Robert Paterson's Weblog

If I was Doug Currie - Taxes - Incentives - Politics #healthcare

At the heart of solving the Fiscal Health Problem on PEI is the health of Islanders and the political power of the public sector unions. 

It will be in helping Islanders make better decisions about their own health. It will be in creating the conditions where dramatic changes to the system can be made.

It will be in being politically very smart. There is no room for mistakes on taxes or spending.

So if I was Doug Currie I would work very closely with Wes Sheridan and the Premier.

Already some recent tax choices are weakening everything that will have to be done.

It makes no sense to make it cheaper to go and watch a game than to go to a gym and work out. 

It makes no sense to make golf fees less when golf is a sport for the well healed and make health advice expensive. 

We are already in a zone here where it is clear that there is no plan. Is revenue talking with Health? It does not look like it is. Health now drives our future. Get it wrong and the government and PEI has none. So how things affect health and the system must drive policy - all policy.

The tax code will be a critical device in shaping a new lifestyle on PEI. Every single thing that is done with taxes will have to be judged by the lifestyle impact.

At some point all provinces are going to have to use the tax code to shift our addiction to highly processed food. I don't just mean a Pop tax - but an entire tax strategy. What will we incent and what to make more expensive? All will have to be thought through.

So if I was Doug Currie, one of the things I would do is to work on the 5th floor for a long term tax and lifestyle plan. This has to be ready soon. The HST will  focus all minds on tax - this is not the time to be casual.

Every spending decision that is taken by government will also be seen soon in the health context. The government will be judged on its own choices. You cannot tell Islanders that there is no money for things they are attached to and then spend money on things that they don't want. They see that you are making a choice and you will lose or gain political capital accordingly.

This is why Plan B is a suicidal idea. It involves a lot of money and few if any voters want it. For in this mandate there will have to be major cuts to how health care is now delivered. I anticipate that the small hospitals will have to go. If all this money has been spent on a road, there will be no mercy from Islanders.

This is also why a pay raise for MLA's is suicide. There will be a loss in professional health care jobs. It's inevitable. The government sets itself up for a repeat of the 7% debacle if MLA's get a free ride. If MLA's are seen to put themselves then ALL politicians will suffer here. 

Islanders have to see that their elected leaders are in the same boat as they. Only then will they give politicians the room to make tough calls and also survive politically.

We really have a chance to make PEI viable. But not thinking ahead and not having a framework for tax and spending will doom us all to failure.

Did your Dr help you get like this?

Source: sciencedaily.com via Rob on Pinterest

You don't have to be like this but if you take your doctor's advice and eat up to 300 grams of carbs a day you will be

Going Deeper on Tiny Houses and so Freedom

I have been advocating that Pub Media get behind the Empowerment Movement that comes from using networks to help people gain freedom - local food - health - 3D printers etc. 

My pals at WGTE in Toledo are doing this. Here Jay Shafer is interviewed in depth. If you invest your time in this video, you will see more than merely a small house but how by seeing how our house can make us either a prisoner or a free person, we can change our lives completely. For the ideas of a big house and student debt keep us in chains. 

 

Testing - what are schools for?

What if our schools were focused on this?

What if the purpose of schools changed from producing the highest test scores to a place where kids learned to be a member of their community—focusing on cooperation, not competition? In the words of GOOD Magazine’s Liz Dwyer, who recently wrote an article about this issue, what if school were a place where students “learn to live a life of selfless service on behalf of the community; it’s where (students) find the path of virtue, subordinating inner self-interest as individuals to the interests of the community, the good of the whole.” What if schools were, essentially, “the birthplace of the citizen ideal?”
 
Imagine the impact of students dedicating over twelve years of their lives not to learning information geared towards a test, but learning about, and working on, the challenges the world currently faces—starting at a community level. The results would be a tangible difference in their own community, not a piece of paper with numbers and letter-grades. What if students had the ability to work on projects that interested them, and worked with teachers to integrate the learning of necessary skills into their projects—learning how to apply them in the real world?
 

Politics of a Tiny House - Freedom

The Politics of a Tiny House - Freedom from the System - a new vision for retirement - for the best set up is to have low operating costs.

A day in the life of a Tiny House

A day in the life of a TIny House

The Ethics and Health of Meat - Why I back Small Farmers

Which ones do you eat? (Link)

Big Food is killing off Heritage Pigs - This means War

I am appalled - link here - Our future is in heritage breeds and seeds. This is war!

Photo: Carly and Art/Flickr

For those concerned about the welfare of farm animals in the typical conventional situation, there are two options. You can go vegan and completely avoid all animal products, or you can buy meat from farms that raise animals in a more holistic, healthy manner. These animals live happy lives, are fed well, and slaughtered humanely.

 

For someone who considers eggs, meat, and other items an important part of a nourishing diet, the latter is the route I have chosen to take. Therefore, protecting the farmers who try to raise animals in a worthy manner is important to me. I was recently very disturbed to find out about a severe blow delivered to many small pig farmers in Michigan. This blow involves the slaughter of entire farms of pigs, without any compensation to the farmers.  Some farmers made the difficult decision to shoot their own pigs (including piglets) rather than letting government officials carry them off to do the deed themselves. This massacre of pigs is happening under very dubious circumstances.

 

On April 1st, the Invasive Species Order (ISO) went into effect.  This order conferred upon the Michigan Department of Natural Resources (DNR) the power to prohibit certain breeds of pigs and the New Zealand Mud Snail. I haven’t read of any mud snail owners tearfully killing their beloved pets. However, because heritage pigs come under the order, the Department of Natural Resources are making sure that all farms who breed heritage pigs are killing their stock. If they don't comply, farmers are faced with high fines and jail time.

 

A published email from a farmer who had to kill his pigs shared this:

 

Subject: search warrant

I was served a search warrant yesterday at 7:45am.

After 8 guys, 3 four wheelers, and 4 hours, DNR decided I was correct. I have killed all my hogs. They gave me papers that say I do not have any hogs on my property. All they saw were dead hogs laying around from my mass slaughtering. It took 12 guys 4 times in there to kill all of them, sows with young, Pregnant sows, dozens of piglets, and old mature boars. It has been a sad few weeks.

Does anyone know what it feels like to open fire on 20 baby piglets in one group which weigh between 5 lbs and 15 lbs. They are so adorable and cute.

They commented to everyone that they never saw a fence built so tough and no way would a hog get out of this area. I trenched 2′ then installed chain link fencing, then a 10′ high tightlock fence on top of that. ( 200 acre area ) They never saw a fence like that.

Dave Tuxbury

deer tracks ranch

 

It is stories like this one that makes me feel like the world is indeed crazy.

 

Of course, conventional pig farmers who raise their pigs in tiny quarters on concrete are thrilled to see the removal of any competition. With one swift blow, entire herds of pigs can be eliminated. Not just one herd is affected by this order as it affects 2,000 farms and private hunting ranches.

 

The official statement from the DNR explains the justification for these drastic measures by saying that it was necessary "to help stop the spread of feral swine and the disease risk they pose to humans, domestic pigs, and wildlife as well as their potential for extensive agricultural and ecosystem damage."

 

 

 

Health Costs on PEI - If I was Doug Currie I would..

The minister made a long announcement yesterday. It could seem like a survey of what was being done to offer Islanders the best health care possible for such a small place. 

But lost to many journalists who focused on the details of some cuts and services were 3 big messages. You had to hear the code.

1. PEI is at the limits of what we can afford to pay for health care. 
2. In spite of all that we have spent Islanders are getting less healthy.
3. We have to find a new way

So not in the news is the sub text that Doug Currie was offering us all in code: as we get older and we get more sick we will bankrupt the province AND we will not be any less ill. All of this will happen in the next 10 years.

So he implied, we have to rethink the entire idea. It will not be enough to get more efficient - though that is good too.

He put on the table that we have to have a game changer. Only a game changer will head off the impossible burden of the demands of an aging population and our chronic illness epidemic.

And this is why he is going out to all Islanders to have conversations.

This is why there were really not cuts of any size this time. Doug has to do the hard work of working to change how Islanders see themselves and their health.

For to try a game changer, Doug has to get some support from us. If he did this on his own, he would have to fail. If he does nothing, he knows he will fail. This is hs and our only chance. It's not about what party you support. We get this right now, or there is no next time.

Here then is what he has to change - how we see the system and us.

At the moment, most Islanders see their health as being Doug Currie and the system's responsibility. "When I am ill" You fix me. When I am old, you look after me. With so few young and tax payers, this cannot be our future.

Most health professionals are tied into what they do now and will hate any changes. They see their future as needing to get more of the old. They do not want any change in their world. They have a lot of power, because we think that they are gods.

So if I was Doug preparing to cross the Island I would prepare like this:

My objective - To be resolute in sharing  with Islanders and Health Professionals that trying to fix us when we are ill with Diabetes etc is off the table. That we will indeed go bust in no more than 10 years if we don't rethink this. 

We have to defeat chronic illness.

That we have to find ways of helping us to eat differently and to take charge of our health. No small task!

Telling will not work. I would design a process where people had to work with the numbers and see how they fit as people. 

I would design a process that showed hope too. Share Stories of people who have taken charge of their health and pulled back from chronic illness. There are a number of Islanders that have done this - SHOW THAT WHILE HARD THIS IS NOT IMPOSSIBLE.

I would have to influence the system as well. For most health professionals are tied to fixing you when you are ill and nearly all offer the pill versus a change in lifestyle. Or worse offer advice that will make you more ill. telling will not work here either.

There is a large body of health professionals and scientists out there who know all about what our health professionals should know. Bring them here and have conferences for the professionals. A core of the system has to get this too.

This process has to be peer to peer. Islanders to Islanders. Health Professional with Health pros. We don't hear outsiders.

What the process must not be - A lecture tour or a venting platform where people just complain and want their old ways back.

So in summary, if I was Doug Currie I would design a truly interactive tour that would be based on peers and that would offer scenarios for people and health pros that would enable them to struggle with the issues themselves.

With luck, he may have 25% of Islanders and the Pros onside - that is enough to tip the system.

This is our only chance. If we get this wrong we will go bust and we will lose our sovereignty like many nations are in Europe right now. 

Reducing Health Care Costs - Start with Type 2 Diabetes

State Paid Health Care systems are especially exposed to TTD.  PEI has one of the highest exposures to TTD. So if we are to work on the demand side - The Real Science behind the epidemic and a Program that works socially has to become a priority on PEI.

To put the risk into perspective here is the threat to the UK's National Health System - We are not alone here!

The key is to shift from treating symptons to helping people avoid the disease and to pull them back when they have it. 

Report: Rising Diabetes Costs Could Bankrupt NHS 

The disease and its complications currently account for 10% (£9.8bn) of NHS spending. 
But this is projected to rise to £16.9bn over the next 25 years, or 17% of the health service's funds. 

Researchers at the York Health Economic Consortium also found that up to four-fifths of the cost of treating complications such as kidney failure, nerve damage, and amputation could be avoided by investing in better preventative measures and management of the condition. 

The Impact Diabetes report - published in conjunction with charities Diabetes UK, the Juvenile Diabetes Research Foundation and Sanofi Diabetes, also looked at the indirect costs to individuals living with the condition. 

It found the total associated with these extra burdens in addition to direct patient care in the UK stands at £23.7bn and is predicted to rise to £39.8bn by 2035/36. 

There are around 3.8 million people living with diabetes in the UK and this is expected to increase to 6.25 million in just over two decades. 

Barbara Young, chief executive of Diabetes UK, said: "This report shows that without urgent action, the already huge sums of money being spent on treating diabetes will rise to unsustainable levels that threaten to bankrupt the NHS. 

"But the most shocking part of this report is the finding that almost four-fifths of NHS diabetes spending goes on treating complications that in many cases could have been prevented. 

"The failure to do more to prevent these complications is both a tragedy for the people involved and a damning indictment of the failure to implement the clear and recommended solutions.