Tag: Health Care

Alberta Politics: Never mind the evidence! Full speed ahead! An expert unpacks Alberta’s unending experiment in health care staffing

PHOTOS: Nursing professional responsibility advisor Joshua Bergman addresses UNA’s annual general meeting in Edmonton Wednesday (Dave Cournoyer photo). Below: Conservative premier Ralph Klein, whose government began the province’s long experiment in health care staffing mixes as part of an ideologically motivated attack on social programs. For nigh on 20 years,

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Accidental Deliberations: Sunday Morning Links

Assorted content for your Sunday reading.

– Tim Harford discusses how insurance and other industries are built on exploiting people who are risk-averse due to the inability to absorb substantial costs as “money pumps” for those who have more than they need:

(L)et’s step back and ask ourselves what insurance is for. Classical economics has an answer: people are risk-averse, which means that they will pay good money to reduce the variability of outcomes they face. If home insurance guards against the loss of a million pounds when my house burns down, I’m happy to buy the insurance even though the insurance company expects to make a profit from it.

But this risk aversion emerges from the fact that money is worth more to poor people than to rich people. Gaining a million pounds would make me rich but losing a million pounds would make me poor. I should not gamble a million pounds on the toss of a coin, because the million pounds I might lose is more precious to me than the million pounds I might gain.

As so often with classical economics, this is an excellent description of how we should behave. It is not such an excellent description of how we actually do behave. Risk aversion can only explain why we insure large risks. It cannot explain why we insure small ones. 

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A money pump is a person whose irrationalities can be systematically exploited for financial gain. The simplest money pump is a person who prefers an apple to a doughnut, prefers a doughnut to a chocolate bar, and prefers a chocolate bar to an apple. Just offer them an apple in exchange for their doughnut plus a penny. They will accept. Then offer them a chocolate bar for their apple plus a penny. Then offer them a doughnut for their chocolate bar plus a penny. They end up with their original doughnut and are three pence poorer. Repeat for ever.

Money-pump arguments are sometimes deployed to object that people cannot be irrational, otherwise they would be bankrupted by money pumping. But economists are increasingly coming to realise that, instead, we should be looking for money pumping in action.

Given our anxiety about small risks, what would the money pumping look like? It would be an insurance policy focused on the narrowest possible slice of risk. It would be sold alongside another product or service, often at the last moment. It would be marketed by creating anxiety and then offering the product to make the anxiety go away. In short, it would look like the collision damage waiver, the extended warranty, and PPI. These bespoke slices of insurance are among the largest money-pumping projects in the modern economy. No wonder the banks abandoned their principles to join in.

– Jared Bernstein and Lori Wallach highlight (PDF) the need for an international trade regime which serves the public interest, not only the greed of the people who already have the most. And Yves Smith theorizes that the public backlash against corporate-centered trade deals may lead both to changes in how international trade is managed, and the identity of the countries at the forefront of developing the standards to be pursued.

– Needless to say, the Libs’ devotion to the current trade model figures to exclude Canada from that group for the foreseeable future. And the Alberta Federation of Labour laments the Libs’ determination to exploit foreign labour at the expense of both easily-abused temporary workers, and the Canadians who would otherwise fill the positions.

– Derek Thompson makes the case for a long-overdue round of trust-busting to reduce corporate power over innovation and economic development.

– Finally, Ed Finn writes that our health system should focus far more on maintaining wellness rather than responding only once an illness develops.

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Accidental Deliberations: Friday Morning Links

Assorted content to end your week.

– Scott Sinclair, Hadrian Mertins-Kirkwood and Stuart Trew study the contents of the Canada-EU Comprehensive Economic and Trade Agreement. Sinclair and Trew also highlight why Canadian progressives should oppose the deal, while Howard Mann notes that the same criticisms, including a gross transfer of power to the corporate sector and the absence of any concern for developmental and environmental issues, apply to all of the new generation of corporate rights agreements. But the Council of Canadians notes that not only are the Trudeau Libs pushing ahead with every single trade agreement currently on the table, they’re also trying to lay the groundwork for a similar deal with China – even if it comes with both a blind eye to human rights violations, and an obligation to approve a tar sands pipeline.

– Bill McKibben examines how new climate data shows that we need a nearly immediate transition away from dirty energy in order to meet the Paris conference commitment to rein in global warming. And Seth Klein and Shannon Daub call out the new form of climate denialism – which pays lip service to the science of climate change, but attempts to detach it from any policy steps to improve matters.

– Kate Pickett and Richard Wilkinson argue that there’s no reason to keep hewing to neoliberal orthodoxy when decades of evidence show how it exacerbates inequality and harms health:

Even before the 2008 global financial crisis, neoliberalism was causing what the University of Durham’s Ted Schrecker and Clare Bambra have called “neoliberal epidemics.” As Schrecker and Bambra and many others have shown, income inequality has profoundly damaging and far-reaching effects on everything from trust and social cohesion to rates of violent crime and imprisonment, educational achievement, and social mobility. Inequality seems to worsen health outcomes, reduce life expectancy, boost rates of mental illness and obesity, and even increase the prevalence of HIV.

Deep income inequality means that society is organized as a wealth-based hierarchy. Such a system confers economic as well as political power to those at the top and contributes to a sense of powerlessness for the rest of the population. Ultimately, this causes problems not only for the poor, but for the affluent as well. 
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Careful analysis of statistical data debunked the idea that stressed executives are at a higher risk for heart attacks. Now, it has debunked the 1980s myth that “greed is good,” and has revealed the extensive damage inequality causes. It was one thing to believe these myths decades ago, but when experience and all the available evidence show them to be mistaken, it is time to make a change. 
“Any man can make mistakes, but only an idiot persists in his error,” said the Roman philosopher Cicero. Now that we know how inequality harms the health of societies, individuals, and economies, reducing it should be our top priority. Anyone advocating policies that increase inequality and threaten the wellbeing of our societies is taking us for fools.
– And Ashley Quan points out how a basic income could alleviate many of the harms caused by precarious financial situations.

– Finally, Thomas Walkom rightly notes that a federal crackdown on extra-billing under the Canada Health Act is long overdue.

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Alberta Politics: Guest Post: Is the Wildrose Party seriously suggesting Alberta permit private blood brokers?

PHOTOS: Mr. Justice Horace Krever, who led the Canadian Royal Commission into Canada’s tainted blood scandal. Below: Guest poster Trevor Zimmerman (Ray Domeij photo), Wildrose Health Critic Drew Barnes, Alberta Health Minister Sarah Hoffman, and Kat Lanteigne, co-founder of BloodWatch.org. Guest post by Trevor Zimmerman Last spring, Wildrose Health Critic Drew Barnes stood up in […]

The post Guest Post: Is the Wildrose Party seriously suggesting Alberta permit private blood brokers? appeared first on Alberta Politics.

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Accidental Deliberations: Monday Morning Links

Miscellaneous material to start your week.

– David Dayen and Ryan Grim write that “free trade” agreements are in fact turning into little more than cash cows for hedge funds and other big-money speculators:

Under this system, a corporation invested in a foreign country can appeal to arbitration panels, consisting of three corporate lawyers, if that country enacts a law or regulation that violates a trade agreement or discriminates against the company. The ISDS courts can then award billions of dollars to the corporation to compensate it for the loss of expected future profits.

The problem is that these courts can also be used by speculators, who buy up companies for the sole purpose of filing an ISDS claim, or who finance lawsuits from corporations for a piece of the claim award.

“ISDS allows a small group of ultra-rich investors to extract billions of dollars from taxpayers while they undermine financial, environmental and public health rules across the world,” Sen. Elizabeth Warren (D-Mass.), an early opponent of ISDS, told HuffPost. “Our trade deals should not include ISDS in any form.”
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The use of ISDS as a moneymaking engine, rather than for its initial purpose ― to protect foreign investors from having their factories expropriated or their businesses nationalized ― raises the question of whether there’s a better system available.

“Why should hard-won sovereign advances, like rules against polluting or consumer protections, be at risk when the obvious solution is for the investors to put their skin, not ours, in the game?” wondered Jared Bernstein, former chief economist to Vice President Joe Biden and a critic of TPP. “The simple solution is to have them self-insure against investment losses.”

– Mike Balkwill highlights the need to stop consulting endlessly about poverty, and instead take action by ensuring people have enough resources to meet at least their basic needs. Ann Hui reports on the especially dire circumstances facing First Nations families in Northern Ontario who have to spend upwards of half of their income on overpriced food. And Miguel Sanchez criticizes the Wall government’s attack on benefits to people with disabilities in Saskatchewan.

– Nicole Thompson points out how the Libs’ changes to the temporary foreign worker program are actually making matters worse for caregivers by eliminating any right to apply for permanent resident status. And Martha Burk documents how workers can lose out when employers force them to accept payroll cards rather than paycheques.

– Erich Hartmann and Alexa Greig argue that it’s long past time for Canada’s federal government to provide stable funding for health care in partnership with the provinces, rather than contributing only as much as it wants to at any given point. And Tom Blackwell reports on the dangers of relying on private providers by highlighting how they inevitably leave the public system to deal with complications.

– Finally, Tom Parkin notes that we should base our discussion of electoral reform on the actual experience of similar countries, not the obviously-false claims of people wanting to fearmonger us into accepting the status quo. And Andrew Coyne draws a parallel to the census as an argument for mandatory voting.

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Accidental Deliberations: Saturday Afternoon Links

Assorted content for your weekend reading.

– Don Pittis writes that it will take far more than words and sentiments to reverse the trend of growing income inequality. Elaine Power points out that Ontario’s social assistance programs – like those elsewhere – far fall short of meeting basic human needs. And Christopher Mackie reminds us that the effects of poverty go well beyond immediate financial consequences:

Canada has free, high-quality healthcare for everyone. So why do the richest 10% of people live seven years longer than the poorest? Deep poverty can be associated with a drop in life expectancy of 20 years or more. If we look at both life expectancy and years lived with disability, the rich are 39% healthier than the poor.

Income affects health in several ways, including the direct impact on the resources needed for healthy living, access to healthy physical environments and access to healthy social environments.

Poverty limits access to nutritious food, recreation opportunities, adequate housing, and the education needed to pull oneself out of poverty. Each year, the Middlesex-London Health Unit issues a report that compares the cost of nutritious food to income received from minimum or welfare wage. This Nutritious Food Basket Report consistently shows that it is impossible for people on low income in London and Middlesex County to afford healthy food once basic costs such as rent and utilities are paid.
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The benefits of policies that address poverty go far beyond simply helping the poor. Research has consistently shown that everyone is better off in societies that are more equal. Comparisons of countries which are part of the Organization for Economic Cooperation and Development (OECD) consistently show that in societies that are most equal, even the poor are healthier than the rich in societies that are the least equal. In other words, greater income equality means better health for everyone – including the rich.

This paradox – that my income is linked with my health, but that my society’s income equality is also linked with my health – is not fully understood. One theory is that it is linked with the social environments we live in. More unequal societies tend to be more competitive, with fewer opportunities for upward mobility. This can be associated with stress and hopelessness. Stress is linked with a number of health problems from heart disease to cancer. Hopelessness can be devastating, reducing motivation to seek employment and leading a person to neglect their health or even engage in self-harming behaviours like addiction to alcohol and drugs.

In more equal societies, a feeling that friends, neighbours and fellow citizens will offer help when needed can be motivational, even leading to an increased sense of self-worth. Reduced stress can allow us to see past day-to-day challenges and make better decisions for the long term.

– Christopher Adams exposes how employers are exploiting millenial workers. And Evelyn Kwong and Sara Mojtehedzadeh report on a temporary employee’s workplace death in Toronto, while Adam Hunter discusses the appalling trend of people being killed on the job in Saskatchewan.

– Tonda MacCharles reports on the Libs’ discussion paper on security laws. And Jeremy Nuttall notes that there’s ample reason for concern that they want to make matters even worse by reviving dubious “lawful access” provisions rather than correcting even the overreach found in Bill C-51.

– The Star’s editorial board writes that we should be strengthening our universal public health care system rather than destroying it as Brian Day and others want to do.

– Finally, Kathy Tomlinson details how Canada’s tax laws are being flouted by the investors making millions off of the explosion of Vancouver’s real estate market.

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Accidental Deliberations: Tuesday Morning Links

This and that for your Tuesday reading.

– Erin Seatter interviews Adam Lynes-Ford about Brian Day’s latest attack on universal Medicare. And Ricochet’s editorial board highlights how Day is ultimately fighting only to exacerbate inequality:

Discrimination against racialized and Indigenous patients fosters health disparities across our country and sometimes leads to death.

Poverty hurts Indigenous people in particular, and it’s understandable if you think the wide income gap between them and other groups in our country means privatized health care will leave them behind.

But fret not. Privatization will give them the kick they need to find their bootstraps. Want health care? Make money. Want a physician to check for diabetes instead of assuming you’re drunk? Hand over dollar bills, preferably the red or brown ones. Just throw yourself into the capitalist economy, and you’ll soon get past all that labour discrimination and be able to fork out the cash to be treated right.

Like Ali, and like the founding father of oppressive medicare, Tommy Douglas, Day used to be a boxer too.

“If you’re competitive and you think you’re right, you want to keep going until there’s a final outcome,” said Day.

That’s why he won’t stop until universal health care is down for the count.

– Oliver Milman discusses the climate effects of rapidly increasing ocean temperatures. And Merran Smith and Dan Woynillowicz comment on the need for Canada to pull its weight in shifting to clean renewable energy, while Jackie Wattles and Matt Egan point to Oklahoma’s rash of earthquakes as yet another consequence of insisting on chasing fossil fuels against all rational analysis.

– But Ethan Lou reports that the Trudeau Libs are instead aiming to grease the skids for foreign-owned oil development.

– Tammy Robert exposes the Wall government’s use of federal immigration funding (backed by provincial guarantees) to inflate a housing bubble. And the Leader-Post’s editorial board questions why the Saskatchewan Party is picking the pockets of school divisions and health regions.

– Finally, Kiran Rana takes note of the difficult job market facing new university graduates.

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