Tom Clark:
Hello from the nation’s capital and welcome to The West Block. I’m Tom Clark.
Well, on our show today, the future of healthcare. Atlantic provinces are calling for more funding from the federal government while experts are saying the current levels are already unsustainable. How much longer can the system survive?
Syria, may be on the brink of revolution. We’ll talk to Foreign Affairs Minister, John Baird.
And we go inside the Peace Tower to meet the woman behind the bells on Parliament Hill.
Well tomorrow finance ministers are meeting with Jim Flaherty in Victoria and you can bet that the issue of healthcare will be front and centre. Why? Well, take a look at this…
Primer:
According to the Canadian Institute for Health Information, Ottawa and the provinces will spend just over $4 thousand dollars per Canadian on healthcare this year. And that doesn’t include private costs such as company health plans. But there’s a lot of us here, more than 34 million and so public spending on healthcare will reach $141 billion dollars in 2011. And it’s rising. Over the next few years, costs are expected to be of the charts. Not convinced? Well, take a look at the trend, public healthcare spending from 1975 to 2009 and that’s even adjusting for inflation.
Now the majority of those costs, the vast majority of those costs are shouldered by the provinces and the numbers vary per province. But in Nova Scotia, for example, healthcare accounts for nearly half of the provincial government’s budget.
We are joined now, in Halifax by Nova Scotia Premier, Darrell Dexter. Premier, thanks very much for joining us here today.
Darrell Dexter:
My pleasure to be with you Tom.
Tom Clark:
Thank you. I want to get directly to the ask that you got for the federal government. Currently, you are saying that the Atlantic premiers got together and said, we’re getting 20 percent of our healthcare budget covered by Ottawa, we want that to be 25 percent. Now, if the federal government doesn’t boost it’s amount to 25 percent, what happens in Nova Scotia to healthcare?
Darrell Dexter:
Well, I think there are a couple of things that people have to understand. I mean, first of all, a lot of the comparison on the growth of the cost of healthcare tries to compare years ago with today and the reality is that the healthcare service envelope is a heck of a lot bigger now than it used to be.
We put a lot of things in healthcare, so much of the growth that has taken place and the cost of healthcare has been associated with the new services that we’ve brought in, as opposed to the actual kind of incremental growth associated with existing services; that’s the first thing.
The second thing is that the relationship between the federal government and the provincial government with respect to health transfers was really addressed very broadly by the Romano Commission, and they talked about the necessity for the partnership with the federal government to be a real partnership and they Peg that number at a 25 percent share for the federal government.
And they talked about the fact that, that partnership had to be sustainable over a period of years. In Nova Scotia and the Atlantic provinces, the amount of money that’s being transferred now to us that supports our healthcare system as a percentage of overall spending, is declining quite precipitously. It was 23 percent when the Accord was originally signed.
It will slip below 20 percent in our province this year.
In fact, it’s well below that in Newfoundland than some of the other provinces already. And you know, that makes it a pretty significant burden for provincial taxpayers to continue to carry, and indeed if health transfers don’t keep pace then that will have an impact on our citizens.
Tom Clark:
Let me pick up on a word you used and that was “sustainable”. And right now, as we pointed out, 47 percent of your budget is being eaten up by healthcare.
And that simply means that as that portion grows, as that total bill grows, because you’re quite right, there are two levels of government paying for this, but there’s only one taxpayer.
At the end of the day, you have to make decisions as a premier, if you’re running out of money or getting squeezed because the healthcare budget keeps going up, you can do less for example for things like education and so on.
So isn’t the real question here not so much who pays what portion of this, but is this not the time to fundamentally change the way we do healthcare in this country so that we can afford it for another generation?
Darrell Dexter:
Well, I think there are certain assumptions that are kind of, are made about the way that the healthcare system is administered now, that I don’t think are really quite correct.
As I’ve said, we have stripped services, for example out of housing, out of other departments that we now put in the healthcare envelope.
So although it shows up as a larger and larger part of our budget, the reality is that we’re doing more in health than we ever did in the past.
I don’t really think that the healthcare system or that the question of sustainability is as critical as some people might like to believe, but I do think that…
Tom Clark:
Well, let me just jump in to say that the Canadian Medical Association that represents the doctors in this country, put out a report and it says, among other things, that, “We need a new framework that allows a range of providers, ( public-sector, private-sector and non-profit) to compete in carefully controlled conditions”.
This is echoing what a lot of other people are saying that we need this adult conversation because you know, I mean put it another way Premier, if you took the federal funding out of your budget, 88 percent of your budget is going to pay for your healthcare, whether that includes other things or not.
But the reality is, is that every year this keeps on going higher and higher.
At some point, you’re just going to become a tax collector for the healthcare system.
Darrell Dexter:
Well, again, I mean I think that makes a very difficult assumption, and you know, we’re not talking about the same level of service. But I think the more important point here, is what is our relationship between the provincial and federal government and that’s what’s going to be at issue when we move forward to the new talks on what those transfers are going to look like. Romano talked about a principle of partnership that brought the federal government in at 25 percent.
In the original Health Accord they came in at 23 percent. There was a 6 percent escalator.
I wasn’t there at the time, but my impression was, that what they intended to do was to put the escalator at a point so that we would start to move to that 25 percent. Having readjusted the base, gotten to 23 percent, we would start to move toward 25 percent with a 6 percent escalator.
That didn’t happen because healthcare costs outstrip the 6 percent escalator, and that is a very justifiable concern and one that we are actually addressing here in Nova Scotia. Nova Scotia, our district health authorities were held a zero growth last year.
We are looking to contain healthcare costs by transitioning the system to make it become more efficient, we have brought down the administration costs from one of the highest in the country now to well below the national average. So it was a question of account…
Tom Clark:
I don’t mean to interrupt…I’m sorry, I don’t mean to interrupt you Premier, but would you consider as part of those efficiencies, some of the things that a lot of experts are now talking about openly for the first time, and that is, would we allow some form of private sector involvement in the healthcare system delivery? Still universal healthcare, but involving the private sector, things that have been off the table for so long, are there things off the table that you would consider putting on the table in terms of the structure of healthcare here in Canada?
Darrell Dexter:
I don’t think that there is any doubt and if there is, it should have been done away with by the myriad of studies out of the OECD and you know, various countries around the world that have shown that the public healthcare system is the most efficient way to deliver healthcare. We’re more efficient than the United States. We are much more efficient than many other systems in the world, so moving over into private healthcare delivery would not resolve that problem. And I think, it’s a bit of a false argument. There are parts of our healthcare system now already, that are in fact delivering privately. Those accommodations have been made over many years and you get into a little bit of a fight over the semantics of where the public healthcare system ends and private delivery starts and I’m not really that interested in that. I’m interested in a strong, well structured public healthcare system, and I think that we are, in my province, on the road to that and we’re willing to be accountable for it.
Tom Clark:
Premier, on that note I’ve gotta to wrap this up. It’s just the beginning of a fascination conversation but I thank you very much for kicking it off. Nova Scotia Premier, Darrell Dexter, thanks for joining us from Nova Scotia and Premier by the way, have a great Christmas.
After the break, a discussion with Canada’s Foreign Affairs Minister, John Baird on the situation in Syria, and Canada’s new office of Religious Freedom. That’s coming up next here on The West Block.
Break
Tom Clark:
Welcome back to The West Block, I’m Tom Clark.
Well, the United Nations says that now more than 5,000 people have been killed in demonstrations against the government in Syria. And earlier this week, the Canadian government issued a plea to Canadians still living in Syria basically saying get out and get out now. What’s happening in Syria, well for that I’m joined by Canada’s Foreign Minister, John Baird.
Mr. Baird, thanks very much for being here.
John Baird:
Good to be with you.
Tom Clark:
When you issue, as you did a few days ago, this order to get out, what are you anticipating is going to happen?
John Baird Minister of Foreign Affairs
Well, we’re concerned that the situation will continue to deteriorate. I mean, more than 5,000 people killed, this thing could be coming to a climax and we’re just tremendously concerned that Canadians on the ground should get out now while there are commercial options available. If the airport were to close, we’re not sure we’d have any capacity to get people out.
Tom Clark:
Now when you say coming to a head, I mean have you got a timeline in mind? Are we talking about days?
John Baird:
There’s never anything solid that you can predict when these things come to a head, but there’s not doubt with this past week with the sanctions from the Arab league coming online, it’s going to cause real pain for the regime and that will undoubtedly cause the temperature to rise and rise significantly. Five thousand people killed is a lot and we’re saying to Canadians that are there now is the time to get out.
Tom Clark:
You know, when you talk about evacuation you can’t help think back to the situation in Lebanon a few years ago when there were a lot of Canadians that perhaps we didn’t know about who were there wanting to get out. If the situation in Syria deteriorates quickly and there still are Canadians there, what are out options because we don’t have the capacity as we did in Lebanon to get them out by sea, so what can we do?
John Baird:
We’re making contingency plans right now but it could be very difficult. That’s why, we’ve said it before, and we’re saying it now very loudly, very clearly, is the time to leave now. If the airport would close we would have to evacuate people through Jordan or people through Lebanon and that could be very problematic.
Tom Clark:
Well it also be a dangerous mission for the Canadian…
John Baird:
Absolutely.
Tom Clark:
…whoever the Canadian aid agencies are to get the people out. Tell me something because a lot of people wondering about this. When we saw a situation deteriorate, for example in Libya, there was coordinated world action fairly quickly. A Canadian led that operation and in fairly short time Giddafi was gone and the rein of terror was over. So why can’t that happen in Syria? Why is the world being much more reluctant about Syria than it was about Libya?
John Baird:
Well, with respect to Libya, we saw the United Nations working well, and when it comes to…oh when it comes to Libya, we saw the United Nations working well and when it comes to Syria you see it failing. We can’t even get a resolution of condemnation let alone sanction out of the Security Council so it’s….
Tom Clark:
Because…
John Baird:
…because Russia and China won’t agree and others are not being helpful. So what we have had to work is work with our allies; work with the United States, the United Kingdom, the European Union and we’ve seen some extraordinary leadership from the Arab leagues, which has really been phenomenal over this past month in putting in tough sanctions that will really put a squeeze on the Assad regime.
Tom Clark:
But when you talk about China and Russia blocking any resolution in the United Nations….
John Baird:
We’re talking about a resolution just to say this is a bad thing what they’re doing, let alone sanctions, let alone any intervention.
Tom Clark:
But Russia and China then are acting in defence presumably of Iran because Syria is seen by many people simply to be a surrogate of Iran.
John Baird:
Well, I think it’s far more complex than that. I mean, when I’ve talked to my Russian, Chinese counterparts they were not pleased with the robust interpretation of the United Nations resolution with respect to Libya and that’s probably at the heart of it.
Tom Clark:
Is there some fear though that as you go into contemplating what the options are in Syria, and we know that diplomacy is always the preferred method but, as Von Klaus once said, you know, military action or war is just diplomacy by other means. Is there a possibility in your mind that it could possibly get to that point where we are going to have to talk about an armed intervention, you know, responsibility to protect the population that is being massacred by its own government?
John Baird:
Well obviously our first objective would be to see change from within and we are beginning to see that. You see increasingly, significant…not insignificant numbers of the. Syrian Armed Forces are joining the Free Syrian Army. You are seeing increasingly people on the ground change sides but we haven’t had any generals or big leaders. Increasingly we’re seeing the Syrian opposition begin to get their act together over the past few months. We welcome all of that. The second option is obviously diplomatic means – sanctions. And the sanctions that the west has taken have been very effective but insufficient. That’s why when the Arab League came onboard it was tremendously powerful. I mean, if you’re a member of the regime you can travel to Iran and maybe some African countries, but your options are very limited and that puts a real squeeze on the regime.
Tom Clark:
I just want to switch channels a little bit here because one of the other things that you’ve been talking about as Canada’s Foreign Minister is the establishment of the office of Religious Freedom in this country. We don’t know much about it, so I’m going to try and find out from what this is all about.
First of all, how much are we going to spend on it?
John Baird:
We put in our campaign platform that we’d spend about %5 million dollars.
Tom Clark:
Five million dollars and what’s it going to do?
John Baird:
I think the fundamental purpose of the office of Religious Freedom when we get it up and running we’ll be speaking to this in the New Year is basically going to promote religious freedom around the world. We see people of different faiths under threat and under persecution around the globe, whether it’s the Bahia’s in Iran, whether it’s certain sects of Muslims in Pakistan, whether it’s Coptic Christians in Egypt, whether it’s people forced to worship underground; Roman Catholics in China. And that causes us significant concern and we have religious freedom; you tend to have a lot more other freedoms so it’ll be an issue that we’ve increasingly talked about in our foreign policy over the past year. It’s an issue we want to promote around the world.
Tom Clark:
But isn’t it problematic in this sense, that first of all, this implies that we’d be interfering in the global politics of another sovereign country, which generally we don’t do?
John Baird:
No, listen, we speak up to support the rights of women in Afghanistan. We speak up strongly to support the rights of gays in Uganda or Nigeria so promoting human rights around the world has always been something that’s been central to Canadian foreign policy.
Tom Clark:
But isn’t there a possibility though that when you want to protect religious freedom on one side and let’s take gay rights as the marker on the outside, there are some religions that if promote their freedom are also not great friends of gay rights. So now, you’ve got a dilemma. Do you support religious freedom or do you support gay rights? How do you find that balance?
John Baird:
Well I don’t think it will be a challenge. You know, listen, I use those examples, that the Bahia’s who are being killed in Iran. I don’t think anyone thinks that regardless of your views, other political views that you deserve to be killed for your religious views.
Tom Clark:
What if there is a violation in our view of religious freedom and I’m assuming you’re thinking it’s not an on-off switch; there’s a degree of religious freedom so there’s many, many shades of grey. What if this happens in a country that we’re allied with, that we’re friendly with, that we trade with? How do you deal with that? Or on the other hand, are you saying that the opposite of religious freedom is going to be a filter that we will not deal with these countries that do not believe in religious freedom?
John Baird:
Well, I think if we said we wouldn’t deal with countries who didn’t share our views on human rights, there may be precious few that we would deal with. Obviously, we think we’re better to be there to promote human rights, and we’ll be speaking more to this in the New Year. But we’ve been working hard on it over the past year, speaking up and speaking up strongly for human rights, and particularly religious freedom, and we’re going to continue to do that.
Tom Clark:
Foreign Minister, John Baird, thanks very much for being here and I should ask you, what do you want for Christmas?
John Baird:
I just want a good break.
Tom Clark:
Starting right now. Thank you very much. John Baird.
And we will continue with more of The West Block right after this.
Break
Tom Clark:
The Peace Tower Carillon. Mackenzie King called it the voice of the nation. Well, The West Block stepped inside the tower to meet the woman behind the bells.
You can set your watch by it. The National Anthem ringing out from the Peace Tower Carillon as the Carilloner begins her daily concert.
Dr. Andrea McCrady:
Now, from the sublime to the ridiculous.
Tom Clark:
The woman behind the bells, Dr. Andrea McCrady. That’s right, doctor. McCrady left a 30 years career in family medicine to become Canada’s fifth Carilloner. She says the move wasn’t as dramatic as it sounds.
Dr. Andrea McCrady:
I’ve actually played all 11 Carillons in Canada over the years at the same time as being a doctor. But when I was so lucky to get this job, this was a full time job, so I retired from medicine.
Tom Clark:
The Carillon is made up of 53 bells, each tuned to a specific note. There are clappers connected to the Carillon keyboard.
It is a percussion instrument, sensitive to the touch of the Carilloner. From her hands and her dance shoe clad feet, that is what McCrady loves about it.
Dr. Andrea McCrady:
My hand and my body is an extension of the clapper. I’m an extension of the bell. I can play loud or soft. It’s actually quite sensual.
Tom Clark:
Over her three years as Dominion Carilloner, McCrady’s performance has marked many important occasions; the most memorable, Jack Layton’s lying in state.
Dr. Andrea McCrady:
Thank goodness I didn’t know how quiet the Hill was and how everyone was listening to every darn note, but it really, really affected me.
Tom Clark:
And for her, one of the lighter moments.
Dr. Andrea McCrady:
When the portrait of Jean Chrétien was about to be unveiled and so I ended up playing Chariots of Fire.
Tom Clark:
She’s even performed K’Naan’s popular song, Waving Flag to mark Flag Day. But her flag is the Stars and Stripes. Yes, she’s an American.
Dr. Andrea McCrady:
I was an international competition; so open to everybody around the world and I didn’t think I had a chance but look what happened. So I had to get a work permit to come.
Tom Clark:
Her work permit has since been renewed and permanent residency is in the works, but McCrady is hoping for something even better.
Dr. Andrea McCrady:
I would hope that I’d be one of those lucky people to sort of swear in my citizenship on Canada Day.
Tom Clark:
Now the Dominion Carillon is sacred; few musicians have the chance to sit on that stool. So while playing Chopsticks was out of the question, guests of the Carilloner are allowed one honour. Ringing the biggest bell in the Carillon.
Tom Clark plays one note and says, “I think I played that brilliantly”.
Tom Clark:
Well before we go a little Christmas fun from the Bard of Cape Breton, Liberal MP, Rodger Cuzner. Have a listen.
Rodger Cuzner:
Mr. Speaker:
Twas the week before Christmas and all over the Hill
The humbuggish Tories were imposing their will.
The stockings in Muskoka were stuffed to the brim
But life for First Nations remained woefully grim.
And at the North Pole, Santa’s problems abound
There was much work to do but no workers around.
How can we do Christmas with no reindeer or elves?
The sleigh is a wreck, there’s no toys on the shelves.
Costs have just spiralled, the elves threaten strike
They won’t work this Christmas without a pay hike.
Tory payroll taxes have taken their toll
Now unemployed elves populate the North Pole.
Federal money for deer feed and vets
Have just been re-profiled for big jails and jets.
Heartbroken children would spring from their beds
For the first Christmas ever shut down by the feds.
No presents for Christmas, Tories felt the frustration
So they saddled the elves with back-to-work legislation.
No reindeer or sleigh to fly our roof-topper?
No problem; just send in a Cormorant chopper.
The moral I share: Tories lack rhyme or reason
Nonetheless, all the best for a great Christmas season!
Tom Clark:
And we echo that. Have a very Merry Christmas and Happy Holidays from The West Block. See you on the other side.
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