Letters, Sept. 8

Keep momentum going

There has been some genuinely good news for women’s health in Manitoba.

And it is worth saying that plainly.

Prescription birth control is now covered. Hormone replacement therapy is covered. Pharmacists can now prescribe several forms of contraception. Breast screening access is expanding. Prenatal supports have improved. Some pregnant patients can access funded non-invasive prenatal testing. Fertility supports have also become more generous.

None of this is trivial.

For years, women have quietly absorbed the cost of care that is not optional simply because it happens to be related to reproduction, pregnancy, fertility or menopause. So, when those costs begin to disappear, that is progress.

Credit where it is due. But perhaps the next question is more important: What happens after something becomes covered? Because coverage is not always the same thing as care.

A medication can be free and still be difficult to access. A screening program can expand and still require someone to travel hours to use it. A fertility tax credit can be generous and still require a family to find thousands of dollars upfront. Hormone replacement therapy can be covered, but that does not guarantee a woman will find a clinician comfortable assessing her symptoms and helping her decide whether it is right for her.

This is where the next phase of women’s health policy should probably go.

Manitoba is beginning to remove some of the price tags attached to women’s health. Now we have to remove the distance, delay and fragmentation that remain after the bill is paid. That means paying attention to geography. A woman in Winnipeg and a woman in northern Manitoba should not experience two entirely different definitions of “covered.”

It means looking harder at wait times for imaging and gynecologic care. It means asking why conditions such as endometriosis can still take years to identify, despite how common and disruptive they are. It means continuing to build menopause care beyond medication coverage.

And it means listening to women whose experience of the health system has not always been safe, respectful or culturally appropriate.

There is also something encouraging in the recent move to allow pharmacists to prescribe contraception. It recognizes a simple truth — making care affordable is one thing. Making it reachable is another.

Expanding access also requires good co-ordination between pharmacists, physicians and other providers, so convenience does not become another form of fragmentation. That is the kind of thinking I would like to see more of.

Not simply adding another covered service but asking where the real barriers are. Is it cost? Distance? A shortage of providers? A referral requirement? A long wait? Or a woman becoming tired of explaining the same symptoms before someone takes them seriously?

Women’s health is not one stage of life.

It is adolescence, contraception, fertility, pregnancy, postpartum care, pelvic health, cancer prevention, menopause and healthy aging. For too long, those needs have often been handled as separate episodes rather than one continuum.

Recent policy changes suggest Manitoba is moving in a better direction. That deserves acknowledgment.

But individual wins should eventually add up to something larger — a women’s-health strategy that follows women across their lives and measures access not only by whether a service is insured, but by whether someone can actually receive it when and where she needs it.

So, yes, some good news for women’s health.

Let’s take the win. And then keep going.

Marwa Suraj, Winnipeg

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Hydro plan review raises questions

I recently read Manitoba Hydro’s integrated resource plan (IRP) and the independent review by Daymark Energy. I’m no expert, but it seems clear that Hydro’s plan to add three new gas combustion turbines to the Brandon power station is going to cost Manitobans a lot more than we bargained for.

According to the experts at Daymark, Hydro’s cost estimates for the turbines use figures that are already significantly below market rates — never mind that they are expected to continue rising (like our Hydro bills). It’s also not clear that we even need the kind of capacity Hydro estimates these turbines will add and yet they have downplayed or outright ignored other solutions that could address the peaks and valleys of our power needs more efficiently and with fewer emissions.

Daymark’s report also noted that Hydro’s 10-year plan largely excludes the kinds of long-term projects that will be needed in order to meet the 2050 net-zero target, essentially kicking the climate can down the road while leaving very little time to meaningfully explore our options.

It doesn’t take an expert to imagine what happens if Hydro also spends the next decade throwing good money after bad into a shiny new set of gas turbines.

I’ll summarize: no money, no time, big problems.

I’m not claiming to be smarter than a CEO and I don’t have an engineer’s education, but I can read a report and I can recognize the writing on the wall.

We can’t all be experts, but as Manitobans, we are all stakeholders and our concerns deserve to be heard. It is time for leadership, at Manitoba Hydro and in the legislature, to listen.

Brett McTavish, Winnipeg

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Restrictive standards

Re: Interprovincial barriers falling, challenges remain (Aug. 29)

As Mr. Carney headed to Europe to drum up alternative trade opportunities, challenges remained on the interprovincial trade barriers front. The urgency of responding to the threat of direct tariffs has made clear the need to move in the direction of one Canadian economy, as opposed to the current fractured economy of self-interested provincial fiefdoms.

There are, however, non-tariff trade barriers at play which hamper trade, interprovincially, but also with respect to international opportunities; namely product standards and regulations.

The article references the example of public toilet seat standards: “Ontario is the only province that requires a U-shaped seat. It’s a rule that aligns with U.S. industry standards, limiting trade options with other suppliers … it just shows you how through vested interest, and through sort of locked-in trade relationships, we’re actually not trading enough with the rest of the world.”

The toilet seat example highlights how we can be, and are, subject to American regulations and standards, which are essentially non-tariff trade barriers. Another example would be the standards and regulations imposed on Canadian elevator construction and installation, currently provincially regulated, in Manitoba by the Labour Department.

Canada’s counter tariffs will be blunt instruments, necessary, and which I support, but they can also rebound against Canadian consumers and result in ongoing “tit for tat” blowback from this unstable American government. As Canada looks to Europe, perhaps some creative additions to our sovereignty toolkit, such as moving on elevator standards, and standards in general, can help expand international trade opportunities.

Sig Laser, Winnipeg