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It’s time for all of us to get used to saying yes to no

While Eckhart Tolle, that guru of spiritual enlightenment, advocates The Power of Now, I suggest it’s time to embrace the power of no.

To ward off environmental collapse, we’ll have to say no to the way we’ve done things, from driving gas-guzzling cars to using water like it’s an endless resource.

More importantly, we’re going to force our politicians to learn the word, then to accept the message when we hear it coming from their lips.

It’s too late to prevent bailouts to the financial services and automotive industries – the no should have been delivered months ago. Sure, some of the money has been helpful, but some of the largest players were still forced into bankruptcy and outright failure despite the billions of dollars thrown at them.

On the automotive side, both Chrysler and GM ultimately went through U.S. Chapter 11 proceedings, sloughing off the most burdensome of the anchors weighing them down. The billions — $10.6 billion in Canada alone – have not prevented the layoff of thousands of workers and the pending shutdown of several plants. Calculations put the cost of saving each job at $1.4 million. Of course, there are many spinoff jobs at parts makers, dealerships, garages and the like to take into consideration, but it’s clear governments in both Canada and the U.S. have already gone far past where they’d expected to be, and the worst is not over.

Prime Minister Stephen Harper has admitted the “loans” extended to the industry are unlikely to be repaid. At this point, the cost-benefit analysis is not favourable.

Financial support for the industry has accelerated deficits in Ottawa and Queen’s Park. Federal Finance Minister Jim Flaherty now expects this year’s deficit to top $50 billion. This week, a report by TD Bank economists predicts the national debt will grow by $170 billion over the next five years, the result of increased spending and slower economic recovery.

In order to eliminate the deficit and begin paying down the accumulated debt once again, the government of the day will be forced to cut spending and increase taxes. Politicians will have to say no on a regular basis: no to the provinces demanding more transfer payments, no to each federal department, no to public sector unions threatening action against the layoffs and pay cuts that are inevitable, no to business groups still endorsing trickle-down economics, and a big no to vote-buying spending sprees when the next election rolls around.

Under those terms, dealing with this recession is just a warm-up, however, for the biggest no of them all: the one related to the health care spending crush that’s coming as a result of Canada’s aging population. Quite simply, we can’t go on increasing health care budgets at rates well beyond economic growth.

As with the demands on our pension system, where underfunding and a lack of private savings are major threats still not widely acknowledged, our tendency to live longer is placing larger demands on health care.

Statistics Canada figures show the trend: the number of people aged 100 or older increased 50 per cent between 1996 and 2006, and is set to triple to more than 14,000 by 2031.

Meanwhile, Canadians are having fewer babies, shifting the historical balance between the young and the old. Add to that the reality that the baby-boom generation is entering the retirement years – the first of the boomers turns 65 in 2011 – and it becomes clear the Canadian population is aging.

An aging population places larger demands on the health care system. Simple demographics alone, however, wouldn’t skew budgets beyond manageable, as a Senate’s Special Committee on Aging noted in a report released in April.

Rather, the pressure on health care costs created by population aging results from the fact that health care use is typically most intensive in the first and last years of life – per capita spending starts at about $6,000 for children under the age of one, sinking to below $2,000 up to age 65, then rising to about $5,500 from 65 to 75, where spending jumps to more than $8,000 for the next decade, then to more than $15,000 after age 85.

“Although health care costs have increased at similar levels across all age groups over the last decade, the larger basis of spending in older age categories means that proportional increases translate into much larger real costs,” the report found.

It’s overall spending, particularly on new technologies and new pharmaceuticals, that has put so much pressure on budgets and the health care system. Annual increase of six, seven or eight per cent, occasionally nipping into double digits, have caused all kinds of strain. The tricky part that lies ahead is saying no. Who wants to be the one to tell a patient a procedure won’t be done because it costs too much? Eventually, however, those kinds of cost-benefit analyses will become more commonplace – we might as well start getting used to no.

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