09 November 2020

Paging Dr. Freud #nlpoli

Moya Greene, head of the Premier’s Economic Recovery Team, told municipal leaders last week that the provincial government spends almost $2.0 billion less on health care than it actually does.


She said the government spent 25% of its budget on health care.  VOCM reported it: “Greene says healthcare is about 25 per cent of the province’s total expenditures, and that it is a conversation we have to have.”

The actual share in 2019 was 42% and the forecast share in 2020 in 37%. You can find the figures in the budget tabled in the House of Assembly at the end of September.

This is a really bizarro comment since Greene is already well into her job of sorting out both government overspending and re-organizing the economy.  She should have a handle on all numbers. 

After all, Greene and her provincial recovery team will deliver a preliminary report by the end of February. Sure she’s not due to have the whole thing finished until April, but the first deadline of February is really only about three months away, if you allow an interruption for Christmas.

But that’s not the only weirdness.

Two groups – same territory

 VOCM also reported Greene saying that “her team will be guided on that front by the advice of the Health Accord NL team.” Greene’s bunch “will be mindful of that team’s advice on the subject,” according to VOCM.

The weirdness is that the health accord crowd seem to have other ideas.

Co-chairs Pat Parfrey and Sister Elizabeth Davis did the media rounds on Friday. When asked about the relationship between Parfrey and Davis’ tribe and  Greene and her crowd,  Davis told NTV on Friday that she and her bunch would look at one thing care while the provincial recovery team “is looking purely at the economic future” of the province.

If you listen to the clip, you can notice that Davis leaned on the word “purely” almost like it was a synonym for “just”.  *They* are just talking about the economy, and by implication, that really doesn’t have anything to do with what “we” are talking about.

Thinking of the two committees would be fine except that, as Davis and Parfrey made plain they aren’t limited in what they are talking about.

Sure, the crowd currently running the place call it the health care accord. But listen to Davis, Parfrey, or health minister John Haggie.  They talk about social determinants of health.  That’s way more than how many hospitals there are or whether you can see a doctor on your iPad. “Social determinants of health” includes minimum wage, income support, education, child services, Indigenous relations, women and gender equality, and the criminal justice system.  

Oh yes, and jobs, too. 

After all, people with good jobs that pay well tend to be healthier than people who don’t.

Now you have two groups looking at pretty much everything going on in the province that involves the government.  Davis is aware of this, by the way.  She said in another part of the interview that both groups might wind up in the same spot, even as she claimed they were talking about different things.  On top of that, Parfrey and Davis are keen to get all sorts of people talking and, inevitably, that will turn into a list of new things that everyone wants.

All of that costs money and that’s where the whole thing runs smack into Moya Greene and her comment about how much money the government spends on things like health care and ferries. 

Now go back to Greene’s comment.  Except instead of a mistake, just suppose she made a Freudian slip.

Maybe Moya was talking about reducing health care spending to the point it only took up 25% of the provincial budget.  That would take the current health budget of $3.0 billion down to something like $2.0 billion.

Now go back to the terms of reference for the committee.  Moya alone delivers the final plan by the end of April next year.  She has to present “a plan and recommend options for the [provincial government] to address these challenges over the next three years.”

Three years.

Starting next April.

Meanwhile, as they told reporters last week, Parfrey and Davis are to deliver the first cut of their plan around the same time Greene and her crowd get their first cut of the plan back to government.  They will deliver the final version by the end of next year.

The result is two groups looking at essentially the same sorts of things, both going at it simultaneously, on very tight if not completely unrealistic time-lines, and at least one team - which still hasn’t been named yet - not really sure how it relates to the other.

The Strategic Economic and Social Plans

The last time we collectively went through this exercise of changing the strategic direction the province was in, it took the economic strategy crowd two and a half years of extensive discussions and study, plus detailed public consultations, to come up with a viable plan that looked ahead 25 year.  The strategic social plan  took about as long and for the good reason that it takes time for people to get to grips with complex issues and agree on them.  The consultations they held were not these superficial tick-the-box jobs the government does these days.

Both the 1990s plans were genuinely strategic in that they recognized how the issues are interconnected.  The way government tackled the plans reflected the understanding that a fundamental change of direction for the province was a political exercise, not a managerial one. 

The final documents represented not just a bunch of ideas cooked up by a committee sitting around a table.  It reflected what had become the consensus across the province about how to leave behind the old ideas we knew didn’t work.  There were still lots of folks wedded to the past and sure, enough, they came to power in 2003.  

But changing direction took a consensus that came - by definition – out of the way the government  developed the two strategic plans.  As Bob Rae said, "Politics [is] the art of pursuing common interests through... active listening, advocacy, public persuasion, compromise and negotiation."

Contrast that with the current approach. 

You see the point.

The Two 800 Pound Gorillas… and what next?

Then there are the issues that no one is talking about.

Muskrat Falls is due to come online next year.  We still have absolutely no idea what the provincial government will do to deliver the promise that the cost of paying for the project will have no financial impact on consumers and/or taxpayers. 

We have no rate mitigation plan.  Whatever Dwight Ball’s crowd came up with, the first thing Andrew Furey did as Premier was scrap that and set up another bunch to not only talk about rate mitigation but also explore the prospect of building Gull Island.

In the most optimistic scenario, people in the province will get two plans – possibly ones that don’t fit together – dropped on them over the next few months.  People might have some clues as to what is coming, but in all likelihood, they will get them once they are done.  Sure that’s the way government works these days but that, in itself, is a huge part of the problem we have in this province.  That’s how we got into this mess with government spending and Muskrat Falls.

And what happens then?

Maybe we find out in the budget that this is a done deal.  That’s a reasonable assumption given the way government has worked since 2003.

Or will the government call an election before we get the reports?

Odds are against them calling one after Moya says we need to haul a billion bucks out of health care and close a raft of hospitals and health centres. 

Will it take another year beyond that?  Will deadlines get extended? 

Will the whole thing get scrapped?

No one knows. 

That's because, ultimately, none of this matters.

Whatever Moya, Pat, and Elizabeth do, the only thing that counts is the reaction of the politicians once they get the reports in their hands.