Part 1 on decoding public v private healthcare.

Why peer review takes me so long: Started reviewing a paper citing works I hadn't read. Had to read them to inform my review. Learned of tangential works relevant to my teaching. Had to read them and revise my lectures. Had to get coffee. Finally got back to the peer review.

Viewpoint: To effectively reduce drug costs, the US needs its own price negotiation framework rather than relying on international benchmarks, as proposed by the Trump administration. ja.ma/4o0PF66

💯 Changing payments without changing critical institutions related to delivery, governance, and accountability will not produce long-desired improvements in primary health care. Providers and some patients will be happier but the system will remain a fragmented and underperforming one.

Canadian “Medicare” is a public good that provides essential services while also creating jobs, economic growth, and competitive advantages for Canada’s economy. Letter reminding our governments of this, signed by 200+ colleagues and me: centreforfuturework.ca/2025/06/17/t...

Highly recommend.

The 2025 Speech from the Throne mentions #pharmacare once, and only in a promise to keep what is already in place--which is next to nothing. I think the prospect of a meaningful program in the 2020s is dead. Feels like 2006.

Get out and vote as though your country depended on it! #Never51

A lot of national pride tonight.

A great 10-second summary of the stupidity of the Trump/Musk tariffs.

Economic historians are going to look back at this era and wonder what the $%@% people were thinking! This isn't Liberation Day in the USA. It's Liquidation Day!

This is, in large part, pandemic revenge. As far as these oligarchs are concerned, all science does is tell them stuff they cannot do. They can't keep spewing carbon. They can't keep businesses open as usual when millions are dying. They have concluded that research is the enemy of profit.

“Just as strong banking regulations guard against economic catastrophe, comprehensive oversight of our digital landscape is essential to protecting democracy, public safety and national security,” write @petermacleod.bsky.social and @taylorowen.bsky.social

It's 5 yrs today since lockdown started in England, but "We must never have lockdown again" is the wrong lesson. Lockdowns are terrible but so are deadly pandemics. Our choices 5 years ago were limited - we can & must do better in the future. Do read my post. open.substack.com/pub/christin...

Hundreds of unsold Teslas being stored in a rented parking lot outside of Vancouver — a scene playing out across the globe. But, sure, buying shares in the company is a GREAT idea right about now!!!

Danielle Smith & LaGrange say if there was anything amiss about health procurement, it was all internal to Alberta Health Services. Here's a long look at the UCP government's many interventions into contracting at AHS: www.cbc.ca/news/canada/...

From the US: maybe not such a good idea having secretive, for-profit financial intermediaries influencing what insurers pay, how pharmacies are reimbursed, and which medications people can access.

“Canadians are entitled to a comprehensive health-care plan that prioritises access, equity, and sustainability for all.“ www.thelancet.com/journals/lan...

More of this please!!!

This got me. I love this country. I love its hope, its compassion, and its humility—that we know we are not perfect and that we believe we can and must always strive to be better. youtu.be/vhiKlhTmwDU?...

Now is the time for a united and hopeful Canada, not a divided and hateful one. Be strong and resolute without becoming that which we are defending ourselves against.

Two posts about the authoritarian attack on American universities out today. The first is an excellent review of why any how this happens. 1/2: "Autocracies require ideological control and a single narrative about what is happening within the country." @chrischirp.bsky.social

If you run into an American travelling abroad -- even right next door, here in Canada -- treat them with kindness. It is highly unlikely they voted for Trump. And nobody voted for Musk.

In 1890, the Tariff Act came into place in the United States. It placed tariffs on imports of up to 50%. While touted as a way to build American industry, there was also the hope it would force an annexation of Canada. It backfired. Let's learn more. 🧵1/10

Can Canadian institutions please get the hell off of X now?!?!?

There is not a lot of good news out there but I think this is good news. Vancouver Coastal has the lowest levels of COVID in wastewater since the beginning of the pandemic -- especially for February (latest data). I'm glad they keep measuring this and I hope this trend holds.

“If the American people don’t want this why are we doing it.” 🤔 youtu.be/iSW8ezOmYHs?...

HSR peers, watch this space (and consider submitting work) on US health policy in the Trump era. (Yes, my Bluesky account is @commonwealthfund.org stan account.) www.healthaffairs.org/content/fore...

Musk and Trump solve Canada’s health human resources problem!

Happy #FlagDay and #SNL50, eh! #CanadaSky

Now might be a good time for students to re-read Deborah Stone's chapter on efficiency in "Policy Paradox."

If your argument is "sure, a terrible modern event has a parallel in the 1920s and 30s but don't worry we turned out just fine", might I suggest reading about the 1940s.

TLDR: "tough-on-crime" illicit drug policies are ineffective, oppressive, and extraordinarily expensive. The underlying problems are complex but there are far better ways to address them if you actually cared about people who use drugs.

Should I start a series called “cartoons you wouldn’t see in Canada”?

Billionaires view the world as a video game in which everyone else is an NPC.

If for-profit surgical facilities cream skim the lowest-risk patients AND receive inflated-price contracts, can anyone tell me how it is they are “more efficient” than public facilities?

“Premier Danielle Smith’s government dismissed the head of AHS two days before she was scheduled to meet with the province’s Auditor-General to discuss her investigation into procurement contracts and deals for private surgical facilities, according to a letter obtained by The Globe and Mail.”

AI tools from three years ago increased cancer detection rates and positive predictive values by about 25%. Imagine what AI tools are able to do today…and will be able to do three years from now. www.thelancet.com/journals/lan...

"Everyone thinks of solar like the Whole Foods of energy - better for you, but pricey. In fact, it's now the Costco of energy, and everyone needs to know that." - yet another unforgettable thought from @billmckibben.bsky.social

RONALD REAGAN (1988): We should be aware of the demagogues who are ready to declare a trade war against our friends, weakening our economy, our national security, and the entire free world—all while cynically waving the American flag.

Got to say, that was a good speech.

I signed the Pledge for Canada to reflect on the challenges Canada faces and what we can do to respond together: actionnetwork.org/petitions/pl...

Never have I seen more “made in Canada” ads in my life. Also, does anyone want to buy a used Tesla?

Community health centers provide essential primary care to more than 31 million people. Without reliable, congressionally-authorized support, the U.S. risks losing an essential lifeline for millions of people. #CHCs #communityhealth

Private equity acquisitions of US hospitals have increased over the past decade, and such acquisitions were associated with a worsening of patient care experience compared to non-acquired hospitals. #MedSky ja.ma/3WaBGhK

More work from the @commonwealthfund.org that, although for a US audience, is also of relevance to Canada. Private health insurance imposes sizable burdens on workers...and those burdens vary by workplace. www.commonwealthfund.org/publications...

Latest international data from the Commonwealth Fund shows, once again, the American private-public model of health benefits is not a model to follow. www.commonwealthfund.org/publications...

This is a good discussion of Canada's first stage (or "pilot") of a national pharmacare program. Well worth the read and serious contemplation over what should and could come next. www.cmaj.ca/content/196/...

Late announcement (I've been sick): it is an honour to be appointed to this committee on national pharmacare. I look forward to the work involved. Please contact Health Canada for info and media inquiries. www.canada.ca/en/health-ca...

If you have access to the Hill Times, here's a column that took a look at the recommended next step for national pharmacare: the most commonly prescribed clinically-important drugs, AKA essential medicines. www.hilltimes.com/story/2024/0...