Part 1 on decoding public v private healthcare.

Why peer review takes me so long:

Started reviewing a paper citing works I hadn't read. Had to read them to inform my review. Learned of tangential works relevant to my teaching. Had to read them and revise my lectures. Had to get coffee. Finally got back to the peer review.

Viewpoint: To effectively reduce drug costs, the US needs its own price negotiation framework rather than relying on international benchmarks, as proposed by the Trump administration.

ja.ma/4o0PF66

💯 Changing payments without changing critical institutions related to delivery, governance, and accountability will not produce long-desired improvements in primary health care. Providers and some patients will be happier but the system will remain a fragmented and underperforming one.

version française
centreforfuturework.ca/2025/06/17/l...

Canadian “Medicare” is a public good that provides essential services while also creating jobs, economic growth, and competitive advantages for Canada’s economy. Letter reminding our governments of this, signed by 200+ colleagues and me: centreforfuturework.ca/2025/06/17/t...

Book cover. Carol Off, At a Loss for Words: Conversation in an Age of Rage.

Highly recommend.

The 2025 Speech from the Throne mentions #pharmacare once, and only in a promise to keep what is already in place--which is next to nothing. I think the prospect of a meaningful program in the 2020s is dead. Feels like 2006.

Get out and vote as though your country depended on it! #Never51

A lot of national pride tonight.

A great 10-second summary of the stupidity of the Trump/Musk tariffs.

Economic historians are going to look back at this era and wonder what the $%@% people were thinking! This isn't Liberation Day in the USA. It's Liquidation Day!

This is, in large part, pandemic revenge.

As far as these oligarchs are concerned, all science does is tell them stuff they cannot do.

They can't keep spewing carbon.

They can't keep businesses open as usual when millions are dying.

They have concluded that research is the enemy of profit.

In a changed world, Canada faces an information war. There is an answer To fight misinformation, we need to re-establish a critical cabinet portfolio for the digital age.

“Just as strong banking regulations guard against economic catastrophe, comprehensive oversight of our digital landscape is essential to protecting democracy, public safety and national security,” write @petermacleod.bsky.social and @taylorowen.bsky.social

We are learning the wrong lessons from lockdown And unless we learn the right ones, we risk making the same mistakes in a new pandemic

It's 5 yrs today since lockdown started in England, but "We must never have lockdown again" is the wrong lesson.

Lockdowns are terrible but so are deadly pandemics.

Our choices 5 years ago were limited - we can & must do better in the future.

Do read my post.

open.substack.com/pub/christin...

Hundreds of unsold Teslas being stored in a rented parking lot outside of Vancouver — a scene playing out across the globe. But, sure, buying shares in the company is a GREAT idea right about now!!!

ANALYSIS | How province kept rein on health contracting, despite what Danielle Smith says | CBC News CBC News has obtained documents that lay out extensive government influence over AHS contracts with private surgery clinics and more.

Danielle Smith & LaGrange say if there was anything amiss about health procurement, it was all internal to Alberta Health Services.
Here's a long look at the UCP government's many interventions into contracting at AHS:
www.cbc.ca/news/canada/...

What Pharmacy Benefit Managers Do, and How They Contribute to Drug Spending Policymakers at the federal and state level have considered a number of reforms, many of which have bipartisan support, to regulate pharmacy benefit managers.

From the US: maybe not such a good idea having secretive, for-profit financial intermediaries influencing what insurers pay, how pharmacies are reimbursed, and which medications people can access.

Health in Canada: a pivotal political moment As Justin Trudeau steps down after a decade as leader of Canada's ruling Liberal Party, Canadians face a pivotal moment. Although attention is focused on trade tariffs and souring relations with the U...

“Canadians are entitled to a comprehensive health-care plan that prioritises access, equity, and sustainability for all.“ www.thelancet.com/journals/lan...

More of this please!!!

Dear Canada YouTube video by Hockey Films by Tim Thompson

This got me.
I love this country.
I love its hope, its compassion, and its humility—that we know we are not perfect and that we believe we can and must always strive to be better. youtu.be/vhiKlhTmwDU?...

Now is the time for a united and hopeful Canada, not a divided and hateful one. Be strong and resolute without becoming that which we are defending ourselves against.

The universities are next Friends,

2/2: The second points out the long-term cost to America of this authoritarian tactic. "Trump speaks of putting America First, but his attack on the nation’s great research universities is ensuring that the U.S. comes in second — to China." @rbreich.bsky.social

Censor, purge, defund: how Trump is following the authoritarian playbook on science and universities I have mapped 35 of the Trump administration's attacks on science and universities to the authoritarian playbook - and consider what it means for attacks still to come

Two posts about the authoritarian attack on American universities out today. The first is an excellent review of why any how this happens. 1/2: "Autocracies require ideological control and a single narrative about what is happening within the country." @chrischirp.bsky.social

If you run into an American travelling abroad -- even right next door, here in Canada -- treat them with kindness. It is highly unlikely they voted for Trump. And nobody voted for Musk.

The image is a black-and-white political cartoon depicting a man in a suit standing behind a counter labeled "Republican Platform." He is holding a bottle labeled "Untaxed Whiskey, 20¢ Gal." in one hand and a piece of cloth labeled "War-Taxed Common Cloth, Tariff 84%" in the other. Above the counter, a sign reads, "If you don’t see what you want, ask for it." The cartoon, signed by W.A. Rogers, appears to satirize the Republican Party's economic policies, highlighting the disparity in taxation between luxury items like whiskey and essential goods like cloth.

In 1890, the Tariff Act came into place in the United States. It placed tariffs on imports of up to 50%.
While touted as a way to build American industry, there was also the hope it would force an annexation of Canada. It backfired.
Let's learn more.

🧵1/10

Can Canadian institutions please get the hell off of X now?!?!?

Plot of COVID viral load in Vancouver Coastal wastewater treatment plans, showing varied but declining trends since 2022, with comparatively low levels in recent months.

There is not a lot of good news out there but I think this is good news. Vancouver Coastal has the lowest levels of COVID in wastewater since the beginning of the pandemic -- especially for February (latest data). I'm glad they keep measuring this and I hope this trend holds.

Maddow: Two new details learned from Trump's Oval Office meltdown YouTube video by MSNBC

“If the American people don’t want this why are we doing it.” 🤔 youtu.be/iSW8ezOmYHs?...

Announcement: Health Policy At A Crossroads | Health Affairs Forefront <i>Health Affairs</i> is pleased to issue a call for submissions to the new Forefront Featured Topic, “Health Policy At A Crossroads,” focused on salient health policy developments and debates as Pres...

HSR peers, watch this space (and consider submitting work) on US health policy in the Trump era.

(Yes, my Bluesky account is @commonwealthfund.org stan account.)
www.healthaffairs.org/content/fore...