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    Far from pharmacare

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    CKirkby

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    The new federal pharmacare bill has been posted.

    I was curious to see how far left the NDP had managed to push the Liberals, and to guess how long it might plausibly be before Canadians start getting even contraception and insulin paid for, much less any other drugs required to live a happy and healthy life.

    Having now read the bill, my bet is “years from now, possibly never.” First, there are all the uncertainties and delays to overcome in the legislative process before this bill becomes law. But even assuming it passes, the bill pretty much just creates more work for other people (the Minister of Health, the provinces / territories / Indigenous peoples, the Canadian Drug Agency, the “Committee of Experts”).

    The big news provision is s. 6(1), which says no province or territory is getting any money until after it negotiates an agreement with the Minister:

    The Minister may, if the Minister has entered into an agreement with a province or territory to do so, make payments to the province or territory in order to increase any existing public pharmacare coverage — and to provide universal, single-payer, first-dollar coverage — for specific prescription drugs and related products intended for contraception or the treatment of diabetes.

    Looks to me like it’d be pretty easy for a province to “opt-out” of this scheme, by simply not entering into an agreement with the feds (or perhaps by not having “any existing public pharmacare coverage” in the first place). Maybe some provinces will get an agreement for payments before the election that is likely to result in a health minister who will refuse to negotiate this.

    In relation to the creation of “a list of essential prescription drugs and related products,” there is section 8(1), which is a weird combination of precise and vague:

    The Minister must, after discussions with the provinces and territories, request that the Canadian Drug Agency prepare, no later than the first anniversary of the day on which this Act receives royal assent, a list of essential prescription drugs and related products to inform the development of a national formulary that will establish the scope of prescription drugs and related products to which Canadians should have access under national universal pharmacare.

    The Minister is going to have to those discussions with the provinces and territories very quickly if the Canadian Drug Agency is expected to prepare this list within a year of royal assent. … Unless the Canadian Drug Agency already has a list of “essential prescription drugs and related products” and the discussions with the provinces and territories are a sham.

    Regardless, this list of essential prescription drugs is nowhere close to binding law. It will simply “inform the development of a national formulary that will establish the scope of prescription drugs and related products to which Canadians should have access under national universal pharmacare.” When would Canadians have actual access? Given where our governments seem to be heading, I’m guessing never.

    If you think I am being pessimistic, I invite you to read subsection 8(2):

    The Minister must, after the list referred to in subsection (1) has been prepared, initiate discussions based on the list with provinces, territories, Indigenous peoples and other partners and stakeholders with the aim of continuing to work toward the implementation of national universal pharmacare.

    The government doesn’t even bother establishing a timeline for the Minister to “initiate” these discussions. There’s certainly no timeline to conclude them and actually implement national universal pharmacare. Just a vague obligation to talk to stakeholders “with the aim of continuing to work” towards implementation.

    Section 9 imposes another challenging timeline on the Canadian Drug Agency, to develop “a national bulk purchasing strategy for prescription drugs and related products” (“in collaboration with partners and stakeholders” and “within a year of royal assent,” but again only after the Minister holds discussions with the provinces and territories). Unlike the “list of essential prescription drugs,” the “national bulk purchasing strategy” doesn’t get a subsection imposing even the wishy-washiest of obligations on the Minister. It’s almost like the government already doesn’t intend to do anything with it.

    There’s other fancy-sounding language in the bill too, including a whole string of whereases, a “purpose” section chock-full of buzzwords, lofty principles, and allusions to advice, reports and recommendations. None of this means the actual implementation of national universal pharmacare.

    I do not think the bragging is merited.

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  • Covid-19 in 2024

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    CKirkby

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    I still wear a mask when I go to the mall or take the bus.

    I usually don’t see too many others who do.

    Sometimes it turns out the others I see wearing a mask in public are actually sick, they just don’t get paid time off.

    Many sick people, it seems, just don’t want to change their plans.

    But people act like me masking as a preventive public health measure is weird.

    Here is a better explanation for why I wear a mask in public than I could possibly write myself. “Wanting to avoid a virus that can cause death and disability is not a mental illness.”

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  • Upcoming: profile(s?)

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    I’m working on a profile of a friend who is doing some cool shit that I think more people should learn about.

    I used to interview people doing cool shit all the time, for both newspaper and radio. I miss it.

    It’s been a long time since I last interviewed someone but old practices reminded themselves to me. Outline. Recording device.

    Some things I was a bit rusty on, though. Timing. (Don’t ask your first question just as the interviewee starts eating a handful on chips.)

    Overall I think it went quite well. I deeply enjoy throwing questions at people with expertise. I might do more of it.

    We need more art and joy and creativity in this dying world.

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  • Bragging about times when I Did Good / Gave Heck

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    Today I am reminiscing on some minor successes as I think about what I want to do with my time and energy, which are finite.

    Once upon a time I pointed out some inaccessibility in a document posted to the Senate of Canada’s website and they fixed it promptly. Didn’t ignore, didn’t argue, just fixed. Good job, the Senate of Canada.

    There was also that time when I bullied a CBC radio program into making amends for some egregious sexism. This took more effort on my part than I expected, including a bunch of statistical analysis. If I remember correctly, their first response was defensive crap, but more objectors joined in and eventually they made amends. But: I haven’t done a statistical analysis of that show’s episodes since then, so who knows about broader impact.

    My proudest professional success, though, is making Canadian law slightly less heteronormative.

    Before I objected, everyone who applied for a social insurance number was required by law to provide (2e) the full name at birth of their mother and (2f) the full name at birth of their father. The law said the application “must contain” this information. No exceptions were provided for.

    This is obviously bad law because not every person applying for this important document can identify one “mother” and one “father.” Why would you prevent someone from getting a SIN on that basis.1

    Now, instead, the Social Insurance Number Regulations require applicants to provide (2e) “the full name at birth of their parents.” I personally think “the full name at birth of their parent(s)” would have been better still (maybe also “if known”), but anyway it’s a clear improvement.

    (Law-makers took the opportunity to brag too: “Furthermore, [these amendments advance] the Government of Canada’s agenda on gender equality, diversity and inclusion, as well as supporting LGBTQ2 rights, by … taking action to reflect diversity … by rendering the requirement for parental information gender neutral.”)

    My current Do Good / Give Heck projects are more ambitious than these examples. We’ll see…

    1. A friend commented, re: my last post, that my use of question marks confused him, so I will explain.

      There’s no question mark at the end of the in-body sentence that starts “Why would you” because, although it at first looks like a question, an answer would be a waste of time. There is no valid reason to do this.

      But, as seen in my last post, I will sometimes add a question mark in places where there’s no clear question. I do this when I’m less confident about something, so that readers can confirm or correct the information. In last night’s case: the question mark was whether a press conference for a (month-long!) strike was cancelled because police arrested a union leader / speaker for “mischief.” ↩︎
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  • “Mischief”

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    Good article from Emily Leedham at PressProgress: “Ottawa Police Using ‘Intimidation Tactics’ Against Striking Workers, Canada’s Biggest Federal Public Sector Union Says” (15 Feb 2024):

    Last week, Ottawa Police arrested labour leader Alex Silas during a press conference and rally in support of striking workers. Silas was released Wednesday with five criminal charges: Mischief, causing a disturbance by impeding, intimidation by blocking or obstructing the roadway, and counsel of an uncommitted indictable offense.

    I’ve formed a few opinions after however many years of reading case law. One is that “mischief” can mean whatever a police officer wants it to in the moment.1 Cops are, after all, the ones with the guns.

    Another opinion is that while the law includes, in constitutional principle, (2) a variety of “fundamental freedoms” such as expression and peaceful assembly, (7) the right to life, liberty and security of the person, and (9) the right not to be unreasonably detained or imprisoned, those ideals cede on the spot and by force. It seems to me that no matter how often judges say to police years after the fact “you did wrong; please learn,” the main observable outcome is that governments give cops more money. Maybe some of that increased funding gets allocated to the occasional Charter training module.

    So. “Mischief” is the basis on which police arrested a prominent public figure at a protest for labour rights / press conference that got cancelled as a result of that arrest (?). Relatedly, I would be interested to learn if the “indictable offence” Silas is said to have counselled was also “mischief.” There can certainly be creativity in how charges pile up.

    This display of force will of course be a deterrent to many underpaid and under-appreciated workers. If they could arrest him with his profile and his privilege, imagine what they could do to a nobody for speaking up. “Best not rock the boat.”2

    If I’m reading correctly there’s an additional dystopian twist to this story: this labour union leader was arrested while advocating for better working conditions for military support staff.

    [Non-Public Funds workers provide] morale and welfare services on military bases. …

    With an average salary of around $18 to $20 an hour, [Cathy O’Kane, vice-president for the Non-Public Funds with the Union of National Defence Employees] said NPF workers planned to continue to escalate strike actions, with another Ottawa event likely to take place next week.

    “We have to escalate because it’s been four weeks now that these people are on strike,” O’Kane said, adding that members were receiving $75 a day in strike pay as long as they were on the picket line for four hours. “Some of them don’t mind because they’re making more money on strike than they actually were at their own jobs.”

    https://ottawacitizen.com/news/local-news/union-leader-alex-silas-arrested-at-psac-rally-wednesday

    $18 to $20 per hour is not significantly above minimum wage — which is of course not the same as a living wage — for the work of providing “morale and welfare” services to people in what I understand to be an extremely stressful job. Police arrested a prominent public figure speaking out against the underpayment of workers who deal with the second-hand trauma of a militaristic lifestyle. “Mischief.”

    Imagine a world where the police thought “no, you know what, actually those workers do deserve a comfortable life; I am going to do differently than arresting this man who is pointing out appalling facts and calling for humanity.” But, that is not the culture.

    “We see this arrest as an attack on workers,” National PSAC President Chris Aylward told PressProgress. “The Ottawa Police Service are using intimidation tactics, plain and simple. And that’s meant to demoralize and discourage striking workers.”

    Ottawa Police have continued to intimidate workers, Aylward added, noting the OPS sent three police cruisers to monitor a peaceful information picket yesterday, though there were no arrests or charges.

    “Police services and governments need to understand that people are going to continue to rise up until all workers – be it public sector, private sector, unionized, non-unionized – get what they deserve, and that’s fair wages and decent working conditions,” Aylward added.

    https://pressprogress.ca/ottawa-police-using-intimidation-tactics-against-striking-workers-canadas-biggest-federal-public-sector-union-says/

    Reporter Emily Leedham does a really nice job, including drawing the contrast with how police treated the convoy. Quotes also from Paul Champ, Alex Neve, and Sam Hersh. Heroes all.

    1. Readers are of course free to draw their own conclusions from the case law. ↩︎
    2. A thing I hear a lot from government workers who are afraid to rock the boat is: “Other people have it worse.” More people will have it more worse very quickly if more of us don’t start insisting on change. ↩︎
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