Brain-injured street people require compulsory treatment

Pivot Legal Society is calling on the B.C. government to stop its proposed expansion of forced mental health and addictions treatment.

image: STAT News

Compulsory treatment must proceed.

I sympathize with the legal society but the reality is that the number of street people that are brain-injured is unprecedented.

Brain Injury Canada has identified that reality. There is a growing prevalence of brain injury due to substance abuse.

“Opioid overdoses can have catastrophic results, including brain injury,” says Brain Injury Canada’s website.  “The effects of the brain injury will change them as well. It’s a scary experience that can be hard to put into words or share with others and can have a huge impact on mental health and wellbeing for both the person with a brain injury and you as a friend/family member.”

Under B.C.’s Mental Health Act, a person can be detained in a psychiatric facility if a physician deems it necessary for their own health and safety and for the safety of others.

When the act was constituted in 1965, no one could have imagined the growing number of British Columbians who would be brain damaged because of the toxic brew of drugs now available.

B.C. Premier David Eby says the province needs to expand the availability of “involuntary care” and to update the Mental Health Act to provide clearer options for intervention.

Under section 28 of the Mental Health Act, police have the authority to bring a person to a hospital to be assessed by a doctor if the police have reason to believe that the person who is suffering from a mental illness is likely to cause harm themselves or others if not treated.

Pivot Legal Society argues that compulsory care is an outdated approach that is harmful, degrading and often discriminatory.

I agree that compulsory care can be discriminatory.  In 2021, I wrote about “A.H.,” a First Nations woman, who was wrongfully detained for almost a year under the Mental Health Act. In a court case between A.H. and the Fraser Health Authority, the Supreme Court of B.C. learned that A.H. had been held against her will and that she was not even found to be mentally ill. She would still be detained if lawyers had not presented her case pro bono.

But the issue has moved from indiscriminate use of the act to the political arena. Now the safety of citizens and business owners has become paramount.  

Kamloops’ Reid Hamer-Jackson was swept into the mayor’s chair over such safety concerns.

Hamer-Jackson campaigned on establishing a recovery centre outside of the city centre and said transportation should be provided so that the homeless could be returned to their home communities. (One-half of Kamloops homeless have lived here longer than six years or are from Kamloops).

B.C.’s premier understands the impact of drug-induced brain injury.

“For every person that fatally overdoses, there are at least three people that are seriously brain injured,” Eby told The Globe and Mail. “And until you’re sufficiently brain-injured to the point of permanent long-term care, then people are being really spat out from the emergency room back into the community. So it’s cruel and it’s a miserable existence.”

The compassionate thing to do is force brain injured street people into treatment.

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Dr. Day’s marathon to commercialize health care

He may be down but he’s not out. Dr. Brian Day has lost court case after court case but he’s not giving up. I’ve got to hand it to Dr. Day for his perseverance.

image: Eoin Kelleher

He started 13 years ago and isn’t finished yet.

He started his mission in 2009. In echoes of today’s economic turmoil, the Great Recession cast a cloud over the land and Stephen Harper was prime minster. The number one song in Canada was I Gotta Feeling by The Black Eyed Peas.

Dr. Brian Day launched his lawsuit after he learned his clinics were going to be audited by the B.C. Government. The audit was triggered by dozens of patients who complained that they’d been illegally overbilled at Day’s Cambie clinic.

Dr. Day figures that the best defence is an offence. As soon as he learned that the province was going to check into his illegal billing, he launched a court case arguing that B.C.’s Medicare Protection Act violated patient’s freedom under Canada’s Charter of Rights and Freedoms.

It’s so typical. Whenever someone is up to no good they throw up a smoke screen. The guy who’s caught speeding? He’s not breaking the law; he’s taking his terminally ill child to the hospital.

After years of legal delays, the audit by the B.C. Government in 2012 uncovered 170 instances of extra-billing to patients which were contrary to the Act. The audit only sampled 468 services over 10 years, so there were probable many more.

The investigation also uncovered 93 instances of “double-dipping”, in which 19 doctors including Dr. Day charged a total of $66,734 to the province while charged patients $424,232 for the same treatment.

Oh no, said Dr. Day in his defence, we don’t charge patients for treatments, we charge them for “consulting fees,” and “facility fees” for equipment and staff. And no, we don’t pay doctors extra beyond what any doctor would bill the provincial Medical Services Plan.

Financial records later filed in court showed that wasn’t true.

They showed that clinics, including Dr. Day’s,  paid 140 people, mostly doctors, $1.5-million or more per year in “consulting fees,” over five years. That included a total of $1.36-million paid to Dr. Day during that period.

Dr. Day is soldiering on, determined to create a two-tiered health care system in which doctors are pulled out of public health care into lucrative private practices.

British Columbia’s highest court recently upheld a lower court’s ruling that countered Dr. Day’s claim that Canadians should have the constitutional right to pay for private health care. B.C. Supreme Court ruled that Dr. Day’s model would undermine the very basis of universal health care.

In the ruling, the B.C. Supreme Court supported the value of public good.  It’s a concept that greedy heath care salesmen don’t understand. It’s like those “freedom fighters” who don’t get the concept of public good. Public health during a pandemic is paramount; individual rights to refuse a vaccine are outweighed by the need to protect all.

But Dr. Day will continue to try to undermine our health care system which, while struggling, is superior to any private system.

Kamloops’ rental shortage is no accident

The shortage of affordable rental units in Kamloops is the result of deliberate government policy starting with the Mulroney Conservatives in the 1990s. Not just Kamloops but all Canada was affected.

CSI low-income housing in Kamloops

Governments stopped investment in affordable rental units for a number of reasons: strong wage growth from 1996 to 2006 coupled with declining interest rates and modest housing prices enticed more renters into home ownership.

But by the mid-2000s, stagnant wages and the growth of low paying jobs along with escalating housing prices pushed people into rentals.

Now the federal Liberals in cooperation with the B.C. government and CMHC have reversed that trend with an investment in affordable housing.

Our society, the Centre for Seniors Information in Kamloops, is one of the city’s non-profits involved in the construction of affordable housing (I am the president of the society). We are building a five story apartment with112 units, ranging from studio-sized, to two bedrooms on the site of the old Cineplex Odeon theatre on the corner of Sixth Avenue and Victoria Street.

Judging by the response that our housing manager is getting, the building could be full when it opens its doors in just over a year.

The drought in affordable housing has had a devastating effect on low and middle wage-earners.

Canada’s five most common occupations are low-paid and often not full-time. (admin assistants, retail salespersons, cashiers, food and kitchen helpers, food and beverage servers) representing 1.8 million workers or 12% of all jobs,

According to calculations done by David MacDonald, senior economist with the Canadian Centre for Policy Alternatives, wages don’t pay the rent any more. He has come up with a measure of how much wages are short, something he calls the “rental wage.”

He defines the rental wage as the amount you would have to earn so that no more than 30 per cent of your wages goes to rent. In Kamloops, the rental wage is $25 an hour for a two-bedroom apartment. That would leave a reasonable remainder of 70 per cent for groceries, medicine, clothing, fuel, etc.

Another way of measuring rent is by the number of hours you would have to work at a minimum wage of $12.65. In Kamloops, you would have to work 78 hours a week to pay for an affordable two-bedroom apartment.

I suspect that many Kamloopsians are doing without essentials because they pay more than 30 per cent of income for rent.

Between 1980 and 1993, 49% of all rentals built were affordable. Federal tax incentives and loan programs to private investors also played a pivotal role in apartment rental construction over that period.

Now, new federal programs plan to deliver more than 110,500 new units by 2027-28. Combined with other provincial and federal programs, 15,100 and new affordable units were committed in 2017-18 and 16,600 in 2018-19; almost as many as from 1970 and the early 1990s before the cuts.

Canadians desperately need affordable rentals. One-third of Canada’s 14 million households rent their homes.

Without deliberate government policy, private investors can’t deliver the housing needed.

Everybody wins. Mortgages are given specifically for low income rentals, developers build the units and employ trades people, people can afford rent with money left over, and non-profits like ours take ownership of the buildings to generate much needed revenue.

BC Liberals suppressed Hydro rate hikes

For decades, B.C. governments have hidden the true cost of Hydro rates -especially the BC Liberals.

image: Common Ground

Under the direction of the BC Liberals, the Crown utility used “inappropriate” accounting to pile $5.5-billion in what are known as deferral accounts says B.C.’s auditor-general.

“That debt amounts to $1,300 for every residential customer, more than $10,000 for each commercial and light industrial ratepayer, and almost $5-million for each large industrial consumer,” according to the Globe and Mail, February 7, 2019.

Deferral accounts are not improper when correctly accounted for. They can be used as a temporary measure to avoid the shock of sudden rate hikes. After rates are gradually increased, the deferral account can be paid off.

But that’s not what happened. To keep voters happy and to make governments popular, BC Hydro rates were kept artificially low leaving future governments to deal with the problem of billions hidden in deferral accounts.

“BC Hydro was not allowed to charge its customers enough to cover its operating costs each year,” Auditor-General Carol Bellringer wrote.

The current minister responsible for BC Hydro, Bruce Ralston, said his government is committed to fixing the problem but it will take time given the size of the debt. “We are going to keep rates affordable. No one’s rates are going up by $1,300 in a year.” His government has already reduced the deferral accounts by $950-million by bringing that debt onto government books.

The NDP government also intends to prevent misuse of deferral accounts by future governments by restoring the role of the independent regulator, the BC Utilities Commission (BCUC) and ensuring that BC Hydro adopts ordinary accounting practices.

Industries who are used to cheap hydro are not happy with the prospect of paying the real cost of producing electricity. Industry representative Richard Stout says industrial customers shouldn’t absorb the shock of getting Hydro back on sound financial footing. Since the government is responsible for the mess, they should pay:

“I think most would agree the appropriate source of paying down the debt should be from government, rather than the ratepayer.”

Huh? He wants taxpayers (the government) to pay for the meddling of former governments rather than ratepayers? Last time I looked Hydro users and taxpayers were one and the same.

Critics of BC Hydro will point to the debt incurred in building the massive hydro dam at Site C as an additional source of the problem. The project was started by the BC Liberals and given green light by the NDP who said the project had gone too far to abandon.

The government is faced with a hard choice, says Bellringer: “You can either have a rate increase or you can end up with a deficit that ends up getting covered by the government at some point.”

Hiding Hydro debt, which in reality is our debt, is not an option.

Transferring BC Hydro’s debt to the government’s books is the right thing to do but government debt is not popular with voters because it’s visible. Turning control of BC Hydro over to an independent regulator is the right thing do but hydro rates will go up.

We’ll see if doing the right thing pays off for the NDP in the next election.