Social Determinants of Wealth

We learn to fly by looking up, not down. Cheetahs cannot teach us about flight. Only birds can.

We can know everything about ground travel and remain clueless about flight.

If we want to defy gravity, we must study those who defy gravity. We must copy them; adopt their mannerisms; mirror their environment.

We cannot achieve prosperity by studying the destitute. We might learn what not to do, but that is not enough. Experts on poverty cannot teach prosperity.

Poverty as Disease

Medical doctors who study poverty examine it like a disease. Every disease has a cause. Find the cause; cure the disease.

Understanding disease process leads to treatment aimed at cure. This approach has produced tremendous success for medicine.

Health promoters still criticize doctors for emphasizing diagnosis and treatment. Patients can be disease-free but unhealthy. Doctors now promote health, too, but it required a change in focus.

Anti-poverty activists seem to think that expertise about poverty will fix poverty. They start in the wrong spot. They see poverty as an abnormal state arising from some noxious cause or disordered process.

Wealth, in a middle class sense, is common in North America. But it is not normal. Continue reading “Social Determinants of Wealth”

Bill 74 – The Biggest Change to Healthcare in 50 Years! Seriously?

Big things happen every few decades. We landed on the moon in 1969. The Berlin Wall fell in 1989. The Ford government tabled Bill 74 in 2019.

At least that is how everyone talks about Premier Ford’s new bill. Former Deputy Minister of Health, Dr. Bob Bell, said that The People’s Health Care Act is the biggest change to healthcare in 50 years.

Minister of Health, Christine Elliott, announced Bill 74 on Tuesday. It had already been leaked, condemned, defended and modified. So it did not spark the same surprise had we known nothing.

The NDP’s Andrea Horwath said the leaked legislation guaranteed private healthcare. The end was not near: it was here. But Bill 74 does not mention privatization.

Bill 74

The People’s Health Care Act (Bill 74) dissolves the Local Health Integration Networks (LHINs). Most clinicians cheered.

The LHINs are full of eager, well-intentioned people, who inflict programs and metrics on clinicians to justify the LHINs’ existence. I feel bad for the LHIN people. But anytime they launched a new LHIN directive, I felt worse for us.

Here are five things you need to know about the bill: Continue reading “Bill 74 – The Biggest Change to Healthcare in 50 Years! Seriously?”

Physicians Can Finally Move Beyond Fees

Before Netflix, we watched shows at the same time each week.

People built rituals to make sure they could flop in front of the TV on Friday at 8 pm.

We could not miss our show.  There was no way to watch it later.

After the last episode of a favourite series, we felt lost. What were we going to do at 8 pm on Friday?

Last week, doctors across Canada watched the final episode in a seven-year reality show staring the Government of Ontario and the Ontario Medical Association. Most of the audience started watching in 2015, when the Liberal government attacked doctors and slashed fees. Docs had to close clinics. Others laid off staff. Everyone grumbled.

Premier Wynne’s systematic attacks genetically modified a new generation of doctors tuned in to politics. They will never hold an “essentially benign view of government.” They got hooked on a gothic mini-series and have become cult followers.

But last week the show ended: The board of arbitration ruled. Continue reading “Physicians Can Finally Move Beyond Fees”