Authored by Don Drummond, Stauffer-Dunning Fellow in Global Public Policy and Adjunct Professor, School of Policy Studies, Queen’s University.

(Originally published as an Intelligence Memo from C.D. Howe Institute  – January 14, 2020)

From: Don Drummond
To: The Honourable Marc Miller, Minister of Indigenous Services

Re: Improving on a Mandate Letter

Your mandate letter falls short of setting out a vision for really making a difference for Indigenous Peoples because it lacks targets for specific, measurable outcomes that would reflect improvements in living standards.

There is much to be applauded in the letter. Set in the context of the need for “capacity building to bring control of and jurisdiction for service delivery back to Indigenous communities,” it correctly identifies many of the areas, such as health, education, housing, Continue Reading »

(Originally published as an Intelligence Memo from C.D. Howe Institute  –December 23, 2019)

From: Duncan G. Sinclair, David Walker, Chris Simpson and Don Drummond
To: The Hon. Patty Hajdu, Minister of Health

Re: Assessing Ottawa’s New Health Mandate

Your mandate letter from the Prime Minister last week lays out many worthwhile goals to improve healthcare by family doctors, primary health care teams, mental health services, home care and palliative care and pharmacare.

It also identifies the need to address certain public health risks such as opioids, vaping and poor nutrition. You will no doubt run into stiff resistance from provinces and territories as these matters are in their constitutional jurisdiction.  They will undoubtedly protest that while the federal government seeks a partnership in shaping healthcare, it has allowed its once equal partnership in funding to shrink to a one-quarter contribution that will decline further if the current cap on the growth rate of Canada Health Transfer payments is not lifted. Continue Reading »

Authored by Robert Wolfe, Professor Emeritus, School of Policy Studies at Queen’s University and Bernard Hoekman, Professor, European University Institute in Florence, Italy, and leader of a Bertelsmann Stiftung project on World Trade Organization reform.

(Originally published in The Globe and Mail – December 18, 2019)

The World Trade Organization’s appellate body went into hibernation last week when two members reached the end of their term and the Trump administration continued to block a process to appoint successors.

The United States is not alone in its concerns about the appellate body, which hears appeals from reports issued by panels in disputes brought by WTO members. But the current impasse does not signal the end of the WTO, or even its ability to settle disagreements, let alone its role in conflict management. Continue Reading »

(Originally published as an Intelligence Memo from C.D. Howe Institute  –November 6, 2019)

From: Duncan G. Sinclair, David Walker, Chris Simpson and Don Drummond
To: Canada’s health ministers

Re: Getting to a People-Centred Health System

Notwithstanding its iconic standing as one of Canada’s defining characteristics, medicare, our publicly funded health insurance program, is widely recognized to be in need of fundamental change.

It was designed primarily to ensure a younger population’s access to in-hospital and physicians’ services, divorced from ability-to-pay considerations.

But now we face a greater challenge to optimize the health and well-being of people, many of them aging, with multiple chronic conditions, some preventable. Once developed, few are curable but their ill effects can be significantly ameliorated by appropriate care. That appropriateness now involves many institutions in addition to acute-care hospitals, Continue Reading »

(Originally published as an Intelligence Memo from C.D. Howe Institute  –November 5, 2019)

From: Duncan G. Sinclair, David Walker, Chris Simpson and Don Drummond
To: Canada’s health ministers

Re: Toward Healthcare’s Culture Change

Many Canadians have bought into the unsubstantiated hype that our healthcare system is the best in the world, and our political leaders know well that voters get nervous about proposals to change it.

Currently, there is some discussion about how to pay for extending medicare’s first-dollar coverage beyond in-hospital and physicians’ care to prescription drugs. And inclusion of addictions and mental health care and dentistry have also been mentioned. Ironically, no provincial or territorial system has a primary focus on optimizing people’s health. Rather, the focus is on the repair of ill-health, the restoration to health of patients rendered unwell by disease, Continue Reading »