How Canada’s new credit card surcharge will affect consumers and businesses

Visa and Mastercard both recently agreed to remove their no-surcharge rule, leaving businesses free to pass these fees along to customers. (Shutterstock)


THE CONVERSATION
Published: November 15, 2022

Canada has some of the highest interchange fees in the world. Interchange fees are the fees businesses pay each time their customers pay by credit card.

The average interchange fee in Canada is about 1.5 per cent of the transaction value, with fees typically falling between one and 2.5 per cent. The makeup of these fees can be complex, but they generally end up with the issuing bank. Credit card networks receive a much smaller proportion of the transaction.

Up until last month, credit card networks did not allow businesses to pass these fees to customers. That recently changed with the settlement of a class-action lawsuit that alleged certain banks and credit card networks conspired to set high interchange fees and prevent businesses from adding surcharges or refusing high-cost cards.

Several banks, along with Visa and Mastercard, admitted no fault but agreed to contribute to a $188 million settlement fund that will be dispersed to Canadian businesses that have accepted Visa or Mastercard since 2001.

In response to the lawsuit, Visa and Mastercard agreed to remove their no-surcharge rule, leaving businesses free to pass the interchange fee to their customers. For example, on a $50 purchase, a consumer could pay a credit card surcharge of up to $1.25.

So, what does this mean for Canadian consumers and businesses? Now that businesses are allowed to, will they add a surcharge to cover credit card fees or will they continue to absorb the cost? What should businesses know about consumers’ reactions to surcharges? And what are the costs and benefits of credit card surcharges for consumers?

Predicting customer reactions

To help businesses predict how consumers will react to credit card surcharges, we can turn to behavioural economics, which combines elements from economics and psychology to understand how and why people behave as they do in the marketplace.

Behavioural economics has long noted that people show strong diminishing reactions to both losses and gains. This means, for example, that the pain of a $10 loss is much greater than a tenth of the pain of a $100 loss. A surcharge will almost certainly enhance the “pain of paying” compared to including the fee in the overall price.

No one blames businesses for adding tax, but there is a strong possibility customers will blame businesses if they add credit card surcharges. (Shutterstock)

As a teenager working in our family furniture business in the U.K., I recall the time a customer angrily threw his credit card at my mother after she informed him of our credit card surcharge. But the psychology of losses and gains doesn’t provide the whole picture here — part of the reason the customer was so angry was because he blamed us for the surcharge.

This is a reaction that businesses should rightly fear. Blame can dramatically enhance perceptions of unfairness. No one blames businesses for adding tax, but there is a strong possibility customers will blame businesses if they add credit card surcharges.

This means consumers are unlikely to support credit card surcharges, especially if they are simply added to existing prices. In fact, the U.K. banned credit card surcharges in 2018 on the basis that surcharges were simply a “rip-off fee.”

Suggestions for businesses

Although businesses can make an educated guess about how customers will react to surcharges, it is difficult to fully predict. To play it safe, most businesses in Canada will probably refrain from adding a surcharge for credit card use for the time being.

According to a Canadian Federation of Independent Business survey, most businesses either don’t plan to add the surcharge (15 per cent), aren’t sure whether they should (40 per cent) or will simply follow what others in their industry do (26 per cent). About one in five businesses (19 per cent) said they do intend to use the surcharge.

For businesses that are contemplating using the surcharge, there are better ways to implement it than simply tacking it on to existing prices. One approach involves reframing the situation for consumers by offering a discount for cash or debit, instead of adding a surcharge for credit cards.

For the same reason a separate credit card surcharge enhances the “pain of paying,” adding a discount — typically perceived as a small, separate gain — will have an outsized positive impact on customers’ reactions.

Businesses could offer customers discounts for paying with cash or debit, instead of adding a surcharge for credit cards. (Shutterstock)

Although prices could be adjusted so this process ends up being objectively identical to an added credit card surcharge, a cash discount is also much less likely than a surcharge to be considered unfair by credit card users.

A second option is for businesses to reduce their prices before adding the surcharge, making sure customers are aware of the reduction. As long as customers perceive that a business has made efforts to lower prices first, a credit card surcharge is more likely to be seen as a charge imposed on the business, rather than an attempt by the business to boost profits.

Fees improve decision-making

If implemented appropriately, surcharges also have the potential to improve consumer decision-making by allowing consumers to make better decisions about their credit card use.

Credit cards provide benefits for consumers at a cost. In exchange for convenience, credit, rewards, and other perks, customers pay annual fees, interest, and — embedded in prices — interchange fees.

Currently, interchange fees, which are substantial, are hidden from consumers, meaning consumers cannot fully account for the costs of their decision. Not only that, cash and debit card-paying customers cannot avoid interchange fees when businesses are forced to include them in prices despite receiving none of the benefits.

Credit card surcharges, then, would allow consumers to avoid the cost if they don’t perceive the benefits to be sufficient. In other words, surcharges or cash discounts could actually help consumers make better decisions by allowing them to appropriately account for the costs of credit card use.

Author

Laurence Ashworth
Professor, Marketing, Queen's University, Ontario

Smart buildings: What happens to our free will when tech makes choices for us?

A so-called smart building. What will become of our free will when choices are made for us by technology embedded in the building? (Shutterstock)


THE CONVERSATION
Published: December 20, 2022 

Smart buildings, which are central to the concept of smart cities, are a new generation of buildings in which technological devices, such as sensors, are embedded in the structure of the buildings themselves. Smart buildings promise to personalize the experiences of their occupants by using real-time feedback mechanisms and forward-looking management of interactions between humans and the built environment.

This personalization includes continuous monitoring of the activities of occupants and the use of sophisticated profiling models. While these issues spark concerns about privacy, this is a matter of not seeing the forest for the trees. The questions raised by the massive arrival of digital technologies in our living spaces go far beyond this.

As a professor of real estate at ESG-UQAM, I specialize in innovations applied to the real estate sector. My research focuses on smart commercial buildings, for which I am developing a conceptual framework and innovative tools to enable in-depth analysis in the context of smart cities.

Read more: Get ready for the invasion of smart building technologies following COVID-19

“Choices” proposed, or imposed

Thanks to ubiquitous computing, interactions between building occupants and nested technology are quiet and invisible. As a result, the occupants’ attention is never drawn to the massive presence of computers operating permanently in the background.

Personalization allows us, for example, to have the ideal temperature and brightness in our workspace at all times. This would be idyllic if this personalization did not come at a cost to the occupants, namely their freedom of action and, more fundamentally, their free will.

As technology increasingly mediates our experiences in the built environment, choices will be offered to us, or even imposed on us, based on the profile the building’s technology device models have created of us in function of the goals, mercantile or otherwise, of those who control them (such as technology companies).

Having the ability to decide either to do something or not, and to act accordingly, is a basic definition of freedom. Smart buildings challenge this freedom by interfering with our ability to act, and more fundamentally, with our ability to decide for ourselves. Is freedom of action even possible for the occupants of a building where interactions between humans and their built environment are produced using algorithms that are never neutral?
Satisfied… but not free

The 17th-century English philosopher John Locke’s famous analogy of the locked room sheds light on this question. Suppose a sleeping man is transported to a room where, upon awakening, he is engaged in activities that bring him great satisfaction, such as chatting with a long-lost friend.

Unbeknown to him, the door of the room is locked. Thus, he cannot leave the room if he wants to. He is therefore not free, even though he voluntarily remains in the room and gets extreme satisfaction from what he is doing there.

Locke’s analysis reflects the situation of smart building occupants. They benefit from the personalization of their experiences from which they derive great satisfaction. However, once they enter a space, technology controls their interactions outside of their awareness. While they may want to stay in the building to enjoy personalized experiences, they are not free. Smart buildings are a high-tech version of Locke’s locked room.

There’s nothing new about the problem. Already in the 19th century, in Notes from the Underground the Russian Fyodor Dostoyevsky identifies the challenges that computational logic poses to free will.

You will scream at me … that no one is touching my free will, that all they are concerned with is that my will should of itself, of its own free will, coincide with my own normal interests, with the laws of nature and arithmetic. Good heavens, gentlemen, what sort of free will is left when we come to tabulation and arithmetic…?
Deciding on the role of technology in our living spaces

Indeed, what can be said about our free will when choices are made for us by technology?

An action is something we do actively, as opposed to things that happen to us in a passive way. Also, the active will to perform an action differs from the passive desire for an act to be done.

While algorithms are concerned with the predictability of human behaviour, things happen passively to the occupants of smart buildings. Their role is limited to receiving stimuli whilst the invisibility of the technology maintains their illusion that they have sole control over their actions.

These human-built environment interactions erode our will to take action, replacing it with desires shaped and calibrated by models over which we have no control. By denying the free will of their occupants, smart buildings challenge the right to action that the German philosopher Hannah Arendt defines as one of the most fundamental rights of humans, the one that differentiates us from animals.

So, should we prohibit, or at least regulate, the technology embedded in smart buildings?

The answer to this question takes us back to the very origins of Western democracy. Long before the Big Tech companies (GAFAM), the Greek Socrates (who died in 399 BC) was concerned with the nature of an ideal city. In Plato’s The Republic, Socrates explains that the difference between a city where citizens have all the luxuries and a city without luxuries, which he calls “a city fit for pigs,” is the ability of the residents of the former to choose their way of life, unlike the residents of the latter where this choice is simply not possible.

Smart cities are the digital version of the luxury cities of antiquity. However, without granting their residents the ability to make informed choices about technology, they provide satisfaction at the expense of their rights.

To avoid building an entire environment according to the philosophy of pigs, smart building occupants should retain the legally defined right to decide for themselves the role of technology in their living spaces. Only then can their freedom be respected.

Author 

Patrick Lecomte
Professor, Real Estate, Université du Québec à Montréal (UQAM)

Gridiron is a science fiction novel written by British author Philip Kerr. It is a story about a highly technical building (nicknamed The Gridiron), which becomes self-aware and tries to kill everyone inside, confusing real life with a video game.

Let’s call the Nova Scotia mass shooting what it is: White male terrorism

THE CONVERSATION

Published: April 24, 2020

While the mainstream media has been quick to situate the deadly recent events that unfolded in Nova Scotia within the context of Canadian mass murders, no one seems to be drawing attention to the most prominent link connecting Canadian mass killings: all of the accused perpetrators have been men, and most of them have been white.

White men were responsible for or currently face charges for the mass murders at the École Polytechnique in 1989, Mayerthorpe in 2005, Moncton in 2014, Calgary in 2014, Québec City in 2017, Toronto in 2018 (a van attack) and Fredericton in 2019. Those in Vernon, B.C., in 1996, Edmonton in 2014, and Toronto in 2018 (the shooting in the city’s Greektown neighbourhood) were perpetrated by racialized men.

Given this explicitly gendered pattern of perpetration, why don’t we talk about these mass murders as male terrorism?

When speaking about the mass murder during his regular COVID-19 update on April 19, Prime Minister Justin Trudeau referred to the violence in Nova Scotia as “senseless” and proclaimed that “violence of any kind has no place in Canada.”

A woman pays her respects at a roadblock in Portapique, N.S. on April 22. RCMP say at least 22 people are dead after a man went on a murder rampage in several Nova Scotia communities. 

THE CANADIAN PRESS/Andrew Vaughan

As a survivor of multiple forms of violence with more than 20 years of researching and responding to gender-based violence in my academic and professional career, I beg to differ. Male-perpetrated violence underpins Canadian society and is by no means “senseless” — instead, it serves to reinforce patriarchy and male social domination. The mass shooting in Nova Scotia reportedly began with domestic abuse incident against a woman.

As long as we are unwilling to name, acknowledge and address male violence, the lives and well-being of people in Canada, especially women and children, are at risk.
The normalization of male violence

Regardless of specific motive, the fact that Canadian mass murders have been exclusively committed by men makes this violence explicitly gendered. This is male violence and, as such, must be linked to other forms of male violence and understood as gender-based violence.

While the term gender-based violence primarily implies violence on the basis of gender identity, gender presentation or perceived gender, it also encompasses patriarchy and violence perpetrated by men. In other words, regardless of specific motive, we need to consider these mass murders in relation to patriarchy and male social domination in Canada.

People hold photos of the victims of the mosque shooting in Québec City that left six people dead during a vigil in January 2020 marking the third anniversary of the carnage.

 THE CANADIAN PRESS/Ryan Remiorz

Patriarchy establishes what we refer to as “hegemonic masculinity” — the dominant social definition of what it means to be male, and violence is an essential part of this. In fact, violence plays a fundamental role in securing male social dominance: because patriarchal domination is predicated on unfounded claims to male supremacy, violence serves to reinforce this illegitimate claim to social supremacy by force

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Toys guns are popular toys for boys. (Markus Spiske/Unsplash)

To be a dominant socially acceptable man, then, involves the use of violence and aggression and, from birth, males are socialized into this violent hegemonic masculinity. For example, in addition to action figures of superheroes who regularly use violence to “save” the world, my six-year-old son received two toy guns for Christmas last year.

Patriarchy normalizes this violence by ignoring, exonerating and enshrining the right of men to commit violence. Think of all the times you’ve heard someone dismiss male violence with the phrase “boys will be boys.” This phrase is a tacit acceptance of male violence and the right of men to be violent.

The phrasing is frequently echoed in court cases of young men who have committed sexual assault or murder or both. The perpetrators are portrayed as good boys who simply took things too far. Courts, for their part, are notoriously lenient on male perpetrators of violence, reinforcing the right of men to do violence.

Mass murder is white male terrorism

In addition to being an explicitly gendered crime, mass murder in Canada is also explicitly racialized. The perpetrators are overwhelming white males and we must consider how race, and particularly whiteness and white privilege, operate here.

While hegemonic masculinity and the right to use violence is open to all males, race and racism shape that tendency. To establish white male social supremacy, racist discourses portray all racialized males as inherently violent and a perceived threat, justifying white male violence.

This principle is exemplified in policing and the greater likelihood of BIPOC males to be killed by police. While violence is used to pathologize racialized males and justify social domination and violence perpetrated against them, the violence of white males is justified, excused and erased.

So why are white men more likely to commit mass murder? American masculinities scholar Michael Kimmel suggests that social justice efforts aimed at dismantling the social hierarchies that white men sit atop are creating “angry white men” with “aggrieved entitlement.”

He says: “If you feel entitled and you have not got what you expected, that is a recipe for humiliation.”

Three women hug each other after laying flowers in front of École Polytechnique at Université de Montréal three days after a mass shooting that left 14 women dead. Until the recent Nova Scotia mass shooting, it had been the worst in Canadian history. 

THE CANADIAN PRESS/Shaney Komulainen

As hegemonic masculinity makes crystal clear, if your existence is being threatened you have the right — indeed, in the minds of some mass killers, the responsibility — to use violence and set things right.

Addressing mass murder means taking a hard look at white masculinity and the normalization of violence. It requires that we refuse to dismiss mass murderers as mentally defective or a few “bad apples.” Instead, we must understand that the entire system of white masculinity is rotten. Because until we do, aggrieved white men will continue to commit mass murder and we will all continue to pay the price.

Author

Robyn Bourgeois
Assistant Professor, Centre for Women's and Gender Studies, Brock University

I research mass shootings, but I never believed one would happen in my own condo in Vaughan, Ont.

Police cones and tape are seen outside of a condominium building the day after a shooting in Vaughan, Ont. THE CANADIAN PRESS/Arlyn McAdorey

THE CONVERSATION
Published: December 21, 2022 

On the evening of Dec. 18, five people were killed in a mass shooting at a large condominium in the community of Vaughan, Ont., located just north of Toronto. A 73-year-old resident of the building — a man who had a long-standing dispute with the resident-based condominium governing board — opened fire on condo board members and others.

As an associate professor of disaster and emergency management, I have analyzed other Canadian mass shootings like the 2018 incident on crowded Danforth Ave. in Toronto and the 2020 shooting spree in Nova Scotia that left 22 people dead.

But this mass shooting was different for me. That’s because I live in the building.
York Regional Police respond to a mass shooting in Vaughan, Ont. on Dec. 18.

 (J. Rozdilsky), Author provided

I now face the cognitive dissonance of what it means to have both professional and personal survival perspectives of first-hand exposure to a mass shooting.

An otherwise normal Sunday evening

The night of Dec. 18 started off as an otherwise normal Sunday evening. But then I heard a fire alarm and, like many other residents of Bellaria Tower, exited the building. At the time, I had no knowledge of being in the vicinity of an active shooter.

I took the stairs down to the lobby, made my way to the garage and still thinking this was likely a false fire alarm, which usually meant waiting outside for a while, I left the complex to run some errands.

When I returned about two hours later, the level of police response on the scene — along with a large media presence — made it clear this was not a typical fire evacuation. I arrived as heavily armed tactical officers were making sure it was safe to return into the building.

We later learned the rampage ended in the hallways of the building when the shooter was killed by a police officer.

Re-entering a crime scene

In the aftermath, residents gathered outside on the other side of yellow police line tape. It was five hours before I was able to return to my home. When we were allowed to re-enter the building, well after midnight, police officers escorted the returning residents around the perimeter of crime scenes in the main lobby.

That night, I saw things that I cannot unsee. There were pools of blood on the pavement outside the lobby and more blood on the floor inside.

Six people died in a mass shooting incident in Vaughan, Ont., including the alleged shooter.

While I was not physically injured in the incident, I fall into the category of one who was present during the shooting. According to research conducted on the community-level adverse mental health impacts of mass shootings, primary exposure refers to the impacts faced by those who were injured or present and in danger of being shot.

I’m distressed that my neighbours and I are now facing the mental health consequences of a mass shooting, simply because we happened to live in a particular condominium building where this horrendous incident took place.

In the days after being exposed to a mass shooting, it is difficult to pin down my thoughts while living in the environment of a mass shooting crime scene.
Run, hide or defend

During a mass shooting, individual actions one can take in response are run, hide or defend. At the time, I reacted to a fire alarm, meaning I ran out the building. Had I known there was an active shooting in progress, my behaviour may have changed. At the very least, I would have considered what my most viable survival option may have been.

A main experiential takeaway is that during a mass shooting, appearances of the incident unfolding around me were deceiving. I did not realize that I was in an active shooter situation until I was out of it.

Conducting research immediately after a disaster presents ethical challenges that the researcher must navigate. A researcher’s goal is to learn from disaster experiences so that lessons learned in the aftermath can be used to increase public safety in the future.

A major issue in conducting quick-response research is access. Access allows for purposeful sampling, where a goal of the field researcher is to get proximity to a disaster site and interact with the site itself and people with specific knowledge regarding the event.

The Vaughan condominium mass shooting will rank as one of Canada’s worst mass killings. From a professional perspective, I have direct access to a horrendous disaster site.

That degree of access is something that is, in theory, beneficial for a disaster researcher. But it’s also the type of access that I personally never wanted to have.
After a mass shooting in Vaughan, Ont., people leave flowers at a makeshift memorial. (J. Rozdilsky), Author provided

Author

Jack L. Rozdilsky
Associate Professor of Disaster and Emergency Management, York University, Canada
Disclosure statement
Jack L. Rozdilsky is a Professor at York University who receives external funding from the Canadian Institutes of Health Research as a co-investigator on a project supported under operating grant Canadian 2019 Novel Coronavirus (COVID-19) Rapid Research Funding.

Most Canadians welcome immigrants, but anti-immigration sentiments persist

While most Canadians do not reveal strong anti-immigrant sentiments, they are less immigrant-friendly than we might expect. (Shutterstock)

THE CONVERSATION
Published: December 20, 2022 

Hostility towards immigrants has become a powerful component of right-wing populism in several western countries. But for the time being, Canada has not succumbed to this wave.

In Canada, attitudes towards immigration have never been a particularly divisive or salient election issue. Maxime Bernier’s People’s Party of Canada is the only federal party whose platform includes radical reform of Canada’s immigration system. Nonetheless, the party has twice failed to gain any seats in parliament.

Reinforcing the idea that multiculturalism lies at the centre of Canadian identity, a recent Focus Canada report finds that the public “has never been more supportive” of immigrants.

Our ongoing research into anti-immigration attitudes is primarily motivated by recent xenophobic attacks which expose a resurgence in anti-immigrant feelings. For instance, the 2021 London, Ont. hit-and-run, described by the prime minister as a “terrorist attack,” which killed four members of a Muslim family, shocked many Canadians. A man facing terror-related murder charges is scheduled to stand trial in September 2023.

In 2020, Canadian police reported 2,669 criminal acts motivated by hatred —the largest number recorded since 2009

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The Canadian government recently announced plans to welcome 500,000 new permanent residents a year by 2025. Research shows that despite rising hate crimes most Canadians are supportive of immigration. (Shutterstock)

Anti-immigrant sentiments exist, but no province stands out

We conducted a survey in September 2022 with Canadian polling firm Abacus Data on a sample of 1,000 respondents across Canada. We asked four questions:

1) Whether immigration hurts the economy.

2) Whether the number of immigrants should be reduced.

3) Whether immigrants increase crime.

4) Whether cultural diversity limits opportunities for Canadians. By “opportunities,” we mean in areas such as jobs, education and housing.

Previous studies revealed that some provinces were less welcoming to immigrants than others. In 2019, pollsters EKOS politics found that 40 per cent of Canadians were apprehensive about “visible minority” immigrants.

EKOS reported that 56 per cent of Albertans, 46 per cent of Ontarians and 31 per cent of British Columbians echoed this sentiment. Only residents of Atlantic Canada were more immigrant friendly. Similarly, a 2021 report by Maru Public Opinion found that only half of Canadians believed that Alberta was a welcoming place for immigrants.

However, we found no significant differences across Canadian provinces in anti-immigrant sentiments. Furthermore, our research suggests that the majority of respondents do not hold strong anti-immigrant views.

Four questions to measure anti-immigration beliefs. Left-side percentages show tolerance; middle percentages show neutral feelings; right-side percentages show strong anti-immigration feelings. (Author provided)

When asked whether “immigration hurts the economy,” 53 per cent disagreed. While Canadians do not reveal strong anti-immigrant sentiments, they are less immigrant-friendly than we expected. We found that 24 per cent of the respondents do not have an opinion on immigration, while 23 per cent agree that immigration hurts the economy.

Moreover, 34 per cent of Canadians agreed that “immigration should be reduced.” Twenty-four per cent agree that “immigrants increase crime” and 20 per cent agree that “cultural diversity limits their opportunities.”

Attitudes within the immigrant population

Our study shows that recent immigrants to Canada are more tolerant to immigration than those who immigrated in the distant past, but the differences are rather small. Other researchers have arrived at a similar conclusion when examining immigrants’ attitudes toward immigration.

Those who have acquired citizenship in their host countries tend to be more skeptical about immigration than newer non-citizen immigrants. There could be several hypotheses that explain this trend, however, more research is needed to shed light on why that might be.

Anti-immigrant attitudes stronger among convoy supporters

Prime Minister Justin Trudeau described the truckers’ protest in Ottawa in early 2022 as imbued with “symbols of hatred and division” and accused protesters of “abuse and racism.” In contrast, the convoy was endorsed by prominent American right-wing figures including Donald Trump and Fox News commentators

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Supporters of the ‘freedom convoy’ tend to hold stronger anti-immigrant views. (Author provided)

We found that stronger support for the convoy movement is associated with stronger anti-immigrant feelings. This finding lends some credence to Trudeau’s sentiment that racism and xenophobia were present among the convoy protesters.

We found that moderate anti-immigrant sentiments exist in Canada, but without noticeable differences between provinces. The trucker Convoy protest supporters showcased stronger anti-immigrant attitudes than those who opposed these protests. 

This might challenge Canada’s all-encompassing tradition of diversity and tolerance.

Authors

Constantin Colonescu
Associate Professor of Economics, MacEwan University

Andrea Wagner
Assistant Professor, Political Science, MacEwan University

Disclosure statement

Constantin Colonescu receives funding from MacEwan University (Internal funding).

Dr. Andrea Wagner received funding from MacEwan University's Scholarly Activity Support Fund
Partners

THE ALTERNATIVE TO PRIVATIZATION

Looking forward into the past: Lessons for the future of Medicare on its 60th anniversary

Former Saskatchewan Premier and national New Democratic Party leader T.C. (Tommy) Douglas in 1965. Douglas was instrumental in the creation of Medicare. The Canadian Press

THE CONVERSATION
Published: December 21, 2022 

It is the 60th anniversary of Medicare, but no one seems to care.

It is, after all, hard to be enthusiastic about a system in crisis. Patients can’t find doctors (almost one in five Canadian adults). Those who have doctors have a hard time getting in to see them (only 18 per cent can get an appointment within a day or two).

Doctors are burned out, leaving their practices with no one to replace them. New physicians want to focus on patient care, not the business of health care.

This is, of course, just the beginning of the problem. The premiers want more money from Ottawa and Ottawa wants more data from the provinces. Alberta is making health proposals that some say are a short step away from privatized health care, and the recent meeting between federal and provincial health ministers ended in a stalemate.

The dawn of Medicare 

B.C. Health Minister Adrian Dix, right, is flanked by his provincial and territorial counterparts as he responds to questions at a news conference without federal Health Minister Jean-Yves Duclos after the second of two days of meetings, in Vancouver on Nov. 8. THE CANADIAN PRESS/Darryl Dyck

These seem like intractable problems. But our research suggests part of the solution might be found back in 1962, when the model that would grow into our current health-care system was launched in Saskatchewan, spreading to other provinces over the next few years.

At the dawn of Medicare, the proposed new model resulted in a strike by Saskatchewan doctors worried about “socialized medicine.”

Faced with the prospect of losing access to their doctors, almost 15,000 families (representing 50,000 people) formed 34 community clinic associations, raising over $325,000 (almost $3 million today) over less than a year for health-care clinics that patients would own and govern based on democratic co-operative principles.

The clinics adopted a philosophy of care that rejected many of the tenets of conventional medicine, which Stan Rands, a clinic organizer, described as focused on “physiological and biochemical causes of disease” and dependence on “equipment and tests for the diagnosis and treatment of illness.” The result, he argued, was that it was “ill-equipped to deal with the human and social manifestations of illness or disease.”

The community co-operative clinic model

Based on this philosophy, the clinics implemented what were, at the time, radical measures. Instead of being paid on a fee-for-service basis, doctors were paid salaries. Instead of sole practitioner businesses, doctors worked as part of a team deeply engaged and responsive to their communities because the clinics were run by patients. Instead of treating symptoms, the team treated patients holistically, probing the physical and social factors that we now know lead to illness.

Although the clinics strengthened the government’s hand in reaching a settlement with the striking doctors, the province never embraced the co-operative clinic model. Instead, the clinics would spend years struggling to be understood by policymakers who tended to favour a conventional system based on fee-for-service, doctor-led Medicare.

Community co-op clinics are run by patients instead of sole practitioners. Doctors work as part of a team deeply engaged and responsive to their communities. (Shutterstock)

Many clinics folded shortly after Medicare was introduced; today, only four remain, with large clinics in Saskatoon, Regina and Prince Albert, and one smaller rural clinic operating in Wynyard. Even the 2002 Commission on the Future of Health Care in Canada, led by former NDP premier of Saskatchewan Roy Romanow, ignored the sector’s efforts to put its model on the agenda.

Away from the spotlight, the remaining co-operative clinics went about living their philosophy. They hired social workers, offered mental health services, brought in physiotherapists, set up pharmacies, offered in-house minor surgeries, performed house calls, operated forerunners to modern-day telehealth, and set up shop in disadvantaged, poorly served communities like Saskatoon’s west side.

The future of co-op clinics

Meanwhile, there are signs that the philosophy of team-based, patient-focused, community-based care may be gaining ground. In 2017, for example, Ontario’s Matawa First Nation opened the country’s first Indigenous-run co-operative clinic.

The provincial government in Ontario operates a large network of not-for-profit community clinics similar in structure to Saskatchewan’s clinics but lacking explicit democratic co-operative control. In addition, some Canadian doctors are now advocating for a different model.

Read more: The doctor won't see you now: Why access to care is in critical condition

Elsewhere, there are indications that citizens may be tired of waiting for policymakers to act. As the Globe and Mail recently reported, residents of the Saanich Peninsula, on the southeast coast of Vancouver Island, raised money to open two medical clinics and recruit doctors who could take over from physicians at, or near, retirement. As Dale Henley, the co-chair of the non-profit that owns and operates the clinics told the Globe and Mail,

“I think we’ve got to do a little more ourselves. We can’t just keep looking at governments all the time, because they’re not that good at it.”

As we look back on 60 years of Medicare and contemplate its many challenges, it may be time for communities to heed Henley’s call and once again voice their desire in words and action for access to the kind of holistic care pioneered by the co-operative clinics. Maybe this time, policymakers will listen.

Authors

1. Marc-Andre Pigeon

   Assistant Professor, Johnson Shoyama Graduate School of Public Policy, University of Saskatchewan

2. Haizhen Mou

   Professor, Johnson Shoyama Graduate School of Public Policy, University of Saskatchewan

3. Natalie Kallio

   Professional Research Associate, Canadian Centre for the Study of Co-operatives, University of Saskatchewan

Disclosure statement

Marc-Andre Pigeon is the director of the Canadian Centre for the Study of Co-operatives. It receives funding from the co-operative and credit union sector. The research into the co-operative clinics is funded, in part, by the Saskatoon Community Clinic, one of the clinics being investigated in this research.

Natalie Kallio is a Professional Research Associate at the Canadian Centre for the Study of Co-operatives, which receives funding from the co-operative and credit union sector. This research is funded, in part, by the Saskatoon Community Clinic, one of the clinics being studied.

LA REVUE GAUCHE - Left Comment: Socialized Medicine Began In Alberta 

LA REVUE GAUCHE - Left Comment: Search results for PROLETARIAN DOCTORS 

To attain global climate and biodiversity goals, we must reclaim nature in our cities


Conserving nature in cities can help protect the biodiversity within them. (Unsplash)

THE CONVERSATION
Published: December 21, 2022

The climate and biodiversity crises we have been experiencing for the past few decades are inseparable. The scientific research presented at the back-to-back international summits on climate and biodiversity held in Sharm El-Sheikh in Egypt and in Montréal, Canada, respectively, has made this abundantly clear.

Addressing these crises requires real transformative action and commitments — including plans that call for the conservation of 30 per cent of global land and sea areas within the decade — have been made to halt biodiversity loss by 2030. But where do we start implementing these targets?

At the 7th Summit for Subnational Governments and Cities, an official parallel event to the COP15 biodiversity conference, cities were brought to the forefront of conversations on how to protect life on Earth.

As a researcher of terrestrial ecosystems, I believe that we cannot think of nature as something set aside in wildernesses, far from human activity. We need to conserve some elements of nature everywhere, including in the cities we live in.

Read more: COP15's Global Biodiversity Framework must advance Indigenous-led conservation to halt biodiversity loss by 2030

Cities need nature

Cities are growing rapidly and covering more and more land. They are often built on the most fertile land, near rivers or coastlines. This is also where most of the biodiversity lives. It is, therefore, crucial to conserve nature in cities.

Healthy soils and wetlands absorb rainwater and snowmelt to buffer floods.

 (AP Photo/Bruce Smith)

To add to this, some ecosystem services that humans rely on only operate within short geographical limits. Healthy soils and wetlands absorb rainwater and snowmelt to buffer floods, while trees filter pollutants from the air and alleviate heat waves. All these services are most effective when nature is close to where people live, making it crucial for cities to preserve their nature.

In Canada, the richest ecosystems and the highest numbers of species are found in the south, and this is also where most of the cities and farms are, leaving little land available for wilderness.

To protect healthy population sizes of species native to this region, we need to preserve green spaces in cities. Research has shown that small protected areas can have disproportionately large effects in protecting biodiversity.

Contact with nature also brings tremendous physical and mental health benefits as seen during the pandemic when spending time outdoors became very valuable to people suffering from stress and isolation.

Equitable distribution of natural areas around a city is also important. Public green spaces can be especially valuable to people who do not own country cottages or backyards.

Montréal leads the way

Montréal, the host city of the COP15 biodiversity conference, is a perfect case in point for how cities are both succeeding at and struggling with conserving nature.

The City of Montréal committed to protecting 10 per cent of its territory in November 2022. This commitment was reaffirmed at COP15, along with the launch of the Montréal Pledge, which called on cities around the world to protect biodiversity on their territories and provided practical steps on how to do so. So far, 47 cities from all five continents have committed to the pledge.

The Falaise St-Jacques green space boasts of 83 species of birds including some threatened species.

Meeting this target includes the creation of new parks like Montréal’s Falaise St-Jacques escarpment and Champ des Possibles.

The Falaise St-Jacques, long used as a dumping ground by businesses nearby was revitalized by a community group. They organized clean-ups, removed hundreds of tires and other debris, built trails and transformed the site into an urban oasis enjoyed by local residents, human, feathered and furry. Home to 83 bird species, including two species at risk, the Chimney Swift and the Wood Thrush, Falaise St-Jacques has become an important habitat for migratory birds.

The Champ des Possibles — a railway triage site turned industrial wasteland — was saved by a group of local residents, who planted gardens, installed beehives and held concerts, creating a de-facto park that is now co-managed by the community organization and the city. This area now boasts of a wealth of biodiversity too.

However, the island of Montréal continues to include many other unprotected green spaces, including the Technoparc and Parc-Nature Mercier Hochelaga Maisonneuve, which are threatened by industrial expansion.

The Technoparc attracts thousands of nature enthusiasts and bird watchers. 

(Technoparc Oiseaux), Author provided

The Technoparc, which comprises a mature forest, marshes and meadows and is a birding hotspot in Montréal (216 birds including 14 species-at-risk), is attracting thousands of nature enthusiasts to document the ecological value of the site, to tag endangered Monarch butterflies and to chart the cooling effects of the meadows and forests in the surrounding industrial heat island.

Despite numerous pressures exerted on the space, efforts like citizen-science documentation, gained notably through iNaturalist observations and City Nature Challenge bioblitzes, have succeeded in dissuading developers from moving into the site so far.

Politicians at all levels of government — from the municipal to the provincial to the federal — have now started to call for the site’s protection.

Researchers here have also mapped remaining green spaces around the island of Montréal and calculated the ecosystem services they can provide to help communities better plan for the future.
Community efforts can go a long way

Researchers and students at Concordia University have been working with community organizations to study and educate about biodiversity in these spaces.

We use citizen-science tools like iNaturalist.ca to welcome people from all walks of life to the community of biodiversity scientists, help them identify the fauna and flora around them and share the collected data with scientists around the world.

Community members identify trees in an urban forest at an event organized by Concordia University in Montréal. (Emma Despland), Author provided

Building a relationship with nature around us can help foster human engagement with the natural world and a desire to learn more and to protect, restore and steward the living ecosystems around us.

At the COP27 climate summit in Egypt last month, UN Secretary-General António Guterres called for “all hands on deck” to address the climate and biodiversity crises. He said, “Making peace with nature is the defining task of the 21st century. It must be the top, top priority for everyone, everywhere”.

What better place to start than in a park or green space near our homes?

Author

Emma Despland
Professor, Biology Department, Concordia University