Trudeau Wants Digital ID from Provinces in Exchange for Health Funds

[Colin Parkinson]

For the first part, globalization in and of itself is not a bad thing. There is nothing inherently wrong with globalization. If there was, well then you must also have a problem with "regionalization", and "countryalization", and "provincialization", etc.

Also, lots of people are envious of Xi's power. PP is envious of Xi's power. Seriously, the vast vast vast majority of people are selfish and crave power. Besides, a benevolent dictator is the best form of government.

As for the rest of what you said, I'll make my response shorter by just saying "reverse everything you said and thats my response".

In China, they track your phone and contacts. Based on your social credit score, you may not be able to get a plane or train ticket, your mere presence with other people, can effect their social credit score. It's a very insidious system. They plan to add more and more to it. Without a phone you cannot do anything in China nowadays, it's the perfect leash. We need to be on guard from everyone who pushes to much control. However JT is an utter control freak, both on a micro and marco scale. I shudder to think what he would be capable of, had he been brought up in the PRC.

 

[Kat Stevens]

In China, they track your phone and contacts. Based on your social credit score, you may not be able to get a plane or train ticket, your mere presence with other people, can effect their social credit score. It's a very insidious system. They plan to add more and more to it. Without a phone you cannot do anything in China nowadays, it's the perfect leash. We need to be on guard from everyone who pushes to much control. However JT is an utter control freak, both on a micro and marco scale. I shudder to think what he would be capable of, had he been brought up in the PRC.

Or North Korea;
"Hey Kim, hold my kimchi and watch this..."

 

[Eaglelord17]

Digital IDs & CBDCs are the future. Good luck fighting the future.

CBDC doesn't have to be the future. So far no one has explained to me what benefits CBDCs have over our current currency system as we can already do everything that a CBDC does right now, and have the added benefit of using cash. The only benefit CBDCs have as far as I am aware is that the government can track every dollar on a whim, which I don't see as a benefit.

 

[Navy_Pete]

A bit more detail here.

That seems more like the 'deliverology' BS. In theory sounds good, but relevant statistics for health outcomes in a big city don't make sense for a remote community, and the solutions need to be tailored for the context. I really don't see why they need individual IDs when they aren't using the existing info and the whole 'if it gets measured it gets done' fell apart about six months into the LPC coming to power when they started not doing things they had promised, so quietly shelved it.

I think more inter-provincial coordination for some things would be good (like the residency programs that heavily favour students from Canadian universities, and actually leave spots empty rather than have foreign trained Canadians that went to AUS and other countries have those spots).

 

[Halifax Tar]

The primary issue in healthcare is demographic collapse.

Healthcare is collapsing for a number of reasons, but chiefly because governments have refused to pay attention to the population pyramid for the last 20 years. We are now at the crossroads of increased numbers of patients, and decreased staff levels, both due to the same dynamic. For example, in Canada in 1950, we had 27.04 live births per 100000, by 2000, that was down to 11.1. Over the period of 1960 to 2022, the percentage of folks over 65 has gone from 7.7% to 18.1%. I would expect similar changes in the US population. In addition, health authorities have attempted to save money by reducing staff. The primary tool has frequently been to offer early retirement. COVID encouraged many others to cash out and stop working.

We have ignored the increased demand for long term care which has caused people to remain in hospital as they have nowhere to go. When I started my current job, we were 1600 LTC beds short inside the city limits. It is now estimated that that number has risen to 2400. This for a city that has about 2000 in-patient hospital beds. The knock on effect is that patients can't be admitted from ER, which in turn causes waiting rooms to back up. On the surgical side, the increased demand (need) for hip and knee surgery, coupled with COVID, has created significant increase in morbidity, which then has a knock on effect on primary and urgent care providers. Admittedly, I'm not sure how the other surgical services are impacted. Add to the mix the effect of the obesity, diabetes, cardiac disease in the last 50 years, and it becomes a crushing problem.

We hoe the same row. But you're more articulate than I.

 

[Colin Parkinson]

That seems more like the 'deliverology' BS. In theory sounds good, but relevant statistics for health outcomes in a big city don't make sense for a remote community, and the solutions need to be tailored for the context. I really don't see why they need individual IDs when they aren't using the existing info and the whole 'if it gets measured it gets done' fell apart about six months into the LPC coming to power when they started not doing things they had promised, so quietly shelved it.

I think more inter-provincial coordination for some things would be good (like the residency programs that heavily favour students from Canadian universities, and actually leave spots empty rather than have foreign trained Canadians that went to AUS and other countries have those spots).

Health outcomes get skewed when you have a major hospital that specialises i X where people from the province come to get treatment like cancers or bowel surgeries. so you see a larger cluster of cancer deaths and the likes

 

[Navy_Pete]

Health outcomes get skewed when you have a major hospital that specialises i X where people from the province come to get treatment like cancers or bowel surgeries. so you see a larger cluster of cancer deaths and the likes

For sure, and I imagine you get similar differences when you are in an area with a specialist children's hospital etc. Stats without context are meaningless.

I'm in Ottawa and there are 10s of thousands here without a family doctor, but at least there is a walk in clinic etc. For someone living in a remote community up north, they may have some kind of family doctor via remote access, but may need a bush plane to get to a hospital, so something like that would skew outcomes as well.

The reality is we're a massive country with a lot of isolated populations, so you won't get the same outcome for everyone. Even in the same city, some of the suburbs are so convoluted to navigate can still take 30 minutes to get to a house that isn't geographically very far (which is also stupid for first response to a fire where the building code assumes 10 minute response time), so it's complicated.

Not a big fan generally of this kind of effort to build really complicated stats into a 10k' picture; it's really easy to get huge amount of data that doesn't necessarily tell you anything, and they already have a lot that they don't do anything with.

 

[Remius]

So it looks like ALL the premiers have accepted the health care deal as tabled.

 

[Lumber]

So it looks like ALL the premiers have accepted the health care deal as tabled.

Well of course they did; it's free money, and a lot of it. They were never going to seriously push against it. They were just being greedy and trying to use whatever dirty BS polticial tactic they could to goad the government into giving it to them without restrictions.

 

[Brad Sallows]

An average of $4.6B per year spread among all the provinces and territories isn't that much money, relative to the costs of health care. The federal government should be giving it to them without additional restrictions: we already have the CHA for that, and the feds are a long way behind getting anywhere near that old 50/50 cost sharing target. Provincial governments ought to be smart enough to stop being low-balled into agreements that see them shouldering the long-term fiscal commitments. But if some Canadians are going to defend the feds' position in this, I suppose they deserve the results and the rest of us are stuck with it.

 

[Good2Golf]

22/78 now…50/50 seems like half a century ago. It’s a bully’s way that makes it seem like they’re doing everyone else a favour.

How about the PM direct CRA not to ignor the $15B+ in ‘not worth the effort to recover’ COVID over-payments with all those thousands and thousands of additional public servants CRA is getting from the PM?

 

[Spencer100]

Why is the federal government even involved? It so backwards that the provinces are responsible for healthcare delivery but have to ask the Federal government for more.

We should just back out all federal amounts transferred to the provinces out of the federal taxes then let the provinces raise province taxes to what they think they need. The system is broken. The feds tell the provinces you do this and here is some of the money for that mandate....and also you can’t do anything the feds don't like.

 

[Remius]

I’m going to go with the “it’s a start but more needs to be done”.

 

[Eye In The Sky]

Why is the federal government even involved? It so backwards that the provinces are responsible for healthcare delivery but have to ask the Federal government for more.

We should just back out all federal amounts transferred to the provinces out of the federal taxes then let the provinces raise province taxes to what they think they need. The system is broken. The feds tell the provinces you do this and here is some of the money for that mandate....and also you can’t do anything the feds don't like.

I don’t like the “leave the tax rate up to the provinces” part.

 

[Brad Sallows]

Why is the federal government even involved? It so backwards that the provinces are responsible for healthcare delivery but have to ask the Federal government for more.

We should just back out all federal amounts transferred to the provinces out of the federal taxes then let the provinces raise province taxes to what they think they need. The system is broken. The feds tell the provinces you do this and here is some of the money for that mandate....and also you can’t do anything the feds don't like.

That's exactly the reason the feds are involved. They want to influence health care in Canada. The feds use money as leverage to work around constitutional divisions of powers. Any province is free right now to opt out, raise its taxes, and run its health care (insurance, mainly) exactly as it pleases. What scares the sh!t out of the people who can't stand the idea of someone buying better health care is precisely that a province might go rogue and succeed (see improvements in all the usual metrics - wait times and outcomes).

 

[Lumber]

Why is the federal government even involved? It so backwards that the provinces are responsible for healthcare delivery but have to ask the Federal government for more.

We should just back out all federal amounts transferred to the provinces out of the federal taxes then let the provinces raise province taxes to what they think they need. The system is broken. The feds tell the provinces you do this and here is some of the money for that mandate....and also you can’t do anything the feds don't like.

Call me an asshole, but I like the idea of transfer payments resulting in a slightly higher standard of medical care in another province even if it results in a slightly lower standard of medical care in my own province.

 

[daftandbarmy]

Call me an asshole, but I like the idea of transfer payments resulting in a slightly higher standard of medical care in another province even if it results in a slightly lower standard of medical care in my own province.

Regardless, the way the trend is going we're going to run out of money in about 10 years, it seems:

National health expenditure trends, 2022 — Snapshot | CIHI

A summary of key findings from CIHI’s National Health Expenditure Database (NHEX) related to economic growth, governments’ fiscal position, issues to monitor, international comparisons.

www.cihi.ca

 

[Lumber]

An average of $4.6B per year spread among all the provinces and territories isn't that much money, relative to the costs of health care. The federal government should be giving it to them without additional restrictions: we already have the CHA for that, and the feds are a long way behind getting anywhere near that old 50/50 cost sharing target. Provincial governments ought to be smart enough to stop being low-balled into agreements that see them shouldering the long-term fiscal commitments. But if some Canadians are going to defend the feds' position in this, I suppose they deserve the results and the rest of us are stuck with it.

I don't get the contradiction of opinion among people on this site sometimes. You, among others, have expressed a (I would say healthy) distrust of politicians, yet here you are saying "no, let's just trust them to do the right thing with our money."

Everyone everywhere in every province is saying that our healthcare systems need help. The Feds are offering some money to try and help, and just like you (us, really), the feds aren't wholly trusting of the people who are going to spend our money (in this case, the provs), so they are trying to make sure that the health care money they are giving them is actually being spent on health care.

I thought that's what people in general (and people on this site in particular) wanted; accountability for how the gov. spends our money.

 

[Navy_Pete]

I don't see anything there about a digital ID, just a vague wording around common data collection. That could be as simple as the various provincial health authorities having common definitions on existing statistics they collect, and some starting to collect new data (to them).

So aside from more money for healthcare, any actual substance to that?

And I'm pretty sure everyone with a provincial health card already has a 'digital ID' just from the accounting tracking where things are being billed against.

At the end of the day, it's our demographics that will kill the health care system (and pension system), as there is a huge surge of people coming through, so quality of care will inevitably keep dropping as it's really not feasible to catch up now as those preps should have started decades ago.

 

[Eye In The Sky]

Call me an asshole, but I like the idea of transfer payments resulting in a slightly higher standard of medical care in another province even if it results in a slightly lower standard of medical care in my own province.

This. Small provinces like PEI would be left far behind others like Ontario and Alberta.