Winnipeg Free Press

Winnipeg Free Press (Newspaper) - July 22, 2015, Winnipeg, Manitoba C M Y K PAGE A7 IDEAS �o ISSUES �o INSIGHTS THINK- TANK A 7 Winnipeg Free Press Wednesday, July 22, 2015 " ARE we there yet?" This is a familiar question to any parent with a young child. It's also a question about how Canada supports its families that I ask each month as I pull together the means to pay for my son's child care. I feel fortunate to have had a space for him at the child- care centres where I have worked as a trained early childhood educator. It gives me peace of mind to know he has been learning and has been cared for by great early childhood educators he adores. And yet, we are among the very few. Too many families are struggling to find child care while they work or study, oftentimes relying on uncertain private arrangements as a last resort. As assistant director at the Saskatoon Early Childhood Education Demonstration Centre, I speak to parents every day who are trying to find child care in our community. Come September, my son will head off to Grade 1, and I will need to make private arrangements for his before and after care as there is no licensed school- age program directly available in our town. The reality in Canada is quality child- care spaces are hard to find, they are expensive, and as a result women ( yes, it is still mostly women) end up paying the consequences. As it stands, there are regulated spaces for only one in five children. For many Canadian families, child care is the second- highest household expense - one many are unable to afford, especially with more than one child. Most people would think it absurd to consider such a haphazard, pay- your- own- way- if- youcan- find- it approach to health care or schooling. These publicly funded systems we cherish and all benefit from were developed as responses to collective social and economic needs. Likewise, the social and economic need for building a childcare system has been discussed for more than 40 years. Today a real system of child services parents can count on when they need it is more crucial than ever to support 21st- century families and bolster the economy. When I turn on the news and open a paper lately, I am happy to note the political parties are finally talking about child care. They are putting it front and centre, although they propose vastly different approaches. To me, the answer is universal child care. This means a system of services like the one my son is lucky enough to attend - and like the one I won't be able to find come September. These necessary programs are not going to be delivered through a cheque in the mail covering a tiny fraction of the cost and are taxable. In the lead- up to the federal election, I will be talking with my colleagues, neighbours and family about a real system of quality child- care programs everyone can afford and count on. Quality child care shouldn't be a matter of good fortune, just as accessing health care isn't just for lucky Canadians. So to quote my son, " Are we there yet?" Not yet, but this election puts us within reach, if together we decide to make it a national priority. Brandy Pilon is a mother of one and an early childhood educator living in Saskatchewan. I T'S not only Alberta that's been knocked off stride by Rachel Notley's electoral victory. The federal election is suddenly trending in new directions. The federal NDP was trailing Justin Trudeau's Liberals until that fateful day in May, and its change in fortunes is almost entirely due to the earthquake in Alberta. There is a mysterious force that surrounds political leadership, an indefinable quality of charisma that separates great politicians from the also- rans. Often called " royal jelly," it's practically invisible beforehand, but once the lights begin to shine on it, a wave- like magnifying effect takes place. Pierre Trudeau had it; so did Peter Lougheed. Michael Ignatieff - who has been described as the best prime minster we never had - certainly did not. Rachel Notley has it, even though she leads a rookie government with the shortest " bench" in the history of Alberta politics. Her caucus resembles a university glee club more than a political machine and yet, she seems to be walking on air, hardly putting a foot wrong. When this dynamic young woman walks into a room, it brightens, and conversations stop. Truth is, political power has transformed this former radical into a statesperson of rare quality. She embodies a political magnetism that has already changed Alberta and could ( likely will) alter the outcome of the next federal election. With Notley in the picture, the youthful New Democratic Party all of a sudden looks like the wave of the future. The very fact of Notley's energetic maturity makes an older generation of male politicians tremble. Just ask Jim Prentice. He had solid momentum going into the Alberta provincial election. He was popular, and like many of his generation he was proud of his decades of experience. But frankly, Notley easily made him look out of touch and condescending. And as Saskatchewan Premier Brad Wall discovered this past week, Notley is not only unimpressed with traditional " experience" but is able to challenge older priorities and assumptions with ease. In a Notley flash, the Alberta clich� is history. This province, which was disdainful of the rest of Canada and for decades attempted to protect itself from the dull, socialistic rest- of- Canada, has done a 180. Unbelievably, Quebec Premier Philippe Couillard congratulated Notley for her " wisdom and leadership" while British Columbia Premier Christy Clark praised her " vigorous discussion," during unprecedented meetings to hammer out a national energy strategy. The contrast could not be greater; for an older generation of Alberta politicians the idea of " national" and " energy strategy" appearing in the same sentence was anathema. Notley is challenging these traditional assumptions and putting Alberta back at the centre of Canadian life; her political style is a welcome breath of fresh air. Notley is proving it's no longer political suicide to advance an environmental agenda in this country. And, despite the fact she's raising corporate taxes, the public and - ironically - the oil and gas industry look forward to working with her. They say a week is a long time in politics. Well, three months can change the political landscape profoundly. But Prime Minister Stephen Harper should not underestimate the Notley effect and would be wise to change tack as he launches his campaign for the October federal election because his agenda is old- school. It's Canada as an oilsands- dominated " energy powerhouse" with pipelines at the heart of its economic development strategy. But this strategy reduces Canada to a " dig and deliver" primary producer and, as popular as it was before, it clearly does not suit the temperament of Canada's youth, who want much more. The Notley effect may, at this point, play mostly behind the scenes, but it will elevate the debate over policy direction. Those thorny issues of economic diversification, environmental stewardship and corporate social responsibility are now out of the political closet. The Conservative party slogan for re- election is " We're better off with Harper." But with a new political wind blowing in from the West, the winning slogan could well turn out to be " We're better; off with Harper." Robert McGarvey is an economic historian and cofounder of the Genuine Wealth Institute, an Albertabased think- tank dedicated to helping businesses, communities and nations build communities of well- being. - Troy Media A MALGAMATION as a way of joining forces, preventing duplication and saving money has been suggested for a national pharmacare program. Canada has at least 16 separate public drug plans - each of the provinces, plus ones for the RCMP, veterans, aboriginals and others, as well as hundreds of private drug plans. Wouldn't it also be easier - and cheaper - if we just had one national drug plan? Earlier this summer, at least eight provinces got together to discuss a national drug plan. Cost- efficiencies, a better ability to negotiate drug prices and other economies of scale make it a compelling idea. I agree. Yet, I also agree that if done poorly, a national drug plan could be an utter disaster, characterized by waste, political coverage decisions and even more irrational and unsafe pharmaceutical use than we've got now. Bigger does not always equal better; sometimes bigger means dumber. Let's take a major new drug to see how we might fare with a national drug plan. The diabetes drug Januvia ( generic name: sitagliptin) globally earns about $ 6 billion per year for its manufacturer, Merck. It costs about $ 3.50 per pill in B. C. and lowers blood sugar on par with older, cheaper diabetes drugs. Proponents of a national drug plan would assert that with the buying power of one big agency, we'd negotiate much better prices for Januvia. Instead of paying $ 3.50 per pill maybe we could get it for $ 2 a pill, which is about what Australia pays, seeing as they have national buying power. Sound good? It would be good only if Januvia had advantages over older, cheaper diabetes drugs. Sadly, independent experts say drugs like Januvia are less effective than older diabetes medications. So are they more dangerous? A trial published in early June tested the drug in 14,000 people over three years and found it wasn't any more harmful than " usual care" plus placebo. This " non- inferiority" trial suggested over three years Januvia won't increase your risk of heart failure, heart attacks, death or cancer compared to a placebo. Hmm. Hardly a slam dunk. Taxpayers in Ontario and Quebec pay tens of millions a year for this drug. And Canada's private plans? It's a good chance if you get drug benefits through your employment, then you're paying for Januvia as well. For my tastes, the first priority of a national drug plan wouldn't be price, but evidence. If the best available evidence suggests a new, more expensive drug such as Januvia is in the category of " not better or worse than comparator drugs," you'd have strict rules to make sure the drug was only covered for the subset of people who can't tolerate other diabetes drugs. You'd use the money you saved to expand coverage for drugs that are cost- effective so more Canadians can be covered for high drug costs. These are the types of hard decisions you have to make when you're facing the political power of one of the world's biggest drug companies. The B. C. government, just recently, made a hard decision when it decided BC Pharmacare won't pay for Januvia. Why? Maybe given little evidence the drug could extend the quality or the length of a diabetic's life and the fact Merck refused to lower the price to bring it on par with the other DPP- 4 inhibitors, the government made the decision not to kowtow to the lobbying pressure. That's the kind of spine that would be essential in a national drug plan. Yet if you look at other federal health- related organizations ( Health Canada, CIHR and CADTH) you find very poor models of national spine. We have a watchdog that doesn't bite, a national health- research funder that encourages Canadian researchers to " partner" with drug companies and a technology evaluator that takes money from drug companies in the form of " fees," thus making them beholden to the very industry they are supposed to assess. Any national pharmacare program would need an absolute firewall to protect it from the inevitable politics of drug coverage; otherwise you'd be left with even more irrational and expensive drugcoverage decisions. Amalgamation in a national pharmacare program sounds great in theory. But in practice? Hmm, I am usually optimistic about doing things collaboratively and working for efficiencies, but I'd hate to see Canada accidently create a national form of institutionalized drug coverage that can't make hard, politics- free and evidence- based decisions. Alan Cassels is a pharmaceutical policy researcher, author and expert adviser with EvidenceNetwork. ca. National pharmacare not the way to go ALAN CASSELS ROBERT MCGARVEY By Brandy Pilon We're not ' there yet' on child care in Canada ' Notley effect' changes politics ANDREW VAUGHAN / THE CANADIAN PRESS FILES Alberta Premier Rachel Notley's charisma is turning politics on its head. A_ 07_ Jul- 22- 15_ FP_ 01. indd A7 7/ 21/ 15 5: 11: 19 PM ;