Saturday, August 29, 2009

The London Free Press
By Rory Leishman

United States President Barack Obama has touched off a lively and informative debate over the best way to reform health care, but in Canada, no politician of any party is willing to do the same. Why is that? Why is there so little support for major medicare reforms in Canada.

After all, it’s plainly evident that the Canadian system is far from perfect. In a recent international survey, the Commonwealth Fund found that the proportion of adults with chronic health problems who had to wait four weeks or longer for elective surgery was 33 per cent in Canada, but only eight per cent in the United States.

Among the 30 members of the Organization for Economic Cooperation and Development (OECD), Canada ranks fifth in total health care expenditures per person, yet lags in advanced medical technology. For example, Canada has just 6.7 magnet resonance imaging (MRI) units per million population, far below the OECD average of 11.0 and the record 25.9 MRI units per million in the United States.

Given Canada’s shortcomings in medicare services and equipment, it’s hardly surprising that the five-year survival rates for cancer are significantly lower in Canada than the United States.

Granted, the U.S. health-care system is also beset with serious problems. Costs are out of control. Over the past 15 years, total U.S. health care spending has more than doubled to $7,290 per person. That’s almost twice the Canadian level and much the highest in the world.

Some 47 million Americans do not have even basic health insurance, while millions more fear they could also end up with no coverage if they lose their jobs or contract a serious illness. That’s scandalous.

To remedy these defects, Obama initially proposed a comprehensive public-sector medicare plan to compete with private medical insurance. However, he seems to be backing away from this “public option” under pressure from critics who apprehend that it would be ruinously costly and lead to the imposition of a Canadian-style medicare monopoly.

In a recent column in The New York Times, Paul Krugman, the left-wing, Nobel-prize winning economist, pointed out that a public option is not the only route to universal coverage. As an alternative, he speculated that Obama might endorse the Swiss medicare system, which relies entirely on private insurance companies to provide affordable medical care for everyone under strict government regulation.

The Swiss model requires every resident to purchase a basic medicare policy from one of several competing private insurance companies. To assure affordability, the government subsidizes premiums for the needy and requires the health insurers to offer basic coverage to all applicants at a uniform rate, regardless of age or medical history. The additional expense of insuring higher-cost clients is offset through a system of reinsurance.

Unlike Canadians, the Swiss are allowed to contract with private insurance companies for supplementary benefits beyond the basics required by the government. Yet on an age-adjusted basis, the total costs of medicare in Switzerland are no higher than in Canada.

This Swiss model works. It provides the Swiss people with superior medicare services without the long waiting times, shortages of medical technology and other chronic deficiencies that plague Canada’s grossly inefficient, public-sector, medicare monopoly.

Krugman is not alone in taking note of the Swiss success. After extensive study, the Dutch Parliament decided in 2006 to replace the Netherlands’ inefficient and unresponsive mixture of public and private medicare with an all-private system on the Swiss model. The Dutch health ministry boasts that the new system delivers “more choices for customers, more competition and guarantees of affordability.”

Let us hope the Obama administration likewise embraces the Swiss model of medicare that relies on competing private insurance companies to provide efficient and affordable coverage for everyone under strict government regulation. Perhaps eventually, even Canada might do the same.

The Dutch health ministry persuasively argues that there is no alternative to competing private insurance companies as a means of ensuring “better quality of care, greater cost consciousness, better affordability and more tailor-made care through greater influence by customers.”

Saturday, August 08, 2009

Effective compassion for the needy

The London Free Press,
By Rory Leishman

Anyone who dares to present a reasonable challenge to some received nostrum of conventional thinking should beware: They are liable to come under vicious personal attack.

Dambisa Moyo is well aware of the problem: Instead of rationally evaluating the thesis of her compelling book Dead Aid: Why Aid is Not Working and How There is a Better Way for Africa, many critics have maligned her as a cruel, grasping and heartless conservative.

Among Moyo’s fiercest detractors is Jeffrey Sachs, professor of economics at Columbia University and consultant on economic development to the United Nations Secretary General. In the left-wing Huffington Post on May 24, he derided Moyo as “an African-born economist who reportedly received scholarships so that she could go to Harvard and Oxford but sees nothing wrong with denying $10 in aid to an African child for an anti-malaria bed net.”

That criticism must have stung. Moyo is a former student of Sachs’s at Harvard. In a polite and measured response to his personal attack, she explained that she has rejected an aid-based strategy that “hurts more than it helps” in favour of working towards “a sustainable solution where Africans can make their own anti-malaria bed-nets (thereby creating jobs for Africans and a real chance for the continent’s economic prospects) rather than encouraging all and sundry to dump malaria nets across the continent (which incidentally, puts Africans out of business).”

Sachs was unimpressed. In another rejoinder, he charged that Moyo is “unmoved by the massive suffering” of Africans afflicted with malaria.

Coming from a leading academic like Sachs, such vitriol is disgraceful. It’s also false and malicious.

In the course of a brilliant career, Moyo has served as a consultant for the World Bank and as a senior executive with Goldman Sachs. But in no way can she be dismissed as a cold-hearted conservative. To the contrary, she has demonstrated her compassion for suffering humanity, by generously volunteering her time and money to charities.

Currently, Moyo serves as a patron of ARK (Absolute Return for Kids), an agency founded by a group of hedge-fund managers in 2002 that employs over 1,200 staff to provide health and educational services to needy children in Asia, Africa, Eastern Europe and the United Kingdom. Moyo and her fellow patrons and directors of ARK contribute expert managerial advice to the agency and defray all of its administrative costs through their personal donations so that 100 per cent of all other donations go directly to ARK’s programming for children.

Moyo also serves as a director of Room to Read, another non-governmental and non-profit agency. Room to Read constructs schools, builds libraries, operates computer labs, provides scholarships and has donated literally millions of English-language and local-language books to some 10 million impoverished children in Asia and Africa.

Executive Director John Wood is a former Microsoft executive. He was moved to leave Microsoft and found Room to Read, after witnessing the pitiful resources of a Nepalese rural school while on a trekking vacation in 1998.

Room to Read has a savvy board of directors and an experienced management team that works in conjunction with 14 knowledgeable Asian and African nationals who are employed as regional and local managers. Together, the Room to Read staff have established an exceptional record for efficiency and effectiveness in helping impoverished students. According to the agency’s audited report for 2008, Room to Read devoted 85 per cent of total spending to programming, while allocating only 15 cents of every donated dollar to fund-raising and administration.

Moyo exemplifies the meaning of true generosity: Instead of clamouring for more government spending of other people’s money on failed foreign-aid programs, she donates her own time and money to non-governmental agencies with a proven ability to help the needy overcome their disadvantages.

By this standard, it’s evident that many of us – perhaps including Sachs – are a lot less generous, compassionate and effective in helping the needy than Moyo.

(Canadians can make tax-deductible donations to Room to Read Canada through the online charity CanadaHelps.org)

Saturday, July 18, 2009

The calamitious impact of foreign aid

The London Free Press
By Rory Leishman

In a candid address to the Parliament of Ghana last Saturday, United States President Barack Obama pointed out to the oppressed people of Africa: “Development depends on good government. This is the ingredient which has been missing in far too many places for far too long.”
With reference to the corrupt rule of Robert Mugabe, the longstanding Marxist dictator of Zimbabwe, Obama observed: “The West is not responsible for the destruction of the Zimbabwean economy over the last decade.”
Dambisa Moyo disagrees. She is a former consultant to the World Bank who was born and raised in Lusaka, Zambia, and holds an earned doctorate in economics from Oxford University. In her book, Dead Aid: Why Aid is Not Working and How There is a Better Way for Africa, she persuasively argues that African dictators like Mugabe would not have been able to maintain their prolonged grip on power, if their grossly incompetent governments had not been propped up with hundreds of millions of dollars in foreign aid.
Altogether, the United States, Canada and other donor countries have handed out close to $1 trillion in foreign aid to Africa. Most of this well-meant assistance has been wasted. Moyo points out: “Africa’s real per capita income today is lower than in the 1970s, leaving many African countries at least as poor as they were 40 years ago.”
Half of the 700 million people living in Sub-Saharan Africa get by on less than a dollar a day. Life expectancy in the region averages only around 50 years.
Meanwhile, many less-developed countries on other continents have achieved rapid and sustained economic growth. China is a case in point. Despite having had a lower standard of living than most African countries just 30 years ago, China now has an annual income per person of close to $6,000: That’s more than three times greater than Ghana, Kenya and almost all other African countries.
Moyo asks: “Why is it that Africa, alone among the continents of the world seems to be locked into a cycle of dysfunction? Why is it that out of all the continents in the world Africa seems unable to convincingly get its foot on the economic ladder? … What is it about Africa that holds it back, that seems to render it incapable of joining the rest of the globe in the 21st century?”
She explains: “The answer has its roots in aid.”
Granted, not all foreign aid is bad. Moyo acknowledges that the equivalent of $100 billion in today’s funds which the United States dispensed under the Marshall Plan to the war-ravaged countries of Western Europe was hugely successful. Why, though, has almost $1 trillion in aid to Africa so failed to benefit the people of Africa?
Moyo argues that among many social, cultural and economic factors, one key element was that recipients of assistance under the Marshall Plan realized the program was only temporary. They knew they had better make good use of the aid, because they would soon have to get along without it.
In contrast, leaders in Africa have learned to look upon foreign aid as a permanent handout. Instead of using the assistance to promote self-sustaining economic growth, most African rulers have diverted the proceeds to enrich themselves and prop up their corrupt governments.
Obama told the Ghanaian parliamentarians that his administration will increase assistance to African countries that have established democracies, uphold the rule of law and are determined to curtail corruption.
Moyo thinks this approach is inadequate. She calls upon the United States, Canada and other donor countries to liberate Africa from a stifling dependence on foreign aid, by announcing their intention to phase out virtually all aid to Africa over the next five to 10 years.
Will leaders of the donor countries pay heed to this advice? Let us hope so. Moyo pointedly notes: “one would expect Western moralizers to adopt policies which help those in need rather than hinder them in the long run and keep them in a perilous state of economic despair.”

Saturday, July 04, 2009

The sobering reality of immigration

The London Free Press
By Rory Leishman

As the baby-boom generation begins to retire, the ratio of Canadians over age 65 to those of working age (the old-age dependency ratio) is set to increase so rapidly that the costs of sustaining Canada’s retirees threaten to reduce the rate of growth in Canada’s national standard of living.
What can be done? Robin Banerjee and William Robson of the C. D. Howe Institute have addressed this issue in an illuminating report released on Thursday: “Faster, Younger, Richer? The Fond Hope and Sobering Reality of Immigration’s Impact on Canada’s Demographic and Economic Future.”
It might be supposed that immigration will offset the growing burden of Canada’s aging population. This year alone, Canada is expected to take in an additional 245,000 immigrants. With the exception of Australia, Canada maintains much the highest ratio of immigrants to population in the industrialized world.
Nonetheless, Banerjee and Robson estimate that even if the extraordinarily high current rate of net immigration into Canada is retained, the old-age dependency ratio will more than double to 46.3 per cent in 2057. That’s up from 21.5 per cent this year and less than 15 per cent in 1977.
Is even more immigration the answer? Definitely not. Banerjee and Robson project that if Parliament were to rely on an increase in the current pattern of immigration to stop population aging, Canada would have to take in such a colossal number of additional immigrants that the total national population would reach 210 million in 2058.
That’s out of the question. No conceivable amount of immigration can prevent a rapid and burdensome growth in the aging of Canada’s population.
An increase in the age of retirement would help. Most Canadians at age 70 are no less fit today than were most Canadian workers at age 65 a few decades ago.
Banerjee and Robson conclude that a gradual increase in the normal retirement to age 70 would significantly reduce the rise in the old-age dependency ratio; but only temporarily. It’s likely that within 15 years, the proportion of elderly dependants would resume a steadily upward trend.
There can be no lasting solution to the multiplying difficulties posed by Canada’s aging population short of dealing with the fundamental underlying problem – namely, the devastating collapse in the national fertility rate over the past 40 years. In 2005, the average number of children per woman in Canada was just 1.54 -- far below the ratio of 2.1 that is necessary to sustain the population.
Banerjee and Robson have considered the combined effects of a gradual increase in both the age of retirement to age 70 and the national fertility rate to 2.1. The results are encouraging: Other factors remaining the same, the old-age dependency ratio would remain well below 30 per cent.
Banerjee and Robson do not suggest how Parliament and the provincial legislatures might encourage a rise in the national fertility rate. However, at least one part of the solution is obvious: A major reduction in the catastrophic increase in abortions over the past 40 years.
According to Statistics Canada, there were 28.3 induced abortions for every 100 live births in Canada in 2005, down from a peak of 32.2 in 1998. While that slight downward trend is encouraging, it’s hardly sufficient.
Sooner or later, our politicians will have to take decisive action to curb abortion. Few reforms could do more to eliminate a huge amount of suffering and death.
Moreover, as Banerjee and Robson point out, boosting fertility rates could also play a key role in holding down the rate of increase in old-age dependency that threatens the economic prosperity of Canadians.

Correction: In “Ontario should continue to fight menace of marijuana” (Free Press, June 27), I attempted to summarize my findings from a review of the literature on the harm produced by the recreational use of cannabis with the assertion: “there is overwhelming scientific evidence that cannabis is no less dangerous to life and health than alcohol and tobacco.”
That statement is incorrect. I very much regret the error.

Saturday, June 27, 2009

Curbing drug abuse

The London Free Press
By Rory Leishman

So far this year, London police and RCMP officers have conducted more than 80 raids on illegal marijuana growers within the city, and seized tens of millions of dollars worth of plants. Other municipalities across the province are in the throes of a similar law-enforcement struggle.
Is it time, then, to give up on the war on drugs? Should Parliament and the Ontario Legislature not frankly acknowledge that at least in the case of marijuana, prohibition for recreational use is plainly not working?
Most definitely not. Marijuana is not harmless. Despite the contrary claims of infatuated pot heads, there is overwhelming scientific evidence that cannabis is no less dangerous to life and health than alcohol and tobacco.
Perhaps so, some might argue, but alcohol and tobacco are legally produced and sold. Why not marijuana as well? Why should the Ontario government forgo the huge revenues it could gain by taxing and selling marijuana through government-controlled outlets like the LCBO?
The answer is, or should be, obvious: Addiction to alcohol and tobacco ruins the life and health of tens of thousands of Canadians every year. No legislator with a prudent regard for the health and wellbeing of Canadians would compound these problems by legalizing marijuana as well.
Granted, the suppression of marijuana production and consumption is a never-ending and expensive proposition. But the same is true of any major law-enforcement operation. The police expend vast resources in a perpetual effort to enforce the highway traffic act, yet no one would suggest that the Ontario Legislature should give up the struggle and legalize speeding, careless driving or any of the other all-too-frequent traffic infractions.
Besides, the aim of the police is not to eliminate crime altogether, but to curtail it at reasonable cost. By this standard, there is no reason for police, educational and health authorities to give up on the struggle to curtail marijuana trafficking, addiction and abuse.
Certainly, OPP Commissioner Julian Fantino is not about to surrender in the war on drugs. On a recent radio call-in show, he maintained that Ontario police are doing a good job of holding down the number of marijuana grow-ops. Last year, his force dismantled 499 of them, seized 211,919 marijuana plants, removed more than $264 million drugs from circulation and brought 4,700 charges against 2,400 people.
Moreover, there is evidence that the combined efforts of health, education and law-enforcement officials to combat drug abuse is paying off. According to the latest data on drug use among Ontario students compiled by the Centre for Addiction and Mental Health (CAMH), the proportion of students in Grades 7, 9 and 11 who admitted to having used cannabis at least once in the past year was 22 per cent in 2007, down slightly from 23.9 per cent in 1997, but significantly below the peak of 29.1 per cent in 1979.
While the great majority of Ontario students use cannabis only occasionally or not at all, CAMH estimates that an alarming 10 per cent use the drug on a daily basis and may already have developed a problem with cannabis dependence.
Meanwhile, there has been a dramatic reduction in tobacco smoking among Ontario students. According to CAMH, the proportion who report that they have smoked tobacco in the past year was just 11 per cent in 2007, down from 27 per cent in 1997 and a peak of 35 per cent in 1979.
The McGuinty Liberal government deserves much of the credit. In 2005, it initiated a Smoke Free Ontario Campaign that featured tougher enforcement of the ban on tobacco sales to anyone under 19 as well as an unprecedented $50 million in funding for enhanced health and educational programs to combat tobacco smoking.
Clearly, this Ontario anti-smoking campaign has been a huge success. While continuing to discourage tobacco smoking, the Ontario government should now focus on a stepped-up campaign to combat the even greater menace posed by marijuana. At stake is the life and health of literally hundreds of thousands of people, young and old, in Ontario.

Saturday, June 06, 2009

Misguided bailouts

The London Free Press
By Rory Leishman

So far this year, the governments of Canada and Ontario have handed over $9.6 billion to the failing General Motors and Chrysler corporations. For the people of Ontario, that works out to more than $2,500 for every family of four.
In defence of these whopping corporate bailouts, Ontario Liberal Premier Dalton McGuinty insisted on Monday that he and his government colleagues had no choice: “The auto sector sustains thousands of current jobs for Ontario families and supports the pensions of many of our retirees,” he said. “That's why we're partnering with the federal and United States governments to put the industry on a more sustainable footing for the long term."
There can be little doubt that without government support, GM and Chrysler would have closed down all their operations in Canada. As a result, many related car dealerships, auto supply firms and other companies would also have gone out of business. Ontario government officials peg the total job loss in the province at 85,000.
But is that a compelling argument for the bailouts? In April, there were 5,283,200 full-time workers in Ontario, down 184,500 from a year earlier. Yet the governments of Canada and Ontario offered no corporate bailouts to prevent any of these job losses. Why should the workers whose jobs depend on GM and Chrysler qualify for special treatment?
Bloc Quebecois leader Gilles Duceppe is at a loss for an answer. Speaking in the House of Commons on Monday, he pointed out that over the past two years, 50,000 jobs have been lost in the forestry sector in Canada, with half of those job losses in Quebec. Yet in this year’s federal budget, the Harper government has provided only $270 million for corporate handouts to the forestry industry.
Regardless, the federal Liberals and New Democrats support the Conservative government’s record auto-sector bailouts. And the reason is clear: Unlike the Bloc Quebecois, the Conservatives, Liberals and New Democrats are all vying to win or retain seats in Ontario that include hundreds of voters who are employed in the auto industry.
This overriding political consideration also explains the abandonment by Prime Minister Stephen Harper of his promise to do away with corporate bailouts during the 2004 election campaign. At that time, he pointed out: “It doesn't matter how many millions or hundreds of millions of dollars a Liberal-NDP coalition will be willing to give the auto industry to win an election … their reckless use of taxpayers' dollars will make us less competitive.”
Quite so. Who would have thought that within five years, a Harper Conservative government would squander billions of dollars in corporate welfare on GM and Chrysler, alone?
Note also that as a condition for receiving $10.5 billion in additional handouts from the governments of Ontario and Canada, GM Canada has agreed to make an immediate payment of $4 billion toward the $7-billion shortfall in the company’s insolvent, gold-plated pension plan. How can that be? Are not all companies in Ontario required by law to keep their defined-benefit pension plans solvent?
Not exactly. During the recession of 1992, the Ontario New Democratic Party government of former premier Bob Rae helped sustain GM Canada, by granting the company an exemption from the full-funding requirement for its pension plan. With the support of the Canadian Autoworkers Union (CAW), that exemption has remained in effect ever since.
Even when GM Canada was racking up profits over the past 15 years, both management and union agreed to improve promised pension benefits rather than return the plan to solvency. For the Harper and McGuinty governments now to shore up that insolvent plan at a cost to taxpayers of $4 billion is entirely unjustifiable, especially inasmuch as three-quarters of private-sector workers have no pension plan.
Clearly, while it’s politics, not considerations of economics, equity or justice, that has dictated the billions of dollars in auto-sector bailouts, will taxpayers get at least some of that money back?
Harper says he is not counting on it. Neither should anyone else.

Saturday, April 25, 2009

Gairdner on natural and moral absolutes

The London Free Press
By Rory Leishman
For the past 40 years, most intellectuals have embraced moral relativism -- the calamitous notion that the difference between right and wrong is merely a matter of arbitrary personal tastes and historical circumstances.
William Gairdner, the best-selling author of The War on the Family and The Trouble with Canada, has addressed this issue in his latest dissertation The Book of Absolutes: A Critique of Relativism and a Defence of Universals. In this extraordinarily wide-ranging and informative book, he presents a compelling argument for the truth that there are universal moral truths grounded in natural law that apply to all peoples, at all times, and in all cultures.
The contrary proposition -- that all moral values are relative -- is an ancient fallacy that was utterly discredited by Plato, Socrates and Aristotle. Yet it keeps recurring. Gairdner traces the reemergence of moral relativism in modern form to Franz Boas, a cultural anthropologist at Columbia University.
During the 1920s, Boas was horrified by the rise of Nazi antisemitism and the eugenics movement which was backed by intellectuals like Margaret Sanger, the "Godmother" of Planned Parenthood, who advocated birth control for "racial regeneration" as well as feminist freedom. To combat these racist ideologies, Boas propounded the theory that the key determinants of human behaviour and social diversity are cultural factors, not race or biology.
Correspondingly, Boas also insisted that no culture or civilization is any better than any other. Inspired by his teaching, Margaret Meade, Ruth Benedict and a host of other prominent cultural anthropologists set out to prove, as Gairdner observes, that "all cultures are equally good and already fully civilized; that none are morally better or worse than others."
Meade gained international renown in the 1930s with her best-selling book, Coming of Age in Samoa, in which she depicted an idyllic Polynesian community where young men and women enjoyed casual sex before marriage. The accuracy of this portrait is now a matter of hot academic debate.
Gairdner underlines a more fundamental objection: Meade might not have been so tolerant of the prevailing moral code and cultural diversity in Samoa if she had observed that society before Christian missionaries and colonial rulers had persuaded the Samoans to renounce the evils of slavery, human sacrifice and cannibalism.
In addition to cultural relativism, Gairdner describes existentialism, structuralism, post structuralism, deconstuctionism, post modernism, post-post modernism and legal positivism. Running through all these trendy intellectual fads is the perverse notion that there are no knowable and universal principles of morality.
This is a novel doctrine within Western Civilization. Prior to the 1960s, it used to be generally understood in the English-speaking countries that there is a natural law knowable by reason that is the moral basis for valid laws. Thus, Sir William Blackstone explained in his classic Commentaries on the Laws of England that "no human laws are of any validity if contrary" to the natural moral law.
Today, most lawyers and jurists subscribe to the theory of legal positivism -- the doctrine that the law is whatever the sovereign authority in a state says it is. By this reasoning, the Nuremberg jurists had no moral basis for condemning the Nazis who murdered millions of innocent people in conformity with the so-called laws of Nazi Germany.
That's preposterous. And so is the entire theory of moral relativism. Notwithstanding the pretensions of Boas and his followers, no society or culture has survived -- or could survive -- without moral constraints governing such matters as incest, adultery, lying, cheating, stealing and murder.
Typically, the transgressive proponents of moral relativism are inconsistent: While subscribing to moral relativism in theory, they would be quick to denounce in practice the immorality of a fraud artist who victimized them.
Such is the absurdity, but also the appeal, of moral relativism. As Gairdner explains, for all too many of us, moral relativism "is a very handy concept to keep in our knapsack because it helps us to dismiss all sorts of rules and absolutes for ourselves, without altogether denying the need to apply them to others."