With no success at reducing local emissions in the CRD, maybe it’s time to try something different.
By Peter Gose and Zeb King
THE RECENT DISCOVERY that the CRD is “not even close” to meeting its emission targets (Times Colonist, Aug. 11, 2020) shows that nibbling around the edges of the climate crisis will not get the job done. Existing measures like active transit, charging stations and building retrofits are fine, but do not address the core of the problem. Worse still, they continue the illusion that the solution lies in individual lifestyle decisions. Instead, we need to ask where the bulk of our emissions come from and develop a social infrastructure that eliminates them. The CRD study reveals that automobiles are the single largest source (46 percent) of the region’s emissions. Any real solution must begin by getting cars off the road.
What we need is an electrified, expanded, high-quality public transit network that is fare-free. Any of these changes is welcome and ultimately all are necessary but we see eliminating fares as the crucial first step that will put people in bus seats, build ridership, and so make the case for expanded service. For decades, our leaders at the Transit Commission have tried the reverse approach of improving service levels within the existing fare model and have failed to build a system that reverses automobile dependency. Maybe charging fees for a service you want people to use is counterproductive. It’s time to try something different. How about getting rid of fares to encourage use of public transit as an environmentally responsible alternative?
So our call is to temporarily put aside all the technological discussions about how great our transit system could be if only it was fully electrified to eliminate carbon emissions and featured amazing apps. None of that matters unless ridership dramatically increases. For now, we even suggest parking the hope of extending service to currently neglected areas. Yes, these should be goals, but they put the cart before the horse. Demand must come first and can surge even with the existing service if we only remove fares as a regressive user fee. Once public transit has a larger user base, the Commissioner’s dreams of an improved bus fleet and levels of service will have a natural constituency. If we want the CRD to act fast in “getting close” to meeting its emissions targets, fare-free public transit is where we have to start.
Our belief in fare-elimination as the first step in a transformative sequence is grounded in historical experience. When the University Pass was applied to every student at UVic in the 1990s, ridership increased dramatically. In fact, it was such a success with packed buses that transit had to scramble to improve service, put on more buses and thus increase frequency. This wasn’t the “wait for service changes” approach. It was about unleashing demand which forced service improvements. We simply propose up-scaling this proven approach to the entire system.
How would we pay for fare-free transit? The short answer is by following through on the logic of our existing system, in which provincial and municipal taxes already pay around 75 percent of the costs. By eliminating the fare-box and topping up the difference with increased taxes, we will acknowledge that public transit depends on public funding, and end the charade that a regressive user fee that suppresses ridership is how we actually pay for it. Instead, we would adopt a progressive funding formula, one that is based on the ability to pay through our tax system. We do not charge user fees to take elevators in buildings, walk on sidewalks, drive on roads, borrow books from libraries, put out fires or for medical services: why, especially during a climate crisis, should user fees exist for public transit? More to the point, if we fail to address the climate crisis now, exponentially greater costs await us in the coming decade. There is no economic case against effective climate action.
The CRD cannot just passively audit its own failure to meet emission targets. Mayor Lisa Helps has called for “bold suggestions” but our proposal for expanded, fare-free public transit is hardly that. It merely applies to public transit a full public funding formula that we successfully use for other essential services. Neither business as usual nor green austerity, our proposal would reduce emissions dramatically while also creating a more inclusive society for low-income people, safer neighbourhoods with reduced traffic, and a higher quality of life for everybody. It is a collective solution whose time has come.
Peter Gose, (Professor Emeritus, Carleton University) and Zeb King, Central Saanich Councillor
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Nurse Practitioners can offer care is equal to or better than that of family physicians and is more cost-effective—but there are some hurdles to overcome. THE EVOLVING PHYSICIAN SHORTAGE in BC and elsewhere in Canada is receiving a great deal of media attention. Our region is not immune to this growing shortage, as many residents know well. Most of the solutions proposed involve making it more attractive for doctors to practice here. There is an alternative. I firmly believe that if certain barriers were overcome, we could have comprehensive, patient-focused primary health care for people of all ages with better utilization of Nurse Practitioners (NP). So what are some of the barriers that NP’s face, and why are they not more widely used? The public, doctors and health care administrators do not realize their full scope of practice and may not trust that they are as well trained as doctors in diagnosing and treating disease. According to Dr. Susan Prendergast, an NP professor at the University of Victoria, “the evidence strongly shows that their care is equal to or better than that of family physicians and is significantly more cost-effective.” NP’s are Masters prepared nurses who are trained and licensed to autonomously diagnose and treat illness. They can order and interpret lab tests and x-rays, prescribe medications and perform many medical procedures. They are trained to treat you as a whole person, to consider your health’s impact on your family and community, and to teach you about disease prevention and promotion of good health. They can also assist people with management of chronic illnesses such as diabetes or Alzheimer’s Disease. They work in medical clinics, community health centres, hospitals, long-term care settings and outpatient clinics. Most are hired on a salary which in Canada is estimated to be $98,000 annually. There are currently about 7,140 licensed NPs in Canada. A recent NP client, Linda B., commented that “Following my NP doing my annual physical and lab work, I had an extensive interview with her, and I felt like I was really being listened to. My doctor retired, and now my NP does everything he did except surgery. I find that with the other members in her team practice, I get care that is complete, efficient and timely.” Another major barrier is the current hiring practices of NP’s. Most are hired on contracts, with inadequate compensation that does not include benefits such as health care and maternity leave. Dr. Prendergast noted, “many leave high paying Nursing positions only to discover that after expenses, they are actually working much harder for less pay.” A third barrier exists in the education of NPs. Because there are too few practicing Nurse Practitioners in the province, practicum placements for students are at a premium, thereby limiting enrolment size. The government had planned to double the number of enrolees in BC, but Nursing Schools are unable to comply. Physicians can—and sometimes do—supervise NP students, but they must do so without pay. Most prefer to take on medical students as the compensation rate for their supervision is significant. It is clear that a partial solution to the current physician shortage is to fully engage Nurse Practitioners in our health care system. They have the potential to more fully involve patients in decisions about their health care, improve access to primary care and reduce pressures on the health system. As a health profession in Canada since the 1960s and regulated in BC since 2005, it is time to renew our commitment to NPs and address our primary care shortages. Zeb King is a Municipal Councillor for Central Saanich and Royal Roads University student. He formerly spent 13 years in Health Human Resources at the Ministry of Health.
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