Provinces don’t want/want to meet with feds over health care

Provinces are sending mixed messages. First they meet but reject previously negotiated terms. A month later, they want to meet but are unwilling to negotiate.

Make up your mind. Meetings require negotiations, not a hand-out.

It seemed like a done deal when provincial and federal health ministers met in Vancouver in November.

Federal Health Minister Jean-Yves Duclos had negotiated in advance of the meeting with his provincial counterparts and all seemed to be going well. In a proposed deal, the feds would give the provinces more money in exchange for two things: a human-resources action plan which would see the credentials of health care workers recognized from province to province; and the sharing of health care statistics across Canada.

Provincial health ministers had voiced no objections just days before the meeting.

Image: CTV Montreal

Then the premiers got involved.

It’s hard to know just which premiers pulled the rug from under the proposed agreement.

British Columbia Health Minister Adrian Dix, co-chair of the get-together, seemed disappointed. He told a news conference that the federal offer had moved the parties “a sound bite further ahead.”

New Brunswick Premier Blaine Higgs was ready to deal. He said there should be talks and “let’s see where the discussion goes.”

Other premiers categorically dismissed the federal plan. Quebec Premier François Legault rejected any transfer from the feds that came with conditions.

It seems reasonable to me that data on diseases and successful treatments be shared nationally. It’s reasonable to make the movement of health care workers across the country as seamless as possible.

Now, only a month after rejecting the fed’s modest proposal, premiers want to meet again to ask, again, for money without conditions. It would be a short meeting because the feds won’t, and shouldn’t, hand over money unconditionally.

Even before any new money is negotiated, the provinces and territories are already on track to get a 9.1 per cent boost next year – a $4.1-billion increase.

Federal Health Minister Duclos is ready to talk but belligerent premiers only have their hands out. What the feds want to talk about is data and indicators that measure results. “The problem is, until now, the premiers refuse to speak about those results,” Duclos said.

The problem is that money transferred to the provinces is not necessarily spent on health. The feds can specify targeted transfers for things such as mental health but provinces will do what they want with it. Ontario Premier Doug Ford was candid. He said provinces need flexibility to move money between different “buckets.”

In other words, provinces will do want they want with federal transfers.

“All that premiers keep saying is that they want an unconditional increase in the Canada Health Transfer sent to their health ministers,” said Duclos. “That is not a plan; that is the old way of doing things.”

Money alone will not fix our health care. More national data would make the system more efficient by putting resources where they are needed. Health care workers should be able to move easily from province to province where the need is greatest.

Bluffing on the part of premiers is so tedious, as Alberta Premier Smith has demonstrated so well. Let’s get past the BS and get down to honest negotiations.

Advertisement

Lies, damn lies, and category 1 carcinogens

The World Health Organization recently placed processed meat in category 1 of carcinogens, along with radioactive elements and asbestos. That’s the list of agents “carcinogenic to humans.” They also placed red meat in 2A which includes Glyphosate (Roundup) and lead compounds which are merely “probably carcinogenic to humans.”

Is eating bacon more likely to cause cancer than exposure to an herbicide? No. Agents aren’t listed according to risk. The criterion used is: do they or do they not cause cancer. The categories are grouped by experts according to certainty from the most evident all the way down to category 4, “Probably not carcinogenic to humans” of which there is one item, Caprolactam (used to make nylon).

Risk is determined by how much you are exposed to the carcinogen. André Picard, public health reporter for the Globe and Mail explains:

“The expert group does hazard identification, not risk assessment. Practically, that means they determine, yes or no, whether something may cause cancer, but not how potent it is at a causing cancer,” and adds, “It’s important to remember, however, that not every exposure to a potential carcinogen will cause cancer: Frequency, intensity and potency matter.”

All agents in a category don’t carry the same risk. If they did, people would be dropping like flies from eating meat. Compared to other items, they are not.

Eating processed meat and smoking tobacco, both in category 1, don’t have the same mortality rate. Processed meats result in 34,000 deaths worldwide annually whereas smoking causes about one million cancer deaths. Also in category 1, asbestos kills more than 100,000 and alcohol causes 600,000 cancer deaths a year.

Also misleading is the way percentages are used to translate statistics. For example, two slices of bacon are reported to increase your risk of colorectal cancer by 18 per cent. Eating a 4 ounce steak will result in a similar increase. But when risks of colorectal cancer are low to begin with, a small percentage increase of a small risk is still a small risk. The actual numbers expose this fallacy, explains Pickard:

“Based on these estimates, about 66 in every 1,000 people who eat a lot of red meat or processed meat will develop colorectal cancer in their lifetime; by comparison, 56 of every 1,000 who eat very little meat, processed or otherwise, will develop colorectal cancer.”

In other words, the increased risk is 10 out of 1,000. If you are one of those 10 persons who acquire cancer from eating meat, it’s tragic but as a risk assessment it’s not that bad.

Risk assessment is complicated by the toxicity of the agent, the amount of the agent you are exposed to, the length of time exposed to it, the way you are exposed (inhaled, ingested, topically applied), and your genetics.

The categories are useful in determining what to avoid, if possible. But some things are almost unavoidable. Like living: walking in the sun (ultraviolet rays), working (painter, hairdressers and shift-workers), eating (barbequing at high temperatures), camping (wood smoke), and travelling (cosmic rays from flying in a plane, breathing vehicle exhaust).

Unavoidable, like being alive: the naturally produced hormone estrogen has been linked with cancer, especially when combined with the artificial hormone progestin.