The Future of Customer Loyalty in American Business

It is worth noting that this is essentially the same promise that was made by the Ford administration. According to the premier's press release, "Our government is taking bold action to reduce wait times for surgeries, all while ensuring Ontarians use their OHIP card to get the care they need, never their credit card."Regardless of the bluster from unions and left-wing academics, it's tough to say that the Ford administration is motivated by a hard-right, anti-public health-care ideology when it's just implementing an NDP government's plan more than two and a half years later.The genuine story may be less appealing to ideologues and partisans, but it does not make it less true. These administrations, with varying priorities and inclinations, have reached the same conclusion: we must increase health-care supply to match demand, and it would be immoral to forego private diagnostic and surgical capacity only for ideological grounds.Make a one-time charity payment to help keep The Hub free of advertisements. Even $5, $10, and $15 helps The Hub continue to provide an ad-free reading environment.There are real concerns regarding invoicing, personnel, and standards in public and private delivery, but these are primarily technical matters. They are easily addressed through a mix of regulation, financial conditions, and market forces. Ontario is hardly the first jurisdiction in the world to address these fundamental issues. The administration may even confer with other provinces and foreign counterparts on how to increase commercial supply while without damaging the public health-care system.

The crucial point, however, is that the glib 

criticism that the Ford government is made up of right-wing dogmatists hellbent on undermining the principle of universal health care simply contradicts the facts. Its plan is standard fare that should help dig the province out of its pandemic-induced hole without addressing the Canada Health Act or more fundamental problems about how to finance and deliver health care in Canada in a more efficient and sustainable manner.Health-care reform will not be implemented without opposition. Of course, certain groups and voices are determined to preserving the failing status quo for ideological and self-interest reasons. But the conditions for reform have never been better, and the ad hominem attacks have never been weaker. The Ford government should be commended for taking realistic, common-sense efforts to solve Ontario's diagnostic and surgical backlog—even if it is simply borrowing from its provincial peers, including progressive ones, across the country. An end-of-year news release caused an important economic story to go mostly ignored late last year. The federal government announced its key budgetary transfers to the provinces and territories for 2023-24, revealing that the Province of Ontario will receive an equalization payment for the eleventh time since the program's inception in 1957, and the first time in five years.

There are mitigating conditions at play

The confluence of strong inflation and the equalization program's design (in which the funding envelope grows in tandem with nominal GDP growth) resulted in an increase in total program spending and increased equalization entitlement for Ontario. Trevor Tombe, an economist from the University of Calgary and a regular Hub writer, has published an excellent explanation of the policy quirks that resulted in such an outcome.But it would be incorrect to dismiss the news entirely as an arithmetic anomaly. The fact that Ontario's fiscal capacity surpasses the national average does not necessarily indicate a dynamic and vibrant economy. For example, even before accounting for resource-based earnings, the province's fiscal capacity is lower than that of Alberta and British Columbia.This shift toward a middling economy did not occur suddenly. As co-authors and I explained in a 2020 policy study, Ontario's economic growth rate has been in secular decline for decades. Over the course of the century, its yearly average growth rate has been less than 2%.Slow growth is not without consequences. It has become a cumulative drag on Ontarians' living standards, particularly in comparison to their American neighbours. When I was born 40 years ago, the province's GDP per capita (which is a good indicator of its standard of life) was higher than that of neighboring states such as Michigan, Ohio, and Pennsylvania. Today, Ontarians are poorer than their American counterparts from Warroad, Minnesota to Buffalo, New York.

There is an argument that Ontario has 

effectively become North America's "sick man". And there's reason to believe it'll just become sicker.RBC Economics predicts that Ontario's real GDP growth will be the lowest among the provinces in 2023 and the second lowest in 2024. In fact, RBC predicts that the Ontario economy will be the only one in the country to decrease during the next year.

One would expect such a distinction to push Ontario leaders into pursuing a pro-growth agenda. The province's economy need "shock therapy." However, it would most likely not receive it.The Ford administration first took office in 2018 with big promises of a "open-for-business" agenda, which never materialized. That's not to say there haven't been any positive policy changes. Early regulatory reforms; tax cuts (including accelerated depreciation on capital investment, as well as lower business property taxes and employer health taxes); significant investments in public infrastructure; some interesting intellectual property developments; and Labour Minister Monte McNaughton's ambitious agenda in the labor, skills training, and immigration portfolios.However, it is fair to argue that the government's overall performance is disappointing. Its early aspirations have generally been reduced to an odd mix of populist economics, left-wing accommodation on COVID-19, education, and public spending, as well as a proclivity to become embroiled in political controversies without resulting conservative reforms.The province is now at a crossroads. It's caught in a slow-growth cycle of sclerosis and stagnation. It is no longer enough for the government to concentrate on trivial matters. It has to recommit to growth.