Thursday, September 16, 2004

Big hopes, small results from health summit

VICTORIA - I try to be positive, but Paul Martin's health summit strikes me as a dumb exercise.
Not that the people are stupid. B.C.'s delegation is probably typical, and the politicians and senior staffers are dead bright and fully committed to making health care better.
But I started to write this Wednesday evening. I had spent the day looking after two boys, four and one, reading stories, frying up cheese sandwiches and wreaking minor havoc in the local Toys'R'Us.
This meeting was supposed to be all about those boys. The goal was to fix health care for a generation.
It didn't.
The result - useful enough - is a little more money from the taxes you pay to Ottawa, so the taxes you pay to Victoria don't have to rise. Martin succeeded in getting the provinces to offer a nod towards accountability, for which we should be thankful.
But fixing health care for a generation? Not a chance.
The bare bones of the deal are pretty simple. Ottawa will come up with about $3 billion a year more as its share of health care funding. That translates into about $400 million a year for B.C., or enough to fund a 3.3-per-cent spending increase.
That's welcome, although hardly revolutionary. If $400 million a year was enough to fix health care for a generation, the B.C. government had half-a-dozen ways to raise the money. (Just dedicating the extra cash from the Liberals' gambling expansion to health care would produce a similar amount.)
Martin talked a lot about accountability in the unproductive run-up to the summit.
But based on the sketchy details released so far, the deal did little to ensure greater accountability to you - the consumer of the services, and the one who pays for them.
The premiers did promise that by the end of next year they would come up with standards for the wait time for key treatments, and begin reporting on how they are doing at meeting those standards. The idea is that British Columbians may be able compare their wait for hip surgery with people in P.E.I. Provinces making their citizens wait for long times will have to explain why.
But the promise is still vague, and premiers didn't commit to "meaningful reductions" in waits for critical health care like cancer treatments and knee and hip replacements until March 31, 2007.
Health ministers are going to talk about a national prescription drug strategy and report on their progress in June, 2006. The premiers say they'll phase in some sort of minimal guaranteed home care standards, if they can afford to, and report on their progress by the end of 2006.
It's all useful. But it's also the kind of thing Canadians have heard before, in the same context of federal-provincial financial wrangling.
The summit highlighted just how bizarre the health care model remains. You buy home insurance, and you know what you get. Car insurance, the same. But you pay for health insurance - about $2,700 each year per British Columbian - and you're promised nothing.
You pay, and the government makes up the coverage rules on the fly. Maybe hip replacements will be a political or medical hot button, and you'll wait three months. Maybe tax cuts will be the priority of the day, and you'll limp for a couple of years.
There is generally little information about how well, or poorly, the system is working, partly because health care providers have remarkably little useful data about what they do and what it costs.
Martin and the premiers took some small steps to improving accountability.
But mostly the meeting seemed like another federal-provincial money wrangle. Despite the promise of an open meeting, with Canadians able to see the issues being discussed, the real deal was done behind closed doors in the usual last-minute round of dealmaking.
And that will not fix health care for a generation.
Footnote: The premier's idea for a new federally funded national pharmacare plan - credited in part to Premier Gordon Campbell - never made it out of the starting gates. Campbell was one of four premiers - along with Ontario's Dalton McGuinty, New Brunswick's Bernard Lord and Quebec's Jean Charest - who represented the provinces in behnd-the-scenes talks.

Tuesday, September 14, 2004

Big surplus big good news for Liberals

VICTORIA - Yes, that is a real $1.2-billion surplus the Liberals are suddenly projecting for this year.
And it makes both the job of governing and their re-election campaign a lot easier.
Finance Minister Gary Collins unveiled the latest financial update Tuesday. Five months into the fiscal year things are going a lot better than he predicted. Instead of a skimpy $100 million surplus - not much in the context of $30 billion in government spending - B.C. is on track for a $1.2-billion surplus.
Things look even better for next year's election budget. The Liberals had been projecting a $275-million surplus. Now Collins is projecting $1.3 billion.
That leaves the Liberals with some enviable choices. They can spend more money, cut taxes or pay down the debt. Or, most likely, do some combination of all three.
It is good news.
Government revenues have are on track to jump about 9.5 per cent over last year. Lumber prices - in part due to a couple of hurricanes in Florida - are nearing record levels, which means both a bigger harvest and higher royalties. Natural gas prices are also high, pushing royalties about $200 million above plan. And low interest rates and a strong economy have pushed up tax revenues.
You can decide how much credit - or blame - any government can take for economic performance. No government policy change can cushion B.C.'s export-based economy from big weakness in our major markets. But the Liberals' tax cuts and move to more business-friendly policies have helped encourage investment in the province.
However before you get too fired up about plans for the money, recognize that even $1 billion isn't all that much in the government scheme of things.
Collins has already set aside $200 million as a cushion in case things take a turn for the worse.
And the Liberals are already under pressure to undo the sales tax increase they imposed in 2002. Knocking the rate back to the original seven per cent - the Liberals raised it to 7.5 per cent - would cost another $280 million.
That leaves $520 million, enough for a 1.7-per-cent overall spending increase. (The Liberals' budget for this year called for a 1.3-per-cent increase, not enough to keep up with population growth or inflation.)
Still, the Liberals can now talk about spending, not cutting. Collins unveiled the background pamphlet for a legislative committee heading out to get input on next year's budget. Should we spend, or cut taxes, or pay down the debt, it asks? How much more for schools, or health care? Those are good questions for a government to be putting before voters.
The Liberal campaign will talk about the shared sacrifice, the tough decisions and the benefits to come, with the larger-than-expected surpluses as the first big example. (And, of course, about the New Democrat's dismal record.)
That still leaves NDP leader Carole James with opportunities. She was quick off the mark in responding to the surplus.
James argued that the Liberals had simply benefited from a strong global economy. And the surpluses had been produced by shifting the tax burden on to middle and lower-income families - a fair charge - and unreasonable spending cuts, she said. Health care and education have been starved of money.
And the issue, says James, is trust. Who do voters trust to make decisions about dealing with the surplus in an effective and equitable way?
That is a pivotal question in the campaign. But there's no way of knowing yet how voters will answer.
James is lugging the NDP's past baggage, her own fiscal plans are still fuzzy and she has no track record.
But trust isn't exactly Campbell's biggest asset either. He's profoundly unpopular, according to the polls, and has already broken trust on BC Rail and other campaign promises.
Both leaders have the next eight months to persuade voters that they can be trusted.
Footnote: The government's numbers look sound, although there always risks froma volatile global economy. GIve the Liberals full credit for consistent openness in setting out the state of the province's finances, and the assumptions underlying them. They have set a high standard for transparency and - aside from a consistent conservative lean in the budgeting - for accurate forecasts.

Monday, September 13, 2004

Da Kine follies a fine symbol for our pot policies

VICTORIA - It's hard to see the people who run the Da Kine pot shop as criminal masterminds.
The little store on Vancouver's Commercial Drive has been the city's most famous site for the last two weeks. Hundreds of hours of police time, lots of media coverage, police and politicians running to and fro, all for a small store that's committed the crime of openly selling marijuana.
No doubt it was a good business, especially once the media told everybody about the opportunity. When police - some 30 of them - finally raided Da Kine they scooped up $63,000.
But despite the cash, Da Kine looks mostly like disorganized crime. If the goal was big profits, they could have quietly kept on selling. Instead, the store operators embraced the publicity, and pretty much dared the police to do something.
Which, or course, they did.
The whole weird saga says something about our doomed war on marijuana.
The story broke that Da Kine was selling over-the-counter marijuana about two weeks ago. Customers had to say they needed the drug for medicinal reasons, but the rules were, shall we say, relaxed.
So the reporters asked police what they knew, and what they were going to do.
We know they're selling marijuana, said Vancouver police. And we're not going to do anything, because - in case you haven't looked around lately - Vancouver has bigger crime problems.
Vancouver city councillors mostly expressed the same ho-hum attitude. As long as nobody gets too upset, they had other issues to worry about.
But then Da Kine kept making the news. Solicitor General Rich Coleman said he was sure police would act. Vancouver politicians started getting a little more worried.
Instead of quietly skirting the law, the Da Kine operators were making police look like they weren't doing their jobs. So they did, scooping up half-a-dozen people.
The next day the store was open for business again. If it keeps making news, the police will probably have to arrest some more people.
It's a bizarre little story, and one that shows just how muddled our approach to marijuana has become. Marijuana possession is a crime, sort of, at least until Paul Martin changes the law. Selling marijuana is a crime, but not one ordinarily of high police interest unless you work at attracting their attention.
The confusion is understandable, since police and prosecutors are in an impossible position. One in six B.C. adults, according to StatsCan, used marijuana in the last 12 months. That's more than half-a-million people, too many to arrest.
Those people are also a significant market, one that is virtually certain to attract people keen on supplying it. The tougher enforcement efforts against them, the higher the profits for those who are successful, the more people who enter the business, and the more likely organized crime becomes involved. (See the U.S. attempt at alcohol Prohibition, and the rise of big-time gangsters.)
Arresting the staff of the Da Kine cafe didn't even shut down the store, let alone make a dent in the marijuana supply.
There was no real alternative to raiding Da Kine, given the operators' provocations.
But there is an opportunity to rethink our overall approach to marijuana.
In a perfect world, few would choose to use a drug to alter their reality - not marijuana, or alcohol, or crystal meth.
But we do, and that leaves three challenges. We need to make sure people, especially young people, get an accurate understanding of the risks of all drugs. We need to have adequate support for people who are dealing with drug problems.
And we need to come up with an effective enforcement approach.
Rushing around ripping up grow ops - or raiding a store - accomplishes nothing. The marijuana supply isn't reduced; organized criminals are only inconvenienced; drug use is unaffected.
And what is the point of that?
Footnote: What are the alternatives? If the aim is organized crime, then come up with more money for law enforcement. The now defunct Organized Crime Agency of BC has complained that a budget freeze left it unable to do its job. For a more radical approach, simply legalize possession of a few marijuana plants. The commercial grow op business would wither away.