Monday, November 28, 2016

MRIs: The New Provincial - Federal Grudge Match

SOURCE: CBC News - No Plans to End Private MRIs, Says Sask. Health Minister to Federal Concerns

While there's some interesting things happening with the GTH as of this morning (Wall's Chief of Staff being involved in an e-mail chain, the auditor indicating a police investigation is underway, etc.) we're going to talk about the thing that came out of left field.

Earlier today, the federal Health Minister Jane Philpott sent a letter to Saskatchewan Health Minister Jim Reiter that effectively said it was time to "put an end" to private MRIs within the province. Reiter, and his government colleagues, scoffed at the notion.

Bill 179, the MRI Facilities Licensing Act, passed back in 2015 established private MRI clinics in our province under the system of a "2-for-1" trade off; the idea being that for each private scan conducted in the clinic, that clinic would then be responsible for providing a public scan as well.

Reiter's letter back to Philpott more or less doubles-down on the practice; saying that it has been responsible for more than 2,200 scans and the removal of 1,100 from the wait list. However, these numbers are a little confusing for me.

Back on October 20, 2016 the government released numbers regarding the current "2-for-1" system and the results. Their numbers,from February 2 to September 30, 2016 were as follows:

  • 943 private scans performed in the province
  • 757 public scans performed as part of the "2-for-1" deal
  • 186 public scans in the process of being scheduled
Now,  all of those numbers combined add up to 1,886 scans. Take away the "in-scheduled/not-happened yet" scans and those numbers drop to 1,700. So, where is Reiter getting the 2,200 scans and 1,100 people taken off the wait list numbers from?

Now, that's 241 days being accounted for in the government's October release. In those 241 days, 1,700 scans occurred (Not including the 186 in the "scheduled" portion). That's roughly, if my math can be trusted, about 7 scans a day. At that level, from the period of October 1 until Today, that means we'd have at most 2,113 scans performed in the province.

Yet, Reiter says the system has contributed "more than 2,200" scans. So, I'm not seeing where he's pulling the numbers from on this one...At least, not from the public data that was released a little over a month ago.

But let's bring it back to the basics and talk about the numbers from the release, as opposed to Reiter's numbers that we can't explain. What's the one facet of that that sticks out?

The difference in private scans versus public scans.

At one point or another, the private scans managed to move almost 200 scans ahead of the public scans. That hardly sounds like "2-for-1", given that it shows the scans are not close to parity. And the main reason this is a problem: As far as we know, private clinics have been given no directive to focus on public scans to eliminate the gap.

So, while 186 scans were "in the process of being scheduled" how many scans were added to that backlog?

If private clinics don't have to prioritize ensuring the 2-for-1 ratio is being met, this swap deficit is only going to continue to grow. It doesn't matter if the 186 waiting for a scan to be scheduled eventually get in, if at the same time, 200 more private scans are conducted leading to 200 more people waiting for their swap scan.

So, unless the government issues a directive that private clinics could risk losing their license unless parity is kept and maintained the swap deficit is unlikely to ever actually go away. And that undermines the entire notion of a "2-for-1" swap, when it's painfully clear that the clinics have already placed a greater emphasis on private scans over public ones.

Which brings us to the federal intervention.

One can argue that perhaps this is just desserts for Wall, who has managed to find something new to complain about with regards to the Federal Government pretty much every day. (Don't get me wrong, there's lots wrong with the Federal Government [and we'll talk about that sometime) But as Premier, Wall needs to be diplomatic and receptive, not combative and seeing every Federal action as a personal slight. So, it's not surprising to see the Feds finally kick back on something they can actually do.

On the other hand, Harper had a hands off approach to the Canada Health Act; and one can argue that with tweaks in various provinces, it was only a matter of time until the Trudeau Government did something to try and bring some balance back to the act.

Philpott invoked the ultimate clause in the Canada Health Act: The clawing back of health transfer funds.

As per Article 10 of the Canada Health Act:
In order to satisfy the criterion respecting universality, the health care insurance plan of a province must entitle one hundred per cent of the insured persons of the province to the insured health services provided for by the plan on uniform terms and conditions.
Effectively, provincial governments must ensure that health care services are universal. All people resident in their province should have the same level access to health services as everyone else in the province. If the 2-for-1 trade was at parity, with no discernible deficit for the public scans, you could argue that the province was keeping its end of the bargain.

But, given that we do have this gap between the two, a case can indeed be made that universality is not being maintained under this current system.

Article 19, Section 1 lays out the penalty for breaking universality:
In order that a province may qualify for a full cash contribution referred to in section 5 for a fiscal year, user charges must not be permitted by the province for that fiscal year under the health care insurance plan of the province.
So, what does that mean?

Effectively, Ottawa can decide that the full cost of user fees charged by Saskatchewan should be deducted from their health transfers.

So, if Saskatchewan charged $4 million worth of MRIs in one year; Ottawa could turn around and retract $4 million in health transfers because the province violated the Canada Health Act. And while Saskatchewan receives about $1.6 billion in transfers, $1.1 billion of which is for health transfers,  and a few million less in transfers sounds like a drop in the bucket...Consider the deficits for Saskatoon Health Region and the Regina Qu'Appelle Health Region, where that additional funding could prevent front line layoffs.

If the 2-for-1 system showed promise of working, by which I mean it kept public-private scans at parity with one another, then the SK Party might have had a leg to stand on here. But given that all public data currently available shows that parity has not been achieved, and current practice means striking that balance gets tougher every day with every new private scan conducted, I think the feds are in the right here.

And given that the province plans to expand the system to CT Scans in the near future, it seems increasingly likely that the province is unlikely to blink on this matter.

Which means, of course, that the province will be going to court on it and spending some tax dollars fighting the federal government. At the same time, I'm sure, the feds will invoke the Canada Health Act to claw back Health Transfers to the tune of the private MRI fees. And, sadly, it's the taxpayer who loses here. Since we're either losing money from the federal government, at a time when our health regions need every dime they can get AND that we won't get back unless our side wins a court case (which seems unlikely, in my opinion) OR we're spending money to fight a court case.

Either way, it's money that's being spent or lost that could be making a difference somewhere else in our province.

Tuesday, November 22, 2016

Going for a New Record, Perhaps?

Source: CBC News: Sask. Now Projects $1B Deficit for 2016-2017
Source: CJME News: $1B Deficit Forecast for Saskatchewan by End of April

I did say I would get to the growing deficit eventually.

So, at a time when the Finance Minister Kevin Doherty is arguing with former NDP MLAs and candidates on Facebook, to our Premier effectively calling for a boycott on A&W...It really makes you wonder what other potential distractions are going to come out now that the news has finally confirmed what we've all long feared: Saskatchewan deficit for the 2016 - 2017 year has hit $1 Billion Dollars.

Before the last election, the SK Party was taking an incredible amount of flak for postponing the budget until after the election. The NDP rightfully called them out on this issue, but for one reason or another, voters handed Wall another majority government in the province.

The 2015 - 2016 Budget showed a narrow surplus of $107 million dollars, in March of 2015. Although, it's worth noting, that many commentators were already shaking their head at this figure, given that the government borrowed $700 million and didn't include it as 'debt' in the budget, but most people have already moved on from that.

By November 2015, that $107 million surplus had become a $262 million deficit. By February 2016, the last look at the books before the election, the deficit had grown to $427 million. Wall and Company assured electors that by the time the 2016 - 2017 Budget would be released, the deficit would be back to a manageable $259 million, and that the budget would return to balance come 2017 - 2018.

But weeks after being elected, Wall's comment on the deficit: "“I think it’s going to be higher than that,"and it was with the deficit clocking in at $434 million. Well, given the Sask Party's shoddy record of forecasting economics; for once, Wall was dead right about this one, as it did indeed get much higher.

By June, the deficit was finalized at $675 million. A far cry from the $262 million forecast nearly a year before hand, and still more staggering than the $434 million presented after the election. However, let us not pretend that this was a new experience for Premier Wall and his party.

As Murray Mandryk points out since 2009, four summary budget deficits occurred under Wall and the Saskatchewan Party. A brief refresher for everyone:

Up until 2015 - 2016, Saskatchewan had two accounts that they reported on: The General Revenue Fund (GRF) which accounted for general government revenues and spending. The second was the Summary Financials, which included things like Crown Corporation Debt and the like. Saskatchewan was the only jurisdiction in Canada who presented their budgets primarily on the GRF; where it was easier to present a balance.

It's effectively like saying "Well, we've got $500 in our chequing account and only $200 for bills this month, so we're breaking even!" while you neglect the fact that you've got $20,000 in debt from various other sources at the same time.

In fairness, the NDP used the GRF during the Romanow and Calvert years, so they take a bit of the blame on the way accounts were presented to the province. But, also in fairness, Wall and his party had nine years in office before they saw the need/were pestered enough to officially change the way budgets are presented.

But, back to the modern.

Now, Saskatchewan finds itself staring down the barrel of a $1 Billion dollar debt. And given the history of listed above, one does have to wonder if the buck is going to stop at the $1 Billion mark...Or if the number will continue to climb. Again, given the SK Party record on financial forecasting, I'm not entirely sure we're locked into this number yet.

There is also something to keep in mind: As this deficit grows, Wall and company are hitting a financial record that has stood in Saskatchewan for nearly 30 years: The whopping $1.2 billion dollar deficit of Grant Devine in the 1986 - 1987 budget year.

Much like Wall, prior to an election Devine's team forecasted a modest deficit of $389 million. Devine's deficit, however, grew out of naked self-interest. The government opened the spigot before the election to avoid a potential defeat; and the PCs did lose the popular vote in the province but won the most seats. One does wonder if Devine had shown restraint with tax-payer money, if he'd had gone down as a one-term Premier.

Wall's deficit is a lot more opaque than Devine's.

Doherty has blamed lower than projected resource revenues, especially in oil & gas and potash, as well as decreased tax revenue. And while those are parts of the story, they're only parts of the whole.

The SK Party has been unable to admit when they've made mistakes, and believe me, there have been plenty of them. Things like $1.5 billion, and raising, spent on the Boundary Dam project. A $35 million contract to bring Lean to health-care with questionable results. To a completely questionable land deal that continues to perplex and lead to government stalling to produce any meaningful answers, that has cost at least $22 million if not more.

Yet, Wall and Co. are unable to admit that perhaps they made missteps on these files.

And that brings us to the bigger elephant: Wall is also on track to top Devine's record of being leader when Saskatchewan's overall debt is at its highest. By 1991 - 1992, Saskatchewan's debt topped $15 Billion.

Public debt in Saskatchewan now is expected to hit $15.2 Billion by the end of the fiscal year.

As stated before, yes, the market economy does take some of the blame for this. But, and this is the important bit: We're also coming off some of the best fiscal years Saskatchewan has had since being a province.

When the market was strong, we were taking in record amounts of income. And yet, the SK Party was spending it just as quickly as it was coming in and putting nothing away at the same time. And that, rightfully, is on them.

Saskatchewan stands on the precipice of uncharted territory for our province. Our previous benchmark of "the worst time period in our history" is close to being blown out of the water. And most of us should remember that it took a little over a decade for the province to pull itself back from the brink last time; and that it happened at an enormous cost.

While the SK Party can try and lay the blame as much as they like on anyone but themselves, they have to take ownership of this situation. The market economy only drops so much, it's the government's response that helps determine what happens after the bottom falls out. And so far, Wall and Co. have proven sorely lacking in this area.

I suppose I need to include the standard refrain of during the good times, they were quick to take as much credit as they could. When the bad times started, they started pointing fingers in as many directions as they could.

For years, they were in charge of guiding an unheard of economy in our province. Throughout it all, they were told by numerous sources that they should plan for the future, work on diversification, and be prepared for the eventual bust.

They didn't. They bet the farm on oil & gas, with a side bet on potash, and the dealer ended up having a stronger hand then they did. Unfortunately, for all of us, they we gambling with our money and the debt collector is on the phone.

Thursday, November 3, 2016

Premier of Saskatchewan, Not Alberta Opposition Leader

SOURCE: Alberta Politics - The Question Must be Asked: Was Brad Wall's Party Being Paid to Undermine Alberta's NDP?
SOURCE: CBC News - Saskatchewan Party Received Millions in Donations from Alberta Companies
SOURCE: CKOM - Premier Brad Wall Gets Extra Top-Up Salary from Sask. Party

One of these days, I'll get to the Global Transportation Hub and the stuff coming out from there...OR the proverbial war of words between Wall and any member of the Liberal Federal Government he feels like complaining to about the Carbon Tax...OR the state of the increasing deficit...Or any of the other myriad of problems that continues to creep up under Wall's watch.

But what I want to talk about today is some revelations about electoral funding that came out this week. Predominantly, the fact that Wall and the Saskatchewan Party have raked in millions of dollars from out of province donors; predominantly from Alberta based companies in the oil and gas sector.

Now, a cornerstone of democracy is the idea of transparency. Citizens remain informed on what their elected representatives are up to in our name; or at least, in theory, that's part of how this is supposed to work. Part of that is knowing about monied interests when it comes to our politicians. That's why we have financial disclosures and rules revolving around conflict of interest and codes of ethics.

We like to know where the bread is buttered, and by whom, when it comes to our politicians raising money to get elected or re-elected.

We can watch and see whether they're getting grassroots support from a bunch of individual donors, or if they're taking in dollar over fist of donations from large special interests (Corporations, Unions, Lobby Groups, etc).

That way, when it comes time to make a difficult decision that impacts a certain group, we can be sure that our politicians are acting in the best interest of the voters and not in the interest of their major donors.

Which brings us to the Alberta donations.

Saskatchewan's electoral finance laws have been described as "the wild west", which is an over-used cliche by the way, with regards to rules and restrictions. In terms of residency, Saskatchewan simply requires that you be a Canadian citizen to donate to a party here. So that means Mrs. Entity from BC can hand out as much money to any Saskatchewan based party she'd like, even though she doesn't live in the province or is eligible to vote for any of those candidates.

Some provinces do have residency restrictions on donations to political parties. Ontario, for example, requires you to be a resident in order to make a contribution. It seems like a common-sense argument: If you are unable to cast a ballot in the province, why should you be allowed to contribute huge sums of money to a party there?

Yet, Premier Wall has "no plans" to discuss changing the laws regarding this issue. He even cites that not a single voter mentioned the problem with this during the last campaign; so, if that's the only benchmark we need, we'd best start getting that letter writing campaign going to see if the voters who do complain about it are enough to sway him.

The opposition NDP have taken on the issue, with Trent Wotherspoon calling for an end to corporate, union, and out-of-province donations. Wall's response was to complain that the NDP got money from unions, and more or less left it at that.

The difference here, of course, is the NDP is putting up ALL of those donors on the chopping block. So, the NDP has shown that they're willing to stop allowing union contributions moving forward in the future. Whereas Wall has not shown any evidence that he's ready to cut ties to the nearly $13 million received over the last 10 years from corporate donations.

For fun, let's look at some of the numbers dating back to the 2011 Election. All numbers taken from Elections Saskatchewan.

2015
NDP
Total Raised: $1,326,180.09
Corporate: $144,870.40
Union: $211,156.90

Sask Party
Total Raised: $4,264,352
Corporate: $1,699,139
Union: $2,510

NDP Union Total - SK Party Business Difference =  $1,487,982.10

2014
NDP
Total Raised: $908,542.40
Corporate: $28,683.09
Union: $47,783.48

Sask Party
Total Raised: $2,731,762
Corporate: $894,638
Union: $990

NDP Union Total - SK Party Business Difference = $864,854.52

2013
NDP
Total Raised: $1,177,515.47
Corporate: $24,004.82
Union: $137,108.09

Sask Party
Total Raised: $2,680,215
Corporate: $992,887
Union: $1,801

NDP Union Total - SK Party Business Difference = $855,778.91

2012
NDP
Total Raised: $956,597.01
Corporate: $25,055.85
Union: $73,977.64

Sask Party
Total Raised: $3,267,950
Corporate: $1,042,015
Union: $3,702

NDP Union Total - SK Party Business Difference = $968,037.36

2011
NDP
Total Raised: $2,096,988.92
Corporate: $609,088.08
Union: $325,552.25

Sask Party
Total Raised: $6,113,499
Corporate: $3,086,535
Union: $10,752

NDP Union Total - SK Party Business Difference = $2,760,982.75

So, looking at the numbers, what do you notice?

Effectively, since 2011, the SK Party has had nearly $1 Million dollars more each year in corporate donations than the NDP received in Union donations. So, Wall's defence that the NDP takes union money so his party can take corporate money falls apart when you look at the actual numbers being donated.

Wotherspoon and the NDP are right: It's time to put an end to corporate, union, and out-of-province donations in Saskatchewan.

One more note on this matter before we wrap up the post.

A reason why these out-of-province donations are especially problematic in Saskatchewan is because of the Saskatchewan Party's policy towards paying their leader a "top-up" salary in addition to monies received by being MLA/Leader of the Opposition/Premier.

Wall came under heat, slightly, after the practice was noted in BC for Liberal Premier Christy Clark. Wall and Clark, to public knowledge, are the only two sitting Premiers who receive a top-up salary from their party.

Wall receives $37,000 a year from the party (which is an additional $148,000 over the course of a four year legislative term), and now with the question of out-of-province donations this issue becomes infinitely trickier.

While it is true that a party more or less has the right to spend their donations as they see fit, there are serious implications to consider when you are receiving out of province money and making direct payments to your leader at the same time...Especially if your leader is also the current Premier.

While it's not as bad as direct payment to Wall from these companies, it's close to it, given that monies are being rendered to a party and the party is then using those monies to provide a salary to their leader.

It may not be dishonest, or even improper on the face of it, but it's ethically dodgy and just enough of a "oh, that seems wrong" thought for it to warrant a degree of concern. And while you can argue that their donation is just part of the money raised by the party, it would be impossible to link it to the leader's top-up, there's still a perception of this being quite ethically questionable.

And for Wall, and his party, the only way they're going to be able to put that to bed is to fundamentally prove, once and for all, that the Saskatchewan Party is standing up for the people of Saskatchewan. And a good way to prove that, would be to make sure only the people of Saskatchewan have any sort of say in how OUR representatives are elected.

So, I guess, ultimately: For a party that uses the provincial name, it's time for them to put their money where their mouth is and either close off Saskatchewan's electoral financing to out of province actors...Or maybe think about changing their party name.