“Well, we’re going to push that,” he said. “The health transfer issue itself has taken up a lot of oxygen because we have this divide in terms of the provinces and I respect everyone’s position… So depending if there is any oxygen left, sure, we can talk about this notion of an innovation fund and proposing something like that with the government.”

Mr. Wall acknowledges the Harper government’s “unilateral declaration” did not foster good will, but he and his officials are not dwelling on that.

He said an innovation fund could also help the provinces set up electronic health records.

“Here is a way to drastically improve health care in a country that is still very rural… electronic health records can really improve health care delivery and make the system much more efficient and probably in the long term save a lot of money,” he said.

All provinces, he argued, are facing “massive” costs in terms of converting to digital records.

“There is a role for the federal government if we can tie it to outcomes,” he said. “So we’re going to ask the question anyway. And say, sure the transfer’s the transfer but now let’s talk about ways to improve health care – and both parties should be at the table for that.”

He said comments from Federal Health Minister Leona Aglukkaq after the release of the accord give him some hope that the federal government may be interested in doing more than simply the transfers.

In a letter to the provinces, Ms. Aglukkaq proposed to work with them to find a solution to spiralling health costs.

Mr. Wall said Ms. Aglukkaq is to visit his province next week and will be meeting with his health minister.

< http://www.theglobeandmail.com/news/politics/brad-wall-prescribes-collaborative-federalism-to-improve-health-care/article2302398/ >

Stephen Harper says the most fun he had in 2011 was winning his majority government. And now Canadians are seeing just how much fun he is having as he pushes through his long-promised agenda of political and justice reforms.

Canadians are seeing something else, too – how the Prime Minister is beginning to reshape the way Canada is governed.

Those who have worked with Mr. Harper and are close to him are not surprised by his approach to federalism.

Tom Flanagan, the Prime Minister’s former mentor who is now a political science professor at the University of Calgary, sees Mr. Harper moving away from “executive federalism” – constant negotiations with the provinces – to a “more classical view” of federalism, in which constitutional jurisdictions are respected.

The first hint of that came this week with the take-it-or-leave-it health-care accord with the provinces.

Standing in the living room of 24 Sussex, where he was playing host to reporters at a Christmas reception Monday night just hours after the health deal became public, Mr. Harper was in an engaging mood.

He talked about the accord and the style in which it was presented to the provinces, suggesting that he was not one for first ministers’ meetings and long, protracted negotiations.

In addition, he was adamant that the provinces not be the ones deciding how much the federal government should spend.

His deal is generous, by most accounts. The new funding formula guarantees a 6-per-cent annual increase until 2017, then it is tied to the increase in the gross domestic product until 2024.

But what the deal doesn’t do is try to impose standards or make provinces accountable for the funding.

Mr. Harper also spoke about former Liberal prime minister Paul Martin’s marathon session with the premiers that resulted in the 2004 health accord. Mr. Martin had no agenda going in to the meeting, said Mr. Harper, who was dismissive of its results.

“He’s just not one for those kind of large meetings,” says Doug Finley, who served as the Conservative campaign manager in the 2006 and 2008 elections in which the Tories won their first two governments. Mr. Harper then appointed him to the Senate.

“Stephen likes to take things on in a very direct way,” he says. “He’s very focused.”

So direct that Mr. Harper is putting the onus on the provinces to find a fix for health care. In fact, he told reporters Monday night that he doesn’t know what the answer is.

But that’s not his problem. The provinces have expertise and operational responsibility for health and the federal government is nothing but a financial partner, others have pointed out.

By dealing swiftly with his election promises and now the health-care issue – there were expectations that it would dominate the parliamentary agenda in 2012 – political observers are now looking for what may be the Prime Minister’s “big idea.”

Mr. Finley says, however, don’t expect “anything big or sweeping” in 2012. “He’s never really talked about grand visions.”

Instead, 2012 will be all about dealing with the world economic situation, Mr. Finley says. A large part of next year, he says, will be defined by the budget and the strategic review that is trying to find $4-billion in annual cuts from government spending.

“The thing that’s obviously overarching is still the economic situation around the world,” Mr. Finley says. “I think everything of a financial nature … will be formulated with that very much in mind. He [the Prime Minister] and the caucus are both extraordinarily targeted to a sound fiscal system in Canada.”

The government’s proposed national security regulator had been part of that plan, Mr. Finley notes. But it was rejected this week by the Supreme Court.

The health-care deal fits into the economic strategy by providing financial stability for the provinces and time to plan. And by taking it off the federal table as an issue, it allows Mr. Harper and his Finance Minister, Jim Flaherty, time to focus on the upcoming budget, which will involve what some are describing as “hellish decisions.”

Prof. Flanagan, meanwhile, notes the Prime Minister “can be bold at times” but “is basically an incremental thinker.” He wonders how far Mr. Harper will take this idea of revamping the way the nation is governed.

“Let’s see what happens with equalization,” says Mr. Flanagan, referring to the federal government’s program of making payments to the so-called “have-not” provinces. “This is pretty wonkish stuff, but it could have a major impact over time on the design of the Canadian welfare state.”

Could this be Mr. Harper’s “big idea?”

< http://www.theglobeandmail.com/news/politics/prime-minister-reshaping-the-way-canada-is-governed/article2282886/ >

Saskatchewan Premier Brad Wall says provinces are focusing too much on money and not enough on innovation and results when it comes to dealing with health care.

Money is only one part of the solution, he says. And although Saskatchewan is supportive of the federal government’s commitment to 6-per-cent annual increases in health-care funding until 2015-16, it is “not there yet” in terms of demanding another 10-year deal.

Other provinces, including Ontario, want the Harper government to commit to another long-term deal like the one reached in 2004 under Liberal prime minister Paul Martin. But the National Post is reporting that Finance Minister Jim Flaherty willcap health transfers and tie any increases to economic growth.

With the issue coming to a head, Mr. Wall told The Globe he doesn’t want to make upcoming negotiations all about money, percentages and escalator clauses. Rather, the Premier believes Canadians want the provinces to have a “discussion around results and better health care.”

The Council of the Federation meets in Victoria in mid-January and the expiry of the health-care accord is on the agenda. Mr. Wall is planning to bring this message to the table when he speaks with his provincial colleagues.

Last week, the Atlantic premiers met in Newfoundland and Labrador and demanded the federal government increase health transfers. They would like to see the Conservative government pay 25 per cent of their health costs, up from the 20 per cent Ottawa pays now.

The Saskatchewan Premier, meanwhile, says his province is successfully using private clinics to help reduce wait times for certain surgeries. They operate under the Canada Health Act but allow patients to have certain day surgeries outside of a hospital.

(Ian Hanna, a senior Wall official, noted that Saskatchewan inherited “the longest waiting lists in Canada from the previous government.” This is why the Premier “introduced private clinics” as a way of temporarily getting over the “waiting list bulge.” Most of the surgeries are orthopedic, including hips and knees, he added.)

The Premier says there is no “queue-jumping” in Saskatchewan’s program. Given the choice between timely surgery and having to wait, Mr. Wall said, people will choose surgery over ideology.

The issue of private medicine is a touchy one with so many politicians afraid that even whispering the word will lead to their defeat. But lately there has been a call from opinion leaders, including former Bank of Canada governor David Dodge, for an “adult, public conversation” on health-care funding.

Mr. Dodge believes there should be some kind of “co-payment,” requiring Canadians to pay for part of their care. Mr. Wall, meanwhile, says the conversation about changing health care has already begun in his province – and he believes the public is ahead of politicians on this front.

The Premier said his new plan is working. So far, according to Saskatchewan government statistics, there are about 19 per cent fewer patients waiting for surgery in the province than there were a year ago.

The province’s numbers show that a total of 99 per cent of surgeries are completed within 18 months, 96 per cent within 12 months and 87 per cent are completed in six months. The goal is that by 2014 no one will wait longer than three months for surgery.

A study by the Fraser Institute, however, shows that wait times for surgery and other treatments increased in Saskatchewan to 29 weeks from 26.5 weeks last year. It has one of the higher wait times. And the province also recorded the longest wait time between seeing a specialist and receiving treatment – 19 weeks.

< http://www.theglobeandmail.com/news/politics/ottawa-notebook/health-care-talks-arent-just-about-money-saskatchewan-premier-says/article2269360/ >

FOLLOWING THE MONEY IN PATIENT-FOCUSED FUNDING

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What politician recites poems by 20th century Japanese poets about schizophrenia during election campaigns – and then throws in a line from a Wordsworth sonnet, to boot?

The Liberal Leader does. He did so after first commenting on the weather, saying the skies may be overcast but he knew everyone at the event had “sunshine” in their hearts.

Schmaltzy.

His handlers noted later, however, that a member of his large and extended family suffers from mental health problems. They wouldn’t say who.

But it’s not surprising as one in every five Ontarians suffers from some sort of mental health issue.

Mr. McGuinty focused his remarks on youth, noting that 70 per cent of mental issues begin in childhood. His party is pledging $257-million over next three years to help Ontario children and youth, he said.

The money is aimed at providing faster access to services, put mental health workers in schools, allow for video counselling for rural children and help for aboriginal kids.

“There’s a guy by the name of Wordsworth, who I think had the best definition of hope of all,” Mr. McGuinty told the crowd gathered outside the Queen St. W. site.

“Hope is the paramount duty that heaven lays for its own sake on mankind’s suffering heart,” he said.

(He got it almost right. The correct quote is: “From hope, the paramount duty that Heaven lays, For its own honour, on man’s suffering heart.”) “I love that definition of hope because it speaks of it as a duty, as an obligation, as a responsibility,” said Mr. McGuinty. “We cannot allow families to lead their quiet lives of desperation. They are looking to us, they are looking to you …”

The Japanese poet, who he said he “recently discovered” and whose poem he read, was Kotaro Takamura whose wife Chieko suffered from schizophrenia.

He wrote a book of poems about her and her disease, which he called “Chieko’s Sky.”

It was evocative, talking about how his wife is weeping and feeling as if her life is falling apart.

“That poem was written in 1938 and the sad truth is for that for generations, mental health issues have been misunderstood, stigmatized and concealed,” said Mr. McGuinty. “Families, too often, felt alone and in many cases helpless.”

Mr. McGuinty claimed all that is now changing and he used the metaphor of the walls coming down around the Queen St. W facility to back up his claim.

“For many years there was a wall around this place … a big grey, foreboding thing,” he said. “Two years ago part of it came down and I think the symbolism is powerful. Our world has changed. Today we are more open, more understanding and more determined … (to deal with mental health issues.)”

Poetry and lovely sentiments aside, the Liberal leader announced that a third-phase expansion at CAMH has been approved, but didn’t mention the dollar figure yet. The expansion will house inpatient beds for schizophrenia, a community support and research and clinical programs.

< http://www.theglobeandmail.com/news/politics/ontario-election/on-the-hustings/mcguinty-shows-off-his-poetry-chops-at-mental-health-event/article2177843/ >

Parliamentary Budget Officer Kevin Page has put a price tag on the Tory’s tougher sentencing law, and it’s a big one.

According to a report released by Mr. Page this morning, the Harper government’s Truth in Sentencing Act will cost federal and provincial governments an additional $8-billion by 2016.

That’s the total cost of constructing new prison facilities on account of the act. The federal cost is projected to be about $1.8-billion, while the provinvial cost is roughly $6.2-billion.

The new law, passed in February, will keep offenders in jail longer, taking away a judge’s discretion to compensate an individual for pre-sentence time spent in detention.

There had been reports that it could cost up to $10-billion.

< http://www.theglobeandmail.com/news/politics/ottawa-notebook/budget-officer-sounds-fiscal-alarm-on-tory-sentencing-law/article1612988/ >

2. In search of the recovery. Bizarre but kind of funny, Jim Stanford, the Canadian Auto Workers economist, is using videotape and his acting skills to make his point that there is no economic recovery.

For just under $10,000, Mr. Stanford shot a video last December (the editing was just finished and it’s been posted to YouTube) called “The Curious Case of the Missing Recovery.”

In it, Mr. Stanford assumes a Colombo-type character – calling himself Lieutenant Stanfordo. He is dressed in a trench coat; he carries a magnifying glass and chews on the stub of a cigar.

And for the duration of the film, he drives around parts of Toronto, Mississauga and Brampton – “all the hot spots of the industrial meltdown,” he says – in search of the recovery that Bank of Canada Governor Mark Carney insists is here.

He talks to CAW members who have lost their jobs or whose companies have gone bankrupt and he deals with disappearing pensions.

Mr. Stanford, who is on a sabbatical right now but still writing on economic matters, says he came up with the idea after speaking to union and community where he would use the detective analogy in his talks.

The official CAW version of the movie is being shown at membership meetings across the country, he said. And it’s on YouTube for all to see.  < http://www.youtube.com/user/CAWMedia#p/u/1/pTjEMTaJeEU >

The video ends with the detective not finding the recovery because there “never was a recovery,” he says. And then he jumps into a Hummer that is driven by an actor, who looks just like CSI Miami’s Horatio Caine (he is actually a friend of Mr. Stanford’s – Robert Storey, a McMaster University professor), and they go to Florida.

Go figure.

< http://www.theglobeandmail.com/news/politics/ottawa-notebook/stephen-harper-loses-another-communications-chief/article1518270/?cmpid=rss1&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+TheGlobeAndMail-HYPolitics+%28The+Globe+and+Mail+-+Politics+News%29 >

Albina Guarnieri wants the sacrifice and generosity of Canadians rewarded with transparency.

So the Liberal MP for Mississauga East–Cooksville has crafted a private member’s bill requiring that the five highest-paid employees of registered Canadian charities publicly disclose their salaries. In that way, Canadians can make more of an informed decision as to where they want their donations to go and how they will be spent.

And the MP’s bill is timely given that Canadians gave so generously and quickly for the Haiti earthquake.

In her proposed legislation, Ms. Guarnieri is also setting a salary cap of $250,000 for the senior executives. Her bill asks that a charity be deregistered if it pays an employee more than $250,000 in a single year.

However, she has left it up to the discretion of the National Revenue Minister to allow a charity to continue to operate if the executive earns more than the cap.

Ms. Guarnieri notes that $250,000 is more than what a minister or deputy minister earns.

“The principle is clear,” Ms. Guarnieri said in outlining her bill in the Commons yesterday. “If you take home taxpayers’ money, you can’t hide how much.”

“It is the goodwill and trust of these donors that must be a priority for this Parliament,” she argued.

Ms. Guarnieri’s bill is the result of the controversy last year over the $2.7-million in salary and severance earned by the head of the SickKids Foundation.

Yesterday, she said the only reason the salary was revealed because the charity is also registered in the United States, where transparency is required.

The MP had the Library of Parliament research how charity executives in Canada use their salaries. She said the library could only “scrape together bits and pieces.”

“Here is how some of our charities spend money on themselves,” she said. “Dining club memberships, golf memberships, fitness memberships, business class travel, so-called ‘flexible’ expense account provisions, and even scholarship programs for their own kids.”

She says there are 85,000 registered charities in Canada. Canadian charities distribute almost three billion a year in tax credits.

The NDP and Bloc support her bill going to committee for further investigation. Some Tories support it as well.

Ted Menzies, the parliamentary secretary to the Finance Minister, was less committed. Instead, he simply sang the praises of the transparency he says is in the system now.

Liberal finance critic John McCallum, meanwhile, said this bill would help to restore credibility in the charity business, especially after the government’s failure to match the Haitian earthquake donations.

“News has broken that the government has not sent a single matched dollar down to Haiti,” Mr. McCallum said. “This is causing a certain amount of anger in the Haitian community and among those who have contributed to Haiti on the understanding that the government would expeditiously match their contributions dollar for dollar. That hurts the government’s credibility.”

He said Canadians may be reluctant to act as quickly the next time there is a disaster.

The vote on Ms. Guarnieri’s bill is likely to take place some time next month.

< http://www.theglobeandmail.com/blogs/bureau-blog/liberal-mp-wants-to-bring-transparency-to-charity/article1501959/ >