Beyond the Palewall (8)

 

Coming Soon Next to the Shawarma Shop Near You: A Private Clinic

   If you need a knee or hip replaced, you may be able to soon hobble down the street and get one, or two, or even four. Our government announced that more private options were being made available and that news was nicely conveyed by the Canadian correspondent for the New York Times: The Growing Private-Sector Involvement in Canadian Public Health Care Systems," Canada Letter, Ian Austen,

January 20, 2024.

This week, the provincial government in Ontario announced that it was expanding the number of private clinics providing medical services.

Right now, Ontario has about 900 such clinics, and they mostly offer medical imaging and cataract surgeries. Sylvia Jones, the province’s health minister, said this week that the government was expanding its program to include hip and knee replacements.

The province is being careful not to violate the Canada Health Act by requiring people to pay for medically necessary procedures. That would jeopardize the 20 billion Canadian dollars the province will receive this year from the federal government for health care. While the clinics will be privately operated, their procedures will be covered under the provincial health care plan as if they had been performed in public hospitals.

Ms. Jones said that the expansion would allow more such procedures to be performed and that doing so would cut wait times for patients. Her critics say it will further undermine the public system, that it may actually increase wait times and that it is a step toward full privatization of health care.

   You may not be able to read the NYT article, but you can read this 36 page report which has just been released: "The Scope and Nature of Private Healthcare in Canada," by Katherine Fierlbeck. It is published by the C.D. Howe Institute.
 A serious subject which I should not treat so lightly.

Boil Water Advisory in the Nation's Capital

   Not in Ottawa, but Washington. I mentioned in "Water Woes" that, soon we are all likely to  be very thirsty.  A recent headline indicated that it is true, even in D.C., where a great deal of water is needed for the scotches. In this article, one learns that even the citizens in the ritzy areas (Chevy Chase, Bethesda) were likely to experience problems. Apparently these city dwellers need advice that is much clearer than the water: “Do not drink the water without boiling it first,” the D.C. Water said in an alert issued Friday evening. (The water should be allowed to cool before drinking it.) ("Many Residents of Northern D.C. Are Asked to Boil Water," Martin Weil, Washington Post, Jan. 19, 2024.)

  Some related CANCON: A Canadian Press headline: "Long-Term Prairie Drought Raises Concerns Over Groundwater Levels," Bob Weber, Jan.20, 2024.

“The lowest water levels are all in the last seven years and the levels are much lower now than they were in the ’70s and ’80s,” Pomeroy said. “It'll be a climate signal that we’re seeing....” “It’s something we need to keep an eye on.”

Don't Bet On It

   At the end of last year, I suggested in "On Betting" that perhaps we should be as worried about the gambling situation as we are tired over watching all the ads promoting it. I did offer one source suggesting that money was being made and people are getting jobs in the gambling sector. If you think you can find better statistics related to Ontario, Don't bet on it.  
   Read, if you can, this good article: “Got Questions About Ontario’s Online Gambling Industry” Don’t Bet on Getting the Answers,” Simon Houpt, Globe and Mail, Jan. 19, 2024. He begins by noting that this gambling thing is supposed to be great and he attempts to find out how great from iGaming Ontario. He wasn't able to get much information from them, but it was easy to find out from the folks in New York and Massachusetts.

  

When Ontario announced a few years ago that it was giving the green light to online gambling, politicians made familiar promises about the scheme. It would be great for consumers. Great for the province’s tax revenue. Great for jobs, great for the local innovation economy. (They didn’t say anything about how great it might be for our blood pressure to be subjected to the ensuing flood of sportsbook ads.)

Since then, most of the talk about online gambling has focused on its downsides: the volume of ads; the disappointment in seeing heroes such as Wayne Gretzky or Auston Matthews encouraging fans to get into the betting game; the cautionary tales about addicts losing their homes, their jobs, their families, their lives.

Would the conversation be different if the government actually trusted the public enough to give them real information about the state of the industry?

For almost two years, iGaming Ontario (or iGO), which oversees online gambling in the province on behalf of the Alcohol Gaming Commission of Ontario (AGCO), has followed a policy of saying as little as possible. It releases quarterly snapshots that contain a handful of data to show things are going swimmingly.

Which they might be. Who knows.

For the first year of those quarterly reports, iGO revealed almost nothing. It published the total amount of money that had been wagered, but refused to outline how much came from the different types of betting: casino, sports, or online poker. It was hardly a vote of confidence in a promising industry.

It’s finally begun breaking out those figures. Still, it evidently believes most information is like thrash metal or direct democracy: potentially dangerous if released onto an unsuspecting public. And so it withholds data that might help Ontarians grapple with the emerging place of online betting in the province.

He then made a few phone calls and it seems our southern neighbours were rather chatty.

Other jurisdictions seem to recognize the benefits in giving the public access to timely, comprehensive information....

A quick scan of the information published by Massachusetts and New York may give you some idea of the warts that Ontario might be trying to hide.

Last month, mobile sportsbooks in New York State took in US$2.04-billion in total wagers. Of that amount, the market goliath FanDuel handled US$835-million, or about 41 per cent of all wagers. DraftKings handled US$773-million (about 38 per cent), and Caesars handled US$202-million (or almost 10 per cent)....

The Massachusetts numbers for December echo the winners-take-all landscape in New York. Of US$643-million wagered on online sportsbooks, DraftKings handled US$316-million, or 49 per cent. FanDuel handled US$187-million (29 per cent). ESPN Bet, newly rebranded from Penn Sports Interactive, handled US$50-million and saw its market share jump to almost 8 per cent from 6 per cent. The other five licenced operators handled the remaining 14 per cent of the action.

All of which is to say the industry looks a little like America itself: a few fat cats at the top, with everyone else scrambling to survive.

And what does the landscape look like in Ontario, where there were an astonishing 49 licensees operating 72 gambling websites – including, by my count, 30 sports-betting operations – as of Dec. 31, 2023? Are two or three foreign juggernauts dominating an industry the government had hoped would become a central player in the province’s innovation economy, as people suspect? Are Canadian-based companies, which have much smaller marketing budgets than the global behemoths, connecting with consumers? Are they barely keeping their heads above water? Are they targets for the industry consolidation that so many observers believe is inevitable? Will the jobs that the province trumpeted as a major reason to greenlight gambling never materialize, or evaporate? Will online gambling be yet another branch-plant economy of foreign giants?

The questions were not answered.