Tag Archives: Pharmacare

Roundup: The reality of negotiation

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As was ever thus, the Twitter Machine erupted with fury and disingenuous outrage when health minister Patty Hajdu told reporters that she couldn’t guarantee that a national pharmacare programme would be in place at the end of the current parliament (for which we don’t know when that will be, as a hung parliament rarely lasts beyond two years.

“Some of that will be predicted by, predicated by, the responses of the provinces and territories,” said Hajdu, because *mind blown* healthcare is largely the domain of the provinces and any pharmacare system would have to be negotiated with them – in particular, a national formulary, which is going to be extremely complicated to ensure that existing plans don’t get left behind or that the new national plan isn’t worse off than any existing ones that it would replace.

What is especially irritating are all of the voices crying out that this just means the Liberals were lying on the campaign trail, which is false and ridiculous – Trudeau spent the campaign not overpromising on this file, but rather kept saying that it was contingent on negotiation with provinces, which is why their fiscal plan only called for a “down payment” on such a programme rather than the whole thing, but nevertheless, the promise was to go by the principles of the Hoskins Report, which they have bene doing thus far. The NDP, by contrast, insisted that this could be done by 2020, and whenever anyone brought up the fact that the provinces may object, the line was largely that why would anyone say no to federal dollars? It’s absurd, of course, because provinces are rightfully afraid that they would be stuck with an expensive programme to run if the federal government suddenly cut out transfers or funds to it because they suddenly had other priorities (which has happened in the past).

And to that end, we have a bunch of premiers who are balking at it, Quebec and Alberta want to be able to opt-out with compensation, and Ontario is instead insisting that the federal government pay for drugs to treat rare diseases – the most expensive kind, and the ones where costs are rapidly escalating. So of course they want the federal government to pay for them rather than to share the burden. It’s predictable, and for anyone to be shocked and appalled that the Liberals have to deal with this reality is really, really tiresome.

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Roundup: Competing economic illiteracy

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As someone who covers a fair bit of economic stories, the absolute inability of this government to come up with a definition of “middle class” is exhausting – and those of you who read me regularly will know that I will instead use Middle Class™ as a means of showcasing that it’s a meaningless branding exercise. And lo and behold, when challenged to offer up a definition during one of his year-ender interviews, Justin Trudeau said that “Canadians know who’s in the middle class and know what their families are facing and we focus more on the actual issues.” And I died a little bit inside. For a government that keeps insisting they’re all about data, and evidence-based policy, their refusal to offer a meaningful measure of what their core narrative is all about is entirely about branding. By not offering a definition, they don’t have to exclude anyone – because everyone believes they’re middle class (whether they had ponies or not). And more to the point, by not offering a metric, they can’t measure whether they’ve succeeded for failed – it’s only about feelings, which makes their talk of data and evidence all the more hollow.

And then there’s Pierre Poilievre, who, when challenged about the definition of a recession, makes up a bullshit response and thinks it makes him clever. It’s as economically illiterate as the Liberals’ Middle Class™ prevarication, but the fact that the Conservatives keep cheerleading a “made-in-Canada recession” that no economist sees on the horizon, and which they can’t even fit into the actual definition of what a recession is (two consecutive quarters of negative GDP growth) sets a dangerous path of spooking markets. It’s all so stupid, and reckless, but the party’s current path of pathological dishonesty makes them blind to the danger of it all.

On perhaps a related note, Trudeau’s director of communications, Kate Purchase, is leaving to become a senior director at Microsoft, and good luck to her – and she really is one of the nicest staffers and was actually helpful to media in stark contrast to the Harper crew. But I also hope that perhaps this means that her replacement can start ensuring that this government can start communicating its way out of a wet paper bag, because cripes, they have done themselves zero favours over the past four years.

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QP: All about aluminium

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On the first Wednesday of the new parliament, the prime minister was present and we were due to be treated to the first proto-“Prime Ministers Questions” of the 43rd Parliament. Andrew Scheer led off, and he demanded to know what new concessions the government agreed to with the New NAFTA, to which Justin Trudeau assured him that they got a good deal, particularly around aluminium and automotive rules of origin. Scheer rhymed off that “senior Democrats” said that the Canadians gave up everything asked of them, and Trudeau simply responded with some congratulations to the negotiators on getting a good deal. Scheer then demanded a new fiscal update this week which includes a path to balance, citing a fictional “high-tax, high-regulation” agenda, to which Trudeau recited his worn points about making the choice to invest in Canadians. Scheer then railed that Trudeau was creating a “made in Canada recession” — which was 100 percent pure and unadulterated bullshit — and Trudeau reiterated their choices to invest. Scheer then demanded the government pull out of the Asian Infrastructure Bank as a way to send a message to China, to which Trudeau warned that he hoped the new special committee on China wouldn’t be a vehicle for the opposition to play politics and endanger Canadians. Yves-François Blanchet decried the lack of aluminium protections in the New NAFTA, to which Trudeau started frankly that Blanchet was wrong, and they got guarantees around the use of aluminium in the automotive industry. Blanchet disputed this, and Trudeau repeated his assurances. Jagmeet Singh then took his turn to lament the New NAFTA, to which Trudeau picked up a list to read off improvements. Singh then demanded an immediate universal pharmacare programme, to which Trudeau insisted that they did more than any government in a generation to lower drug prices, and the next step was to sit down with the provinces.

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QP: Begun, this 43rd Parliament has

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The first Question Period of the 43rd Parliament just happened to be on a Friday, and for the first time in my memory, all of the leaders were present. The PM at Friday QP? Unheard of! And yet, here we are. Andrew Scheer led off in French, mini-lectern reliably on his desk, and he raised this morning’s job numbers and the 71,000 reported job losses, calling it a “crisis.” Justin Trudeau, without script, told him that their plan was about creating jobs and investing. Scheer tried again in English, and Trudeau made points particularly related to the jobs created by the construction of the Trans Mountain pipeline. Scheer insisted that other countries were increasing investments in natural resources, and Trudeau reminded him that blaming foreign activists didn’t get pipelines built. Scheer said that of all the divisions in the country that Trudeau allegedly created, he stated that provincial premiers were united in opposition to Bill C-69, and Trudeau reminded him that the previous Harper environmental regime didn’t work and singled out two projects that continue to face delays. Scheer then worried about a vote around Israel at the UN that he called “anti-Israel,” to which Trudeau took up a script to reiterate the country’s support for Israel. Yves-François Blanchet was up for his federal debut to worry that the government ignored the call by premiers to increase health transfers to the provinces. Trudeau responded that they had committed to some increases related to getting people family doctors and implementing pharmacare. Blanchet then demanded that provincial environmental assessments get priority over federal ones, to which Trudeau spoke about partnerships on the environment. Jagmeet Singh led off for the NDP, and concern trolled that the prime minister was not brave enough to stand up to pharmaceutical companies and implement pharmacare. Trudeau, without notes, said that they were committed to pharmacare but it was an area of provincial jurisdiction and needed negotiation. Switching between English and French in the same question, Singh demanded the government stop taking Indigenous children to court, and Trudeau assured him they were committed to compensation.

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Roundup: Big numbers for hate clicks

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I’m not a big fan of pieces that construct data in a way to give the worst possible reading, with the intention of making readers angry, because it’s not only bad journalism but it’s irresponsible because our job should be about providing context – not weaponizing it for hate-clicks. And yet, here is a shoddy piece from the National Post designed entirely for the purpose of stoking the fires of the supposed anger in Western Canada right now, by producing a piece which purports to show how Alberta is basically funding Quebec. Oh, they’ll say – this is all Statistics Canada data! But as with any statistical data, it is dependent upon how it is contextualized and presented, and in this case, it’s in terms of “net fiscal transfers” without breaking out what that entails, nor does it actually explain equalization in any way. The most nuanced the piece gets is citing economist Trevor Tombe who reminds people that Albertans pay more in taxes because they have the highest incomes in the country – but it doesn’t then explain that those taxes go to federal general revenues, which then get distributed in programs, which can include equalization. There is no talk about equalization being about the fiscal capacity of a province and ensuring that they can have an equal level of service compared to other provinces, and how that is impacted by their provincial tax rates, or the fact that Alberta has chosen to keep its provincial taxes artificially low and making up the shortfalls with the revenues from their non-renewable resources. The favourite figure is how much Quebec gets in equalization payments, ignoring that on a per capita share, Quebec’s equalization is actually below most other provinces. These are all figures and context that matters – simply throwing big figures around is only designed to make people angry. It’s shite journalism, and yet here we are, yet again.

And speaking of fiscal transfers, here’s a look at how the $1.6 billion that the federal government has been using to bail out Alberta after their last oil crash has nearly fully been paid out, while the province keeps insisting that Ottawa has been “indifferent” to their situation.

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Roundup: Singh thinks he has leverage

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Yesterday it was Jagmeet Singh’s turn have his one-on-one with prime minister Justin Trudeau in advance of the Cabinet shuffle and Throne Speech, and Singh came with his own list of priorities and demands – most of them as unrealistic as Andrew Scheer’s. And Singh’s insistence that he was open to voting against the Throne Speech, and that the party was ready to go to another election at any time, was simply precious. Unable to read the room, or calculate the seat maths, Singh apparently thinks he’s going to play kingmaker when there are more willing partners on the dance floor.

To that end, Singh was demanding immediate action on pharmacare, and pretending that Trudeau hasn’t been clear that he plans to implement the Hoskins Report, which called for a universal pharmacare system. The problem is that you can’t have “immediate action” on it, because it’s actually a very complex thing. You can’t actually just say “we’ll pay for all pharmaceuticals” because the costs would be extraordinary, and phasing it in with a single national formulary is actually incredibly challenging to do, especially across all provinces and territories, because they have different formularies currently and you run the risk of reducing people’s existing coverage (as what happened in Ontario when they briefly offered pharmacare for all young people in the province). It’s going to require careful negotiation with the provinces and stakeholders, and Singh’s constant refrain that this can happen immediately is fantasyland – just like his request that they also consider adding dental care in there.

As for some his other demands, the one about more “science-based” targets for emissions reductions is pure buzz-word. Science is not public policy, and you can’t just hand-wave and go “science” because it doesn’t work like that. Demanding the government abandon its judicial review of the Canadian Human Rights Tribunal decision on compensation for Indigenous children in care? As a lawyer, you think he would be sensitive to the concerns of bad precedent – particularly if the Tribunal did exceed their statutory authority. Energy-efficient retrofits? Electrified transit? Green jobs? It’s like they haven’t paid much attention to the Liberal climate plan and what carbon pricing does to create market incentives. Electoral reform? Apparently he didn’t pay attention to the hot garbage report that the parliamentary committee released last parliament. His “super-wealth tax”? The one that would require the government to rewrite the entire tax code to make it conform to American concepts? I’m sure they’ll get right on that. Singh has no leverage, and yet he thinks the government should simply adopt the NDP platform or have the party’s support withheld. I’m sure the government will get right on that.

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Roundup: Performative or procedurally correct?

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The NDP held their first post-election caucus meeting yesterday, saying goodbye to departing MPs and welcoming their rookies and returning MPs, and when they met the press afterward, Jagmeet Singh announced that he is going to press for pharmacare and for the government to abandon their application for judicial review the Human Rights Tribunal compensation for First Nations youth. But there are problems with both – on the former, he is proposing the party’s first private members’ bill be taken up with the matter, and on the latter, the substantive problems with the Tribunal likely exceeding its statutory authority to make that kind of compensation order is kind of a big deal and as a lawyer, you would think he might have an appreciation for bad jurisprudence while still pushing for the government to go ahead with the compensation that they said they would honour. But you know, performative outrage.

Which brings me back to the notion of pharmacare legislation. The whole promise is built on both bad practice and bad procedure. Remember that when it comes to private members’ bills, they are allocated by lottery, meaning that it’s random as to who gets what slot, and Singh is not proposing as leader to take away the slot of the first NDP MP whose name comes up so that he can dictate what bill will be presented. That’s not only heavy-handed, but it actively removes the independence of that MP (which the NDP is used to doing while pretending they don’t, but let’s call a spade a spade). So much for any of the issues that MP cares about – the leader demanded their spot. The second and more important aspect is that private members’ bills can’t initiate government spending, and pharmacare is provincial jurisdiction, meaning that it’s depending on negotiating with premiers. The bill, essentially, is out of order, unless it becomes an exercise in demanding a national strategy, which the NDP love to do, but one of their MPs went on TV last night to say that they intend to use it to lay out the framework they want to implement. I can pretty much guarantee you that it means the bill will be dead on arrival, and that the committee that decides on what private members’ business is voteable will decide that it’s not. (The sponsor who was forced to give up their spot for this bill will then demand that the Commons vote to override the committee, and when they don’t, the NDP will wail and gnash their teeth that the Liberals don’t care about Pharmacare, which is a script so predictable it might as well be a Hallmark Channel Christmas movie).

https://twitter.com/BradWButt/status/1189643457444417536

What the NDP could do instead is use their first Supply Day to debate a motion on Pharmacare, which would then have a vote and let them scream and moan if the Liberals don’t adopt it for the reason that they’ve already committed to the implementation plan in the Hopkins report (which the NDP decry as not being fast enough), but at least that would be procedurally sound. But their apologists have been telling me on Twitter that all private members’ bills are theatre and only exist to make a point (untrue), or that they could simply get a minister to agree to it in order to spend the funds (never going to happen), but hey, it’s a minority parliament so the NDP can pretend to dictate terms as though they actually had bargaining given the seat maths. It’s too bad that they can’t be both performative and procedurally correct.

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Roundup: Get away from that hot, hot mess of a debate

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The morning wasn’t quite as uneventful as one might have hoped – Justin Trudeau want to a school in Ottawa to talk about provincial cuts and how teachers feared federal ones, while Andrew Scheer announced that the Conservatives would make national museum admission free (which doesn’t really help with affordability, especially as most of these museums are in Ottawa), and that the RCMP Heritage site in Regina would be turned into another national museum. That said, he also took swipes about “political correctness” supposedly “erasing history,” which is false when there is a move to expand the historical record to include effaced minorities like Indigenous people. A few hours later, the Liberals held a press conference to point out that the Conservatives were planning a stunt during the debate to point to a website that would again recirculate the lie about a supposed “capital gains tax” on selling houses, which I will reiterate, is a lie. There is no such plan. That didn’t stop the Conservatives from sounding all-hands-on-deck over social media to circulate this lie over the remainder of the afternoon, and they even had a doctored version of the original recovered Liberal discussion document on their site to eliminate context (which they later had to remove to put the original up once they were called out on it).

And then came the Leaders Debate (not “Leaders’”), at a time slot too early for anyone west of Ontario to really get to watch it (likely so that the private networks didn’t have to unduly inconvenience their American programming). It was a gong show, where in order to accommodate six leaders, all of the exchanges were too short and the questions inconsistent, so most of the time the leaders focused on getting their canned lines out, to hell with the substance of it. And they all said misleading things. Maxime Bernier sucked up too much oxygen for someone who shouldn’t have been on the stage at all but was simply there to act as a spoiler. The whole way this was done, trying to please everyone, pleased absolutely no one, and we are all the poorer for it.

 

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Roundup: Admitting the need for negotiation

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With the policy-over-controversy reset now in full swing, Justin Trudeau was out first this morning in Hamilton to announce next steps in the government’s planned universal pharmacare programme, with a $6 billion “down payment” in the system, along with more funding for increased access to family doctors and mental health services. Unlike other campaigns – looking specifically at you, NDP – this one was honest in the fact that it would rely on negotiations with the provinces, and that it would be incremental (something the NPD promise handwaves over), though where Trudeau got into a talking point was where he kept bringing up Doug Ford in this, and asking who Canadians trusted to negotiate with Ford – Scheer, or him? And he repeated it over, and over, and over again, to the point of parody.

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Andrew Scheer was in Vaughan, Ontario, to announce a four-point plan to make housing more affordable, which included a plan to “fix” the mortgage stress test (erm, have you read anything the Bank of Canada has put out?), let first-time homebuyers take out thirty-year amortized mortgages (almost like the 2008 financial crisis didn’t happen!), launch a national enquiry into money laundering in real estate, and make surplus federal real estate available for developers. The first two seem to ignore the actual issues at play regarding bad debt and the past financial crisis, and has instead swallowed the arguments of real estate lobbyists wholesale – never mind that the housing market has come roaring back in recent months, showing that the stress test was not the issue, and it’s almost like these plans could have the effect of driving up housing prices again. Funny that. Like Trudeau invoking Ford, Scheer was also invoking Kathleen Wynne’s name as his own scare tactic, which seems like a poor choice considering that her government has already been defeated, and Ford was found to have mislead Ontarians on the size and scope of the deficit (while he spends more at the same time as cutting services).

Jagmeet Singh finally visited New Brunswick for the first time in the 23 months he’s been leader, where he announced a “star candidate” (very loose definition), apologised for not having visited sooner (offering no excuses), and repeating his plans for pharmacare – again, with no details about how exactly he’d get the provinces to sign onto a very expensive programme with disparate systems and formularies within a year.

In an interview broadcast yesterday, Singh also said that he would allow any province to have a veto over projects like pipelines, which is also ridiculous, goes against the whole notion of why we have a constitution, and also goes against his whole platform where he wants to impose federal programmes on areas of provincial jurisdiction (being pharmacare and dental care).

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Roundup: Gun control theatre

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While there was suspicion that the announcement was timed as a pivot from the past two days of bad press – Liberals insisting that his has been planned for days – Justin Trudeau was in Toronto yesterday for a morning of meeting people on the streets before he announced his long-awaited additional gun control measures which are guaranteed to please nobody – a total ban on semi-automatic assault rifles (never mind that there’s no actual definition of an “assault rifle”) with a buy-back programme, and the ability for cities to make additional regulations around handguns (as in, allowing them to attempt to ban them), plus some additional offers around licensing and the ability to forbid the purchase of new weapons after certain red-flags. The measures are not enough for those who want a national handgun ban, too far for certain gun enthusiasts, and almost certainly going to be useless because the problem of illegal guns is that the vast majority of them are smuggled from the US, which these measures largely won’t address (I didn’t see any promise for more resources for CBSA in the backgrounder). In other words, it’s a political play, trying to balance the need to be seen to be doing more about gun control for big cities where it’s a problem, while not alienating their rural voters (again), while also being hemmed in by jurisdictional considerations (Doug Ford, for example, has said he won’t go along with any kind of handgun ban that would fall under provincial jurisdiction). Nevertheless, the symbolism of banning AR-15s is something they hope to capitalise on, while they castigate Andrew Scheer for his promise to relax some gun control regulations, so that may be enough for them in the election in any case.

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Speaking of, Andrew Scheer was in Saint John, New Brunswick, to promise that a Conservative government would spend $1.5 billion to get provinces new MRI and CT machines in an effort to reduce wait times (structural issues? What structural issues?) – never mind again that it’s provincial jurisdiction and he may have a hard time getting them to actually spend dollars that he’s earmarked for said purchases. Scheer also clarified that oil and gas subsidies would not be part of those he plans to eliminate – try to look surprised, everyone!

Jagmeet Singh was in Windsor to talk up the party’s pharmacare plan, and answer yet more questions on the Blackface issue, citing that he didn’t want to be complicit in Trudeau’s public exoneration. (And yet, the media is demanding this kabuki theatre to play out).

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