Wednesday, March 29, 2023

NOT MAKING IT CHEAPER EITHER

Walmart and Costco in Canada not making food inflation worse: experts

TORONTO — Experts say the Canadian presence of American retail giants such as Walmart and Costco isn't likely to blame for rising grocery prices.

Sammy Hudes, The Canadian Press

Although the heads of Canadian grocers pushed for MPs to also call on Walmart and Costco to testify for their research into food inflation, experts say the presence of those American retail giants in Canada isn't likely to blame for rising grocery prices. Customers shop for food at Walmart in Salem, N.H., Monday, June 5, 2017. THE CANADIAN PRESS/AP-Elise Amendola

TORONTO — Experts say the Canadian presence of American retail giants such as Walmart and Costco isn't likely to blame for rising grocery prices.

That's despite Canadian grocery chain executives having pushed for MPs to question those retailers as part of their study on food inflation.

University of Toronto economist Ambarish Chandra called ongoing hearings before a parliamentary committee studying the issue, "performative," saying all retailers seek to maximize profits despite their stated efforts to minimize price hikes.

"It's easy to call on the foreign companies and make them explain why they're fleecing hardworking Canadians," said Chandra.

"It's not as though American grocers are taking advantage of Canadians and Canadian grocers aren't. The grocers are going to charge what they can get away with, what the market will bear."

His remarks come as Canadian grocers and consumersare under pressure as food prices continue to skyrocket despite overall inflation easing in recent months.

Grocery prices were up 10.6 per cent in February compared with a year ago, while overall inflation was 5.2 per cent. The grocery inflation rate was down from an 11.4 per cent year-over-year increase in January.

Walmart Canada president and chief executive Gonzalo Gebara told the parliamentary committee Monday that his company is not trying to profit from food inflation.Instead, he insisted it is striving to maintain a price gap between its products and those sold by its competitors.

Walmart Canada’s gross profit rate for its food business and its total operating profit in dollars declined last year, he added.

Gebara's testimony followed a highly-anticipated, March 8 committee meeting in which the heads of Metro Inc. and Empire Co., two of Canada's three biggest grocery chains, questioned why MPs had not called on American retail giants to answer questions for their research into food inflation.

The committee then unanimously agreed to invite the leaders of Walmart and Costco's Canadian arms to speak.

Pierre Riel, Costco's senior vice-president and country manager for Canada, is scheduled to appear before the committee on April 17. A Costco spokesperson did not respond to a request for comment on Riel's upcoming appearance.

Canadian grocers including Loblaw chairman and president Galen Weston told the committee earlier this month that food inflation is not being caused by profit-mongering, insisting their margins on food have remained low.

But Chandra said that framing is merely "window dressing."

"We've seen, frankly, bad behaviour from these grocers over the years, whether it's price fixing or other sorts of scandalous issues, like co-ordinating on reducing pay for cashiers during the pandemic — all of these things stemmed from the fact that we just don't have enough competition," he said.

"We should look into encouraging competition, and one way to do that is to actually have more foreign grocers in the country. So, the presence of Walmart is actually good for Canada in the long run, not bad for it."

Simon Somogyi, an agribusiness researcher at the University of Guelph, added that Walmart and Costco are larger companies than Canadian grocers, which gives them the ability to source products in greater volumes, ultimately allowing them to sell at lower prices.

"Their inclusion in our retail landscape is important and allows consumers to have a choice of where they want to put their money," he said.

"Typically, their motto is 'come to us because we sell in bulk, at a typically lower price than our competitors.'"

He said "any competition that can come into the marketplace is welcomed" in order to help keep costs down.

Factors such as high costs for delivery, packing and labour, along with historically high commodity prices, are still contributing to rising grocery bills, but experts have said they expect food price increases to normalize by the end of 2023.

If the ongoing committee hearings yielded increased transparency surrounding the mechanisms that lead to increased costs for suppliers, Somogyi said it would benefit the public.

"The hearings that we've been seeing are really about, from a consumer perspective, why are prices going up? I'd sort of hoped in some ways for far more discussion on how supplier prices are set," he said.

"The two are linked, but a lot of the theatrics that we've seen in this hearing haven't really got to the bottom of that."

This report by The Canadian Press was first published March 29, 2023.

Sammy Hudes, The Canadian Press

Inequality starts before birth – so child benefits should too

Mary Reader

Providing a safety net from ‘cradle to grave’ is already too late. Time to revive an old Labour policy that can make things fairer

Tue 28 Mar 2023

By the time children start school in the UK, those from low-income backgrounds are already an average of four months behind their peers in terms of educational development. The gap only widens from there. By the end of primary school, it’s nine months. By the time they take their GCSEs, 18 months. Inequality grows exponentially throughout childhood, gaining momentum with every year a child gets older.

That’s why it has been so refreshing to see childcare and the early years firmly back on the political agenda since the spring budget. But interventions in the early years of a child’s life may already be too late. We know that inequality starts much earlier than nursery: it starts in the womb.

From the moment they are born, babies in low-income families are more likely to have a medically low birth weight and be born prematurely. Tragically, they’re also more likely to die within 28 days of birth. Inequalities are established well before children even qualify for the chancellor’s free childcare.

This has long-term consequences. Babies born small or early are more likely to have health problems in later life. Premature babies start nursery and school weeks or months younger than their peers, putting them at an educational disadvantage from the start. Poor health at birth has a ripple effect, culminating in poorer adult health and lower adult earnings.

The postwar welfare state was founded on the principle of providing a safety net “from cradle to grave”. Today, policies to support children still typically start at birth. But should they? We know that the cradle is too late to tackle some of these inequalities that start in the womb. Could interventions during pregnancy be the answer?

Lack of data makes government claims about English childcare ‘meaningless’

Some countries are beginning to consider this. In 2022, Italy introduced a new, universal child allowance that starts in the seventh month of pregnancy. In the US, the Mitt Romney campaign has called for the child tax credit to be paid to pregnant women. My research, published this week in the Journal of Health Economics, shows that health inequalities starting at birth could be tackled by a simple, low-cost intervention: starting child benefit payments during pregnancy.

The evidence that this works does not come from another country but from the UK, where we did this in all but name for a short period between 2009 and 2011. The last Labour government, shortly before the end of its term in office, introduced the health in pregnancy grant: a universal cash transfer equivalent to three months of child benefit. A lump sum of £190 was given to all pregnant women who visited their GP or midwife in the third trimester of pregnancy.

My research shows that this relatively small sum led to significant improvements in babies’ health. Average birth weight increased, while the proportion of babies born prematurely fell. The biggest winners were low-income, young mums. On Mumsnet, women reported using the £190 in a range of ways to reduce stress and promote wellbeing, whether by reducing their overdrafts, covering large expenses like pushchairs, or investing in antenatal swimming classes.

This evidence wasn’t available at the time and the policy fell victim to austerity, scrapped just two years after it was introduced on the grounds that it was a gimmick that would be spent on “booze, fags, bingo or plasma screen televisions”. Universal cash with few strings attached was seen as a risk rather than an opportunity.

We now know that it wasn’t a gimmick. Starting child benefits in pregnancy should instead be seen as a low-cost, effective option for any chancellor looking to tackle inequality and boost economic growth.

Small, early interventions have ripple effects that can reduce inequality in the long run. This makes them highly cost-effective. My research indicates that the health in pregnancy grant will increase lifetime earnings for the babies who benefited from it by three times more than the cost of the policy.

Similarly, recent Institute for Fiscal Studies research has shown that Sure Start – which provided universal parenting support, preschool and antenatal advice in children’s centres across the country – saved £5m of NHS spending by improving children’s health. Investing in the health of future generations means better labour market outcomes, more growth and more tax revenue for governments to spend elsewhere. A little, invested early on, goes a long way.

Looking back at which policies worked in the past can help us innovate in the future. By building on the principle of “cradle to grave” and updating it, given what we know now, we can make progress on inequality. Over the last decade, the gap in birth weight between different social classes has tripled in size. What is true of child benefit also applies to wider government action: the earlier we start the better.

Mary Reader is a research officer at the London School of Economics

Adventure on high seas inspired ocean drone

Open Ocean Robotics developed solar-powered robotic vessels

By Nelson Bennett | March 28, 2023,

Whether it is listening for noise in areas frequented by whales or watching for illegal fishing boats in marine protected areas, a solar-powered ocean drone developed by a Victoria husband and wife team is starting to prove itself a versatile ocean sentinel.

Open Ocean Robotics, based in Victoria, was among the recipients of funding from the provincial government’s Innovative Clean Energy (ICE) Fund Tuesday. The company is getting $1.75 million to help the company scale up its business.

“This really allows us to scale our technologies to continue commercializing it,” said Julie Angus, CEO and co-founder of the company, which developed solar-powered ocean robotic vessels -- also called uncrewed surface vehicles (USV) -- that can remain at sea for months at a time.

Julie Angus and her husband, Colin Angus, are probably better known as professional adventurers than as entrepreneurs.

Colin Angus’ expeditions have included tracing the Amazon River from source to sea, and travelling around the world by boat and bike. Julie Angus joined him on a portion of the latter adventure, when the couple rowed across the Atlantic Ocean in a wooden boat from Portugal to Costa Rica. The couple also cycled and rowed from Scotland to Syria in 2008. Their adventures have been the subject of a number of books and documentaries.

It was during their Atlantic crossing in a rowboat that the couple first came up with the idea of an autonomous ocean vessel. Nearly five years ago they founded the company, and now employ a team of 33 in Victoria that has built and operates five of the solar-powered robotic vessels.

“One of our big challenges with our oceans is that it’s extremely difficult to monitor,” Julie Angus told BIV News.

To address this problem, the couple developed a small, 12-foot vessel that is solar powered and which can stay at sea for long periods of time without needing to be recharged.

“The longest deployment we’ve done to date has been 25 days continuously and that was monitoring a marine protected area in Hawaiian waters,” Angus said. “But if we have missions that are longer, we can deploy for a longer period of time.”

The company doesn’t make the maritime drones for sale. Rather, they are provided as a service.

“We’re actually a data company,” Angus said. “It’s the data that we sell.”

Solar power allows robotic vessels to stay at sea for months at a time.

The drones are equipped with a camera, and can be outfitted with a variety of sensors that can monitor weather conditions, temperatures, currents, and do ocean floor mapping. While the robotic vessels can be programed to follow specific courses, they are also monitored around the clock and can be piloted remotely.

Angus said a lot of proprietary technology went into the drones’ design. They were designed to be able to function in heavy seas and right themselves in the event they capsize, for example.

“We can go out in really high sea states and we can endure those conditions, whereas a lot of other boats or robots wouldn’t have been able to endure that,” Angus said. “All of our electronics, all of our software, all of our code is also all proprietary.

“We can put on a thermal camera for nighttime operations,” Angus added. “We can tow an acoustic array, which allows us to listen for noises in the ocean. So for example, if you wanted to do marine mammal monitoring, you can listen for marine mammal vocalizations.

“Areas that we are most active is in environmental monitoring and maritime domain awareness. We’ve been involved in illegal fishing enforcement. That was in the States. We did a project in a Hawaiian sanctuary.”

According to company case studies, the marine drones could also be used in the detection of oil spills, monitoring vessel traffic in the Arctic, and for anti-submarine warfare.

Promise to regulate money services businesses follows collapse of major B.C. organized crime investigation

The alleged money laundering case had been one of the biggest organized crime investigations in B.C. history and was featured throughout the BC NDP government’s public inquiry into money laundering

By Bob Mackin | March 28, 2023,

The federal government has pledged to fill a gap in Canada’s anti-money laundering laws, less than a month after a special prosecutor’s report cited existing laws as the reason why charges weren't brought against an alleged Richmond-based money launderer.

But an anti-corruption watchdog says that improving the law on its own won’t be enough.

In Tuesday’s federal budget, the Liberal minority government revealed plans to amend the Criminal Code and Proceeds of Crime (Money Laundering) and Terrorist Financing Act. Key measures include criminalizing unregistered money services businesses and requiring criminal record checks for currency dealers.

Weeks earlier on March 1, special prosecutor Chris Considine published statement that succinctly explained the main reason why he agreed with a B.C. Prosecution Service decision in late 2021 to not charge Paul King Jin for allegedly moving $2.4 million in dirty money during the first half of 2017.

“At present, the act criminalizes the failure to obtain a licence, but does not explicitly criminalize the operation of an unlicensed [money services business],” Considine wrote.

The Jin case had been one of the biggest organized crime investigations in B.C. history and was featured throughout the BC NDP government’s $19 million Cullen Commission public inquiry into money laundering.

Transparency International Canada executive director James Cohen said an amendment is better than a whole new legal structure, but, “as always, it comes down to enforcement.”

“Getting the resources there to the administrative bodies, and to law enforcement, so that we don't just have something nice on paper, but we have the actual capability to enforce it,” Cohen said. “That's really where this all comes down to, the rubber hitting the road.”

Cohen cautioned that the embarrassment of a case falling apart means there is also the risk of going too far in the other direction.

“So we always want to see any new tool used wisely. But, definitely let's plug the gaps that were being exploited.”

The federal government said it also plans to amend the Bank Act, the Insurance Companies Act, the Trust and Loan Companies Act and the Office of the Superintendent of Financial Institutions Act, improve intelligence sharing between law enforcement agencies, the Canada Revenue Agency and the Financial Transactions and Reports Analysis Centre (FINTRAC) and provide whistleblower protection to employees who report information to FINTRAC.

“Language is one thing you always want, you can’t take stern words as proof of something that's going to happen. But it definitely feels as if the ears are open for, and there's political will for, action,” he said. “So hopefully, this is an opportunity where the government's listened to experts and doing a thorough review of what needs to be done.”

Many of the topics in the five-page section of the 270-page annual financial blueprint were already canvassed during B.C.’s Cullen Commission. The federal government already committed in last year’s budget to a public, searchable beneficial ownership registry of federal corporations by the end of 2023. Another round of amendments to the Canada Business Corporations Act is required before that comes to fruition.

Cohen has campaigned for years for such a registry, which would be a key tool in combatting money laundering, tax evasion and terrorist financing in Canada.

Last year’s budget included $2 million for Public Safety Canada to establish a new Canada Financial Crimes Agency. Further details are coming this fall.

Meanwhile, the budget also includes $48.9 million over three years for the RCMP to beef up its investigations of foreign interference and $13.5 million over five years to open a National Counter-Foreign Interference Office under Public Safety Canada. Both moves are in reaction to recent leaks from reports by Canada’s spy agency about Chinese government meddling in Canada’s 2019 and 2021 federal elections and Vancouver’s 2022 civic election.

"There are implications of under the table money being given between intermediaries and politicians or even nominee for political office,” Cohen said.

twitter.com/bobmackin

Infrastructure bank offers $277-million loan to enable Canada’s largest biofuel refinery in Quebec

JEFFREY JONES

PUBLISHED MARCH 27, 2023

Canada Infrastructure Bank is lending $277-million to developers of a Quebec biorefinery, which is being built to convert non-recyclable waste and cast-off wood into low-carbon fuels.

CIB, a Crown corporation, said the financing will support construction of Varennes Carbon Recycling, a $1.2-billion joint venture of Shell PLC

The project is already under construction in the off-island Montreal suburb of Varennes. It will employ waste-to-methanol technology developed by Enerkem, the Canadian cleantech company. It is designed to convert more than 200,000 tonnes of waste annually, including wood waste, into biofuels and commonly used chemicals. The waste products are currently landfilled or burned.

The biorefinery will have a capacity of up to 130 million litres a year when it starts up in 2025, and the developers say it is expected to cut more than 170,000 tonnes of greenhouse gas emissions a year, which is 4.25 million tonnes over the project’s 25-year lifespan.

The facility will include one of the world’s largest plants for producing hydrogen using non-fossil-fuel sources: a 90-megawatt electrolyzer, which splits water into hydrogen and oxygen. The developer said last week it had selected Indiana-based Accelera, a unit of Cummins Inc.

CMI-N

+1.11%

, to supply the equipment.

The CIB loan is on top of $390-million in funding for the project from the Quebec government and $450-million from the private sector. There is also additional federal and provincial funding, CIB spokesman Ross Marowits said.

Ottawa founded CIB as a $35-billion corporation in 2017 to invest in large projects and encourage institutional investors, such as pension funds and private asset managers, to boost their investments in Canadian infrastructure. In 2020, it hired former Infrastructure Ontario head Ehren Cory as chief executive officer.

It has been criticized in the years since its inception. In May, the House of Commons transport committee issued a report that recommended the bank be abolished over concern among non-Liberal members related to its efficiency. It noted several witnesses expressed concern during committee hearings about CIB that projects were not flowing as quickly as expected.

However, the bank’s role was expanded in the 2022 federal budget “to invest in private-sector-led infrastructure projects that will accelerate Canada’s transition to a low-carbon economy.”

In the past year, it has invested in a host of projects, including $970-million for the country’s first small nuclear reactor in Ontario; $500-million to triple the number of electric-vehicle charging stations in Canada; and $800-million for a First Nations-owned hydro project in Yukon.

“The Canada Infrastructure Bank is pleased to have acted quickly on its expanded role to support transformational efforts to accelerate Canada’s transition to a low-carbon economy,” Mr. Cory said in a statement announcing the financing for the Varennes project.

“Converting waste and residual biomass into clean hydrogen is the CIB’s latest effort helping the country reach net zero by 2050 and represents its first investment in low-carbon fuels.”

The developers said the project will employ 500 people during construction and 100 when it is operational.

N.B. residents suffering from mystery brain disease call for fresh investigations

The Canadian Press
Updated March 28, 2023

Sarah Nesbitt turned 40 on Sunday but says she is not sure if she will be around to celebrate many more birthdays.

Nesbitt, a resident of Moncton, N.B., said she began experiencing symptoms of a neurological disorder of unknown cause in the summer of 2020.

She is part of a group of New Brunswick patients who say they are suffering from a mystery brain illness. But the provincial government maintains that there is no new neurological disorder and that studies have shown that the patients who are sick are likely suffering from known diseases.

On Tuesday, Nesbitt joined a group of patients and their families who have called on the provincial government to investigate the link between their symptoms and environmental toxins -- particularly the popular weed killer glyphosate. The news conference was organized by the Green Party of New Brunswick.

Their call for new investigations came after their doctor, Dr. Alier Marrero, asked federal and provincial health authorities in January to look into the link between their symptoms and the herbicide.

"I had a lot of different symptoms that all piled up to realize, 'OK, this is something going on,"' Nesbitt said. "I went to my doctor in November of 2020. And he couldn't find anything."

A slate of tests later, she said her doctor thought she had multiple sclerosis.

"For almost two years, I thought that's what I had."

Nesbitt was referred to Marrero last year, who tested for and ruled out diseases such as cancer, epilepsy and multiple sclerosis, she said. But further tests have shown that she has high levels of glyphosate and other chemicals in her system.

Health Canada said on its website that glyphosate is the most widely used herbicide in the country and figures prominently in the agricultural industry. Products containing glyphosate are used to control weeds, including toxic plants such as poison ivy.

Marrero said in a letter dated Jan. 30 to Dr. Theresa Tam, Canada's chief public health officer, and Dr. Yves Leger, New Brunswick's chief medical officer of health, that he has been working with about 147 patients experiencing symptoms such as rapidly progressing dementia, muscle spasms, atrophy and other complications.

Marrero said that cases have also been reported in Alberta, Quebec and Nova Scotia.

"I am particularly concerned about the increase in numbers of young-onset and early-onset neurological syndrome," he said in the letter.

"I now call to your attention one of the major hypotheses extensively discussed during previous meetings during the years with national and international experts, including possible environmental toxins."

Tests from patients in Nova Scotia show high amounts of glyphosate and other compounds from that family, he said.

"On behalf of our patients and families, I request your support to further and detailed testing of patients and environments for these and other toxins."

New Brunswick health authorities concluded in a February 2022 report that "there is no evidence of a cluster with a neurological syndrome of unknown cause."

They said that the cluster of disease had been subject to "many theories" that were based on "speculation, uncorroborated opinions and the absence of a thorough analysis of epidemiological and clinical information."

The province said a review of 48 cases of patients suffering from a neurological syndrome of unknown cause found that the patients didn't have symptoms in common or a shared illness.

On Tuesday, New Brunswick Health Minister Bruce Fitch told reporters he was briefed about Marrero's letter.

"Public health is drafting a response," he said. "If they require more information, they will go back to the doctor in question and get that information and then proceed from there."

Fitch said he recognizes that it's difficult for families and patients when they don't get the answers they want.

Nesbitt said she is heartbroken that she had to give up her cabin and her dream of living in a rural area because she suffers from seizures, tremors and moments where she doesn't know where she is, "almost like dementia."

"The sad part is I'm going to rapidly keep on declining."

This report by The Canadian Press was first published March 28, 2023.

Family members and patients of those suffering from a mystery neurological disease gather at hotel in Fredericton, Tuesday, March 28. The group is calling for an investigation into potential environmental causes afflicting New Brunswick residents for more than two years. THE CANADIAN PRESS/Hina Alam

UK report: Black children are 6 times more likely to be frisked by police

March 27, 2023

LONDON –

Black children in England and Wales were six times more likely to be strip-searched by police, according to a report published Monday that found children were left uncared for by those sworn to protect them.

Children’s Commissioner Rachel de Souza found that nearly 3,000 children were strip-searched between 2018 and mid-2022, with more than half of the searches taking place without an appropriate adult present.

The investigation was launched after a 15-year-old black girl suspected of having marijuana was strip-searched at a London school in 2020 by two officers without another adult present. The girl, identified as “Girl Q”, was menstruating and no drugs were found. An earlier report said racism was a likely factor for the humiliating search.

“The courage of a girl to speak out about something traumatic that happened to her” led to the report that found a “widespread breach” of assurances and evidence of a “deeply troubling practice,” de Souza said.

The findings follow a scathing report last week that found the public had lost trust in London’s Metropolitan Police and that the force was plagued by institutional racism, misogyny and homophobia and did not do enough to remove bad officers. . That report was commissioned after an officer raped and killed a young woman.

The new report said children as young as 8 were being searched in places that were often inappropriate, such as amusement parks or vehicles, and sometimes even in public view. In some cases, at least one officer present was of a different gender than the child being searched.

More than a third of the 2,847 searches were for black children, making them six times more likely to be searched based on population numbers, according to the report. White children were about half as likely to be registered.

De Souza called the disparity “totally unacceptable.”

The Runnymede Trust, a think tank on racial equality, said the findings were “even harder to swallow” than the report on the Metropolitan Police, which has faced critical reporting in the past. The trust called for removing police from schools and revoking their authority to strip children.

“Officers often cannot justify the need for strip searches, nor can they report the protection impact on the child in question,” the group said. “Quite the contrary. It also confirms that our police crisis is not limited to London, it is national.”

De Souza said strip searches may be necessary, but there must be “robust safeguards” in place to protect children.

Among his 17 recommendations, he called on the Home Office to review search law and policy and make specific changes to police and criminal evidence codes.

A spokesman said the Home Office takes the protection of children very seriously.

“Strip search is one of the most intrusive powers available to police,” the spokesman said. “No one should be strip-searched for reasons of race or ethnicity and there are safeguards in place to prevent this.”

De Souza also called on the National Police Chiefs Council to publish a plan to reform child registries.

Police Chief Craig Guildford said the council welcomed the scrutiny and would consider the findings.

Ford government cuts medical funding for the uninsured, and a doctor finds it ‘shocking’

March 26, 2023

The Ontario government is canceling a pandemic-era plan to pay for medical and hospital costs for the uninsured, a move some critics say will leave residents vulnerable without necessary medical care.

Doug Ford’s provincial government introduced the Hospital and Medical Services for the Uninsured program in March 2020. Under the plan, hospitals and doctors could bill the government for “medically necessary” treatment provided to patients without OHIP coverage.

The program was programmed for COVID, but was never specific to COVID; all medically necessary care was eligible for reimbursement.

Advocates dealing with the undocumented and homeless say it closed a crucial and long-standing gap in Ontario’s health coverage. Closing it now, they argue, is “devastatingly cruel.”

“We are now talking about a healthcare system in Ontario where homeless and recently arrived permanent residents, temporary workers and international students are at risk of paying significant medical bills and debt,” said Dr. Andrew Boozary, M.D. primary care and executive director of population. health and social medicine on the University of Toronto Health Network on Twitter. “The mirage of universality is over.”

Ontario hospitals were informed of the upcoming change, effective April 1, in a memo from the Ministry of Health. (The version sent to the Star is undated.) Many doctors only found out on Friday night when the Ontario Medical Association sent a note to its members.

“That was a shocking email Friday night,” Boozary said.

The ministry memo described the program as an effort “to help reduce the spread of COVID-19 by allowing uninsured people in Ontario, including those without Ontario Health Insurance Plan (OHIP) or other health insurance health, access medically necessary medical and hospital services. .”

But all that, says the government, is no longer necessary.

“Ontario continues to scale back COVID-19 response measures that are no longer appropriate or necessary,” the memo said. “As part of this, please note that the funding (of uninsured hospital and medical services) announced in … March 2020 will end on March 31, 2023.”

According to the OMA, the total cost of the program was about $15 million over three years. That dropped to about 400,000 individual patient services provided by 7,000 Ontario doctors as of March 2020.

Many of those caught by the program may actually have been OHIP-eligible, according to OMA president Dr. Rose Zacharias, but for whatever reason have never been able to enroll or keep their information up to date with the government.

“We know that a lot of people are going without coverage and don’t have easy access to coverage,” he said. “Anyone who has a language barrier or a mobility issue or is homeless, or even a migrant worker, these are people who have particular stressors and barriers that get in the way of getting their OHIP card.”

There are still programs available in Ontario to help those who are not covered by OHIP. But for Boozary, they are not complete enough.

“When you look at the elements here around health equity and health economics, this is scary on both fronts,” he said. “We knew about these health care gaps and who has had worse health outcomes for many decades before the pandemic… We have seen the most obvious lessons of the obstacles and barriers that exist for too many people. And now withdrawing the (program) and imposing the (barriers) again is a very cruel and reckless health policy.”

In a statement, the Ministry of Health said that “with lower rates of COVID-19 and the end of public health restrictions, the province is reducing its pandemic response measures to focus resources on service delivery. What Ontarians Need Most…

“As was the case before the pandemic, effective April 1, those who are not eligible for the Ontario Health Insurance Plan (OHIP) and do not have any other form of health insurance coverage are encouraged to speak with the treating hospital and/or physician to develop plans for future care.”

OMA’s note was sent out to its approximately 44,000 members just before 7pm on Friday night and quickly began to spread online. Maggie Keresteci, executive director of the Canadian Association for Health Services and Policy Research, call it “a horrible affront to the values inherent in Canada’s universal healthcare system” on Twitter.

In the note, the OMA said it had asked the ministry to temporarily extend the program. The organization added that the WCO had not been meaningfully consulted about the change.

“This was definitely a band-aid during the pandemic, but there is no good reason not to continue. Works. It’s important,” said Marit Stiles, leader of the Ontario NDP. “It’s not a humane system if people who are sick don’t get the care they need.”

The New Democrats originally charged in a statement that eliminating the program would mean refugees from the Ukraine would no longer have access to health care in Ontario. Hannah Jensen, press secretary to Health Minister Sylvia Jones, insists that is not the case.

“Perhaps instead of making partisan attacks, (the) NDP should pay attention to the facts,” he said in an email. Last April, the government amended the Health Insurance Act to extend OHIP eligibility to people who have been granted emergency authorization to enter and remain in Canada for humanitarian reasons, he said. That should include Ukrainians fleeing the war, he said.

But Stiles said that doesn’t mean everyone who needs health care in Ontario will get it. “A lot of people fall through the cracks. They are not recognizing it,” he said.

“There are many, many people who end up in our communities who are undocumented… And we really can’t afford to make sure they don’t get the care they need when they need it.”

Gender-affirming care bans expanding, access being cut: U.S. laws now targeting transgender adults

Alexandra Mae Jones
CTVNews.ca writer
Published March 27, 2023

Within the last few years, hundreds of bills have been introduced in the U.S. with the aim of stripping away, restricting, or even criminalizing gender-affirming care for transgender youth under 18 years of age, with proponents arguing that minors are too young to make these medical decisions.

But in 2023, legislative attempts to strip trans people of health-care options have expanded their reach to a new age group: adults.

In the past three months, at least five U.S. states have proposed bills that would limit gender-affirming care for adults either through direct bans or by barring medical facilities and Medicaid from covering this care.

Two states — South Carolina and Texas — are considering bills that would ban all gender-affirming care for those under the age of 26, modelled after an Oklahoma bill introduced in January, though the age in that bill has since been lowered to 18 after backlash. Kansas is considering banning gender-affirming care for people up to age 21.

“This is going against every idea of freedom and opportunity in this country,” Vivian Topping, director of advocacy and civic engagement at the Equality Federation, told CTVNews.ca in a phone interview.

Gender-affirming care is medically necessary, evidence-based care that allows trans and gender diverse people to transition to the gender that matches their lived experience, according to the leading medical organizations in the U.S., including the American Medical Association and the American Academy of Pediatrics, which have condemned legislative attacks on this care. Read more: As anti-trans health bills surge in U.S., some Canadian experts are expressing concern

Arguments in favour of banning care for trans people are largely made by conservative lawmakers, who believe they are protecting children and that minors cannot consent to medical care that could include irreversible changes.

Last year, as Alabama governor Kay Ivey signed a gender-affirming care ban for minors, in 2022 saying she said, “We’re going to go by how God made us: if the Good Lord made you a boy, you’re a boy, and if he made you a girl, you’re a girl. It’s simple.”

Opponents of the legislation say that banning care for trans people at any age is dangerous, but suggesting trans adults shouldn’t be allowed to make their own decisions about their bodies is a jump in rhetoric.

“We expect that folks have the right to live our lives how we see fit as long as we aren't hurting anybody,” Topping said. “Deciding what people can do with their bodies … try(ing) to obfuscate as much as we can about access to gender-affirming care, it’s just a continued attempt to erase and attack people who are marginalized.”

It’s the latest step in a strategy that advocates say began with sporadic bills banning trans people from using bathrooms or playing on sports teams that align with their gender identity, and has now snowballed into hundreds of bills ranging from anti-trans health-care bans to those barring any mention of LGBTQ2S+ identities in school curriculums, to bills threatening to separate trans children from affirming parents.

“We have to understand the discussion around trans youth as a vector into the wider conversation and the goal to disrupt and limit trans rights overall,” Imara Jones told CTVNews.ca in a phone interview. Jones is the founder and CEO of TransLashMedia, runs a podcast about trans lives and topics in the U.S., and has produced a related docuseries.

“The expansion of these bills into adults … makes total sense when you understand that that was the strategy all along.”

Some of the most vocal proponents of bans on gender-affirming care have openly stated that the focus on youth was to open the door to further attacks on trans rights and health care. Terry Schilling, president of the conservative American Principles Project, which lobbies and runs ads for Republican candidates, told the New York Times in January that their ultimate goal was to eliminate all transition care, and that focusing on minors was just “going where the consensus was.”

The American Civil Liberties Union is currently tracking 431 anti-LGBTQ2S+ bills that are on the table for the 2023 legislative session in the U.S.

More than 115 of those bills pertain directly to health care for trans people -- largely seeking to ban or restrict access to gender-affirming care.

Gender-affirming care can include puberty blockers, hormone treatments and surgical interventions, depending on the age of the patient and their individual goals. Studies have shown that depression, anxiety and suicidality are significantly reduced in trans people when they are able to access gender-affirming care.

Since the start of 2023, seven states have prohibited gender-affirming care for those under 18 years of age through bills or medical board rules: Mississippi, South Dakota, Tennessee, Utah, Florida, Georgia and Iowa.

No laws that include adults in an outright ban on gender-affirming care have been passed at this stage.

Under Texas' and South Carolina’s proposed bans, it would be a felony for a health-care provider to even refer a patient under the age of 26 for gender-affirming care. Health-care providers could be criminally prosecuted for providing this care up to 40 years after the patient underwent treatment.

In practice, this would mean that while a cisgender 23-year-old could get a nose job or a breast augmentation without legal repercussions, a transgender 23-year-old in the same state would be barred from accessing similar procedures purely due to them being related to a gender transition.

“It is all just discrimination,” Topping said.

Oklahoma Sen. David Bullard stated in a January press release that 26 was chosen as the initial age cutoff for the state's gender-affirming care ban “to account for scientific findings that the brain does not fully develop and mature until the mid- to late 20s”. No other laws in the U.S. use this theory, which some experts say is often misinterpreted, to rescind health care from legal adults. Oklahoma lowered the age cutoff to 18 after a wave of protests in February at the Oklahoma Capitol, according to the Washington Examiner.

Topping is concerned that even if bills banning health care for adults don’t pass into law, their existence could make health-care bans for minors seem less extreme.

“It's them trying … to make the idea of banning best-practice medical care from transgender youth a normal idea,” she said. “And they're doing that by introducing the bigger, broader ban (that) makes their bans for youth seem moderate and normal.

“The important thing to remember is that no matter what age range these bills are targeting, they are attacking best-practice medical care, and they are unnecessary.”
ELIMINATING CARE BY ELIMINATING COVERAGE

No less dangerous to trans people, according to advocates, is the sharp rise in bills seeking to limit the capability of adults to access gender-affirming care by removing funding and coverage.

The Texas Senate has introduced a bill that would ban public funding for all gender-affirming care, ban some health plans including Medicaid from covering any gender-affirming care, and make a health benefit plan issuer liable for a patients’ gender-affirming care in perpetuity.

Essentially, it would not only vastly limit health-care coverage, but would spook potential providers away from offering gender-affirming care by making them liable for decades, and making it impossible to receive malpractice insurance.

Similar bills are being considered in other states.

A month ago, while discussing a separate Tennessee bill banning gender-affirming care for minors, Republican State Sen. Jack Johnson said that he wanted to “put children first … and let them make those decisions as adults.”

But Johnson is also backing HB1215, which would prohibit Tennessee’s Medicaid program from covering gender-affirming care, shutting off access to trans adults who cannot afford to access private care.

A bill being considered in Florida includes a ban on gender-affirming care for youth, would prevent birth certificates being updated to reflect transition, allows courts to take custody away from a parent who affirms their trans child, and bans both public funds and private insurance being used for gender-affirming care for adults.

Florida is also currently considering Bill SB952, the “Reverse Woke Act,” which would place excessive liability on employers if they cover gender-affirming care.

An Oklahoma bill called HB2177, which passed in the Oklahoma House at the end of February and now is in the Oklahoma Senate, bans facilities that receive public funds from allowing staff or facilities to be used for the provision of gender-affirming care “on any minor or adult.”

This would make it nearly impossible to find a provider, as all hospital systems receive public funds.

Oklahoma already limited access in 2022 when it withheld millions in COVID-19 relief funds from the University of Oklahoma medical system until the system agreed to stop providing gender-affirming care.

Others who've backed similar measures include former U.S. president Donald Trump, who promised in a January video that if he was re-elected, he would punish doctors who provide gender-affirming care to minors and would create “a new credentialing body for teachers” in order to “promote positive education about the nuclear family, the roles of mothers and fathers and celebrating, rather than erasing, the things that make men and women different.”

He also added that he would prohibit any federal agency from “promot(ing) the concept of sex and gender transition at any age” — another sign that the anti-trans crusade is expanding far beyond children.

Eliminating care by severing access is straight out of the anti-abortion playbook, advocates including Topping say.

“What they're doing is saying, ‘OK, fine, you won't let us block, ban it completely, we will just make it incredibly hard to access,’” Topping said. “They've done the same thing when it comes to abortion. And the same through line here is that bodily autonomy.”
TRANS REFUGE

Not every state is looking to limit access to care. Many have also increased protections for trans people, or passed bills or executive orders designating them as “trans refuge” states for families and individuals fleeing anti-trans laws elsewhere.

“We now have a situation in the United States where we have political refugees in our country,” Jones said. “I personally know families that have been planning for a year what they're going to do if a bill passes in their state, I know that there are groups of parents as well who have trans kids who cannot afford to leave their states, who are keeping the identity of their children a secret in order to protect them in various places in the United States where they know that there are authorities who wish to do them harm because of their gender identity.” Read more: Popular e-petition calling for Canada to allow trans people to claim asylum, but that right is 'already established'

U.S. President Joe Biden denounced Florida legislation targeting trans youth as “close to sinful,” and “cruel” in an appearance on the Daily Show last week, and several senates have seen filibusters recently attempting to protest anti-trans health-care bills.

“I don't think most people are supportive of these bills,” Jones said.

Topping agreed, saying she thinks the vast majority of “folks don't want to ban care that will help someone be the best version of themselves.”

Advocates believe that Texas and South Carolina’s bills banning gender-affirming care for those under the age of 26 are unlikely to pass, but that the escalation is far from over.

“Trans folks are going to continue to speak up,” Topping said.

“At the end of the day, trans folks are your family, they’re your friends, they’re your neighbours and co-workers. And folks just need to remember that.”

In this file photo, demonstrators gather on the steps to the State Capitol to speak against transgender-related legislation bills being considered in the Texas Senate and Texas House, May 20, 2021 in Austin, Texas. New legislation introduced in 2023 in states including Texas are now including adults in health-care bans, either through direct bans or by limiting access to medical coverage. (AP Photo/Eric Gay, File)

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