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Malcolm Jolley: Corked: Three ways your wine can be faulty

Commentary

It’s before the pandemic and a long table’s worth of wine journalists and sommeliers are sitting in the company of a winemaker from Italy and her importing agent. We are going to have lunch at a restaurant that’s a client of the agent’s, but first we’re going to taste a few of the wines.

The agent begins opening bottles and pouring the first wine, while the winemaker talks about what’s in our glasses. One by one we put our noses to the glass once or twice, and then begin giving each other nervous, knowing glances.

The winemaker takes a pause and puts her glass to her nose, shakes her head, and apologizes. The bottle is corked. A new bottle is opened and fresh glasses are produced. We hope it doesn’t happen again.

Corked, as a colloquial term, refers to wine that has been afflicted by a fault. Specifically the contents of a given bottle are tainted by the organic compound 2,4,6-trichloroanisole, which everyone in the wine trade abbreviates to TCA. TCA taint is one of three common wine faults. The other two are oxidation and Brettanomyces, which is almost always abbreviated to Brett.

These three are the faults one checks for when tasting wine at a restaurant. The server has not brought the wine to the customer to see if she likes it; he’s asking her if there is a problem with the wine before he pours around the table. If the wine is faulty, then it should be sent back in exchange for a new one, and the restaurant will either eat the cost or pursue a refund from the merchant who sold it to them.

Here is a quick look at the three common taints.

TCA (Cork Taint)

TCA taint can be distinguished from the other two in that it is uncontroversial: nobody has anything nice to say about it. The byproduct of a chemical reaction between chlorine and a particular micro-organism (mould), 2,4,6-trichloroanisole can lurk in organic materials like cork or wooden barrels. The irony of TCA is that it was born from stricter hygiene in modern wine making: chlorine is used to sanitize to avoid other faults.

The good news is that strong cork taint is easy for anyone to detect: the wine will smell and taste like cardboard. The bad news is that the taint isn’t always that strong and can sometimes elude a sniff test. The resulting wine from marginal cork taint is muted; more an absence of fruit flavour than the presence of cardboard. Marginal cork taint can engender debate between tasters: some suspecting it, some insisting the wine is fine. The surefire way to confirm marginal cork taint is to taste a wine with it against the same wine without it. The contrast is always dramatic. If I suspect marginal cork taint in a wine I have ordered at a restaurant but am not wholly sure, I’ll ask the sommelier or server to taste it as well, in the hopes that she has a memory of what the wine should taste like.

The other good news about TCA is that there is much less of it out there than there used to be. This is partly because many wine producers have switched to non-cork bottle closures, especially for wines not meant to be aged very long (i.e. most wines), and also due to innovations in natural cork making to avoid it.

Oxidation

Wine has three natural enemies: heat, light and air. The part of air that is problematic to wine is oxygen. If too much of it gets in and around wine at the wrong time as it is being made, or at any time after, then it will kickstart the natural process of turning wine into vinegar.

Some wines, like sherry or vin jaune from the Jura region of France, are meant to be oxidized, but the process of introducing oxygen to the wine is controlled. Oxidation is considered a fault when it happens contrary to intent. Small amounts of oxygen exposure can result in the phenomenon of volatile acidity in some wines, which can give them the aroma of nail polish. Whether this is a fault or a derivable seasoning to the wine, at least in small doses, is a matter of taste.

Oxidation can also happen if a combination of warmth, light, and oxygen affect the wine from poor storage. A bottle of wine that’s sat on a store shelf for a year might well end up oxidized. It will taste musty and stale, devoid of fruit flavours and on its way to being part of a salad dressing. Beware of too good to be true bottles of bargain-priced wine that are more than a few years old.

Brettanomyces (Brett)

Another fault that feeds on oxygen is Brett. This fault is tricky because, as with volatile acidity, there are some wine enthusiasts who like it. Others despise it. Brett is a yeast, and the character it imparts on wines is sometimes called animal or barnyard. That character is also sometimes called something far less complimentary and far more scatological. Once one is aware of the aroma of Brett its presence is impossible to miss.

Sulphur compounds (sulphites) are used in wine making to stabilize the wine because they bind to oxygen molecules. This keeps the oxygen molecules from getting up to mischief, like feeding Brett. This practice, along with higher standards of cellar hygiene, has largely reduced the number of wines affected by Brett, with one categorical exception: producers of so-called natural or low intervention wines without sulphites.

Natural wines often depend on the tannins from grape skins or stems to do the work of stabilization. The incidence of Brett in these wines tends to be much higher than in others. Many fans of natural wines don’t seem to mind, or might even enjoy, some Brett in their wines. This has caused some controversy in the wine world, especially among older drinkers who consider it an unpleasant fault.

Perhaps one wino’s fault is another wino’s pleasure.

Except for TCA; nobody likes TCA. Apart from sending wine back in restaurants, many provincial liquor retailers, like the LCBO or SAQ, will accept returns of opened bottles of defective wine, although it seems the BC Liquor does not. One would hope that honourable private retailers would also accept the return of faulty wines. And one would hope even more that one’s exposure to faulty wines is rare.

Livio Di Matteo: Health spending during COVID-19: It’s Complicated

Commentary

The National Health Expenditure Trends 2021 report from the Canadian Institute for Health Information (CIHI) has just been released, and the data provides a much-awaited, macro level first look at what happened to health spending during the COVID-19 pandemic. At first glance, the numbers are what one expects—and quite sobering.

Canada is expected to spend a new record of $308 billion on health care in 2021. That is $8,019 per Canadian. It is also anticipated that health expenditure will represent 12.7 percent of Canada’s gross domestic product in 2021, following a high of 13.7 percent in 2020.

In terms of composition, hospitals (25 percent), drugs (14 percent), and physicians (13 percent) continue to account for the largest shares of health dollars (more than 50 percent of total health spending) in 2021.

A new spending category—COVID-19 Response Funding—makes its debut, and consists of the federal direct and provincial/territorial government–sector spending to combat the pandemic. This includes money for treatment costs, testing and contact tracing, vaccination, medical goods, and other related expenses, and is a separate category from the standard ones used. Overall, it constitutes 7 percent of total health spending.

As reported by the CIHI, total health spending is expected to have increased by nearly 13 percent between 2019 and 2020, a rate of increase not seen in more than 30 years and triple the growth rate experienced from 2015 to 2019 (which was steady at approximately 4 percent per year). This historic spending increase took place alongside a contraction in the economy that was due in part to the ongoing pandemic. However, 2021 is expected to see a moderation of spending growth down to 2.2 percent as COVID-19 response support drops from $30.6 billion in 2020 to $22.8 billion in 2021, a decline of 25 percent.

While total health spending is up, it remains that the closing of outpatient departments and postponing of medical visits and procedures during the height of the pandemic meant a reduction in some aspects of health service provision and health spending. According to CIHI’s own analysis of COVID-19’s effect on hospital care services, from March to December 2020 overall surgery numbers fell 22 percent compared with the same period in 2019, a drop of 413,000 surgeries.

Indeed, once one starts to examine spending both including and excluding the COVID-19 response spending provided, as well as adjusting for inflation and population growth, the picture looks more variable depending on the categories examined and the financing sector considered. The public sector accounts for three quarters of Canadian health spending, with provincial and territorial governments alone responsible for about two-thirds of health spending in Canada. Other public sector spending accounts for about 9 percent, with the remaining 25 percent coming from private sector spending (mainly out of pocket and private insurance).

Figure 1. Graphic credit: Janice Nelson

Figure 1 presents annual real per capita health expenditure growth rates for the years 2019, 2020, and 2021 (the latter two being forecasts) for total Canadian health spending (public and private sector), provincial-territorial government spending, and private sector spending calculated using the CIHI data. In 2019, real per capita total health spending in Canada grew about 1 percent and soared to 7.2 percent in 2020 but is expected to rise barely one-tenth of one percent in 2021. However, when the COVID-19 response spending is removed it turns out that real per capita health spending (net of COVID) in 2020 declined 3.6 percent but is expected to rebound by 3.1 percent in 2021.

Variable spending across the provinces

Meanwhile, when provincial-territorial governments alone are examined, their real per capita total health spending in 2020 rose 8.1 percent. However, once the COVID-19 response is factored out, their spending declined by about 1 percent, though it is also expected to rebound in 2021. Hardest hit in provincial-territorial health spending in 2020 in terms of percentage declines in real per capita spending were physicians (-5.8), other professionals (-6.1), drugs (-2.3), and hospitals (-0.5). These results are not unexpected given the decline in surgeries and physician visits brought about by the pandemic. Meanwhile, public health grew 4.1 percent, other institutions (including long-term care) grew 1.2 percent, and capital spending grew 10 percent.

Moreover, real per capita spending growth net of the COVID-19 response funding was also variable across provinces in 2020. Newfoundland and Labrador, Prince Edward Island, New Brunswick, Quebec, Manitoba, Saskatchewan, and Alberta saw a decline in real per capita spending net of COVID-19 response funding. On the other hand, Ontario, British Columbia, and Nova Scotia saw small increases, with Ontario the largest at 1.2 percent.

New Brunswick, Quebec, and Alberta saw the biggest declines in real per capita health spending at -3.3, -3.5, and -3.6 percent respectively. This demonstrates that during the health system disruption of the pandemic, the decline in service provision, at least as measured by real per capita spending, was greater in some provinces relative to others.

The postponement of so many treatments and surgeris will have health consequences for years to come.

The impact of COVID-19 was exceptionally severe on elective and discretionary health expenditures as borne out by the private sector impact, driven particularly by spending on private physicians, dentists, and optometrists. Real per capita private health spending in Canada in 2020 dropped by 11 percent. It is only expected to rebound by about 1.6 percent in 2021. Real per capita private sector physician spending declined 24 percent in 2020 while that on other health professionals fell 22 percent. For hospitals this was down 13 percent, and for drug spending this was down nearly 5 percent.

Future consequences

In the end, the impact of COVID-19 on Canadian health spending was not simple. While overall spending grew dramatically in 2020 in response to the pandemic, there was a displacement effect as spending on surgeries and other treatments fell with cancellations and postponements. This hit provincial government health spending hard, but private sector spending was hit even harder. The postponement of so many treatments and surgeries will have health consequences for years to come.

In terms of the implications for future health spending, this snapshot needs to be placed in the context of the longer-term trends in health spending, which has generally grown both in terms of real per capita spending and as a share of GDP. The 2010s saw a moderation in spending growth rates which led some to conclude that the health cost curve may have finally been tamed. Part of the moderation may have been a provincial response to the end of the six percent growth rate of the federal health transfer in 2017 and the new formula restricting the growth of federal transfers to GDP growth subject to a minimum of three percent.

However, there was also a moderation of cost drivers during this period, such as technological extension and the onset of new pharmaceutical products, and that may be coming to an end given that the pandemic has been a catalyst for pharmaceutical development. Combined with the concerns about health human services shortages in health care and the need to reinvest, the pandemic may indeed be the trigger event that starts a new cycle of rising health expenditures.