First published in the Winnipeg Free Press November 12, 2020
The Constitution of Canada identifies health care and education as primary responsibilities of provincial governments. Both are of crucial importance to Manitoban’s quality of life. Yet the provincial government appears to treat both areas as unwanted inconveniences rather than an investment in the people of the province.
When COVID-19 rates and deaths spiked in Manitoba, Premier Brian Pallister claimed that “a government can’t protect you from this virus.” Minister of Health Cameron Friesen recently argued that COVID-19 deaths in personal-care homes are “tragic, regrettable but unavoidable.” Both statements suggest the government has little ability to influence the path of the pandemic — a notion that is denied by experts and flies in the face of casual observation.
Two Toronto physicians strongly objected to this fatalism, arguing that while the deaths in long-term care may have been “tragedies,” they were very “avoidable.” The doctors pointed out that in Manitoba, 243 personal-care and retirement homes had successfully dodged the COVID-19 bullet, showing that tragedy is not an inevitable condition of this type of seniors’ accommodation.
One of the big outbreaks in Manitoba was in Parkview Place, a privately owned, for-profit facility in which inspections found insufficient medical staff, too few cleaners and not enough training. Another outbreak was in the Maples Personal Care Home. Both are owned and operated by the private company Revera.
Studies have repeatedly shown a link between for-profit care and substandard care. A Toronto Star investigation found that for-profit nursing homes had four times the rates of COVID-19 death compared to municipally run facilities (four deaths per 100 beds, compared to one death). Studies in British Columbia and Ontario have shown that both non-profit and government-run long-term care facilities employ more staff and provide more hours of direct patient care than for-profits.
According to University of California/San Francisco health expert Charlene Harrington, understaffing will be an inevitable tendency in for-profit care: “The financial interests of for-profit nursing homes are too often in conflict with their mission to care for older adults.”
Manitoba’s recent daily per-capita number of cases is far and away the highest in the country. Countries such as New Zealand and South Korea have dealt with the disease much more successfully than Canada. In that context, these deaths were only “unavoidable” in a province that does not have a robust strategy in place to deal with the crisis.
In fact, it is the job of the government to provide a well-funded, efficient and accessible public health-care system, but the Pallister government is moving in the wrong direction by inviting private health-care providers to help address the backlog of surgeries due to COVID-19.
On the education front, the Pallister government revealed that it will turn to the “Tennessee model” of performance criteria to better tailor post-secondary education to labour-market needs. This model uses government funding to reward and punish educational institutions based on their success or failure in meeting objectives laid out by the government.
The Tennessee model includes tying funding to institutions with higher participation rates, graduation rates and retention rates in areas that serve short-run private-sector labour market demands.
Putting aside for a moment the crucial point that university education should be much broader than simply providing vocational training, even on their own narrow terms, such performance criteria are flawed. It is easy to predict how institutions will respond to these incentives, and none of them bode well for educational quality in the province.
Most obviously, graduation rates can be increased by grade inflation and by making degree-program requirements easier. Not only is this in direct conflict with the ideal of higher learning to which universities and their professors are committed, but it would result in graduates who are poorly prepared for the labour market.
What does the research tell us about the effects of the high-cost Tennessee model? An article in the American Educational Research Journal concludes that states that don’t use the Tennessee model perform just as well as states that do, and the general educational indicators in Tennessee certainly don’t provide much optimism. In a survey ranking education in the U.S. states, Tennessee came in 41st in terms of the educational attainment of its population and 32nd in terms of the quality its education system.
In rejecting the government’s role in ensuring its citizens’ health and borrowing educational models from the U.S. south, the Pallister government is moving Manitoba in the direction of a red state.