Equitable capital flows will not be achieved through pledges and diversity days

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Diversity is the brand of Canada. Also in Canada, nearly ninety per cent of venture capital investment deals are directed to companies founded exclusively by men. Black charities receive as little as seven cents for every hundred dollars donated to Canada’s big charities. Indigenous organizations receive just over one-half of a per cent of charitable donations in Canada.

 

Eighty-five per cent of money invested in Canadian venture capital funds goes to funds with no female partners. And less than three per cent of venture capital is invested in women founders, with nominal investments in women of colour. Canadian Foundations that invest in impact investing, invest almost exclusively in white or male fund managers.

 

We often think of being good or bad as binary and static. As Canadians, our attachment to being good people risks our ability to be better.

 

Despite the conversations on equity and diversity, there are growing inequalities in capital flows — amplified through the impacts of COVID-19 — that threaten economic growth and social cohesion. From philanthropy to impact investing to venture capital, communities with diversity across gender, ethnicity, ability, sexual orientation, geographically, among others, lack access to capital.

 

When it comes to addressing capital flows, action towards equity is fragmented, siloed and slow, while displays of commitment to change are rapid and abundant.

 

Toronto Raptors President Masai Ujiri reflected on the composition of the audience at his recent Giants of Africa gathering. He noted that had George Floyd been murdered a week ago, the room would look different. Making meaningful change is not accomplished in a moment. It requires a movement and a sustained commitment.

 

We can move beyond a scarcity mindset which makes us believe that we do not have enough money to invest in diverse leaders and founders. This mindset amplifies that one investment we made in a diverse founder or fund while ignoring our broader portfolio. It leaves those with the least power without access to capital.

 

We can collect disaggregated data to know our baseline, set targets and build accountability systems to help make capital more inclusive.

 

We can approach increasing capital to underrepresented communities as a business problem, mobilizing the appropriate resources and capacity to solve it. Building a competitive and economically prosperous Canada is accelerated when we tap into the vast talent across all of our communities. When capital flows are limited due to risk perception, networks and systems, we miss out on this opportunity.

 

Through collaborative research, shared resources and increased transparency, we can accelerate access to capital to those excluded. We can advance inclusive approaches to increase social and economic prosperity for all by flipping orthodoxies, challenging the status quo and investing in undervalued founders, managers and leaders.

 

Equitable capital flows will not be achieved through diversity days. Just as a single workout does not result in rapid health transformation, meaningful progress toward equity requires sustained action.

Narinder Dhami is the Executive Lead of New Power Labs.

Let’s put healthcare ahead of politics in 2022

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Linda Silas

QUOI Media

After close to two years on the front lines of this pandemic, nurses are feeling tapped-out, exasperated and dispirited.

Understaffing has plagued our healthcare system for more than a decade, but COVID-19 has only made it worse. Years of government neglect have created untenable working conditions, with acute levels of stress wreaking havoc on nurses’ mental health.

One nurse described the weight of not being able to provide the care patients deserve as “crushing.” Another nurse told us she was leaving the profession – a profession she used to love – because “no help is coming and no one seems to care.”

It’s no wonder so many nurses are looking for the exit sign.

Job vacancies in healthcare and social assistance soared over the summer, representing one in seven openings in Canada – the largest increase of any sector. Openings for registered nurses and registered psychiatric nurses saw the largest increase of all occupations.

Recently, the Ontario Science Table found rates of severe burnout above 60 per cent among Canadian physicians, nurses and other healthcare professionals – a drastic jump from the equally alarming 30 to 40 per cent prevalence rate affecting the sector just a year before. 

Nurses and their co-workers are beyond the point of exhaustion and exasperated at the inaction of politicians.

If we want to retain nurses and other healthcare workers, they need immediate support – they need some semblance of hope.

Provinces regularly resort to short-sighted tactics to address their nursing shortage. Often, these amount to nothing but an expensive shell game, drawing nurses from one region to another. This approach will not end this crisis. We need to look upstream to address root causes, such as a lack of appropriate data to inform evidence-based health workforce planning. Governments desperately need this data to better forecast healthcare needs and build a truly responsive healthcare system.

Recently, over 60 national health professional organizations collectively urged the federal government to create a national health workforce agency and provide immediate targeted funding to support retention and recruitment efforts.

We simply can’t afford to continue planning in the dark when it comes to healthcare. It’s time to stop pretending that a responsive healthcare system will materialize out of thin air, absent the data, tools and leadership needed to do the job.

While the Prime Minister and Premiers are inarguably busy managing the pandemic, the nursing shortage is a looming crisis that threatens to undermine those very efforts – without a healthcare team, a bed is just a bed. This crisis demands equal and urgent governmental action and collaboration. It requires working across partisan and jurisdictional lines.

Now more than ever, nurses and their colleagues are desperate for optimism.  In 2022, let’s choose to put healthcare ahead of politics.

Linda Silas is a nurse and president of the Canadian Federation of Nurses Unions.

More integrated relationship between post-secondary institutions and industry can boost Canada’s lagging productivity

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Laura Jo Gunter

QUOI Media

As Canadian businesses recover from the effects of COVID-19, the productivity and skills gap twins have re-entered the conversation.

According to the Organization for Economic Co-operation and Development (OECD), Canada continues to have low productivity scores. Our GDP forecast currently sits below the world average, and that gap is projected to increase over time. Meanwhile, disruptions due to technology, changing market demands and environmental, social and governance initiatives create hiring and retraining challenges for businesses.

The productivity and skills gap dilemma hobbles Canadian companies’ local and global competitiveness and threatens our economic recovery.

Unsurprisingly, these problems are directly connected; productivity is down due to a lack of talent. To fill the gap, we need to rethink our talent strategy.

In Canada, we often view our talent pipeline like a supply chain. Industry advises polytechnic institutions and colleges, and they produce graduates to meet the talent demand. This process is often effective, but a more integrated, partnership approach will take us to the next level.

Industry wants graduates who are job-ready, through a blend of education and workplace experiences. Industry also wants people currently in the workforce to have access to better, faster and more affordable options for reskilling and upskilling throughout their careers. The need for a more integrated relationship is clear.

It starts with a stronger linkage between post-secondary institutions and industry regarding talent pipeline development. At the Northern Alberta Institute of Technology (NAIT), we have the strategic goal of being industry’s most trusted partner when it comes to addressing their workforce needs.

The word partner is key. We envision NAIT and our industry partners working together in a much more active and cohesive way to create and maintain the talent pool necessary to sustain the economy.

We have established and proven work-integrated learning (WIL) models in post-secondary education, such as apprenticeship, co-ops and practicums. NAIT has approximately 10,000 students, including apprentices, participating in WIL. These models work so well that the Alberta government has recently set an ambitious goal of including WIL in 100 per cent of undergraduate programs.

In addition, the Alberta government wants to expand the apprenticeship model beyond skilled trades. We are re-imagining how the apprenticeship model could enhance education in professions such as IT, business and hospitality. 

Under this model, over 50 per cent of a student’s education would be delivered in the workplace. Companies benefit from hiring talent sooner, and students benefit from gaining work experience as they pursue their education.

The other major challenge that is critical for both individual and economic recovery is the upskilling and reskilling of the current workforce. Given the level and speed of disruption across sectors and labour markets, the need for rapid retraining and timely hiring with confidence is crucial.

NAIT is reimagining our value proposition when it comes to lifelong learning. We are evolving and expanding how we provide value to individuals so that we focus on filling the gaps in their skill sets by recognizing the knowledge that they already have obtained through on-the-job training and work experience. We also want to help businesses make good hiring decisions and reduce training costs.

We realized that our value comes not just from our role as a content provider, but also from our acknowledged status as an assessor and validator of skills and knowledge, and our ability to confer a recognizable credential. The concept of a microcredential – a specific credential that confirms a discreet set of skills or knowledge – has been gaining in popularity. Because microcredentials are so focused, they can help people demonstrate the specific competencies that employers are looking for.

NAIT is currently developing a direct microcredential model that assesses a person’s knowledge as a first step in upskilling or reskilling. If the individual passes the assessment, a microcredential is awarded. If not, then short courses can be provided to address only the identified skills gaps. This shortens retraining time and provides valid credentials to ease hiring decisions and talent deployment.

Recovering from the pandemic will depend on a different and integrated approach to address the skills gap and increase productivity. The federal government has a role to play, including supporting workforce reskilling initiatives and enhancing needed technical innovation, but we need ground-level solutions that come from polytechnics and industry working together. A more productive Canada starts with stronger partnerships.

Laura Jo Gunter is President and CEO at the Northern Alberta Institute of Technology.

Leave plastic where it belongs

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By Beatrice Olivastri

Canada has just delivered its draft regulations to ban single use plastics. That’s something to celebrate. 

Scientists have identified six plastic products most commonly found in Canadian litter: plastic checkout bags, stir sticks, six-pack rings, cutlery, straws and food service ware made from problematic plastics. Many businesses have anticipated the ban and have already made the switch to reusable or compostable products.

A ban on six single use products, while praiseworthy, should only be the beginning of the journey to leave plastic feedstock where it belongs – in the ground with other fossil fuels.

And there is a loophole in the regulations that allows manufacturing for export to continue. Such a loophole is unjust — we must not inflict more plastic pollution on nations in the Global South while banning it for ourselves.

If certain plastics are bad for Canadians, should Canadian companies be allowed to export them to other countries? Would such a loophole in Canada’s ban regulations for single use plastics undermine the February negotiations of a legally binding international treaty?

Plastic pollution is a global problem that goes far beyond the scope of litter. While the world’s attention is riveted by images of ocean wildlife speared by plastic straws or body cavities packed with plastic garbage, smaller, insidious particles of the same pollution dwell in you and me.

We ingest a credit card weight of plastic every week and we excrete it with a vague understanding of the “inflammation” it may be inflicting in our bodies. In a world’s regrettable first, Italian researchers found particles of micro-plastic in the placenta of pregnant women and in their fetus.

We know there are many pathways for plastic to move into our fresh water and our bodies, including plastic mulch on agricultural fields, laundry waste water, supposedly-flushable wipes in sewer lines, and plastic food containers used in a microwave. Fresh water-based micro-plastic, carrying hitch-hiker pollutants such as long buried PCBs, are eaten by fish, then eaten by you and me.  Harmful additives in plastics across the supply chain can include PFAS, phthalates, bisphenols, brominated flame retardants and heavy metals, as recently reported by the International Pollutants Elimination Network (IPEN).

The feedstock for plastic is extracted from the tar sands just like natural gas, diesel fuel and asphalt. Big oil sees its future in plastic in a replay of Dustin Hoffman’s character in The Graduate. It’s critical that climate action shuts down the extraction of fossil fuels ensuring the backdoor to plastic production is slammed shut too.

When governments meet in February to debate a legally-binding global plastic treaty, Canada must step up to address the full lifecycle of plastics.

We must reduce our plastic pollution and stop dumping it on the Global South. We must ensure that independent scientists have ample funding for research on remedial action for plastic pollution we’ve already accumulated in our bodies, in fresh water, in oceans and on our land.

Beatrice Olivastri is the CEO of Friends of the Earth Canada.

Canadian small business owners need graceful exit strategies as many face bankruptcy and business closures

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Rob Farrelly

QUOI Media

Leslie and David have owned a successful restaurant for almost 20 years. But, as for everyone, COVID-19 has brought uncertainty and stress. There have been added costs associated with safety protocols and shrinking revenue tied to seating and capacity restrictions. Their insurance provider refuses to renew their policy and every new quote is 400 per cent higher than what they are currently paying. 

A global supply chain collapse and a sustained drought is driving food costs through the roof. Like every other restaurant owner, they have taken advantage of low interest COVID-19 support loans which are now all coming due. They have also been forced to tie their personal assets to the business to gain access to additional financing.

They are considering closing a few days a week because they cannot find enough staff to keep the doors open. A mass exodus of talent has left a giant hole in the labour pool forcing never-seen-before bidding wars for experienced employees. All of this, while government subsidies are set to run out. 

After two years of a sustained onslaught of challenges, they are faced with an impossible decision: dive further into debt or declare bankruptcy.  Not only will they lose their business, but their personal assets and financial security are on the line — with potentially catastrophic consequences.

This story is one of many.  It is mirrored across the hospitality landscape. 

The pandemic has taken a heavy toll on Canadian small business owners, especially in the hospitality industry. In August 2021, StatsCan reported that more businesses had closed rather than opened for the first time since May 2020. 

While there has been support for those who decided to soldier on through government subsidy programs, much of the financial shortfall has been offset by an increased debt load. As this debt now becomes due, many are still not seeing their revenues rebound enough to carry on.

Like Leslie and David, many restaurant owners have had enough and are throwing in the towel. To do this however, their only option is to declare bankruptcy, with potential dire consequences.

While business bankruptcies in the third quarter of 2021 recorded the lowest increases since 1987, these statistics do not capture those businesses owners who simply close the doors and walk away from their businesses — and creditors. 

It’s crucial for Canada to develop graceful exit strategies for business owners.  Entrepreneurs are in short supply, and we need them as part of a sustained economic recovery. Ideas for such measures could include agreements with banks not to enforce personal guarantees, establishing an office to support business owners through the process of winding down their businesses, and providing compensation for landlords in exchange for releasing tenants from long-term leases, to name a few.

Entrepreneurs and their families are going to suffer if they are unable to shut down their businesses without lasting impact on their own financial situations, not to mention the difficulties they will have starting much-needed new businesses.

Canadian small businesses have tried their best to keep the economy moving over the past two years. We, as consumers, have relied on their resilience and perseverance for our own survival.

It is only fair to support those, who — after almost two long years of fighting to survive — simply cannot do so any longer.

Rob Farrelly is the founder of GFV Financial Inc., which specializes in business intelligence solutions for breweries, bakeries and restaurants.

A healthier future

DOUG ROTH and ANDREA SEALE

QUOI Media

Building a “cleaner and healthier future for all of our kids” was a clear priority stated in the recent Speech from the Throne. Appropriately, these words were spoken by Governor General Mary Simon just a few days after World Children’s Day, an annual observation set by the United Nations to mark the approval on that date in 1959 of the Declaration of the Rights of the Child. A key principle of the declaration is that in government policy and laws, “the best interests of the child shall be a primary consideration.”

Fortunately in Canada, most children don’t face the worst of what the Declaration intends to prevent, such as enforced labour and the threat of becoming a child soldier. But that doesn’t mean we should not keep working to ensure better lives and better futures for Canada’s young people.

It’s a great opportunity for the federal government to protect Canada’s kids.

There are three important policy steps the newly re-elected federal government can and should take promptly that would have a large positive impact on the health of Canada’s children. These actions would help parents, caregivers and young people choose more nutritious food and protect them from the harmful effects of vaping.

Front-of-package nutrition labelling: This would require simple, clear messaging on the front of food packages so consumers will know quickly whether an item is high in sugar, sodium (salt) and/or saturated fat. This will help parents make healthier choices for their kids and families. This proposed front-of-package labelling by Health Canada would be a more practical and valuable tool for rushed shoppers, as well as those with low literacy skills than the current, difficult to understand nutrition facts table on the backs or even bottoms of current packages.

A further benefit of such a policy would be the incentive it would create for manufacturers to reformulate products with less saturated fat, sodium or sugar so they avoid the “high in” label.

The federal government has publicly committed to this policy and published draft regulations for this in 2018, but the policy has languished without the process being completed. There’s no reason why the policy should not receive final approval — quickly.

Limitations on marketing to kids: Children are bombarded with television and online advertising that urges them to consume ultra-processed foods that are less healthy for them. This consumption, which has been compounded by the pandemic, could have a negative health impact which will be felt for years to come.

Quebec has not permitted such advertising to children under 13 for decades and data show lower consumption rates of ultra-processed foods and lower obesity rates.

Limiting such marketing to children across Canada was approved by the House of Commons but did not get final approval in the Senate before the 2019 election was called. The government should move quickly to reintroduce this vital federal commitment.

Protections against vaping: Vapes or e-cigarettes can be harmful to the health of kids and youth and consequently have become a serious concern for parents across Canada. According to a Health Canada national survey in 2019, among grade 10-12 students, e-cigarette use within the past 30 days was almost three in 10 (29.4 per cent) and 90 per cent said they had used products containing nicotine. Use rates had doubled from just two years earlier.

To lessen these worrying trends, the federal government needs to finalize regulations restricting flavours in e-cigarettes, and to implement an e-cigarette tax. This is important because we know that vape flavours and low prices help to addict kids and youth.

Canadians overwhelmingly support taking these three policy measures as quickly as possible to help consumers and protect our young people. A December 2020 poll, commissioned by Heart & Stroke, showed 80 per cent of Canadians support the idea of the government acting quickly to restrict marketing of unhealthy foods to children and to require front-of-package nutrition labelling. A March 2020 poll showed almost nine out of 10 Canadians (89 per cent) said the government should act quickly to protect youth from vaping.

Taking these three important policy steps forward in the coming months of the 44th Parliament would be a tremendous positive legacy from the COVID-19 era for the future health and well-being of Canadian children. Having all in place by the time of next year’s World Children’s Day would be an accomplishment worth celebrating.

Antibiotics won’t cure the common cold

Olivia Ostrow and Janet Reynolds

QUOI Media

Colder weather is upon us again – and so is cold and flu season. Nearly two years into the fight against COVID-19, we welcome children returning to schools, daycare and sports. But with the loosening of restrictions and increased social contacts, we are also now seeing increased circulation of common seasonal respiratory viruses.

Kids are experiencing cough and cold symptoms including fever, congestion and sore throat due to other respiratory viruses co-circulating along with COVID-19. While an occasional cold is a typical part of childhood, illnesses today come with added stress, anxiety and challenges for families.

Cold and flu symptoms often mean time away from school, daycare and other activities, plus a trip for a COVID-19 test. That can also mean sleepless nights caring for a sick child while also navigating personal and work demands.

For many, these challenges don’t end with a negative COVID-19 test.

Often children continue to experience cold symptoms for days and sometimes weeks due to respiratory viruses. Because of the COVID-19 pandemic, it may also be difficult to get in-person medical care for kids with these symptoms when needed.

Some parents are even waiting in long lines in the emergency department if they are not able to get their child seen in person by their health care provider. This can be a stressful experience for parents and children, and lead to longer wait times for those who really need emergency department care.

Some parents may ask their doctor for an antibiotic for their child with the hope that the antibiotic will quickly clear up the fever, cough and other symptoms their child is experiencing. Unfortunately, antibiotics only work for bacterial infections and do not help respiratory viruses. In fact, unnecessary prescriptions and use of antibiotics can be harmful to kids and can lead to unwanted side-effects, including stomach upset and diarrhea.

Importantly, if antibiotics are used unnecessarily, they may not work as well when they are really needed. 

The added complication of the pandemic is that children with any viral symptoms, such as an isolated cough, are being asked to stay home from school and other settings until their symptoms fully resolve. But antibiotics are not the answer.

Over-the-counter cough and cold syrups and medications also generally don’t work and are not safe for children five years of age and younger.

The reality is that we do not have a quick fix for cold and flu symptoms. Symptoms tend to go away on their own and get better with supportive treatments including lots of rest, fluids and over-the-counter medications to manage fevers, aches and pains. 

As health care providers, we want kids’ cold symptoms to go away as quickly as possible too. It is is important to ensure that routine childhood vacciations are up to date and obtain a yearly flu shot if your child is six months of age or older. Despite these measures, experiencing an occasional respiratory virus is a normal part of childhood. The resolution of cold and flu symptoms often requires time and patience.

Do talk to your health care provider if you have concerns about your child’s symptoms in order to clarify their diagnosis and learn what you can do to help them feel better this cold and flu season.

Dr. Olivia Ostrow is a pediatric emergency physician at the Hospital for Sick Children, the Associate Director for the Centre for Quality Improvement and Patient Safety (CQuIPS) and an assistant professor in the Department of Pediatrics, University of Toronto. Dr. Janet Reynolds is a family physician in Calgary, Alberta, and Medical Director of Crowfoot Village Family Practice.

Almost half of healthcare workers are not doctors and nurses – Health policies must address their burnout too

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By Irving Gold – Quoi Media

Vaccination rates are climbing, and COVID-19 cases are decreasing. While this is surely a relief to most of us, many healthcare workers are bracing themselves for a significant post-pandemic fallout. Far from getting a much-needed reprieve from an emotionally and physically draining 20 months, these professionals will be forced to work under similar strain to deal with the backlog of procedures now being scheduled again.

There is abundant evidence of increasingly high levels of stress and burnout among all healthcare workers in the system. 

National and local television, radio, and print media have been covering the situation extensively with horror stories of doctors working around the clock with no end in sight, and nurses burning out in unprecedented numbers. The warnings are consistent: we are headed towards a full-blown crisis.

Unfortunately, this tells only half of the story. In Canada, 42 per cent of healthcare workers are neither nurses, nor doctors, but hail from other, equally essential professions.  We ignore their well-being at our peril. 

Every time these professionals see “doctors and nurses” used to refer to healthcare workers, they shudder, reminded that they are being ignored yet again. While this media shorthand may be convenient, it only serves to reinforce the alarming tendency of healthcare decision makers to make policy based on considerations that exclude almost half the workforce. 

We’ve already seen the potentially deadly consequences of health policies forgetting almost half the health workforce earlier in the pandemic.

Medical Radiation Technologists (MRTs) have been one of the oft-ignored professions. While many Canadians aren’t familiar with the term MRT, most have relied on them as part of their healthcare team at some point of their lives. MRTs are the professionals who do the X-rays, nuclear medicine, MRIs and CT scans that allow doctors to diagnose and provide medical treatment. They also administer radiation therapy to cancer patients.

MRTs have been on the frontlines of the pandemic, providing the imaging required to monitor and manage COVID-19 patients, and through all the extreme challenges of this pandemic, have maintained the integrity of the health services for other diseases and conditions.

MRTs are the third largest contingent of healthcare professionals working in hospitals, and they also work in clinics, cancer centres and other settings across the country.

Throughout the pandemic, many MRTs have been forced to fight for access to adequate personal protective equipment (PPE), vaccine priority, and acknowledgement that they too were working on the front lines and putting their lives in danger for the well-being of other Canadians. This, despite their numbers and importance to diagnosis and care.

To add insult to injury, they are now being ignored, yet again, in conversations about healthcare workers who are struggling to do their work in the face of enormous challenges to their mental health. For one public example, Quebec Premier Francois Legault, in defending his move to provide relief to Quebec nurses, explained that this relief was not being extended to other healthcare workers and compared them to convenience store workers doing overtime.

I wish these kinds of statements were surprising.

According to our recent survey of MRTs, two thirds of respondents reported high levels of emotional exhaustion (a symptom of burnout). It’s time MRTs and other healthcare professionals were included in policies and programs that address burn out in our health system. 

This month celebrates MRT Week (November 7 to 13), a chance to recognize the indispensable work that these tens of thousands of healthcare professionals do every day to keep the COVID response strong, to keep the healthcare system running, to battle the backlogs in the system and give us the chance to get back to normal.

As we begin to look at how healthcare workers are going to deal with the immediate future, conversations and solutions that focus exclusively on doctors and nurses will have devastating consequences and ultimately undermine efforts to address the crisis.

We will never solve our healthcare crisis by ignoring close to half of those who are paying the price.Irving Gold is the Chief Executive Officer of the Canadian Association of Medical Radiation Technologists.

The federal government should fast track the Canada Disability Benefit

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By Art Eggleton and Rabia Khedr

What do former Health Minister, Allan Rock; Senator Mohamed-Iqbal Ravalia; former Lieutenant Governor of Ontario, David Onley; professional dancer, Luca Patuelli; ‘Mincome’ economist Evelyn Forget; best-selling author, Tara Ross; the CEO of Community Foundations of Canada, Andrew Chunilall; singer-song writer, Christa Couture; disability activists, Ali Mohammed and Meenu Sikand; several order of Canada recipients, noted physicians and academics — along with most major disability organizations from across the country – all have in common?

They are among the more than 200 political personalities, academics, artists, non-profit and business leaders that have signed an open letter asking the federal government to fast track the Canada Disability Benefit — and to do so with the active and genuine involvement of disabled people every step of the way. 

People with disabilities make up 41 per cent of our population living in poverty.

The Canada Disability Benefit was first introduced by the federal government in the Speech from the Throne a year ago and is the direct result of years of advocacy from the disability community.  Legislation tabled before Parliament recessed last summer promised a first: a federally funded income support for persons with disabilities – that would not replace provincial programs and other supports but complement it — so that they are no longer consigned to a life lived in poverty.

Economists predict that poverty in Canada would be reduced by as much as 40 per cent overall by eliminating disability poverty.  It’s an historic opportunity – something no government in the world has ever committed to. 

It’s time now to make the Canada Disability Benefit a reality.

The good news is that Canadians across the political spectrum support the idea. In a recent Angus Reid survey, 89 percent of Canadians say it’s time to end poverty for people with disabilities. And in the recent federal election, all of the major political parties included the needs of persons with disabilities in their platforms.

There is a new awakening, a new dawn in our consciousness with Canadians calling for a recalculating of fairness and justice – and working toward a better future for all, including for people living with disabilities experiencing poverty.

There is no need to study the problem for years first as the federal government has indicated they might do in the last Parliament; we have oodles of data, we have public support, and political will across party lines — now we need action.

As our governments prepare for economic recovery post-pandemic, the sad reality is that people with disabilities may be left even further behind. COVID-19 was especially hard on people with disabilities. 

Currently, a disproportionate number of people with disabilities in Canada are depending on food banks and finding themselves homeless. They are finding themselves without adequate daily living supports. Provincial disability benefits are failing them, falling well below the poverty line. Too many people with disabilities are considering dying from despair.

Canada is a prosperous nation – among the richest in the world.  But in the heart of business affluence in this country, not too far away from Bay Street, there are people with disabilities like Ryan begging money to buy food. There is Mariam living in an inaccessible apartment as her disability progresses toward needing a wheelchair full-time. And there is Precious, whose mental health is deteriorating because she has no job to go back to as a result of the pandemic.

People with disabilities, their families, friends and fellow Canadians want Canada’s 44th parliament to make history and leave a cross-partisan legacy. We expect all-party support for fast action on the Canada Disability Benefit – to make Canada the first country in the world to provide a livable income supplement for people with disabilities.

People with disabilities are ready to work together with the federal government to fast-track consultation, provide the research and move quickly to implement the Canada Disability Benefit.

Let’s work together and make this happen.

The open letter was coordinated by Disability Without Poverty, March of Dimes Canada, the Multiple Sclerosis Society of Canada, Race & Disability Canada and can be found at: https://www.disabilitywithoutpoverty.ca/

Art Eggleton is a former Senator, MP, Cabinet Minister, and a former Mayor of Toronto. He is a long-time advocate to alleviate poverty in Canada.

Rabia Khedr is a National Director for Disability Without Poverty and a former Ontario Human Rights Commissioner. She is currently a member of the Minister’s Disability Advisory Group appointed by Minister Carla Qualtrough.

Spending more on health care does not guarantee better health outcomes

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Michael Wolfson – Quoi Media

Canada’s federal election results had barely been counted when the Premiers resumed making their well-worn demands for more federal health care money. Instead of thanking Ottawa for the billions it has already provided for fighting COVID-19, or asking for short-term pandemic-related funding, the ritual chorus seeks ever-increasing amounts of money for decades to come.

Granted, the need for more money certainly feels urgent right now. Intensive care is on the brink of collapse in Alberta and Saskatchewan, with health officials preparing to make painful decisions around triaging patients as COVID-19 infections surge. A number of provinces are having difficulty even staffing their hospitals, after almost two years of burnout-inducing working conditions for front-line health care workers.

However, the premiers’ multibillion-dollar asks have been for unconditional long-term funding, well beyond the scope of the current crisis. But they have not been clear on how any new money would be used. It is entirely reasonable to ask them to explain themselves – especially since spending more on health care does not automatically mean better health outcomes.

In a recent study, CIBC economists Benjamin Tal and Andrew Grantham found that COVID-related hospitalizations per one million of the population were four times higher in the U.S. and five times higher in Britain than in Canada in early 2021. “Yet, as we all surely recall, the hospital system in Canada during the second wave was at its wits’ end,” they write. “Simply put, we reached capacity at levels that many other countries consider to be acceptable.” They conclude that Canada’s hospitals need more money.

But this is only part of the story. While the U.S. is well known for having much higher health care spending than any other country, both the U.K. and Israel spend significantly less than Canada – and yet neither came close to peaking on hospital capacity. The issue, then, cannot just be a lack of funding; how our health care dollars are being allocated must also be part of the conversation.

One reason provincial governments prefer hounding Ottawa, rather than focusing on more efficiently using the funding they do have, is that passing the buck is painless. As Canadian health economist Bob Evans says, “every health care cost is someone’s income” – that is, controlling or cutting health care costs means controlling or cutting the salaries of doctors and nurses, hospital budgets and pharmaceutical-firm profits. It is much easier politically for provinces to demand more funding than to get into conflicts with such concentrated and powerful interests.

But there is also a deeper reason. The provinces, and the federal government, simply may not have the data to evaluate their health care spending rigorously, even if they even wanted to. If they do have the data, they certainly keep their evaluations hidden.

This is not by accident. The savvier leaders among the key stakeholders have no interest in having such data exist, because they may fear it will lead to results that could embarrass them and turn public opinion against them, possibly in ways that would reduce their incomes or autonomy.

For decades, some of the most important data showing health care waste and inefficiency has looked at variations among small geographic areas – “postal code medicine.” These variations, which are the continuing subject of the Dartmouth Health Atlas, consistently show that while some parts of the U.S. spend two to three times as much on health care as others, key health indicators, such as primary care for diabetic patients and post-surgery complications, are not correlated.

One recent study by leading U.S. health economists concluded that these variations were not due to differences in patients’ needs; instead, they were most closely associated with physicians’ beliefs that were “unsupported by clinical evidence.” The specific examples they studied suggested that 12 to 35 per cent of this health care spending was unwarranted.

Canadians are rightly proud that our health care sector is nowhere near as expensive or inequitable as that of the U.S. But we are not immune. One decade-old study looked at heart attack treatments in Canada and found a threefold difference across health regions with no obvious difference in post-surgical 30-day mortality.

Sadly, no one has updated or extended this study, in part because the data needed are simply unavailable. We could get better value for our health care dollars if we knew more.

Before the federal government signs over any more multibillion-dollar cheques to the provinces with no strings attached, Canadians deserve to know why the additional investment is needed in the first place, how it will be spent – and whether, after all this time, our money has been well used.

Michael Wolfson, PhD, is a former assistant chief statistician at Statistics Canada and a member of the Centre for Health Law, Policy and Ethics at the University of Ottawa.