Un État figé à beaucoup de tablettes en réserve (4)

Voici quelque cas type de rapports publiés par différents ThinkTank canadiens sur nos problématiques.

Combien de rapports, pensez-vous, vont rester sur les tablettes ?

Comme d’habitude, nos politiciens ne voudront pas traumatiser certains groupes d’intérêts ou se chicaneront éternellement entre eux à cause de leurs compétences fédérales – provinciales respectives.

D’après vous, cher peuple, est-ce que nos politiciens nous ont démontré au cours de la dernière décennie suffisamment de maturité pour régler les problèmes majeurs du Canada et d’être capable de faire face à la concurrence mondiale ?


Employment Insurance

 

We undertook this project because we believe that the time is right to revisit Canada’s system of assistance for the unemployed. At the core of our recommendations is a belief that a new national framework is required, one that is more transparent, effective, and equitable.

 

We have come to this conclusion because of the failure of the current program to keep up with a variety of societal and economic changes. It is widely recognized that there are deep problems at the core of the system.

 

Too many people are being left out of Canada’s social safety net, too many are carrying an unfair burden, and too many are not achieving their potential.

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About the fiscal transfers

 

Canada’s fiscal arrangements—the Canada Health Transfer, the Canada Social Transfer and Equalization—are meant to serve a simple purpose: ensure that all provincial governments in Canada have the fiscal capacity to provide their residents with comparable levels of public services at comparable levels of taxation.

 

They clearly no longer do that.

 

Fiscal disparities in Canada are increasingly driven by commodities, yet our fiscal arrangements do not redistribute commodity wealth. This places Ontario in a unique situation, lacking the natural resources of the oil and gas provinces, but also significantly more prosperous than the traditional Equalization-receiving provinces.

 

This is not sustainable for Ontario and it is not in keeping with the most basic understanding of equity. This redistribution undermines Ontario’s ability to provide comparable levels of public services to its residents and also undermines its ability to make capital investments that will ensure its future prosperity.

 

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Healthcare spending is skyrocketing in Canada

 

Healthcare spending is skyrocketing in Canada and governments are struggling to find the money to pay for it. For example, if current trends continue, by 2030 healthcare will account for 80 per cent of Ontario’s budget, up from 45 per cent today. The trends are no different in other provinces.

 

But current trends simply cannot continue. Something has to give. Governments will need to either raise large sums of money to delay budget calamity or embrace transformative change in the healthcare system. “Straight line” projections of indefinite yearly increases in health spending are misleading.

 

They do not, in fact, demonstrate that spending will bankrupt governments.

 

1.       Modernize the Organization of Hospitals by Disrupting Clinical Business Models 21

2.       Use Virtualization to Develop New Roles for Providers and Patients 27

3.       Widely Deploy Digitization in the Second Decade of Infoway 34

4.       Devolve Decision Making Selectively & Where Appropriate 39

5.      Reform the Way Health Services are Purchased

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Health Care Lessons from Australia

 

The combination of superior access to health care and potentially superior health outcomes for substantially lower cost suggests there is much Canadians can learn from the Australian health care system.

 

An Australian approach to health care in Canada would primarily require important changes to financial flows within provincial tax-funded systems, a greater reliance on competition and private ownership, and public support for private insurance cover.

 

The Australian health care system departs from the Canadian model in the following important ways:

 

·         cost sharing for outpatient medical services;

·         some private provision of hospital and surgical services;

·         activity-based funding for hospital care;

·         broad private, parallel health care sector with taxpayer support and dual practice

 

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The Unfunded Liability of Canada’s Health Care System

 

This Alert analyzes the unfunded liability of Canada’s health care sys tem (Medicare). A pro gram has an unfunded liability when it has a short fall between the expected future stream of funding and future benefit obligations.

 

The size and complexity of the unfunded liability associated with Medicare war rants special attention. At its inception, this program was based on the assumption that demo graphics, economic growth rates, and wage increases prevalent in the 1960s would persist.

 

These assumptions have proven false.

 

Birth rates have declined, income growth has slowed, and mortality rates have decreased.

 

Demographic changes will continue to under mine the ability of this plan to pro vide the intended level of benefits at the current level of taxation.

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Corporate Welfare Bargains at Industry Canada

 

Corporate welfare is a multi-billion dollar practice that saw federal, provincial, and local governments disburse over $202 billion from 1994 to 2007 alone

 

Between 1982 and 2012, the federal department of Industry spent$13.7 billion on subsidies to business.

 

Since 1982, on all of the above, just $9 mil lion has been collected in interest by the department of industry on all of its disbursements.

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L’organisation du travail dans le secteur public : l’exemple de la Suède

 

L'organisation du travail dans le secteur public au Québec est depuis longtemps entravée par de nombreuses rigidités. Au cours de la dernière décennie, quelques timides réformes ont été adoptées pour s'attaquer à ce manque de flexibilité, dont la décentralisation de certains éléments des conventions collectives dans le réseau de la santé

 

 

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La dette du gouvernement québécois

 

Selon des estimations fondées sur le budget 2013-2014 du gouvernement du Québec, la dette du secteur public s'élèvera à 257,6 milliards de dollars au 31 mars 2013, une augmentation de 11,4 milliards de dollars depuis le 31 mars 2012.

 

Ce montant est de loin supérieur au déficit budgétaire officiel de 1,5

milliard de dollars. En effet, outre le déficit, la dette du secteur public

a augmenté principalement en raison des dépenses d'infrastructure,

pour 6,5 milliards de dollars.

 

Bien qu'il existe plusieurs définitions d'endettement, la notion de

dette du secteur public représente la mesure la plus exhaustive parce

qu'elle englobe toutes les obligations financières à long terme dont le

gouvernement se porte garant au nom des contribuables d'aujourd'hui et de demain.

 

 

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Le financement des hôpitaux à l'activité : l'attente a assez duré

 

Le financement par enveloppe globale n’offre aucune incitation aux gestionnaires d’hôpitaux à innover afin de réduire les dépenses et d’améliorer l’accès et le temps d’attente.

 

Le financement à l’activité : un mode plus incitatif

 

Le financement à l’activité mène-t-il les établissements de

santé à rogner sur la qualité des services afin de réduire les

coûts? Bien au contraire. Dans la mesure où les revenus

des établissements dépendent du nombre de patients qu’ils

attirent, il est impératif pour eux d’offrir des services de

qualité et de préserver une bonne réputation.

 

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Ottawa’s Pension Abyss

 

Despite recent high-profile changes to the pension plans

of federal public servants, uniformed personnel and MPs, a

critical flaw remains: the contributions to these plans, before

and after the changes, come nowhere close to covering the

rocketing cost of their promises.

 

Because the value of Ottawa’s pension promises to its employees is  almost $118 billion higher than reported, and the corresponding obligation to taxpayers – which amounts to almost $276 billion, or $31,000 per Canadian family of four – is badly understated.

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Reining in the Risks: Rethinking the Role of Crown Financial Corporations in Canada

 

The extent to which financial Crowns compete in private financial markets poses risks to the overall economy – and these risks seem to have grown. The Crowns’ mandates should be clearly circumscribed, in some cases rolled back. In all cases, Crown financial corporations should be subject to the same capital standards and prudential regulation as are federally regulated private financial institutions

 

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