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Profiting from Opioid Crisis

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Yesterday’s article in the Globe and Mail was a shocking eye opener concerning the potential true culprits of the opioid crisis that afflicts every town in Canada: pharmaceutical companies.

Nearly 20 million prescriptions for opioids were written by the medical community in 2016.

Overprescribing is behind the epidemic, which has worsened in recent years with the arrival of illicit fentanyl, leading to a sharp spike in overdose deaths. Canada ranks as the world’s second-biggest consumer of pharmaceutical opioids.

A Globe and Mail investigation found that Ottawa and the provinces have failed to take adequate steps to stop the indiscriminate prescribing of opioids. As doctors continue to liberally prescribe opioids, a class of painkillers that includes oxycodone, hydromorphone and fentanyl, both the pharmaceutical-grade and illicit markets are thriving. Meldon Kahan, medical director of the substance-use service program at Women’s College Hospital in Toronto, said the numbers show that efforts to educate doctors about the risks associated with opioids have had little impact on prescribing.

Purdue Pharma, the maker of OxyContin, launched sales campaigns two decades ago promoting the benefits of the drug and it quickly became the country’s top-selling long-acting opioid. But it also became a lightning rod in the early 2000s, as reports of addiction and overdoses exploded. In 2012, Purdue pulled OxyContin from the market and alternative painkillers filled the void. Purdue also makes Hydromorph Contin.

“We need to reset the thinking on opioids,” said Gordon Wallace, managing director of safe medical care at the Canadian Medical Protective Association, which provides advice to doctors when medical-legal difficulties arise. “In my time, the benefits of opioids for non-cancer pain were significantly over sold and the risks were under stated.”

So there we have it folks.  Pharma companies ramp up the advertising (and likely the perks for prescribing) and we have a crisis.

How to solve it?  A strict cold turkey program:  stop prescribing and go so far as to ban the opioids from the list of options available for medical care and treatment of pain, at least until the current crisis is under control.  If you can’t do that, let’s at least start educating the medical profession about the cause and effect that’s been created.

To track details about how Canada became addicted to opioids, read more here.

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When Trump is Impeached, Who Will Replace Him?

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The answer is Mike Pence.

Right now, things are NOT looking good for Donald Trump, prima donna extraordinaire.

After the blasting received by Schiff, it now looks like the world can add Paul Manafort to the list of conspirators with respect to the Russian connection.

This article exposes how Manafort who worked as President Trump’s campaign manager in 2016, secretly worked to advance the interests of Russian President Vladimir Putin’s government a decade ago, according to a new report.

With this new nail in the coffin, impeachment proceedings will likely have to begin within the next 3-6 months.

When Trump is impeached, who will replace him?

The official line of succession is that it will be the following people:

  1. Vice-President (Mike Pence)
  2. Speaker of the House (Paul Ryan)
  3. President pro tempore of the Senate (Orrin Hatch)
  4. Cabinet (currently with fifteen members, beginning with the Secretary of State)

There’s just ONE teensy little problem …

They’re all involved!

Well, not quite, but they’re all Republicans and it’s unlikely that any of them will take an aggressive stance against Trump, making them complicit with respect to the issues that Trump has brought to Washington.

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9 Must-Watch Minutes

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At the House Intel Committee, ranking member Schiff (D-CA) summarizes the insanity that has transpired in the last 9 months concerning Donald Trump, Russia, Clinton, Wikileaks and more.

This is 9 minutes well worth watching.  It will shake your world.

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Another Call to Raise Toronto Property Taxes

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This piece by Lawrence Solomon is very effective at pointing out the contrast between property taxes applied to landlords versus those that are paid by private homeowners.

In Toronto, property taxes for homeowners are disproportionately low, not just compared to local rental costs, but also for property taxes applied across the province and rest of the country.

As a result, there’s no logic to renting a property.  When inhabitants of other world-class cities (New York, Chicago, London, etc) have no hope in hell of owning something, why should the people of Toronto (note how I’m equating Toronto with these other top-tier cities)?

Solomon hints that landlords should pay less, but obviously I lean towards the opposite:  property taxes levied on homeowners need to increase.

The frenzy that’s happening with Toronto real estate will not be solved by Ontario’s ‘Hail Mary’ plea to the federal government to alter capital gains taxes. Don’t get me started on the absurdity of this request.  It’s a massive fail on Wynne’s part.

This is asking the Rest of Canada to pay for Toronto’s insanity.

So, NO.  We won’t accept that.

Instead, here are just a few suggestions about how Toronto can moderate the frothiness of their real estate market without pissing off the Rest of Canada:

  1. Institute a gradual increase in homeowner property taxes over the next 5 years so that Toronto leaders can fund their city based on payments from Torontonians.
  2. Put an end to real estate speculation by enforcing transparency with bidding IMMEDIATELY.  The level of disturbing manipulation that’s taking place must come to an end.
  3. Implement a foreign ownership tax similar to Vancouver.
  4. Cap the borrowing rates, especially for new owners.  If all you can afford is a 600-square-foot apartment, that’s all you can afford.

The message for Toronto is that you have to take care of yourself if you want Canada to come to the table.  And you have to accept that you’re a world-class city, so ownership simply may not be an option.

And if that’s unacceptable?

There are hundreds of cities, towns and villages where you can live affordably in Canada and that would be happy to receive you if you gave them a chance.

Creating rules and regs that affect 100% of us for the benefit of a select few is a recipe for disaster.

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Transit: We’ve Been Here Before

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Transit.

There’s nothing like disrupting everyone’s commute to get everyone in a whipped up, frothing mad, blood-boiling rant about getting around.

I’m going to chip in.

I live in a town where the new ‘monorail’ is bus rapid transit (BRT).  You know:  the system where they chew up all of the roads for many years, create dedicated lanes for buses and then keep their fingers crossed that someone will want to swap privacy and singing out load for an hour wait at the corner for a 20 minute drive.

BRT is the new ‘shovel in the ground’ flavour of the day, just after massive swimming pools that leak everywhere and skateboard parks that get shut down after too many lawsuits against the city that built them.

The people in the town where I live show no inclination towards changing their car-driven habits.  They will not convert.

And the students – who are the majority users where I live – might use the bus more often.

Unfortunately, they’re not the ones footing the bill for this infrastructure extravaganza, nor will they ever see the result of the effort after they pack their books away and head to the big city that has real transit and solid intensification plans.

Finally, there’s an assumption prevalent with BRT proponents that relies heavily on the idea that technological advances will come grinding to a complete halt and things like renewable vehicles, car swapping, HOV efficiencies, efficient planning to ensure buses don’t drive around empty, automated cars and other innovations will never materialize.

Even though they’re already here.

And BRT will come to stand for Big Ridiculous (Transit) Tax that no one wants.

Stepping Back …

Let’s step back for a second.

Waaaay back.  Say, about 100 years.

Back at the turn of the 19th/20th centuries, there were no cars.

In Dark Age Ahead, Jane Jacobs clearly traces the transition from rail transit that existed in nearly EVERY North American city to highway traffic dominated by cars.  Buses became the only option and substitute for the highly efficient rail system.

Why?  Because the bus companies were owned by auto manufacturers like GM and Ford and they were substantially more profitable than cars.

And – the double whammy – getting rid of rail also pushed people into the more private experience of car ownership.

With cars and flexibility with choice of where you could live, sprawl was invented.

Back to the Future …

I’m a fan of the following, ideally in the order presented:

  1. Intensification
  2. Beautification of cities, especially the downtown core (1 & 2 really have to happen at the same time)
  3. Accommodation for other modes of transit (walking, cycling, high occupancy / car pooling)
  4. Tax breaks for businesses that setup shop downtown; taxes on businesses outside the core area.
  5. Public transit – subways
  6. Public transit – light rail
  7. Public transit – buses

Today, I counted 7 – SEVEN – empty buses meandering around the downtown core where I live within a few feet of each other.  Of course, there were many more on other streets, but the distinguishing feature for these 7 buses is that they were all empty or nearly empty.

You’re not going to sell me on ripping up our roads if you can’t sell people on using public transit in the first place.

Some Words of Advice …

Hey, I’m not a public transit expert, nor am I a city planner.

I don’t even ride the bus any more.  I walk everywhere because I live downtown and have everything I need.

But what I do is pay taxes.  And I don’t want my taxes going to the latest flash in the pan, must-have municipal boondoggle that everyone else is throwing billions at.

Buses are not the answer.  Not now, not before and not moving forward.

BUT … if you want to sell me on public transit, that’s easy.  I’m a supporter of the idea, but let’s get the country’s municipalities and planners together and agree on these steps when it comes to investing in transit:

  1. Show us your strategy to LIMIT sprawl.  For example, no apartment towers outside a certain radius of town.
  2. Show us your plan for each of the growth stages below and how you’ve already started to expropriate land and negotiate easements.
  3. Approved plans for intensification will get ‘seed’ rounds of funding when they reach specific population sizes.  Examples:  100,000 people = x number of buses.  500,000 = Light rail transit investment with a set range of coverage.  1,000,000 = investment in subway, again for specific corridors of population.

No plans = no money from the province or feds.

Again, my ideas and thoughts may not be perfect, but let’s not sacrifice our downtown areas at the altar of shitty tech and shiny budgets.

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