Provincial borders still barriers to doctors

Health-care professionals are still having difficulty moving across borders within Canada despite provincial governments' efforts to reduce barriers to labour mobility.

Provincial governments agreed in December 2008 to a deal that was supposed to make it easier for professionals to transfer their licences between provinces.

But some doctors say the colleges who are responsible for approving licences aren't respecting the provincial agreement. "This is something that was agreed amongst the politicians but it was not agreed amongst the physicians," said Dr. Rubens Barbosa, a Brazilian-trained anaesthesiologist working in Edmundston, N.B., who recently had an application to transfer his licence to Ontario rejected.

The responsibility for who does and doesn't become licensed is left up to bodies that are run by physicians in each province.

The problem is that these colleges "are reluctant to accept a law that was proposed by the politicians and they're doing whatever they can to prevent this from happening," said Barbosa.

Provincial governments were hoping the changes would help fill in holes in the skilled workforce. Many provinces — including Ontario, Saskatchewan and Manitoba — are currently facing a shortage of doctors as many residents are unable to find a family physician.

About four million Canadians, or about 12 per cent of the population, don't have a family doctor, a 2009 poll conducted for the College of Family Physicians of Canada suggested.

A spokeswoman for the Ontario College of Physicians and Surgeons, the organization that rejected Barbosa's application, denied the charge that it doesn't respect the mobility law.

"The CPSO respects labour mobility," Kathryn Clarke wrote in an email.

But the body that represents colleges across the country said they are aware that those working to transfer special licences across provincial boundaries are still facing challenges.

Differing standards

The issue is that restrictions on special licences, which can include requiring the holders to be supervised by more experienced physicians and only allowing them to operate if the province has a shortage of the physicians' specialty, are not equivalent across provinces.

"We are working on how we could facilitate for them a mobility from one jurisdiction to another taking into account the fact that they don't have a full licensure," said Dr. Yves Robert, the president of the Federation of Medical Regulatory Authorities of Canada.

Robert said he expected a new agreement that would bring in a common set of standards for specially licensed physicians between provinces would be approved within a year.

The majority of physicians who practise with special licences in Canada are internationally trained, said Dr. William Lowe, a past president of the MRAC.

They usually use these as a stepping stone to becoming fully accredited and eventually helping to address the country's doctor shortages.

Barbosa said he has consulted with the Canadian Medical Protective Association, an organization that provides doctors with legal advice, and it is currently looking into the issue on his behalf.

Luce Lavoie, the director of communications for CMPA, did not confirm or deny that was the case. She also declined to comment on the overall issue of labour mobility for doctors because the organization has yet to issue a policy position on it.

Few approvals despite law

Numbers maintained by the colleges suggest the changes to the Agreement on Internal Trade, which was updated in April 2009 with the new labour mobility provisions, have done little to change the number of physicians moving from one province to another.

The College of Physicians and Surgeons of Nova Scotia has granted licences to about 250 applicants since April 2009, six of those under the labour mobility provisions.

"The numbers have not changed dramatically at all," said Bruce Thorne, manager of policy and communications for the college, referring to the approvals they've given since the new provisions were introduced.

The College of Physicians and Surgeons of Alberta has approved five applicants under the new labour mobility provisions out of a total of about a thousand approved in 2009 and 2010, said spokeswoman Kelly Eby.

They have another 22 who are currently in the application process.

The Ontario college rejected 26 applicants who had applied under the labour mobility provisions between January 2010 and April 2011, said Clarke. Most of these people had restricted licences.

Many other licensing bodies don't maintain numbers showing how many applicants who applied under the labour mobility provisions have been approved or rejected.

Barbosa had applied under the inter-provincial mobility rules the provinces had promised would bring an end to the restrictions for physicians.

The College of Physicians and Surgeons of Ontario rejected his application in December 2010.

Colleges are only required to accept an application under the labour mobility provisions if they have a similar category in their licensing process.

The Ontario college did not grant Barbosa a licence because they said there was no equivalent category in Ontario, a copy of the decision reached by the province's Health Professionals Appeals and Review Board reads.

But Barbosa disputed that claim, saying he already had a full licence he has been operating under for five years.

Related articles

• Doctors face issues moving between provinces (ctv.ca)
• Provincial borders still barriers to doctors (cbc.ca)

Ouch! U.S. booted from Triple-A debt club

Source: CNN money
By Annalyn Censky @CNNMoney August 6, 2011: 2:52 PM ET

These 15 countries (and the Isle of Man) have the world's highest credit rating, AAA from both Moody's and Standard & Poor's. The U.S. lost that high standing Friday, when S&P downgraded it to a AA+ rating.

NEW YORK (CNNMoney) -- The Triple-A debt club just got even more exclusive: Late Friday, the United States was booted out of a prestigious group of countries that boast a spotless credit rating.

Now only 15 countries (and the very small Isle of Man) hold the triple-A rating from both Standard & Poor's and Moody's.

Canada, France, Germany, Norway, Sweden and Switzerland are among those with the undisputed stamp of approval -- so is Isle of Man, a British crown dependency off the United Kingdom's west coast, and Singapore (both of which are too small to see on our CNNMoney map above.)

The triple-A rating enables nations to borrow funds at a low cost, because their governments are considered stable and their bonds safe.

S&P downgrades U.S. credit rating

The United States for example, has seen its dollar become the world's No. 1 reserve currency because its bonds are held in such high regard by investors. They're backed by the "full faith and credit of the U.S. government" -- which until now, has never seriously been called into question.

On Friday, S&P downgraded the United States to AA+, an investment grade level just one notch below triple-A. It marked the first time the world's largest economy has been downgraded, since Moody's first gave the country a credit rating in 1917.

S&P cited estimates that U.S. government debt would balloon to 79% of the size of the entire U.S. economy by 2015, and 85% by 2021 -- a level S&P says is consistent with AA+ rated countries.

In comparison, estimates from the International Monetary Fund show triple-A rated Canada's debt is likely to only rise to 34% of its economy by 2015, and Germany's is forecast to rise to 52%. (The IMF does not publish forecasts out to 2021).

Your money in a AA-rated U.S.

The debt of Belgium, another AA+ rated country on S&P's list, is expected to grow to 85% of GDP by 2015, according to the IMF.

Abu Dhabi, with a AA rating, is just a step below AA+. Also in that group are Bermuda, Chile, Qatar, Slovenia and Spain.

Meanwhile, China -- the world's second largest economy -- is rated two notches below the United States, at AA-.

Greece -- the lowest rated country in the world -- is forecast to see its debt well exceed the size of its economy, at 149% the size of its GDP in 2015. 

First Published: August 6, 2011: 11:47 AM ET

Canada keeps AAA credit rating

Image via Wikipedia

BY ERIC LAM, POSTMEDIA NEWS JULY 28, 2011

As the debt spectacle continues in Washington, Moody’s Investor Service renewed Canada’s AAA credit rating on Thursday.

While all eyes are on the United States as it tries to hammer out a deal to raise its borrowing limit by Aug. 2, avoid a debt default and a possible debt downgrade, Canada sailed through its annual credit checkup with flying colours.

Moody’s said the country’s high resiliency, government financial strength and low susceptibility to risk were key to the top marks.

Here’s a breakdown of the reasons why Moody’s says Canada deserves the highest possible credit rating:

Economic strength: Very high.

Canada missed the worst of the financial crisis because of the financial strength of its banks and only a mild downturn in the housing market.

The country had a stronger rebound from the recession, with a 3.2-per-cent rise in gross domestic product, compared with 2.9 per cent south of the border. Moody’s said monetary policy and Ottawa’s stimulus program helped the recovery.

There are important differences between the Canadian and U.S. economies that affected Moody’s evaluation of Canada’s strength, including the fact that trade in goods and services makes up more than half of Canada’s GDP, compared with less than one- third in the U.S. This points to a greater degree of openness in the economy, it said.

Canada also has lower federal debt and a stronger banking system and housing market, as well as a higher domestic saving rate, resulting in less reliance on external financial markets.

Institutional strength: Very high.

Fiscal discipline at the Bank of Canada, inflation control, government effectiveness and rule of law all rank highly.

Economic and fiscal policies have remained stable for the past 15 years under Liberal and Conservative governments. Some tax differences exist, but the overall goal of fiscal balance and declining debt has been a constant.

While the proportion of total government debt credited to provincial, territorial and local governments is the highest among major countries, and Moody’s judges the risk of the federal government having to step in to assist these governments with their debt payments as high, it said local ratings indicate little risk that such assistance would actually be needed.

Government financial strength: Very high.

This evaluation is based on a well-established pattern of budget surpluses at the federal level, except during exceptional circumstances such as the financial crisis, leading to declining government debt and debt ratios since the 1990s.

Susceptibility to event risk: Low.

The most important risks are related to the housing market and to separatism in Quebec, although the probability of either affecting Canada’s rating is quite low.

© Copyright (c) The Montreal Gazette

Read more:http://www.montrealgazette.com/business/Canada+keeps+credit+rating/5175904/story.html#ixzz1UIAx3oiE

Moody’s maintains Canada Aaa credit rating

Moody’s Investor Services is renewing Canada’s triple-A debt rating, the highest possible.

In its annual report on Canada's sovereign ratings, the firm said the Aaa rating was warranted due to the country’s high degree of economic resiliency, efforts by Ottawa and the provinces to deal with their debt ratios over the coming years and other factors.

The economy’s very high degree of resiliency is demonstrated by a high per capita income, the large scale of the economy, and its diversity, says the Moody’s report. Natural resource industries, a competitive manufacturing sector, and a well-developed and well-regulated financial market also support the country’s resiliency.

While Canada’s public finances deteriorated as a result of the global financial crisis, the federal government and the provinces are now on a track of fiscal consolidation that will improve general government debt ratios over the next few years, according to Moody’s.

Although general government debt, including the debt of the provinces and municipalities, is similar to that of other large Aaa-rated countries, the federal government’s debt position by itself is relatively low. As the provinces are highly rated, Moody’s considers the contingent liability from this source to be low, despite the relatively large size of provincial debt.

Canada’s current account balance returned to surplus in 1999 and remained there until 2008, bringing down the reliance on foreign capital inflows. This has risen somewhat in the past two years but is still not considered a risk to financial stability. Canada’s susceptibility to event risk is low and is related to the housing market and to Quebec’s sovereignty issue.

S&P affirms Canada rating, lauds fiscal discipline

Reuters) - Ratings agency Standard and Poor's affirmed Canada's AAA rating on Friday and lauded the country's strong finances compared with its Group of Seven peers.

The review stood in sharp contrast to growing pressure on the ratings of many Western countries, highlighted by this week's downgrade to Greece's sovereign debt by Moody's Investors Service. [ID:nLDE63L28G]

Standard & Poor's affirmed Canada's AAA long-term and A-1+ short-term sovereign credit ratings with a stable outlook.

"Canada has what we view as strong public finances, a relatively diversified economy, stable public policy, and a sound financial sector," the agency said in a statement.

"The stable outlook reflects our opinion that Canada has the political capacity and will to respond quickly to changing conditions, and the strongest fiscal position of the five 'AAA' rated G7 sovereigns."

The other G7 nations with AAA ratings are the United States, France, Germany and Britain.

S&P cut the outlook on Britain's AAA rating to "negative" on May 21, 2009, a move that typically carries a one in three chance of a downgrade. [ID:nLL292085]

Some analysts have speculated the top-tier credit rating of the United States could be cut one day, an idea rejected by U.S. Treasury Secretary Timothy Geithner. [ID:nN16225360] [ID:nN18366282].

Canada's Conservative government, in presenting its annual budget last month, pledged to turn off the stimulus tap and curtail spending sharply after the economy recovers. [ID:nCFB000108]

"We expect the prevailing consensus on the need for robust public finances, across Canadian regions and political parties, to avoid a return to recurring, structural deficits, in the medium term," S&P said.

The agency also said Canada's financial system is well-developed and sound. The nation's banks did not require government bailouts during the economic crisis and have been ranked as the world's soundest by the World Economic Forum. (Reporting by Jeffrey Hodgson; editing by Rob Wilson)