Health Care Directive Manitoba: Fill & Download for Free

There are basic similarities, The states and the provinces are both the subfederal units of their countries. They occupy important governmental roles.However there are some quite important differences. Provinces cannot charter banks. Nor can they pass criminal laws. Provinces can licence credit unions, but this is a small-scale activity. Provinces sometimes create “quasi-criminal” offences, for example, for violations of the provincial highway traffic acts. However, at a certain point, they can impinge on federal juridiction and then matters end up in the Supreme Court of Canada.However, There are Psychological DifferencesCanada only has ten provinces. Ontario alone has about 38% of Canada's entire population. This makes for a very different dynamic. Just think if one state has the same proportion of America's entire population, so 139,000,000 people! This is Ontario to Canada. The Province of Quebec has almost a quarter of Canada's total population, so the equivalent of 87,000,000 Americans.The federal government of Canada doesn't want to take a province on, not even a smaller one. Even if they try to bully a tiny province like Prince Edward Island, the other, bigger provinces will feel threatened and will come to P.E.I.'s aid.In Canada, we assign group identities to some provinces, so the four small eastern provinces are referred to as Atlantic Canada, and Manitoba, Saskatchewan and Alberta are the Prairie Provinces. This creates a little bit of cognitive assistance but the generalization only goes so far. Each of the four Atlantic Provinces are different and certainly each of the other Prairie Provinces are different from each other. Each province has an identity and loyalties of its own.The Federal Government of Canada is a compromise between the predominantly English-speaking provinces and territories and Quebec. It is not in a position to claim ownership of an overriding national identity. English-speaking Canada only has a limited number of institutions that go beyond provincial identities. There are institutions like the English-speaking wing of the Canadian Broadcasting Corporation, the CTV television network and Maclean's Magazine. However they are more identity reporters rather than identity creators.It is left to the individual provincial legislatures to express the identities, values and issues of their part of Canada. The Quebec National Assembly takes it one step farther, defending Quebec's existence as a nation.These strong, coherent provincial identities in a country with a divided, rather diffuse national identity, together with constitutional limits, mean that the Federal Government of Canada cannot impose common rules on anything within provincial jurisdiction. By contrast the Ronald Reagan government imposed a common drinking age of twenty-one on all the USA. An American administration imposed the infamous “double nickel” 55 mile an hour speed limit on America. It can't be done in Canada.In the USA we see lobby groups and industrial organizations writing model legislation that is hopefully meant to be adapted by all the state governments. This cannot be done in Canada. The Eisenhower administration began to create the Interstate Highway system. This type of federal initiative does not happen in Canada. The federal government of Canada can offer money to the provinces to build better roads and expedite interprovincial trade. However, the roads are provincial roads.So, in Canada, the provinces insist that areas within their constitutional authority are for themselves alone, not for federal guidance. They will not accept pressures to create a nation-wide standard. The closest there is, is medicare. There is the Canada Health Act:https://en.wikipedia.org/wiki/Canada_Health_ActBut, as Wikipedia says:“The CHA deals only with how the system is financed. Because of the constitutional division of powers among levels of government in Canadian federalism, adherence to CHA conditions is voluntary. However, the fiscal levers have helped to ensure a relatively consistent level of coverage across the country. Although there are disputes as to the details, the CHA remains highly popular.In popular discussion, the CHA is often conflated with the health care system in general. However, the CHA is silent about how care should be organized and delivered, as long as its criteria are met. The Act states that "the primary objective of Canadian health care policy is to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers."Non-Canadians sometimes misunderstand. There isn't a Canadian medicare system. There are ten different provincial and three different territorial systems that receive federal funding. But the provinces and territories decide how services will be provided.Provinces Provide a Lot More Services Than StatesWhile the individual provinces and territories have somewhat less constitutional powers than states do, in practise they control a large areas of services (that require support from taxation) that states are not involved in.In Canada, it is the responsibility of the provincial and territorial governments to operate not just medical insurance but the hospital system. Provinces and territories operate most of the post-secondary educational system. Private hospitals are not encouraged in Canada and there are only a few private universities.The reason for this is not because all the provinces and territories have an insatiable desire for socialism. It's because there weren't private sector investors and donors to create their own, non-government, institutions. Under the Canadian constitution the responsibility defaulted on the provincial governments to provide services. For example, almost all universities in Canada are the equivalent of “state” universities.This is how hospital services get provided in the Province of Saskatchewan:https://www.saskatchewan.ca/residents/health/emergency-medical-services/find-a-hospital:and:https://www.saskatchewan.ca/residents/health/understanding-the-health-care-system“The Saskatchewan health care system is made up of many provincial, regional, and local organizations working together to ensure we have healthy people in healthy communities. The Minister of Health oversees the strategic direction of the system, and the Ministry of Health oversees and co-ordinates the delivery of health services in the province.Saskatchewan's health system relies on partnerships at local, regional, provincial, national, and international levels that enable Saskatchewan to provide quality health services that meet the needs of our communities. Most services are delivered through the Saskatchewan Health Authority, their affiliated organizations, and the Saskatchewan Cancer Agency.”Saskatchewan has a Ministry of Health. It's not the American way. Saskatchewan is not Montana.And, higher education in the Province of Ontario:https://www.ontario.ca/page/ontario-universitiesand:https://www.ouac.on.ca/ouac-101/The Province of Ontario operates the undergraduate admission application system. All major universities in Ontario are public ones.So, in Canada, no Kaiser-Permanent. And, there are no prestigious private universities like Harvard. There aren't huge endowments in Canada.In Canada, you want higher education? Deal with your provincial government institution. You need health care? Go to a provincial hospital.Immigration and the ProvincesImmigration is a concurrent power under the Canadian constitution. The federal government has superior jurisdiction. However, the federal government knows, when you are nice and respectful to any given province, the people there are a lot more likely to vote for you. They like to hear the federal government respecting provincial sovereignty and praising the expertise of provincial governments.So, in Canada, provincial immigration nominations:https://www.canada.ca/en/immigration-refugees-citizenship/services/immigrate-canada/provincial-nominees.htmlThis federal website says:“Most provinces and territories in Canada can nominate immigrants through the Provincial Nominee Program (PNP). These immigrants must have the skills, education and work experience to contribute to the economy of that province or territory, and must want to live there.Each province and territory has its own “streams” (immigration programs that target certain groups) and criteria for their PNP. For example, in a program stream, provinces and territories may target students, business people, skilled workers or semi-skilled workers.Since January 1, 2015, many provinces and territories have launched new Express Entry streams. Check their websites to learn more about which streams they offer.”Provincial nominations account for a sizable part of all immigration. This table reports on economic immigrants in 2015. It is from https://www.canada.ca/en/immigration-refugees-citizenship/corporate/publications-manuals/annual-report-parliament-immigration-2016.html#s1.2Economic immigrants are by far the largest class of immigrants to Canada. In 2015, Quebec selected and other province selected immigrants accounted for nearly 40% of all economic immigrants to Canada.The Provinces Mean Something DifferentThere is no real Canadian equivalent to The South or The Midwest. Individual provinces matter. Groupings of province don't mean that much.From the viewpoint of either a Quebecois or someone in the predominantly English-speaking provinces, the federal parliament partially represents another language and another culture. The Federal Government of Canada cannot claim to express a national identity. It doesn't have the prestige or authority to impose common Canadian standards on matters within provincial jurisdiction. Nor can lobby groups, industry organizations, advocacy group or others.Provinces do what they see fit to do in their own juridiction. They have an importance in defining the identity of individual Canadians and in providing them services that states don't.Martin Levine

Probably the public service (federal, provincial and municipal governments) in aggregate is the largest employer and the provincial government no doubt has the most public service employees in the province with almost 14000 full time and part time direct employees. Manitoba Hydro which is a Crown Corporation employs another almost 6000 employees. Then there are the health care workers who are employed by various regional health authorities which are funded by the province. And we should not forget the post-secondary institutions which also receive provincial funding.In terms of private employers I would expect that mining, forestry and agriculture are the big ones.

[EDIT: The question as originally posted contained a Robert Rector - Heritage Foundation study which OP cited to prove that the US overspent its welfare dollars with poor results. That was OP’s attempt to sustain the attitude of the question itself. It has since disappeared. But a skim of the material shows that you can get the sense of Rector’s position from any of a number of his articles.]When testing the assumption of the question ("When will liberals stop denying that social welfare programs only make a country poorer?"), we come up against the theory that "When private-sector contributions to retirement, health care, and education are added to the count, social welfare spending in the U.S. dwarfs that of other nations." (From the referenced article.)OK, the US is the third most populous country in the world, and controls per-capita assets far beyond those of other nations in its class. So spending ought to “dwarf” that of other nations. But let’s look more closely at that spending.The Heritage author, Robert Rector, includes sources such as employer-provided health insurance, retirement pensions and even the imputed benefit of leaving the child with your mother so you can work, as "social welfare" spending. Another huge component of "social welfare"? The dollars you set aside into your 401(k). In fact, the "social welfare state" the writers complain about includes some $6.8 trillion (2015, Employee Benefits News, Trends & Sales Tips) in defined benefit pension plans. That's an awfully broad definition.Let's look at just one part of that to see why spending is so high. (Hint: inefficiencies embedded in capital when applied to social demand.)Corporations contributed nearly $40 billion to their pension plans in 2014. That spending was not out of the fundamental goodness of the executive heart, for there is little evidence of goodness residing therein. Instead, the accountants wrap pension spending into the gross "burden" of operating the business.Every dollar spent on operations must show a profit. The average corporate net profit margin is 7.5%. That means that each dollar of corporate "social welfare spending" costs the public at least $1.075: a highly inefficient spending program, to say the least.Those "social welfare spending" funds are managed by private fund managers. Those guys also take their cut, usually between 1 and 2 percent of the gross assets per year. So in the first year, $1.075 in social spending yields $0.98 in net benefit. Ouch.Leaving aside the thought that, even at these levels, corporations only funded 85% of their pension liability, let's look at what kind of "social welfare spending" program this really is.The pension earned by the employee is not in any way a sure thing. He makes payments (oh, not directly, of course; but his burden rate includes them) into a sort of system which insures that he'll get a specific payout for life on achieving a certain age. Sounds like a social security system, right?If he doesn't live long enough, he gets nada and often enough his widow and estate get nothing as well. Even if he lives long enough, his pension is under the shadow of theft, mismanagement, corruption and outright bad luck, which might mean that his future evaporates. And for this privilege the country's pension "social welfare spending" cost is 8.8% (98/107.5) off the top, a very cringeworthy cost.That is extremely wasteful from the recipient's point of view, but immensely profitable from the point of view of capital.The total per-contribution dollar cost of the nation's Social Security is far less. That program is beneficial to far more recipients. Actual benefits are far more certain — though perhaps less so in the fumey Randian atmosphere of 2017-18 —, less costly and more widely distributed.So consider the total demand for social spending in this, or any, country. The Heritage considers health care, education, retirement, cash transfer programs and non-cash aid (like food banks). These costs must be borne by someone. And today's conservatives are determined to ensure that that demand is filled by private enterprise.Now, for every dollar of service provided by, say, a public school, one dollar (and often more) of service is rendered. For the most part, the public is engaged and rallies around its schools.For every dollar of service billed by a private company, a minimum of 7.5% is skimmed off the top. The public receives 92.5 cents of value. Hooray for capitalism! For-profit schools carve out the wealth of the community. Their methods and results are less reliably obtained and less responsive to community concerns. In fact, they divide the community.In terms of certainty and security, the community's public schools will be around and funded for as long as there are people in the community to fund it - and public schools have a knack for cementing that community together. But how many for-profit schools disappear every year? This article Students scramble to find new high school after last minute closure announcement describes the chaos of one such which evaporated with no notice a few months ago.The demand for social spending as defined in the Heritage article is universal and unavoidable. The country must provide food and health and education to the public, by definition. Failing that, the social experiment is dissolved and new, more responsive, countries are created.Americans in 2014 spent $235 per capita ($75 billion gross) on SNAP, to guarantee at least sub-minimal nutrition to the country. No private enterprise can possibly fill that need. Without SNAP, the nutrition needs of the young are not met. They grow up maladapted with poor learning skills, and become the intake of the for-profit prison industry. For which benefit the public is billed $1 for every 92.5 cents worth of value delivered.Does social welfare spending create poverty? Take a look at numerous tests of guaranteed level income. The most famous example is that of Dauphin, Manitoba, which eliminated poverty ( A Canadian City Once Eliminated Poverty And Nearly Everyone Forgot ) forty years ago.In the US, Social Security and Medicare insulated the elderly post-2008, a time when working people saw their pension plans kneecapped and their "social welfare" 401(k) savings obliterated. While millions of working people were foreclosed and dispossessed by the banks' capital excesses, the vast majority of retired people were protected.Poverty occurs when your retired parents lose everything and move in with your family, falling on your limited resources for their food, prescriptions and health.Extreme poverty occurs when the conservative boots her parents into the street.So, if the brunt of your question is "When?", the answer probably resides beyond your lifetime. And if your children survive the rampant weather that climate change brings, their lifetimes as well.