GGR208 Lecture 09

GGR208 Lecturea March 23.pdf

• Health Care Costs
  • Expectations
    • We feel entitled to the proper healthcare that we expect.
    • There is significant misuse of healthcare resources, such as unnecessary tests and procedures.
    • When something is in the healthcare policy, it's basically an entitlement and is hard to change or remove.
    • Hard to also get doctor appointments, etc.
  • Tech
    • Diagnostic tools and treatments are improving, but they are also becoming more expensive.
    • Who's benefiting from these new technologies?
    • Drug interventions rather than lifestyle changes.
      • Band-aid solutions rather than addressing root causes.
    • Conflict of interest with: advertisements by pharmaceutical companies, doctors receiving incentives for prescribing certain medications, etc.
  • Institutions
    • Curative rather than preventive care.
    • Not exactly community care now. It's hard to get this in situations like downtown Toronto or such.
    • If you can't age in place, you have to go to an institution.
    • Idea that you can build larger institutions to care for more people which reduces costs. Economies of scale.
      • More money is going to management rather than delivery.
      • Healthcare expenditure $\uparrow$, but $\frac{\text{Doctor}}{\text{Patient}}$ ratio remaining similar.
  • Improving health in old age
    • Try to improve the chronic conditions that people have, such as diabetes, arthritis, etc.
    • That way the health costs aren't as much when they get older.
  • We're adding programs, without evaluating whether they're necessary or not. What else are we getting rid of to add new ones?
• Potential solutions to this
  • Increase taxes
    • Increases burden on taxpayers and reduces size of labour force
    • Is more funding the solution?
  • Reform
    • Changing retirement age, etc.
    • Health care
      • Deinstitutionalize, make aging in place more feasible.
      • We also have a different problem, because family sizes are getting smaller, less extended family.
      • So you have less chances to take care of your family members, and more people are going to have to go to institutions.
  • Immigration
    • Immigration doesn't address fertility rates, but it can help with labour force and tax base.
    • But it also means absolute value of more people to stress education, healthcare, etc.
  • Address declining fertility rates
    • pro-natalist policies
      • Tax relief, baby bonus.
      • Marginal cost for children is lowest for low and high income families.
      • Middle income families get hit the hardest because they're likely unable to get these bonuses.
      • Doesn't exactly address the gender inequality, work life balance or career goals individually.
      • Just a general incentive to have more children, but it doesn't address the root causes of why people are having fewer children.
    • Separate economic development from the demographics which cause it.
    • Shift in fertility due to:
      • Careers
      • Education first
    • Enhance equality in procreation
      • Scandinavian countries do things like parental leave, which means having a kid doesn't necessarily impact career progress.
        GGR208LectureMarch23.pdf
• Population Mobility
  • Immigration, emigration, migration.
  • Borders, geography of movement.
  • Push and pull factors.
  • Push factors: things that make you want to leave a place, such as war, lack of jobs, etc.
  • Pull factors: things that make you want to go to a place, such as better job opportunities, better quality of life, etc.
  • Immigration
    • Redistribution of population
    • Population growth is an issue:
      • More people means more stress on resources, infrastructure, etc.
      • Might not be growing at rate of Economic Development
    • Impact on country of origin
      • Selective, based on age, education, etc.
      • Remittance
      • Benefits to receiving country
        • Labour force, tax base, etc.
      • If we only take the best and brightest, then we're taking away the people who could help develop the country of origin.
    • Example:
      • Canadian Immigration Policy
        • Canadian-History
      • 1960's points system
        • Removes cultural bias
        • More objective selection
        • Restricts on:
          • Education, age, employment, languages.
          • Application and medical costs
        • We have a multicultural society but not a multicultural immigration policy.
          • If we did have a multicultural immigration policy, we might be implying one culture $>$ another or something.
        • Not the most open door policy, we select middle and upper middle class immigrants. Implied because we choose based on age, education, language which may have pre-requisites of those age / education pieces.
      • Post 1980s Goals
        • Maintain population size.
          • Address the decline in Total Fertility Rate
          • Change the Dependency Ratio
          • Current Total Fertility Rate at $1.4$.
          • Minimal $\frac{500\mathrm{k}}{\text{year}}$ immigrants required now.
          • Immigration doesn't always just help fertility.
        • Grow the labour market
          • Add skills, education
          • Reduce family sponsorship
            • You should be able to produce and add something, not just because you're family
          • Education is a proxy for level of skills
            • They don't select skills, rather education.
            • You need plumbers, electricians, construction guys, people who can do fab.
          • Meaning unemployment and underemployment and such.
        • Can address regional inequality
          • Lots of internationals in Yukon and stuff now, distributes population adds help in those regions.
          • Can the govt restrict where people can settle?
            • Go to medical schools and say, you must go to northern ontario where you're needed for at least 10 years.
            • I think an incentive is better than this hard restriction.
        • Economy and labour market
          • Immigrants: $60\mathrm{\%},56\mathrm{\%}$ bachelors for males and females.
          • Canadian born, $19\mathrm{\%},23\mathrm{\%}$ between males and females.
          • Unemployment
            • If everyone was employed, then the labour market wouldn't be competitive.
            • But for immigrants the unemployment is higher.
          • There's less growth now, so the new amount of potential employees / new jobs is much lower.
        • Immigration is federal, but reality of immigration is different
          • Recognizing credentials / education of those coming in.
        • Language skills
          • Accented speech. This might be judged more than actual language skills.
          • This is also a barrier.
        • Experience
          • Not really transferred
          • You need Canadian experience.
          • The first job determines your next job
        • Discrimination in hiring
          • Hard to track and potentially enforce.
    • Categories
      • Economic criteria is good
        • Skills
        • Provincial nominee
        • Points system
      • Sponsorship
        • If you're sponsored by economic immigrants, family in Canada, etc.
        • With this path you select because family, not because of economic criteria.
      • Refugee
        • $\sim 10\mathrm{\%}$ of annual intake.
        • Under UN, humanitarian.