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Thread: The sky has finally fallen...
04-01-2010, 12:21 PM #137
Our province Quebec is NOT an economic dynamo/driver. Quebec is considered a have-not province and is the net recepient of billions $$ from the have provinces like BC and Alberta. They only have hydropower from James bay which they ripped off from the native indian. This have-not province of quebec has the cheapest univeristy tuition fee of all canada, universal 7$/day daycare, cheapest electricity of the land, ie, best of social programs of canada which even the provinces don't have.
Things are so bad that Quebec's GDP ranks 54th out of 60 provinces and states in North America - behind many with a fraction of its population and resources. It trails Montana and Arkansas, for example, and is only slightly ahead of Mississipi. GDP is routinely 20 per cent below that of Ontario, its closest geographical and economic cousin. "In Quebec, the wealth of a family of four is $21,028 less than that of a similar family in the state of Maine," wrote Alain Dubuc in his pro-business tome, Éloge de la Richesse (In Praise of Wealth). "How is it that an economy such as Quebec's, which is fully capable, doesn't transform into wealth?"
Canadians will be wondering the same thing soon, as Quebec's economic crisis is about to be thrust onto the national agenda. Prime Minister Stephen HARPER has hinted that the March 19 federal budget will take steps to correct the so-called "fiscal imbalance." Translation: a hefty transfer payment to Quebec, which already gets $2.2 billion a year more from the federal government than it contributes. The federal money has already become a hot political issue in advance of the Quebec provincial election, scheduled for just one week after the federal budget. When Premier Jean CHAREST hinted that a Parti Québécois win on March 26 would end the federal gravy train, PQ leader André Boisclair accused him of trying to blackmail Quebecers into voting Liberal.
The trouble now is that Canada is subsidizing a province that is not only in financial trouble, but not all that interested in fixing itself, says Claude Montmarquette, an economics professor at Université de Montréal and one of the signatories of the Bouchard manifesto. "We have a large amount of money coming from the rest of Canada and also a pass to spend a lot of money on social programs that others pay in large part for us," he says. "So why do we have to change until we hit the wall? And that's coming."
While all Canadian provinces devote increasingly large chunks of their budgets to things like health care, Quebec's social programs are far and away the comfiest. Quebec has the luxury of two very expensive programs unavailable in the rest of the country. The first is the province's $5-a-day daycare program. Enacted by the Péquiste government in 1997, and bumped up to $7 a day by Charest, it is as popular as it is wildly expensive: there are some 195,000 daycare spaces, costing roughly $1.4 billion a year. The province now claims 43 per cent of Canada's regulated child care spaces, though it only has 23 per cent of the country's children under the age of 13. The daycare system is credited with helping drive Quebec's eight per cent jump in the birth rate in 2006, the first sizable increase in decades. Nevertheless, this increase comes at a price. According to La Conseil du Patronat, Quebec's main employers' federation, a child care spot in Quebec costs roughly $11,600, nearly double the Canadian average. In five years, the total cost of the daycare system has increased by 140 per cent.
Since 1994, the Quebec government has frozen university tuition at $1,668. Today, a Quebec student entering university pays on average 65 per cent less than his equivalent in Ontario. It might be a sweet deal for students; for universities, not so much. "Quebec universities are underfunded in comparison to other Canadian universities and our peers in the U.S.," McGill President Heather Munroe-Blum says. Recently, the Charest government announced a tuition increase of $100 per student per year, a move Munroe-Blum calls "extremely important." Low tuition certainly hasn't translated to more graduates. Quebec has both the lowest university attendance and the lowest degree-completion rate, according to an Organisation for Economic Co-operation and Development study
Last edited by cooler; 04-01-2010 at 12:35 PM.
04-02-2010, 01:17 AM #138
I think there is some confusion about high debt to gdp ratio implications.
By itself the ratio means nothing. A country's debt to gdp ratio is similar to a person's debt to gdp ratio, which can be very good to very bad, depending on other things.
Say if you have an annual income of US$200,000, net ot tax, and an annual total expenditure of US$210,000. You have a deficit of US$10,000. On top of this you have a mortgage of US$500,000.
Based on the above your annual deficit is 5% (US$10,000) and your debt to gdp is US$500,000 + US$10,000 (debt) to US$200,000 (gdp), or 255%.
Using the same data for say 2 individuals with idnetical numbers except that one has a positive networth and the other a negative networth, we come up with two very different ratings, just like one is Greece the other Sigapore or Japan.
If one is Greece (A), his networth is negative US$200,000 due to a declining market value of his mortgaged property (US$500,000 mortgage-US$300,000 current arket value of his property). A will then have a negative networth of US$200,000 + $10,000 deficit and this plus a 255% debt to gdp ratio will mean a complte disaster.
The other party, say Singapore (B), its mortgage of US$500,000 on a property has a positive networth if its property has a current market value of US$1,000,000. It then has a positive net worth of US$1,000,000 - US$500,000 - US$10,000 = US$400,000. Therefore its high debt to gdp ratio is nothing to worry about.
In other words you cannot jump to conclusions merely from looking at incomplete data.
04-02-2010, 01:57 AM #139
04-02-2010, 03:22 AM #140
That 70s show..
master silentheart had already asked that question and yes, as OTB mentioned, it's partly spending (mismanagement of budget by the California govt). But the downhill slide began in the 70s (during Gov. Jerry Browne's administration) where he supported the now all-powerful unions (which is now sucking up all the resources). They've been the root killer.
OTB: heard of the One World Government and One World Monetary system??..
Last edited by ctjcad; 04-02-2010 at 03:26 AM.
04-02-2010, 04:53 AM #141
The next potentially explosive armageddon may be the EU. The problem in Greece exposes even more serious headaches in much larger problem countries like Italy and Spain. Throw in Ireland and Portugal and we get an EU that just doesn't have the muscle to clean up the mess.
Greece by itself is too small to really cause any serious problem. Germany by itself can bail Greece. But with Italy and Spain in the same dire situation as Greece, the EU will collapse if things get worse.
This is under discussion in China. China is concerned about such an EU collapse. I believe China is now working on contingency plans to help out the EU with huge loans if the situation becomes unmanageable.
04-02-2010, 05:00 AM #142
Of course California can get itself out of the mess. Just like a retired billionaire, having no income stream, can afford a life of luxury simply by selling his assets which he has in billions, California can auction off some of itsr high-value real estate to the public, including China.
Many experts have advised Greece to sell some of their many islands to raise cash but Greece has refused. Sometimes, beggars cannot be picky.
04-02-2010, 07:37 PM #143
04-08-2010, 01:03 AM #144
Perhaps it was the old health care system that has made middle-age Americans now more prone to disabilities. Now 4 out of 10 middle-age Americans suffer from one or more forms of disabilities.
04-08-2010, 08:23 AM #145
I think you only have to look to Canada for the comparison. I don't have any figures but I can imagine fewer illegal immigrants in Canada.
04-08-2010, 02:47 PM #146
Immigration into canada generally is, climbing.
04-08-2010, 02:53 PM #147
04-09-2010, 08:41 PM #148
I don;t believe the healthcare reform will be a panacea for the healthcare system but it's a step along the right way.
04-10-2010, 04:58 AM #149
Going along cost-effective healthcare. I found this article quite interesting. After all, I do know the American consumer is more demanding. Cooler also mentioned how with healthcare insurance, the efficient market fails. The consumer will have to accept a change in practice.
Rather significant is this statement from the article..
Deep down, Americans tend to believe that more care is better care. We recoil from efforts to restrict care.
I think that applies to patients and doctors.
04-13-2010, 07:03 PM #150
tax day this coming thursday for all da americans.hope all of those reportedly half of the u.s. population who didn't pay their income taxes turn in their tax and pay up.
as for the recent healthcare reform bill that was passed,ugh,i can only say, just take a look at romneycare,which is a blueprint of the just passed healthcare reform bill, in the state of massachusets.it's in the red and the state can't keep up.
obama-rama may got it passed and the itnention may sounhd noble and all but good luck with sustaining obamacare.let us see if the lawmakers who passed the bill will actually donate their money to supoprt it ornot.
04-13-2010, 08:07 PM #151
04-13-2010, 08:29 PM #152
The Rush is On
After lining up at McDonalds, doctor's office is the next lineup
Receptionist: Mr Smith, our doctor and nurses are all tied up, if you want to shorten your wait, i can take your temperature and pulse
Doctor shortage? 28 states may expand nurses' role
By CARLA K. JOHNSON, AP Medical Writer Carla K. Johnson, Ap Medical Writer
17 mins ago
.CHICAGO – A nurse may soon be your doctor. With a looming shortage of primary care doctors, 28 states are considering expanding the authority of nurse practitioners. These nurses with advanced degrees want the right to practice without a doctor's watchful eye and to prescribe narcotics. And if they hold a doctorate, they want to be called "Doctor."
For years, nurse practitioners have been playing a bigger role in the nation's health care, especially in regions with few doctors. With 32 million more Americans gaining health insurance within a few years, the health care overhaul is putting more money into nurse-managed clinics.
Those newly insured patients will be looking for doctors and may find nurses instead.
The medical establishment is fighting to protect turf. In some statehouses, doctors have shown up in white coats to testify against nurse practitioner bills. The American Medical Association, which supported the national health care overhaul, says a doctor shortage is no reason to put nurses in charge and endanger patients.
Nurse practitioners argue there's no danger. They say they're highly trained and as skilled as doctors at diagnosing illness during office visits. They know when to refer the sickest patients to doctor specialists. Plus, they spend more time with patients and charge less.
"We're constantly having to prove ourselves," said Chicago nurse practitioner Amanda Cockrell, 32, who tells patients she's just like a doctor "except for the pay."
On top of four years in nursing school, Cockrell spent another three years in a nurse practitioner program, much of it working with patients. Doctors generally spend four years in undergraduate school, four years in medical school and an additional three in primary care residency training.
Medicare, which sets the pace for payments by private insurance, pays nurse practitioners 85 percent of what it pays doctors. An office visit for a Medicare patient in Chicago, for example, pays a doctor about $70 and a nurse practitioner about $60.
The health care overhaul law gave nurse midwives, a type of advanced practice nurse, a Medicare raise to 100 percent of what obstetrician-gynecologists make — and that may be just the beginning.
States regulate nurse practitioners and laws vary on what they are permitted to do:
• In Florida and Alabama, for instance, nurse practitioners are barred from prescribing controlled substances.
• In Washington, nurse practitioners can recommend medical marijuana to their patients when a new law takes effect in June.
• In Montana, nurse practitioners don't need a doctor involved with their practice in any way.
• Many other states put doctors in charge of nurse practitioners or require collaborative agreements signed by a doctor.
• In some states, nurse practitioners with a doctorate in nursing practice can't use the title "Dr." Most states allow it.
The AMA argues the title "Dr." creates confusion. Nurse practitioners say patients aren't confused by veterinarians calling themselves "Dr." Or chiropractors. Or dentists. So why, they ask, would patients be confused by a nurse using the title?
The feud over "Dr." is no joke. By 2015, most new nurse practitioners will hold doctorates, or a DNP, in nursing practice, according to a goal set by nursing educators. By then, the doctorate will be the standard for all graduating nurse practitioners, said Polly Bednash, executive director of the American Association of Colleges of Nursing.
Many with the title use it with pride.
"I don't think patients are ever confused. People are not stupid," said Linda Roemer, a nurse practitioner in Sedona, Ariz., who uses "Dr. Roemer" as part of her e-mail address.
What's the evidence on the quality of care given by nurse practitioners?
The best U.S. study comparing nurse practitioners and doctors randomly assigned more than 1,300 patients to either a nurse practitioner or a doctor. After six months, overall health, diabetes tests, asthma tests and use of medical services like specialists were essentially the same in the two groups.
"The argument that patients' health is put in jeopardy by nurse practitioners? There's no evidence to support that," said Jack Needleman, a health policy expert at the University of California Los Angeles School of Public Health.
Other studies have shown that nurse practitioners are better at listening to patients, Needleman said. And they make good decisions about when to refer patients to doctors for more specialized care.
The nonpartisan Macy Foundation, a New York-based charity that focuses on the education of health professionals, recently called for nurse practitioners to be among the leaders of primary care teams. The foundation also urged the removal of state and federal barriers preventing nurse practitioners from providing primary care.
The American Medical Association is fighting proposals in about 28 states that are considering steps to expand what nurse practitioners can do.
"A shortage of one type of professional is not a reason to change the standards of medical care," said AMA president-elect Dr. Cecil Wilson. "We need to train more physicians."
In Florida, a bill to allow nurse practitioners to prescribe controlled substances is stalled in committee.
One patient, Karen Reid of Balrico, Fla., said she was left in pain over a holiday weekend because her nurse practitioner couldn't prescribe a powerful enough medication and the doctor couldn't be found. Dying hospice patients have been denied morphine in their final hours because a doctor couldn't be reached in the middle of the night, nurses told The Associated Press.
Massachusetts, the model for the federal health care overhaul, passed its law in 2006 expanding health insurance to nearly all residents and creating long waits for primary care. In 2008, the state passed a law requiring health plans to recognize and reimburse nurse practitioners as primary care providers.
That means insurers now list nurse practitioners along with doctors as primary care choices, said Mary Ann Hart, a nurse and public policy expert at Regis College in Weston, Mass. "That greatly opens up the supply of primary care providers," Hart said.
But it hasn't helped much so far. A study last year by the Massachusetts Medical Society found the percentage of primary care practices closed to new patients was higher than ever. And despite the swelling demand, the medical society still believes nurse practitioners should be under doctor supervision.
The group supports more training and incentives for primary care doctors and a team approach to medicine that includes nurse practitioners and physician assistants, whose training is comparable.
"We do not believe, however, that nurse practitioners have the qualifications to be independent primary care practitioners," said Dr. Mario Motta, president of the state medical society.
The new U.S. health care law expands the role of nurses with:
• $50 million to nurse-managed health clinics that offer primary care to low-income patients.
• $50 million annually from 2012-15 for hospitals to train nurses with advanced degrees to care for Medicare patients.
• 10 percent bonuses from Medicare from 2011-16 to primary care providers, including nurse practitioners, who work in areas where doctors are scarce.
• A boost in the Medicare reimbursement rate for certified nurse midwives to bring their pay to the same level as a doctor's.
The American Nurses Association hopes the 100 percent Medicare parity for nurse midwives will be extended to other nurses with advanced degrees.
"We know we need to get to 100 percent for everybody. This is a crack in the door," said Michelle Artz of ANA. "We're hopeful this sets the tone."
In Chicago, only a few patients balk at seeing a nurse practitioner instead of a doctor, Cockrell said. She gladly sends those patients to her doctor partners.
She believes patients get real advantages by letting her manage their care. Nurse practitioners' uphill battle for respect makes them precise, accurate and careful, she said. She schedules 40 minutes for a physical exam; the doctors in her office book 30 minutes for same appointment.
Joseline Nunez, 26, is a patient of Cockrell's and happy with her care.
"I feel that we get more time with the nurse practitioner," Nunez said. "The doctor always seems to be rushing off somewhere."
Last edited by cooler; 04-13-2010 at 08:34 PM.
04-16-2010, 01:44 AM #153
where are the promised jobs?
Obama signs $18 billion jobless benefits bill
By ANDREW TAYLOR, Associated Press Writer Andrew Taylor, Associated Press Writer
1 hr 17 mins ago
.WASHINGTON – Just hours after Congress passed an $18 billion bill to restore unemployment benefits for the long-term unemployed, President Barack Obama made it the law of the land.
The measure comes as welcome relief to hundreds of thousands of people who lost out on the additional weeks of compensation after exhausting their state-paid benefits. They now will be able to reapply for long-term unemployment benefits and receive those checks retroactively under the legislation.
The bill also restores full Medicare payments to doctors who were threatened by a 21 percent cut and refloats the flood insurance program.