Health Policy - Op Eds

On Oct. 17, Canada will be the second country in the world to have fully legalized production and retail distribution of recreational marijuana. There will be considerable international interest in the Canadian experiment, in order to understand what works and what does not. One of the prime objectives of legalization was to stamp out the black market. However, it is now clear that this is extremely unlikely. Both federal and different provincial governments should accept responsibility for this.

Black markets exist if there is insufficient legal supply or if they can offer comparable goods at lower cost. Based on available data on the number of licensed producers and medical-marijuana production and inventory levels, we estimate…

Ontario Premier Doug Ford should be congratulated for improving Ontario’s marijuana market structure last week. He decided to privatize the retailing of marijuana in the province. That decision represents a reversal of the previous government’s choice to place retailing in the hands of a high-cost government monopoly. This is good news.

However, he also decided to leave a government agency front and centre in the wholesaling of cannabis. Having gone some way to free up entrepreneurial energies and create an expansive marketplace, he balked at the idea that this market could function well without a monopsony, or a single buyer, at its core.

For the benefit of Ontarians, the government should go further, and, in particular…

At the heart of health care are face-to-face interactions between health professionals and their patients and families. That is what makes it the ultimate “bricks and mortar” industry.

Health care continues to be defined by visits to hospitals and doctors’ offices and now, increasingly, by time spent waiting in hallways. Answering health care’s challenges in the 21st century will not be achieved by having more 20th century doctor’s offices and hospitals. It will come from modernizing our system through the use of new digital tools and integrating them into the day-to-day work of caring for patients.

In our C.D. Howe Institute paper, “Modernizing Canada’s Healthcare System Through the Virtualization of Services,” we…

Physicians, especially those in Ontario, are furious at the federal government's proposed changes to small-business taxation. The federal changes follow successive unilateral fee decreases imposed by the government of Ontario and will further sour bargaining negotiations, likely resulting in an undesirable arbitration process.

This is the basic state of physician compensation today: Doctors are self-employed small-business entrepreneurs (with one payer) who bargain as a non-union unit with no ability to strike and binding arbitration rights. It is an awkward structure, to put it mildly.

At the outset of Canadian medicare in the 1960s, the major obstacle to making a public-insurance scheme reality came from physician groups…

With much fanfare, Ontario’s 2017 budget announced the introduction of universal drug coverage, starting next January, for those under age 25. True, drugs are an important part of the problem in gaps in publicly funded healthcare. But even with an annual starting cost estimated at $480 million, “OHIP+” looks like a poor approach to closing the pharmacare gap while taking up limited fiscal room to close health gaps elsewhere.

Much of the money for OHIP+ will pay for the drugs of people who didn’t have any access problems in the first place. A more targeted approach could have a much larger effect on addressing the many unmet healthcare needs of Ontarians.