Here’s a question: How will we fund the legitimate concerns of First Nations and also urgently needed health expenditures to contain COVID-19 and any future pandemics?
Rail service across Canada has been halted for nearly three weeks by Indigenous protests. Ships are unable to unload containers in Halifax and Vancouver. Over 100,000 passengers as well as commuters around Toronto, Montreal and several other cities have been severely inconvenienced. The protests have disrupted shipments of food, grain, propane, oxygen and chlorine, and threatened widespread unemployment. They have also increased CO2 emissions as people drive or fly rather than travel by rail.
The Coastal GasLink project in British Columbia not only would have bestowed major economic benefits on Indigenous communities along the route, but it would have possibly reduced Asian demand for coal in favour of cleaner gas and oil.
Ironically, Vancouver is the largest coal-exporting port in North America. India had planned to increase its coal-fired power capacity by 22 per cent in the next three years. Nuclear energy once provided a third of Japan’s power generation, but due to the Fukushima disaster, it dropped to three per cent by 2017. Japan now plans to build up to 22 coal-burning power plants over five years. Thus, those opposed to Coastal GasLink on environmental grounds should consider the effect on total world emissions.
Federal debt has increased 5.6 per cent over the past few years. This year, the total federal/provincial debt will add up to nearly $1.5 trillion. Quebec’s debt is $280 billion. Ontario’s is $348 billion — some 41 per cent of its provincial GDP!
Meanwhile, Oxford Economics estimates that COVID-19 might slash global domestic product by $1 trillion; in Canada, this will be further compounded by the rail blockades.
Many provinces rely on equalization payments (Quebec about $13.2 billion, Manitoba and New Brunswick about $2.2 billion, and P.E.I. $400 million per year). All provinces depend on the Canada Health Transfer for 20-25 per cent of their health budgets. Unlike Europe and most other countries with medicare, due to the Canada Health Act, private funding of our health system is illegal; it must rely almost entirely on government revenues.
Sadly, among countries with universal health care, Canada ranks 26th of 27 in acute-care hospital bed capacity per 1,000 people. Infectious disease specialist Dr. Neil Rau has asserted that we have virtually no surge capacity. As Dr. Alan Drummond of the Canadian Association of Emergency Physicians warned: “Our day-to-day experience in crowded hospitals, unable to get the right patient in the right bed on a day-to-day basis … makes us really question what the integrity of our health-care system would be like in a major pandemic.” This is relevant to Nova Scotians, as 20 per cent are over age 65 and may need hospitalization.
Except for severe economic effects, we may well “dodge the bullet” of COVID-19, which has spread to 44 countries and claimed well over 2,700 lives so far — more than triple the fatalities caused by SARS in less time.
But what of another future pandemic? As Dr. Tedros A. Ghebreyesus of the World Health Organization cautioned, “We must not look back and regret that we failed to take advantage of the window of opportunity that we have now.”
Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases in the U.S., stated: “It’s not a question of if this will happen, but when this will happen, and how many people in this country will have severe illnesses.”
Although Chief Medical Officer Dr. Theresa Tam acknowledged that hospital capacity was a “critical aspect” of our preparedness for a coronavirus outbreak, seemingly no Canadian politicians have heeded this advice.
Government revenues from energy are currently $14.1 billion annually — some 11 per cent of our national GDP. If our oil and gas cannot reach world markets at fair prices, in order to provide for additional health funding, the unpleasant choices are to go deeper in debt or raise sales and/or personal income taxes. The top 10 per cent of income earners (including senior teachers, nurses, and civil servants) already pay 54 per cent of all income tax. Further tax hikes would likely not merely affect the “rich.”
We need extra health funding urgently to increase community care and expand acute-care hospital bed capacity by building more chronic beds. China has built two acute-care hospitals totalling 2,500 beds in about 10 days. If political leaders had the will, could we not, over the next several months, begin to build new chronic-care facilities across Canada?
Logically, much of the required funding could come from a prosperous Canadian energy industry. As Alberta Premier Jason Kenney argued, people want “the right balance between economic opportunity and environmental responsibility.”
At a time when there is a breakdown of law and order, the possibility of a pandemic, and an economic recession, Canadians urgently need leadership from their politicians.
Ottawa physician Dr. Charles S. Shaver was born in Montreal. He graduated from Princeton University and Johns Hopkins School of Medicine. He is past-chair of the section on general internal medicine of the Ontario Medical Association. The views here are his own.