Politicians and bureaucrats are always attracted to simple ways to control health-care spending. In the early 1990s, they decided the best way to control spending was to cut down on doctors. This brilliant idea resulted in a doctor shortage that has taken the past decade to fix.

The reach for the quick fix has made fundamental change in health care all but impossible. It has given us the worst of all possible worlds – a system in which everyone behaves as if the competition for resources is a zero-sum game and no one is rewarded for acting in the collective interest. The system virtually guarantees turf wars. As a result, the medical professions resemble medieval guilds – fiercely protectionist, rigidly conservative and jealous of their status and perks.

This explains why all the sweeping top-down master plans to fix our health-care system will never work. As one insider puts it, “At each step, you find the structural impediments to change are extraordinary.”

There are lots of cheaper, more effective ways to do health care. But the system is rigged to squash innovation. Take a simple thing like colonoscopies. This procedure – the single most effective screening test for cancer – is conducted in Canada by gastroenterologists. In other countries, it’s done by nurse-clinicians. Why can’t we do that too? Because the barriers erected by the various professional silos are almost insurmountable. Who would pay? Who would be ultimately accountable for the procedure? And so on.

Or take prescriptions. Do you really need to see a doctor to renew your Lipitor? Why don’t we give prescribing powers to pharmacists? In fact, much of the work that family doctors do – ordering tests, taking your blood pressure, lecturing you to lose weight, even treating your bladder infection – is routine. Nurse practitioners and physicians’ assistants could do it just as well. Don’t try to persuade the doctors, though. (The last time I tried, they told me I might have bladder cancer and could die.) Besides, they need the fee income they get from seeing you.

But doctors are defeated by the system too. One group of doctors came up with a way to improve care for breast-cancer patients. Instead of sending a woman on an endless round of specialist appointments to the radiologist, the plastic surgeon and so on, they arranged for all the specialists involved in her care to meet with her all at the same time in order to lay out a treatment plan. When they told the hospital CEO about this breakthrough, he begged them not to spread the word. He feared the hospital would be flooded with patients it had neither the space nor the operating-room time to treat.

What kind of room is there to do things more effectively and efficiently? Here’s one suggestive statistic. We spend around 12 per cent of our GDP on health care. Singapore spends around 2.4 per cent. By almost any measure, Singapore has better health-care outcomes than we have.

Everybody knows that health-care costs cannot continue to rise at the current rate. Everybody in the system can point out lots of ways to do things better. We have a highly trained work force full of talented, hard-working and dedicated professionals. But until we can figure out ways to get them to work collaboratively together, and to reward innovation – not punish it – genuine reform will be impossible. Doctor-bashing is not the place to start.

< http://www.theglobeandmail.com/news/opinions/margaret-wente/doctor-bashings-not-the-cure-for-health-care-costs/article2434938/ >

When Linda McQuaig and Neil Brooks write their sequel to The Trouble With Billionaires, let’s hope they’ll help us understand why the 1 per cent whine even when they win.

Take Stephen Schwarzman, chairman of one of the world’s largest private equity firms, the Blackstone Group; worth $4.7 billion, Mr. Schwarzman is the 52nd richest person in America. He describes his business philosophy candidly: “I want war, not a series of skirmishes. … I always think about what will kill the other bidder.” He sees Wall Street locked in fierce battle with President Barack Obama which he once described, yes, as a war: “It’s like when Hitler invaded Poland in 1939.”

Mr. Schwarzman eventually apologized for his language – but not for the sentiment behind it. The heinous act that provoked him to compare the U.S. President to Hitler? Mr. Obama’s attempt to prevent billionaires like Mr. Schwarzman from paying tax at a lower rate than Warren Buffett’s secretary.

What’s particularly noteworthy here is that despite the success of the Occupy movement in putting inequality on the international agenda, it can safely be reported that just about everywhere, the 1 per cent are still laughing all the way to the bank. In fact they own the bank. Just a little south of here, the Bank of America was bailed out by American taxpayers to the tune of $45-billion. It claimed a pre-tax loss of $5.4-billion and so paid no taxes for the past two years. In one of those years, it dished out executive bonuses and compensation worth $35-billion. Could I make this stuff up?

The bargain between the 1 per cent and the governments of the 1 per cent is clear: huge tax breaks for the big boys, austerity for the 99 per cent. Can you handle more figures? Since the geniuses on Wall Street gave us the great crash of 2008, American banks received $7.7-trillion in bailout money and British banks $1.3-trillion. Yes, trillion, in both cases. To offset those losses to the public purse, the United States will cut public spending by $2.4-trillion in the next decade and Britain $128-billion. In Britain this will include almost half-a-million lost public sector jobs.

It’s time to resurrect the biting formula given us years ago by John Kenneth Galbraith, an earlier generation’s Paul Krugman: private affluence, public squalor.

Canada merely proves the rule. Despite our ever-receding kinder/gentler reputation, Canada is actually becoming more unequal faster than most other countries. There’s an elephant in the room here (as elsewhere) that’s almost always ignored. As economists Sam Gindin and Paul Kahnert report in the April CCPA Monitor, there’s far more wealth in Canada today than ever before. Per capita GDP is 50 per cent higher (adjusting for inflation) than 30 years ago. Yet most of that wealth has been transferred to the richest Canadians through tax cuts and government subsidies.

Since 1980, the ultra-rich have increased their share of the national income from 8.1 per cent to 13 per cent, a shift of $67-billion. Here’s a strange coincidence. The combined federal and provincial deficits now run at about $65-billion annually. So let’s see now. If taxes on the super-rich had stayed at their 1980 level – when no well-heeled Canadian was exactly suffering from cruel and unusual tax torture – there’d be no federal or provincial deficits today. Interesting.

Privileging the few and hurting the less privileged has been very much a non-partisan tradition in Canada, from Bran Mulroney through Jean Chrétien and Paul Martin to Stephen Harper. Between 2000 (Chrétien-Martin) and today, corporate taxes have been reduced to 15 per cent from 29 per cent, but instead of putting their extra profits into productive business investments Canadian corporate leaders have engorged themselves on their $500-billion windfall. Looking at the Harper government record alone, from its first year in office in 2006 to 2013-14, tax cuts will cost the government – that’s us, the citizenry – $220-billion, creating the very deficits that are now used to justify government spending cuts. Interesting.

But if the 1 per cent are still winning the brutal class war, the 99 per cent are not yet surrendering. Portents of hope are everywhere. France, of course. Britain, where the austerity-obsessed Tory-Liberal coalition got smashed in municipal elections last week. The United States, where Mr. Obama is framing Mitt Romney as the candidate of the 0.00001 per cent.

And if you sometimes fear that Occupy was just a dream, look hard and you can still find evidence across the United States of its existence. In fact there are mini-Occupies all over the country – Occupy Colleges, Occupy Our Homes, Occupy the Securities and Exchange Commission, even an Occupalooza organized by Occupy Fullerton, which seems to be a town in California.

In Canada too there’s a revival of protest. Of course most controversial are the Quebec students. But whatever you think of them – and I for one believe their protests have become counter-productive – it’s obvious these young people are amazingly committed and tenacious; that’s the spirit that the 99 per cent need.

Voices-Voix, a non-partisan coalition of civil society groups and NGOs disappointed by the Harper government, is revving up its collective clout against the government. Canada can also now boast of Doctors for Fair Taxation, Lawyers for Fair Taxation and Faith Leaders for Fair Taxation. (Anyone who needs extra motivation should take a gander at Kevin O’Leary’s treatment on CBC TV not long ago of a serene and knowledgeable Tanya Zakrison, a surgeon representing Doctors for Fair Taxation.)

A couple of weeks ago 15,000 protestors demonstrated in Toronto against the McGuinty government’s attack on Ontario’s public-sector workers. Along with ever-lower taxes and an end to government regulation of the corporate world, destroying the trade-union movement has for decades been a key objective of the 1 per cent.

Ontario NDP Leader Andrea Horwath has now accomplished what the majority everywhere are fighting for. She actually forced the minority Liberal government, anxious to avoid an election, to agree to a small surtax for the 23,000 Ontarians who declare earnings of more than $500,000 a year. If I were advising Ms. Horwath, I would mobilize those crusading doctors and lawyers for fair taxation and make equality and fairness my campaign cry in the forthcoming Kitchener-Waterloo by-election.

I don’t think either American or Canadian billionaires have to sell off too many of their private jets just yet. But they shouldn’t be too complacent, either. The rich world is due its Spring Revolutions too.

< http://www.theglobeandmail.com/news/politics/second-reading/gerald-caplan/update-on-the-class-war-1-winning-99-regrouping/article2430024/singlepage/#articlecontent >

If there’s any branch of the federal government that should top the “hate list” for Canadian conservatives it has to be the Canada Revenue Agency.

This is the agency, after all, that big government uses to painfully extract our hard-earned wealth – sometimes with bullying tactics – so that Bev Oda has the funds to buy more orange juice.

Yet strangely, the supposedly “conservative” Harper government is giving $8-million in additional funding to the CRA.

What’s going on here? Isn’t that like Hobbits giving arrows to Orcs? Or like New York Yankees fans cheering for the Boston Red Sox?

It just doesn’t make sense.

Nevertheless, it seems the Tories want to bolster the CRA’s muscle so it can more efficiently squelch free speech.

Well OK, that’s not really fair to the Conservatives.

What they really want is for the CRA to more thoroughly investigate charitable groups that are trying (horror of horrors) to sway public opinion.

Under our laws a registered charity is allowed to engage in what’s called non-partisan political activity only if the money spent represents no more than 10 per cent of its resources.

The Conservatives want more information to ensure charities are respecting the rules. The government, by the way, can suspend a group’s charitable status if it doesn’t get the information it wants or if it finds the group has exceeded the limits.

Why are the Tories so interested in charities engaging in political activity all of a sudden?

Well, it’s likely because certain charitable environmental groups have recently spent money in an attempt to turn Canadians against the government’s plan to build the Northern Gateway pipeline.

This opposition has made the Tories very unhappy.

Natural Resources Minister Joe Oliver, for instance, recently decried “environmental and other radical groups” whose opposition to the pipeline, he said, is undermining the national interest.

And so the Tories are unleashing their tax-law legions.

They also want to amend the Income Tax Act to introduce penalties for charities that exceed the limits on political activity or fail to report it.

Prime Minister Stephen Harper says this is just standard operating procedure. As he put it, “What is incumbent upon all charities is that they respect the laws regarding political activities. Those laws are clear.”

Technically speaking, of course, the Prime Minister is right – the law is the law.

But what if the law is wrong?

And in this case, the law gagging charities is most definitely wrong because it infringes on free speech.

To put it another way, democracy would be better served if charities had more freedom to advance ideas and to debate issues.

Certainly, this would help ensure voters are better informed when it comes to policies. And more-informed voters make more-informed votes.

Mind you, this is something Mr. Harper should already understand. In fact, as a conservative, he should be ideologically opposed to government rules and regulations that only serve to stifle free expression.

In other words, he should be loosening rather than tightening the regulatory straitjacket constricting the rights of charities.

And yes, if he did this it would give charities that oppose his agenda more freedom to speak out. But at the same time it would also give charities that support his agenda more freedom to do the same.

In the end the side with the best ideas would prevail in the court of public opinion. That’s the way it should be in a democracy.

If none of my arguments has convinced you, consider this final point: Less-regulated charities should frighten you far less than a better-funded Canada Revenue Agency.

Gerry Nicholls is a communications consultant.

< http://www.theglobeandmail.com/news/opinions/opinion/charities-silenced-by-the-taxman/article2433828/ >

Some young people who have grown up in a mix of broken families, foster homes and group homes deliver a report to the Ontario legislature Monday. Their lives often don’t turn out as well as those of other youth. They think legislators should know that.

About 15 years ago, I received money from a youth charity to give to a youth charity of my choice. I might have given it to groups I had already worked with or knew. But this was a chance again to ask the most basic question: Given all the kids who have needs, who needs help the most?

I asked the advice of people in foundations and other community groups. The most “disadvantaged” of the “disadvantaged,” they agreed, were kids from foster homes and group homes. What these kids needed was a chance, in their words, to “break the cycle” of a family history of poverty and abuse that often went back generations. Their best chance to do this? To go to university or college.

We’ve given out more than 140 scholarships in the years since.

Even when you know these young people’s stories, they strike you with surprise. Not so much the details of parents who have mental illness, alcoholism or drug abuse, but what the day-after-day, year-after-year implications of living with someone with those problems feels like. Yet many of these youth somehow — almost never without big setbacks — reach their last year of high school. Now they are thinking, hoping, dreaming, of university and a future that never was to be. This is their one-way ticket out.

We talk a lot now about the cost of post-secondary education. Imagine as a student trying to meet that challenge if your parents can’t help you out. If they aren’t around to use their contacts to get you a summer job. If there’s no home to return to in the summer even if it’s only not to have four additional months of room and board to pay for. But these youth find a way — big student loans, scholarships — because to them if they’ve made it this far, they’re not not going to go to college or university! This is their chance.

But for them things take longer. Switching foster homes and schools eight times in three years sets them back a year. To pay for college, they need to work a part-time job 20 hours a week, not 10. So they take one fewer course — this year, and next year too. They take a year off to work to save money. Their mother has a relapse. Even though their mother has brought to them little more than misery, she’s the only mother they have. So they leave school for a term to take care of her.

For these youth, without much beneath them to brace their fall when things go wrong — and they do in every kid’s life — the slide is farther, steeper and harder. If gap years and changing majors have made 25 the new 21 for many youth, real life has made it this way for them.

This is what their report speaks of. But first they had to go through some process. They decided if no one else was going to hold hearings for them, they would hold them for themselves, and tell their own story — and they did: for two days last November in the Ontario legislature. In doing so, they were supported by the office of the provincial advocate for children and youth. Their report rarely sounds overdramatized, almost always authentic — exactly what any legislator needs to make the right decisions.

Perhaps most remarkable are the group’s recommendations; or more accurately, their recommendation. In-care youth experience things at a young age things that many others never do until they’re much older, if at all. They make decisions for themselves — about what to eat, what to buy, when to go to bed — that only adults usually make. Yet the big decisions in their life — whether they need to stay with their parents or be put into care; who their foster parents will be; or when they are ready to fly on their own, finally and forever — none of these decisions they make themselves. They’re all made by others.

So their recommendation:

The Province of Ontario should recognize that the current system needs to fundamentally change to better prepare young people in care to succeed. [It] should work with young people in and from care and other stakeholders to complete an ACTION PLAN FOR FUNDAMENTAL CHANGE by November 2012 that addresses our concerns and goals.

The six other “In the meantime” recommendations, as they put it, are all written in smaller print. They talk, among other things, of raising the age for which youth receive extended care and maintenance from 21 to 25, and allowing youth to stay in foster care until they decide themselves when they’re ready to leave. I don’t know if these have merit, or their counter-arguments, or the best way to achieve the goals that need to be achieved. But I do know that the first recommendation, the only one written in big print, is right. Sometimes, it’s not just what you do, but howyou do it.

These youth created their own hearings, wrote their own report, and told their own story better than anyone else could. Now they need to be part of a working group that includes parliamentarians to write an action plan for their future. It’s theirlife.

Ken Dryden served as federal minister of social development under prime minister Paul Martin from July 2004 to February 2006.

< http://www.thestar.com/opinion/editorialopinion/article/1177432–mpps-should-heed-advice-from-youth-who-survived-the-care-system >

Ontario’s child welfare system needs fundamental change to address the isolation, vulnerability and abandonment experienced by too many children in foster care and group homes, says a groundbreaking report written by youth about their plight.

The report, based on unprecedented legislative hearings last fall by youth from the child welfare system, calls on the province and others to work with them to produce an action plan by November.

The goal is to make Ontario a better parent to roughly 8,300 children and youth in its care and make their transition to adulthood more secure.

The report being released Monday at Queen’s Park, says the government should act immediately to raise the age of financial and emotional support from 21 to 25; allow youth to stay in foster care beyond age 18; and declare a “Youth in Care Day” to raise awareness and reduce stigma.

The province should also develop ongoing health and education plans for every child and youth in care; collect and publish information on their experiences during and after they leave care; and create an online clearing house of information and resources for them, the report says.

“Every child and youth deserves to feel and know that we are loved and cared for,” says the report, based on almost 200 submissions from young people during two days of hearings last November. “We are vulnerable youth and need more than a system of policies for this to happen.”

The hearings arose from the youth’s need for “our parent — the province — to listen and to understand the struggles around leaving care.”

The trauma of their young lives, coupled with frequent moves in foster care leave too many ill-equipped for adulthood.

Just 44 per cent complete high school. As adults they are more likely to experience poverty and homelessness, suffer mental health problems and become involved with the criminal justice system.

Youth are counting on Ontarians to listen and act, said Wendy, 20, one of the hearing’s four youth leaders.

Her support from Durham Region Children’s Aid ends in August when she turns 21.

(As with the legislative hearings, only first names are being used to protect the youth and respect the often harrowing nature of their experiences.)

“I think people who read the report will begin to understand what the struggles are and how it can get better,” Wendy said in an interview.

“We were focused on the issue of leaving care (at age 18 and 21), but there are a lot of things that happen during care that affect what happens to you after,” she said. “It really starts from the day we enter care.”

Wendy, who was removed from her substance-abusing parents when she was 13, said she was “lucky.” She was only moved twice and is still living with her current foster parents who treat her like a daughter. Unlike most youth who leave the system at age 18 or 21 with no permanent family, she knows the love of her foster parents is unconditional and forever.

“I have not moved out, nor will I have to when I turn 21,” she said. “When I do move out, I always have them as a safety net to go back to if times get rough, or just to spend the night on the holidays.

“We need to look at how I got here,” she added. “For me it was a stroke of luck. But we can’t rely on a stroke of luck.”

The report, entitled My REAL Life Book, reflects six main themes of youth who addressed the hearings, including feelings of vulnerability, isolation and being “left out” of decision-making about their lives. The unpredictability of foster care and group home arrangements, the struggle when care ends, and the lack of one meaningful adult relationship to carry them into adulthood are also highlighted.

Lindsay, 20, who entered foster care with her younger sister in New Liskeard, Ont. when she was 14, said she is often overwhelmed by loneliness and isolation.

Initially, she thought life away from her addicted and abusive single mother would be better. And in many ways it was: Her foster parents provided love, stability and the expectation that she would go to university and become a successful adult.

But she said it felt odd to be excluded from her foster family’s vacations. And restrictions such as needing her Children’s Aid approval to go on sleepovers or ride in a car driven by adults other than her foster parents, always reminded her of her Crown ward status.

Like most youth in care, Lindsay moved out on the day she turned 18 when the province’s legal responsibility for her ended and her foster parents no longer received funding to support her.

“On my 18th birthday I woke up in my foster home and that night I went home to a completely different place,” she recalled of the student rooming house where she rented a room with the help of a modest monthly allowance from Children’s Aid.

Suddenly she was living on her own and juggling a part-time job while trying to complete Grade 12. Her grades slipped and she didn’t graduate that year. Her delayed transition to college wasn’t any easier and she dropped out after first semester. Although she is back in college now, her shaky start means she may not finish by next May when she turns 21 and loses all financial and emotional support from Children’s Aid.

Lindsay, one of seven youth who wrote the report, longs to go to university after college, but doesn’t know how she will manage unless the government acts on the report’s recommendation to raise the age of support to age 25.

As she says in the report: “All we’re asking for is for four more years. Four more years of care to find people who matter to us, who don’t fall into the circle of the unhealthy lifestyle we’ve been born into.”

Ontario’s Provincial Advocate for Children and Youth, Irwin Elman, released a research report earlier this year that showed the $26 million annual price tag to extend support to age 25 for youth in the child welfare system would be more than recouped through reduced jail and social assistance costs and increased tax revenue as they are better able to complete their education and get good jobs.

Over 40 years, the return on this investment would amount to $132 million in current dollars, the report said.

Elman says Monday’s report is an opportunity for the province to “do right by its kids.”

“We can move when we want to. I don’t think 60 days to appoint a panel and another 60 or 70 days to create a blueprint is too much to ask,” he said.

In a statement, Minister of Children and Youth Services, Eric Hoskins, called the hearings and the report “without precedent,” “groundbreaking” and “brave.” He will respond formally on behalf of the government Monday.

* Almost 17,000 of Ontario’s 3.1 million children are in the care of Children’s Aid Societies

* Of these children, the province is legal guardian to more than 8,300 Crown wards who have been permanently removed from their parents due to abuse or neglect.

* The average annual cost of maintaining a child in foster care is $45,000

* Just 44 per cent of youth in care graduate from high school

* 81 per cent of all Ontario youth graduate from high school

* 43 per cent of homeless youth have been involved with the child welfare system

* 68 per cent of homeless youth come from foster homes or group homes

* 82 per cent of children in child welfare have diagnosed special needs

Source: My REAL Life Book, Report from the Youth Leaving Care Hearings

< http://www.thestar.com/news/article/1177881–ontario-s-youth-leaving-care-hearings-call-for-fundamental-change-to-child-welfare-system >

When a crow went down with West Nile virus somewhere in Ontario, my phone would ring. Practising as an infectious disease specialist at the time, I was alerted to early warnings about threats to the public’s health from infectious agents. Immediate response was expected – and provided – by our strong public health infrastructure.

But here at the children’s hospital where I now work, a group of us meet regularly, if informally, about another pressing public health threat – hunger.

We live in one of the wealthiest countries in the world. But hunger is something that we at the hospital increasingly see among the families that bring their children to us for medical attention.

For 10 days beginning May 6, which marked the start of Hunger Awareness Week in Canada, the United Nations Special Rapporteur on the Right to Food is making a formal country mission visit to Canada. It’s the first-ever visit to a developed nation by Olivier de Schutter, a Belgian law professor who became special rapporteur in 2008.

As a signatory to both the Universal Declaration of Human Rights (1948) and the International Covenant on Economic, Social and Cultural Rights (1976), Canada has a legal obligation to “respect, protect and fulfill the right to food.”

It’s my hope that this visit – and the recommendations in the report that Prof. de Schutter will subsequently produce – will throw a spotlight on the disturbing truth that far too many Canadian children are hungry because their families lack access to adequate and nutritious food.

Food Secure Canada estimates that almost 2.5 million Canadians live without secure access to food.

An infectious agent like West Nile poses an immediate threat as well as long-term health consequences (if almost exclusively in adults). Unquestionably, the consequences of hunger and food insecurity in childhood are similar.

Why are we concerned here? Many pediatricians with community practices tell us that finding the money to feed their children is the top problem faced by many parents they meet.

We see children whose parents struggle with poverty. We admit proportionately more children from high poverty neighbourhoods to hospital than from other neighbourhoods, and the children from poorer neighbourhoods stay longer at the hospital.

We know that childhood hunger – which of course is linked to poverty – has long-term impacts on physical and mental health.

For healthy growth and development, children need sufficient nutrients. Deficiencies of even small amounts during this important period can have long-term health consequences.

One thing we’re seeing in recent years is an upswing in cases of rickets, a condition still prevalent in developing countries but one that I thought would be corrected in Canada through the 1970s, when I trained in Montreal.

Rickets is preventable. It is primarily caused by a lack of sunlight and vitamin D, (including vitamin D supplementation with breast feeding), although a lack of calcium can also contribute to the condition, which causes bones to soften and become prone to deformity. Foods that contain vitamin D include fortified milk, as well as eggs, fish oils, margarine and some other foods.

The children we see who have developed rickets are quite simply not getting adequate amounts of sunlight and nutritious food, including vitamin D supplementation with breast feeding.

As a recent report from Toronto’s medical officer of health states: “Children who live in food-insecure households are more likely to have growth and developmental problems, be susceptible to illness and perform poorly in school, compared to children who are food-secure.”

Adequate nutrition is also a key issue when it comes to mental health among youth. Psychiatrists speaking at the request of community youth in one of our priority neighbourhoods advised that the first two mental-health questions that should be asked of young people are: “How did you sleep last night?” and “Have you eaten today?”

We know that in the Greater Toronto Area, the use of food banks is increasing rapidly. A key reason is that housing costs are eating up a growing proportion of family income. Initiatives are under way to help physicians and other health care providers better link families to resources such as food banks and government services.

But while there is a perception that food banks – as well as programs like school and community meal programs, community gardens and kitchens – are providing the needed response to food needs, Canadian research challenges this notion.

The UN Special Rapporteur will present his preliminary findings on food security in Canada on May 16 in Ottawa. It’s my hope that this will put child hunger squarely on the political agenda in Canada – and galvanize action to eliminate it.

Specializing in social pediatrics, Dr. Elizabeth Lee Ford-Jones is an expert adviser with EvidenceNetwork.ca, project investigator at the Hospital for Sick Children and a professor in the department of pediatrics at the University of Toronto.

< http://www.theglobeandmail.com/news/opinions/opinion/childhood-hunger-is-a-canadian-public-health-crisis/article2430182/ >

British Columbia’s lowest-paid workers finally got a raise last spring, when Premier Christy Clark announced the first increase to the province’s minimum wage in 11 years. The wage increased by $1.50 to $10.25 an hour, in one year bringing it up from the lowest in the country to tie for second highest with Ontario, just behind Nunavut’s $11 per hour.

But even with an increase, full-time minimum wage workers in B.C. aren’t earning enough to meet Statistics Canada’s low-income cut-off line (commonly cited as Canada’s poverty line) for families. Raising the minimum wage also does little for people who can’t work full-time, can’t work at all, or who can’t find work. That means the recent rise in the minimum wage, welcome as it is, won’t do much to rescue the one in 10 households now living below the poverty line in this province.

But if a higher minimum wage isn’t enough, then what income policy is the best choice for eradicating poverty in British Columbia? Economists and social policy groups have no shortage of solutions to suggest. Ideas include a so-called “living wage,” higher welfare rates, a universal guaranteed minimum income, even something called a “Demogrant.” (For a more complete list, see the sidebar to this article, “A Glossary of Anti-Poverty Policies.”)

For the Tyee Solutions Society, I’ve been exploring the pros and cons of three of the most widely advocated of these proposals to put an end to poverty: the living wage, a guaranteed annual income, and government wage subsidies. I spoke to anti-poverty activists, social policy theorists, academics, and economists. Some have devoted careers to advocating for a specific method; others take a more flexible approach to reducing poverty.

Reports in the days to come will detail the merits and drawbacks of a guaranteed annual income and of government wage subsidies. We start here with a look at the pioneers who are turning the idea of a living wage from generality into a meaningful number.

The difference a living wage made for one mother

When Alex Moya started as a shipper/receiver at software maker SAP in Vancouver last September, she was earning $15 an hour. Almost $6 above minimum wage at the time, it was enough for her to get by. But still, she admits it was sometimes “stressful.”

When SAP became a “living wage” employer earlier this year however, Moya’s salary jumped to almost $19 an hour. It was a big help for a young mother who, along with her husband, has a young daughter in daycare and commutes from their home in New Westminster to work in Vancouver.

“Just to have extra cash, it helps for those things that you’re not prepared [for], like if your car breaks down or something happened to your computer. I don’t feel so stressed out. I feel I can have a little bit of extra cash for the ‘just-in-case’ things,” she says.

“I feel like I can have a more normal life, like if I want to just go out and have a dinner or go to the theatre, I have that extra money.”

Unlike a minimum wage, a living wage is calculated using the cost of living in a specific municipality. The idea is that the salary you make should be enough to cover the cost not only of food and shelter, but also of transportation, basic medical care, household goods, school supplies and clothing needs. Differences in rent and food prices mean living wage rates vary across the province.

Anti-poverty advocates like the Canadian Centre for Policy Alternatives, First Call: BC Child and Youth Advocacy Coalition, and half a dozen public sector unions support the idea through A Living Wage for Families Campaign. The non-partisan organization pushes municipalities, private businesses, and the provincial government to adopt living wage salaries for their own and their contractors’ employees.

Each year the campaign releases an updated calculation of living-wage rates for full-time work in several B.C. municipalities. They range from an hourly wage of $14.16 in Cranbrook to $19.14 in Metro Vancouver. Those rates may be lowered, however, if they’re matched with benefits like health and dental coverage, day care subsidies, or bus passes.

For Michael McCarthy-Flynn, director of the campaign, it’s the best method for eliminating poverty for workers who don’t meet the low-income cut-off lines: “It’s a wage that will lift people out of poverty and it’s based on the sophisticated methodology that looks at the basket of goods that the average family needs.”

The basket is quite limited: the “needs” it recognizes include food, clothing, rent, healthcare, transportation and education costs. Notconsidered needs are debt payments, retirement or education savings, home ownership, caring for a disabled or elderly relative or covering emergency costs like car trouble, vet bills or any of those other “just-in-case” moments Alex Moya used to worry about.

And the idea has its detractors. They say a living wage does nothing for people who for a variety of reasons aren’t working. When B.C.’s unemployment rate sits at just about six per cent, tying a poverty reduction strategy to work, they argue, won’t solve income inequality.

Living wage catches on in BC

Although living wage campaigns sprang up across the United States and the United Kingdom in the early 1990s, they’ve only come to the forefront of B.C. anti-poverty discussions in the last decade.

It’s a theory at least two municipalities have already bought into. New Westminster made history in 2010 when it became the first municipality in Canada to adopt a living wage for its workers and contractors. The Capital Regional District of Esquimalt followed suit in January 2011.

This April the Qualicum School District became the first district in the province to adopt a living wage strategy. Over 130 municipalities in the U.S. and more than 100 U.K. employers have also adopted living wage polices.

Several B.C. employers have also embraced the living wage. The most high profile is VanCity Credit Union, which officially joined the ranks of living wage employers last summer. Others include non-profit organizations like the BC Teachers’ Federation, United Way of the Lower Mainland and The Canadian Cancer Society — B.C. and Yukon Division, as well as for-profit companies like SAP’s Vancouver presence and Now Communications.

A public for-profit software company, SAP’s involvement with the Living Wage for Families Campaign started with its pro-bono development of an online living wage calculator. It grew into a living wage commitment from the Vancouver office when managers there realized how the campaign fit into their social and economic sustainability goals.

“SAP is a global multinational company, and we’re very much interested in doing good in the world,” says Kirsten Sutton, managing director for SAP Labs Canada. “But what’s most important is for each location to make sure they’re doing good in their community, and for us here [instituting a living wage] was one way to do that.”

Most of SAP’s own Vancouver employees were already making above the living wage, so the firm’s effort focused on the 50-plus contractors who provide its office custodians, security staff and facility managers. (Shipper/receiver Moya is actually employed by Compass Group Canada, an SAP contractor.)

Sutton says it means paying more money for these contracts. But for their office it’s important not to pass the poverty on: “A good business these days is not just a bottom line,” she insists. “It’s worrying about many other things.”

During the run-up to last November’s municipal elections in B.C., the Living Wage for Families Campaign joined 54 other organizations in a push to convince candidates in Metro Vancouver to support a living wage for workers. Although the effort failed to persuade additional cities to adopt living wages, most of the candidates contacted expressed interest in the idea, even if they did not immediately endorse it.

And the campaigning seems to be paying off in other ways. While the election season was on, the Columbia Institute commissioned a poll asking a representative sample of voters whether they would support their town or city adopting a bylaw to ensure all municipal employees and contractors adopt a living wage. Over 67 per cent said they would.

A partial answer at best

While that kind of support may be promising for the future of municipal employees and contract workers, critics point out that a living wage benefits only people who are able to work, and can never be more than one part of a broader poverty-reduction plan.

“A successful, comprehensive, poverty reduction strategy would include some policy to deal with adequate wages,” says Margot Young, a University of British Columbia law professor. “But [must also] ensure those who aren’t in the paid labour sector have an ability for flourishing, both economically and in terms of participating in the community, that is just and fair.”

Young co-authored a report on the more inclusive idea of a guaranteed annual income for the Canadian Centre for Policy Alternatives (one of the groups with a seat on the Living Wage for Families Campaign advisory committee). It’s a subject we’ll look at in the second part of this series.

Living Wage campaigner McCarthy-Flynn accepts Young’s criticism. “The [guaranteed] income is looking at people who are on welfare, ensuring that they have a dignified existence and [getting] rid of the bureaucracy, whereas the living wage looks at the working poor,” he reasons. “So they’re sort of complementary rather than in competition.”

Simon Fraser University economist Krishna Pendakur endorses paying workers enough money to live on, but he’s uncomfortable with policies that favour select groups. Because only a handful of municipalities and businesses yet endorse a living wage policy, that’s exactly what it does.

“One obvious mechanism the state has is to pay its own workers a lot,” he says. “But not everyone gets to be a public sector worker.”

It’s an investment: McCarthy-Flynn

Then there’s the cost of implementing a living wage. Although it’s difficult to determine what the total cost would be because of the range of living wages across the province, the average hourly wage for workers over 25 in B.C. is significantly above the living wage for a four-person household. Many people’s wages wouldn’t change at all under a living wage.

But according to the Canadian Centre for Policy Alternatives, in 2008 almost eight per cent of the population earned less than $12 an hour.

McCarthy-Flynn says cost is a poor excuse for inaction. He believes governments and employers should see a living wage as an investment in the future, rather than an expense for today.

“We seem to be very good at spending money on poverty after it exists, ” McCarthy-Flynn says, “rather than investing in programs that will prevent poverty from happening in the first place.” Those, he says, “are, one, cheaper, and two, a lot better socially in the long run.”

McCarthy-Flynn cites a CCPA report which estimates an annual poverty cost of $8.1 to $9.2 billion in B.C. alone. A large chunk of that money goes to pay for the healthcare and policing costs associated with poverty.

By comparison, the same report put the cost of a comprehensive poverty reduction plan at $3 to $4 billion per year.

Another CCPA report Working for a Living Wage: 2011 Update cites a finding that employers who paid a living wage in the U.K. saw a decrease in employee absenteeism. Unchecked absenteeism in Canada, itestimated, costs employers up to $6 billion per year. Other changes that came with a U.K. living wage include a reduction in staff turnover, improved performance and production and greater customer satisfaction.

The centre’s research doesn’t directly link a reduction in health costs with a living wage. But it does cite evidence that higher stress levels among low-income households relative to those in the mid-to-higher income bracket lead to poorer overall health and a greater use of health services in the long-term.

To McCarthy-Flynn, a living wage would allow those who have been taking the most from our social safety net to start paying back into it. That, he argues, benefits more than just the people at the lower end of the economic scale.

“If people get a living wage and are lifted out of poverty, they have a higher opportunity to become fully engaged, productive, contributing members of society in terms of the economic return they give and the social return,” he says.

Growing support in the business community and the wider population for instituting a living wage hasn’t been enough to sell B.C.’s Liberal government on raising the provincial minimum wage again any time soon. Its NDP rivals have come out in support of indexing the minimum wage to inflation; it’s unclear whether those changes would become reality should the party come to power in next year’s provincial election. And plainly, when one British Columbia household in 10 struggles below the low-income cut-off line, getting everyone to a living wage is going to take more commitment — from government, the business community and most of all, voters.

But the living wage isn’t the only policy device to help get us there. We’ll look at others in reports to come tomorrow and Wednesday. 

< http://thetyee.ca/News/2012/05/14/Living-Wage-Enough/?utm_source=mondayheadlines&utm_medium=email&utm_campaign=140512 >

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A GLOSSARY OF ANTI-POVERTY POLICIES

Ontario is shaping up for a fight with the federal government over the now defunct long-gun registry after Premier Dalton McGuinty said Friday that he wanted stores to keep records of who buys firearms, despite objections in Ottawa.

The defiant statement came on the same day RCMP Commissioner Bob Paulson warned all chief firearms officers in the country that they must not to create any semblance of a long-gun registry in their jurisdictions.

“The coming into force of the Ending the Long-Gun Registry Act leaves no doubt that Parliament has sought to eliminate any form of a long-gun registry,” Paulson wrote in a letter.

But Ontario has a different interpretation of the Firearms Act, and it will be up to the federal government to introduce legislation to counter the record-keeping practice, said McGuinty.

“We’re not going to adopt a long-gun registry here in Ontario,” McGuinty said after touring a local website development company.

“But we will maintain a practice that’s been in place since 1978.”

At the same time, Quebec has mounted a legal challenge preventing the destruction of federal long-gun records.

“Let’s not have an exchange between the RCMP expert in this area and the provincial experts in this area,” McGuinty added.

“Let’s turn it back to the feds and say if your intention was to not only eliminate the long-gun registry but a pre-existing practice, I think you need to make that clear.

“Right now there’s obviously some uncertainty.”

Federal Public Safety Minister Vic Toews sent a letter Tuesday to all provincial chief firearms officers, telling them the collection of point-of-sale data is no longer authorized under the Firearms Act.

He asked the RCMP to notify him “immediately” if they learn that chief firearms officers are engaged in “unauthorized data collection.”

Toews’ letter to Paulson added that the RCMP and the Canadian Firearms Program were to provide “no assistance or direction” to any province that may be undertaking measures to create a provincial long-gun registry.

Officials with the Chief Firearms Office of the Ontario Provincial Police have previously said the OPP would continue to maintain records of all firearms sales and who bought them.

While they have insisted this is not an attempt to create a provincial long-gun registry, some observers have complained that Ontario police are flouting the will of Parliament, and creating a new provincial gun registry “by the backdoor.”

Toews said the collection of point-of-sale data is no longer authorized under the Firearms Act.

Paulson reiterated this point in his letter.

“I instruct all Chief Firearms Officers to ensure that the licensing conditions you impose on business records pursuant to the Firearms Act do not facilitate the creation of long-gun registries in your jurisdictions,” he said.

Ontario Community Safety Minister Madeleine Meilleur has written Toews to clarify the province’s position on the issue.

Meilleur says recent media attention created confusion, so she wanted Ottawa to know Ontario does not want a provincial gun registry and will “comply fully” with the requirements of Bill C-19, which killed the federal long-gun registry.

But in an interview, Meilleur said Ontario retailers will continue to take down names and address of anyone purchasing a gun as part of the permit process.

She said the chief firearms officer of the Ontario Provincial Police interprets section 58 of the Firearms Act as giving him the power to impose that requirement.

With files from Postmedia News and The Canadian Press

< http://news.nationalpost.com/2012/05/11/rcmp-boss-warns-provinces-against-backdoor-long-gun-registries/ >

Remember that warm and fuzzy ad campaign depicting doctors in white coats, sporting stethoscopes and smiles?

Doctors aren’t smiling any more.

That feel-good branding exercise, part of a year-long charm offensive by the Ontario Medical Association just ahead of fee negotiations, has faded from bus shelters. Now, doctors find themselves sheltering from a perfect storm that is branding them as the fall guys.

It’s not just the governing Liberals taking a hard line, but the opposition Tories demanding a blanket freeze and New Democrats wanting to make the rich pay. With public servants taking a hit, the healing profession is feeling everyone’s fiscal pain.

This time, the writing was on the wall before both sides even sat down at the table. Cabinet approved its final negotiating “mandate” in February for doctors — and teachers: No spending increases.

Doctors are paid about $11 billion; factor in teachers and other public servants with contracts up for renewal, and about $25 billion is at stake in negotiations this year — nearly one-quarter of total government spending. That’s why retreat is unlikely, lest the government’s deficit-reducing fiscal plan crumble.

Read more:How Ontario’s doctors get paid

Outgunned, the OMA deployed a secret weapon of its own: It hired the government’s guy.

As deputy minister of health in the last negotiations, Ron Sapsford helped craft the government line. After leaving in the wake of the eHealth scandal, he joined the OMA, rising to CEO last year.

Sapsford has changed chairs, but times have also changed.

Last time, the government was flush with cash and keen to win OMA support in a highly politicized drive to reduce surgical wait times and increase the supply of family physicians.

This time, doctors can’t complain of falling behind: payments have increased by 75 per cent since the Liberals took power in 2003. They remain the best-paid in the country (despite quibbling from the OMA and others, the data suggest our docs are tops when all payments are included for 2011).

This time, threats of another brain drain are contradicted by the quiet return of émigré doctors from the once-promised land of America, describing how private insurers won’t authorize treatments, patients don’t pay their bills, and malpractice premiums are punishing. Also, medical school slots have recently doubled with a clutch of new schools across Ontario, plus a surge in foreign-trained doctors.

This time, technological advances have bolstered the government’s case for fee reductions. Exhibit A is cataract surgery, which takes 15 minutes today compared to two hours in the past.

This time, expert opinion — and a strong all-party political consensus — is pushing to reallocate spending to long-term care and home care, freeing up acute care beds.

And this time, the government is being goaded by outside experts to hang tough. In his high-profile reported last February on public spending, economist Don Drummond warned, “Aggressively negotiate with the Ontario Medical Association for the next agreement.” In his annual report, Auditor General Jim McCarter complained that Ontario may not be getting value for money from special incentives for doctors.

Against that backdrop, Sapsford hasn’t been able to deliver any medical miracles for the doctors he once bargained against, but now bargains on behalf of. In frustration, the OMA walked away from the table last month.

Sapsford also faces a formidable opponent in Deb Matthews, the health minister whom he served for a few months before taking his leave. Matthews is not above demonizing doctors in public. She has artfully sugar-coated the freeze, which in reality amounts to cuts for some (since more than 550 new doctors every year will compete for that fixed pie).

Last week, Matthews went ahead with nearly 40 unilateral fee changes that achieved most of the government’s targets for this year. Now, she is inviting them back to the table to address the unfinished business for the next three years.

As for Sapsford, his OMA sought a private meeting with Premier Dalton McGuinty. But it was seen as an end-run around Matthews, his former boss. In the end game, the meeting never materialized.

And doctors aren’t smiling any more.

< http://www.thestar.com/news/canada/politics/article/1177718–cohn-why-ontario-s-doctors-won-t-win-fight-on-fees >