Ontario’s doctors react to comments made in the House of Commons

Prime Minister Justin Trudeau attacked doctors in the House of Commons this week.

As doctors struggle to rebuild from 5 years of cuts and attacks, Trudeau decided to throw his own punches.

How much more can doctors take?

Has there been a month when doctors were not under attack in recent memory?

Ontario’s doctors react to comments made in the House of Commons

Toronto, Ont., Sept. 20: The comments made by Prime Minister Justin Trudeau in the House of Commons on Monday, Sept. 18, are unacceptable to myself and physicians across Ontario. These comments undercut the hard work and long hours that doctors dedicate to providing quality patient care. Continue reading “Ontario’s doctors react to comments made in the House of Commons”

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Morneau’s proposed tax changes negatively impact patients

Minister Morneau the Millionaire

I was excited. The Globe and Mail had agreed to publish my op ed. It would ‘go live’ at 10 am.

I checked my phone every 15 seconds.

What did they edit?

What did they cut?

Did it still make sense?

At 10:01, my heart sank.

The editors had added one lethal sentence. Their edit left the reader thinking about doctors’ incomes instead of patient care.  Precisely what the government wanted, and exactly what I wanted to avoid.

The whole point was to show how Morneau’s tax would hurt patients.

I asked them to remove their sentence. They refused.

Here’s the full piece, with their sentence in italics. Let me know what you think: Did their edit ruin the message? Continue reading “Morneau’s proposed tax changes negatively impact patients”

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Incorporated vs. Salaried

I wrote a blog about intimidation versus straight talk today, but I was too intimidated to post it. So, I’ll save it for sometime in the spring.

On a safer topic, finance minister Bill Morneau has sparked outrage in the business community.

He plans to hit small businesses with an over 30% tax hike. Morneau says that incorporated small businesses are no different than a salaried employee.

Tim Paziuk wrote a great list that shows how Morneau is wrong.

Paziuk is an accountant specializing in Canadian professional corporations. His book on corporations was invaluable, when I was setting up my own corp.

The only thing I can add to Tim’s list is that corporations have a greater burden of accessing financing and complying with regulations.

Incorporated vs. Salaried

Morneau starts his dreaded tax proposal by asking us to imagine an incorporated person and her salaried neighbour. Morneau makes a dishonest comparison, and Paziuk shows why below. Continue reading “Incorporated vs. Salaried”

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Neonatal ICU Crisis: Unusual or Inevitable?

Hurricane Katrina demolished New Orleans on August 29, 2005. Katrina killed almost 1,500 people and cost $70 billion to clean up.

People knew it was coming. They were told to evacuate. City planners had warned of something like Katrina for years.

Katrina was the surprise everyone expected but no one wanted to believe.

Canadian healthcare is not well. Sick babies cannot fit into overstuffed NICUs. Young people die for lack of beds. These stories aren’t news anymore.

A journalist from a National paper told me, “I need something new to say. My editor won’t publish without a new angle. People are tired of hearing the same thing about hospital overcrowding.”

Last week, I asked an MP, “What do you think about the new tax changes?” He gave a long defence of Morneau’s tax grab on small businesses. He sliced up all the arguments that he expected I would raise.

Then, he let me ask some questions: Continue reading “Neonatal ICU Crisis: Unusual or Inevitable?”

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Stealing from Patients

Dunkirk opens with soldiers on a deserted street walking through a snowfall of leaflets. The city is empty.

One man catches a leaflet and flips it over. It’s a map of Dunkirk.

WE SURROUND YOU.

SURRENDER + SURVIVE!

Propaganda works: Hopeless soldiers give up. Emotion plays a role in every fight.

I worry that many doctors cannot process attacks from government anymore. They can think, but they cannot feel.

The feds propose:

  • 73% tax on retirement savings
  • 93% tax on inheritance
  • No income splitting, despite the risk that small businesses put on family members.

These proposals wipe out retirement, savings for children’s education and parental leave.  It makes the extra cost and effort of incorporation a total waste.

Sometimes, governments tell voters something so outrageous, that people lose a frame of reference to check the facts. Small lies spark public protest. Big lies elicit shock but no action. Continue reading “Stealing from Patients”

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Who Knows Best?

The dead of summer used to mean rest. Stand-ins covered talk radio. Politicians attended Canada-Day celebrations, and everyone hit pause on life.

Summer meant nothing happened in medical politics; you might as well go to the cottage.

Not anymore. Now, summer means no one is looking, so why not push through something doctors will hate. At this rate, summer will become the new fall, and we will all need vacations in September.

In an effort to pretend I’m ignoring medical politics, here are my rambling from a Muskoka chair.

Who Knows Best?

Mark Twain said,

“I would rather listen to a soldier who has been to war talk about war than listen to a poet who has never been to the Moon talk about the moon.”

Someone also said, “The eye sees what the mind knows.” Doctors see and know problems in clinical care. We must give doctors voice. Government cannot know enough to know, let alone solve, all the problems.

This raises Hayek’s knowledge problem. Every system contains more knowledge than any single person can know. No one can ever know the thousands of decisions people make inside a system. Continue reading “Who Knows Best?”

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Overpaid and Under-Performing

Please, make it stop!

Once again, government has attacked doctors. This time, the federal government took a turn.

Finance Minister Morneau said doctors were using a “loophole” in the tax code, breaking the law against loopholes.

He suggested doctors were cheating and not paying their fair share.

He promised public consultation before addressing the overpaid doctors.

The provincial government gave doctors the ability to incorporate in lieu of fee increases, just over 10 years ago. Most other provinces have had the ability to incorporate for much longer.

Doctors could finally build a pension and create self-financed benefits just like other incorporated businesses and salaried workers.

But the federal government needs money. Continue reading “Overpaid and Under-Performing”

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Can Doctors Rebuild a Working Relationship with Government?

Can a broken relationship be mended? When one party has done something really wrong, and the other has lashed back, can they reconcile?

Doctors in Ontario have been heckled in the legislature, slandered in the media and ignored for multiple pieces of legislation. Unexpected rounds of unilateral cuts have caused festering wounds. It makes caring for sicker patients with longer wait times almost unbearable.

Some doctors are so sick of feeling abused, they only want to mock the other side. A few prefer mutually assured destruction.

But most doctors just want to care for patients. Doctors want to be left alone to care for patients without worrying about the next crisis.

Can doctors find a way to rebuild a new relationship with government? Continue reading “Can Doctors Rebuild a Working Relationship with Government?”

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Patients Need Champions, Not Doormats

People love movies about underdogs. We like watching Harry Potter get picked on because we know that he fights back in the end.

Underdogs create great stories, but they do not stay under forever.

Medical schools look for students who seem able to care.

Do they have empathy? Are they lovers or fighters?

Journalism and law schools look for different things.

Med schools err on the side of sensitivity, even if it means that some gentle souls might burn out now and then. Better that than a class full of fighters and advocates.

It wasn’t always this way. In the olden days, good grades guaranteed a spot. Schools didn’t weed out the way they do now. Each class formed a cross-section of everyone who did well in school and wanted to become a doctor.

Medical school interviews changed all that. Doctors trained since 1990 have been selected for sensitivity. They have endured extensive psychosocial training. They have been selected and trained for professional deference. Continue reading “Patients Need Champions, Not Doormats”

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Equality, Relativity and Democracy

The World Record for solving a Rubik’s Cube is 4.73 seconds. My kids can do a 2×2 in under a minute. I have never solved a Rubik’s Cube.

Inequality has existed for as long as we have.

The Greeks developed philosophy, literature and architecture when Britain was filled with “…illiterate tribal peoples, living at a primitive level.”

The Chinese invented “…the compass, printing, paper, rudders and the porcelain plates that the West call ‘chinaware’…” centuries before Europeans (Wealth, Poverty and Politics, by T. Sowell).

Equality

Some use income to measure fairness and morality. High incomes indicate greed and oppression.

Economic egalitarians believe in equal economic outcomes, regardless of effort and circumstance.  Egalitarians oppose meritocracy. Continue reading “Equality, Relativity and Democracy”

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