PC Leader Tim Houston Has Started His Election Campaign
Posted March 5, 2021
The COVID crisis and the resulting shutdown of legislatures have made it difficult for opposition leaders to have a public profile.
Progressive Conservative leader Tim Houston picked a good time to introduce himself to Nova Scotians. He chose the interval between Stephen McNeil’s departure and the opportunity for new premier Iain Rankin to become widely visible.
An ad campaign began on the Superbowl broadcast and continued through February and into March. More substantively, he has developed major policy proposals around health care.
The party website provides a commendably detailed description of the rationale and expected costs of the initiatives. Some are better thought out than others. Here is a partial list, with comments in italics.
- Virtual care gained prominence as a response to the pandemic. It is here to stay and Houston wants to extend and expand it. Patients waiting to find a family doctor would get virtual access to physicians in a manner like the 811 service which provides advice from nurses. Virtual care from specialists and other health care providers would be enabled.
This is a sensible direction but controlling costs will be tricky.
- Surgical wait times are still too long. Houston proposes to extend operating room hours for surgeons and associated staff willing to work overtime.
New hires might be a better idea–many surgical specialists are underemployed. Available operating room time is not the obstacle. It is the limit on how much government chooses to spend on various services.
- Raise salaries of family physicians by 62%, costing $63 million annually.
This is hard to understand. Doctors Nova Scotia, their bargaining agent, said this about the November 2019 contract: “Family doctors who provide comprehensive care… will see a significant increase in pay, bringing their compensation to the top in Atlantic Canada.”
- Change most long-term care rooms to singles and add an additional 1,000 beds. Increase the ratio of staff to residents.
Both initiatives are seriously expensive, even after factoring in reduced pressure on hospitals. The resident contribution to costs is income-dependent, but at most contributes about a third of the total. That ceiling should be raised for middle- and upper-income residents.
- A Supportive Living option between home care and long-term care is proposed, initially for 1,600 residents.
This is worth pursuing. Notably, in this case, the funding formula has higher-income residents paying their full costs.
At the same time, every effort needs to be made to maximize the use of home care when feasible. It is much less expensive and often better for the resident.
- Expand services by paying for a wide variety of licensed professionals with recognized clinical specialties in mental health, addictions, and therapy/counselling. The annual cost estimate of $102 million imagines that this would be only for those uninsured or for whom their maximum benefit is exceeded.
The cost will quickly spiral out of control. Notwithstanding the proposed mechanism to deter employers from cancelling their coverage, the number having private insurance will shrivel.
More importantly, when unconstrained by costs to their patients the mental health specialists will provide much more in-depth services than they do today.
The hard truth of our health care system is that the only way costs can be controlled in a single-payer system is by limiting supply.
Opposition parties do not have vast resources to develop policy. Whatever the faults, the PC proposals are a conscientious effort to address real issues.
Premier Iain Rankin’s opening salvo gets only half credit for that. He proposes to spend $9.5 million to support low-income families in making their homes more energy-efficient, a worthy cause.
He will spend the same amount to subsidize the purchase of electric cars with the following impacts:
- The electricity would come from generation that is still more than 50% from coal, which is more greenhouse gas-intensive than gasoline.
- A taxpayer-subsidized Tesla buyer will help Elon Musk compete with Amazon’s Jeff Bezos for the title of the world’s richest man.
- Last year Tesla sold almost every car it made. A 2021 Nova Scotia buyer may pre-empt someone from Quebec from getting theirs. There, the electricity is more than 99% from renewable sources and the benefit to the planet would be real.
This has a strong whiff of virtue-signalling, so frequently practiced by the Trudeau Liberals but mercifully absent from the seven-plus McNeil years.
Both Houston and Rankin have focused on spending with not much said about how to get the province back to balance. As we get closer to an election, both leaders need to address that question. Otherwise, NDP leader Gary Burrill will find it crowded in the left field.
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