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Health care: A tale of two electoral timebombs
With Americans heading to the polls in November and Canadians set to join them by October 2025, political parties on both sides of the border are busy defining the stakes of their campaigns. Key themes include the economy, immigration, and, in the US, democracy itself, with health care emerging as a particularly contentious issue affecting nearly every voter.
Pew Research Center in May found that health care affordability ranked among the top issues for Americans, with 57% saying it’s “a very big problem” and 32% citing it as “a moderately big problem” – a concern that held across party lines, but not equally. While 65% of Democrats cited it as “very big problem,” just 48% of Republicans did.
Canadians are just as concerned, with health care ranking third among the top issues facing Canada at 42% and only housing affordability/accessibility (46%) and the rising cost of living (71%) outranking it.
It’s demographics, stupid
Both populations are aging, and seniors require more medical resources. The US is expected to see its 65-plus population rise from 58 million in 2022 to roughly 82 million by 2050.
In Canada, meanwhile, the senior population is expected to jump by 68% between 2017 and 2037, with the 75-plus cohort set to double.
Outcomes are less than ideal
Health-related costs and outcomes in both countries are far from optimal. While some see the Canadian health system as a blessed alternative to the American one, Canada’s outcomes are mixed. Its universal, single-payer health insurance is covered by provincial governments and funded by shared money between the provinces and the federal government, but it’s far from perfect.
Canada spends about CA$344 billion on health care, or 12% of its GDP. And yet a recent study found that in the country’s most populous province, Ontario, wait times varied wildly across hospitals, with some patients waiting for up to a year for hip replacements and knee replacements. For some patients, the waits can be deadly: A report last year revealed that at least 17,000 Canadians died while waiting for surgery or diagnostic scans in 2022-2023, and hundreds of emergency rooms closed nationwide owing to a lack of staff. Meanwhile, more than 6 million Canadians – roughly 15% – do not have a family doctor.
But the Canadian system does have a leg up in some ways on its US counterpart, where the country spends more on health care than any other rich country. American health care spending hit $4.8 trillion in 2023 between private and public sources – roughly 17% of GDP. And it’s rising, with spending expected to reach nearly 20% of GDP by 2032. A huge chunk of that comes from individual Americans, with the average yearly employer health premium running now over $8,400 and family plans just under $24,000. For individual plans without an employer option, premiums averaged nearly $1,200 a month.
The US is the only rich country without universal health care. And while the number of uninsured Americans has fallen in recent years, approximately 27 million lack coverage – and that number may rise as millions more are struggling to afford health insurance.
According to data from the office of Sen. Bernie Sanders, 68,000 Americans die annually because they lack access to health care. Also, a third of Americans do not have a family doctor – a failure that leads to increased chronic conditions and a rise in deaths. The American system is so troubled that it has contributed to a decline in average life expectancy in recent years, from 79 in 2019 to 76.4 today.
Who’s going to fix health care?
In the US, Donald Trumpsays he’s open to cutting Medicare and opposes universal coverage despite supporting it in the past – some have warned that the former president would even “destroy” Medicare. Meanwhile, Trump has warned that if KamalaHarris wins in November, the US would be “thrown into a communist system,” one where “everybody gets health care.”
Harris, who previously backed a universal, single-payer system, has abandoned Medicare for All. Instead, she says she’d build on Biden-era policy planks including Medicare price negotiations aimed at lowering drug costs for all patients, including those on Medicare and other plans.
The Canadian election is still more than a year out, and the main parties haven’t yet released platforms. But the governing Liberals face pressure to fix the health care system. That is primarily the responsibility of the provinces, but the feds pour billions of dollars into it each year.
In May, Prime Minister Justin Trudeau’s budget included an annual 5% health care funding increase to the provinces through 2028 – over CA$200 billion in total. His government also committed to student loan forgiveness for doctors and other health professionals who work in rural and remote communities and to improve the process of getting foreign credentials accepted for immigrants in the field in a bid to boost medical professional numbers, alongside other measures.
The feds are also pursuing dental care and prescription drug programs aimed at covering expenses for millions of Canadians. That sounds like a lot, but the bulk of the work remains up to the provinces, who are primarily responsible for health care policy.
The Liberals claim Conservative Party leader Pierre Poilievre would axe pharmacare and other social programs, but he hasn’t committed one way or another. His party hasn’t released a full plan but has said the solution to fixing problems associated with the doctor and nurse shortage would be a national testing standard for licensing that would speed up the credential recognition of foreign-trained workers.
Poilievre has also committed to maintaining the Liberal’s 10-year funding plan and says he’ll make cutting wait times a priority.
What does all of it mean for the ballot box?
Health care is already shaping electoral strategies in both Canada and the US. At the DNC Convention this week, Sen. Bernie Sanders hammered on lowering health care costs, a goal that’s dominating much of the gathering, and New Mexico Gov. Michelle Lujan Grishamwarned that Trump and JD Vance would “dismantle” affordable care.
Graeme Thompson, a senior analyst with Eurasia Group’s global macro‑geopolitics practice, says Harris is “running away from promises for Medicare for All as part of a broader strategy to tack towards the political center.” He thinks this is a bid to present herself as a “generic Democrat” who’s not going to scare anybody, a move that may be critical to her chances of winning in November.
Up north, however, the governing Liberals can’t do the same. Thompson says it will be tougher for Trudeau to try to pull off such a maneuver since he’s been in power for nearly a decade. Instead, Trudeau will have to make the case that the money transfers and reforms his party has introduced federally will help enable provinces to reduce wait times, keep ERs open, and ensure Canadians can find a family doctor.
“To the extent that [Trudeau] brings up health care as leverage against the Conservatives to try to paint a picture for voters of a Conservative Party that is out of step with the mainstream,” he says, “that may backfire by highlighting the problems in the system already.”
The problems that have mounted over decades won’t be solved in a few months or years, but voters still expect results and both nations face a common challenge in the run-up to Election Day: to fix a healthcare system that neither side can afford to ignore, yet neither seems able to cure.
Shaar Liva Hebrew school and synagogue are operating in Toronto, Ontario, Canada, on August 17, 2024
HARD NUMBERS: Jewish orgs get mass threat, Canada’s inflation keeps falling, Harris’ fundraising dwarfs Trump’s, US jobs numbers revised downward
100: More than 100 Jewish institutions across Canada received an identical bomb threat early Wednesday. The email warned of explosions at synagogues, community centers, and hospitals in Toronto, Ottawa, and Montreal. Authorities are investigating but said the risk was “low.” A recent poll showed a quarter of Canadians consider antisemitism a “serious problem.” Last year, attacks on Jews accounted for 70% of all hate crimes in Canada.
40: Annual inflation in Canada fell to its lowest level in about 40 months in July, as prices grew just 2.5%, down from 2.7% a month earlier. The good news is this gives the Bank of Canada room to continue cutting interest rates at its next rate-setting meeting in September. Markets now expect the regulator to slash rates by another 25 basis points, bringing the benchmark to 3.75%.
4: Good vibes make money, money makes good vibes. Kamala Harris’ main campaign fundraising group brought in four times as much money as her opponent Donald Trump’s in July, raising $204 million to the GOP nominee’s $48 million. The vice president also spent three times more than her rival that month as she looked to get herself on a firm footing after President Joe Biden’s withdrawal from the race.
818,000: The US economy created 818,000 fewer jobs than initially reported in the first quarter of this year, according to a regularly scheduled revision of figures released on Wednesday. If this number holds through the next review of these numbers (in February), it would be the largest downward correction for a quarterly jobs number in 15 years. But look for the Trump campaign to hammer Kamala Harris and the White House over this news well before then…Graphic Truth: Hurricanes US and Canada
The 2024 Atlantic hurricane season is shaping up to be exceptionally active, with forecasts predicting 17-25 named storms, including 8-13 hurricanes and 4-7 major hurricanes. This surge in activity is driven by unusually warm Atlantic waters and El Niño conditions.
Hurricanes are becoming increasingly expensive for the US, with recent storms like Ian in 2022 and Ida in 2021 causing over $113 billion and $75 billion in damages, respectively. This trend is exacerbated by climate change, which intensifies storms and raises sea levels, amplifying coastal flooding.
An unarmed Minuteman III intercontinental ballistic missile launches during an operational test at 2:10 a.m. Pacific Daylight Time at Vandenberg Air Force Base, California, U.S., August 2, 2017. Picture taken August 2, 2017.
Washington tries to reassure Beijing over nuclear strategy
The White House on Wednesday tried to ease Beijing’s “serious concerns” over reports that the US is adjusting its nuclear strategy to incorporate more of a focus on East Asia. The US National Security Council said it “is not a response to any single entity, country, nor threat” and that North Korea and Russia factor into the shift.
China’s foreign ministry said “the United States has constantly stirred up the so-called China nuclear threat theory in recent years.” China objects because it has always maintained a no-first-use policy with its nuclear weapons, and its arsenal is small compared to Washington’s 3,700 warheads.
Still, China has been arming – the Pentagon estimated last year that Beijing now has 500 warheads and may reach 1,000 by 2030. But from China’s point of view, that’s just playing catch up, says Eurasia Group’s Jeremy Chan. “Beijing sees US rhetoric about arms control as an effort to lock in the Chinese arsenal at a level that is still a fraction of Washington’s,” he explained. “They want to play for more time.”
US and Chinese interests may not be entirely misaligned. Chinese President Xi Jinping reportedly told Russian President Vladimir Putin, for example,to quit threatening to use nuclear weapons in Ukraine when the two met in Moscow last year, and Chan notes that nuclear proliferation is one of the few issues where Beijing won’t cover for North Korea.FILE PHOTO: A soldier stands at Trident Pier, a temporary pier to deliver aid, off the Gaza Strip, amid the ongoing conflict between Israel and Hamas, near the Gaza coast, June 25, 2024.
US to scrap Gaza pier project
US military officials announced Wednesday they would dismantle the floating pier they had attempted to operate off the coast of Gaza, ending a difficult, expensive, monthslong mission to provide aid to civilians in the enclave.
Troubled from the start, the $230 million pier was announced in March but did not come online until May. It was only operational for about 20 days and has faced multiple challenges due to rough waters. It is currently anchored in the Israeli port of Ashdod.
When it was functional, it was used to deliver about 8,000 metric tons of aid — roughly equivalent to what humanitarian agencies say needs to enter Gaza every day.
The pier was pitched as a way to ensure Gazans on the verge of starvation could access food, medicine, and clean water while allowing Israel to continue its military campaign against Hamas. A UN-backed global hunger monitor reported last week that over 495,000 people are facing the most severe level of food insecurity, approximately 22% of the population, and hunger is widespread.
Microsoft’s Inflection deal gets a closer look
The UK’s antitrust regulator is scrutinizing Microsoft’s unique relationship with Inflection AI. The PC giant did what some have called an “acqui-hire” — not buying the company outright, but rather hiring many of its former leaders and employees instead.
Microsoft poached the once-$4 billion startup’s co-founders Mustafa Suleyman and Karén Simonyan as well as “most of its staff.” It paid $650 million to license Inflection’s technology, which is how investors will get their returns. Now, the UK’s Competition and Markets Authority is looking at whether the deal is a “de facto merger,” a decision it’s expected to make by Sept. 11.
Microsoft is already facing scrutiny for its $13 billion investment in OpenAI in the US and UK, choosing to relinquish its non-voting board seat to stave off further criticism last week. We’re watching for how Microsoft fares in court, and whether it changes its tack in competing for the top talent and tech in AI development.Japan's Foreign Minister Yoko Kamikawa and Philippine's Defence Minister Gilberto Teodoro shake hands after signing the reciprocal access agreement, at the Malacanang Palace in Manila, Philippines, July 8, 2024.
Can Japan afford to muscle up?
Japan and the Philippines signed a new defense pact on Monday, allowing the mutual deployment of forces to each other’s territory for training – part of a larger mutual effort to stave off China. But while Tokyo’s diplomats are sealing deals with much-needed allies, its defense officials are stressing that a weak yen threatens to eat up their budgets.
Before the Filipino deal, Prime Minister Fumio Kishida reached similar defense agreements with Australia and the UK, and he has established historically warmer ties with South Korea, improving political and military cooperation. He is also trying to double defense spending by 2027, which would make Japan the world’s third-largest military spender. So why is Tokyo slashing orders for new airplanes and warning of more cuts?
Chinese sailors armed with axes and machetes threaten Filipino sailors on a supply run, 17 June, 2024.
Marcos cools temperature in South China Sea
Philippine President Ferdinand Marcos Jr. attempted to de-escalate tensions between Manila and Beijing this Saturday following last week’s violent maritime confrontation during a resupply mission to the Second Thomas Shoal. Chinese forces last Monday rammed Philippine navy boats, confiscated rifles and inflatable craft, and attacked sailors with axes and machetes.Five seamen were treated for injuries including one who lost a thumb.
“We are not in the business of instigating wars,” Marcos said at a ceremony awarding medals to soldiers involved in the mission, but added: “We will never be intimidated or oppressed by anyone.”
Marcos refused to invoke his country’s 1951 mutual defense treaty with the US,which condemned China’s actions, as did the European Union, Japan, Australia, and other Western and Asian nations. Washington has made it clear to Beijing thatthe treaty requires it to defend Philippine forces if they are attacked.
In what some are calling a concession to China, Marcos also approved a recommendation by the Philippine National Maritime Council to publicize the navy’s schedule for supply runs to the Shoal. Executive Secretary Lucas Bersamin suggested that China’s lack of prior knowledge about the latest missionmay have triggered the confrontation. We’ll be watching whether improved communication can keep a lid on Beijing’s aggression in the area.