I almost drowned at summer camp. I told everyone that I could swim.
I just didn’t say that I could only swim as far as I could hold my breath.
I always wore a face-mask. It let me see my next hand hold, somewhere to pull my head above water.
Our summer camp offered one, main activity: swimming. Kids spent all afternoon jumping off a raft, avoiding the leeches near the shore.
The raft floated far out on the water. Could I swim there on one breath? After 2 ½ days of avoiding the water, I started drawing attention. Wanting to play with the cool kids, embarrassment overcame fear.
My breath took me within 10 feet. I saw flashes of raft and swimmers, whenever my mask broke the surface. I flailed, and sank. Kids cannonballed and wrestled around me. They shoved to get on the raft. I gasped and coughed and lost sight of my target.
The next thing I remember, my hand gripped the ladder. Shaking with exhaustion, I crawled up, rolled on my back, and faked a smile. Kids pushed and jumped in the water like I did not even exist.
Desperate Doctors
Doctors tell patients, “Everything is going to be all right. Your lung has collapsed. But we can fix it. We need to place a tube between your ribs…”
What happens when desperate doctors start to panic?
Premier Wynne’s government has attacked doctors and treated them worse than any government in recent history. Wynne has unilaterally cut almost 8% of gross funding, in less than 24 months, and has completely ostracized doctors from decisions about medical care.
Then without warning, in the middle summer, when no one reads newspapers or blog posts, the Wynne government decided they want peace with doctors and offered doctors a new deal.
No one even knew doctors were negotiating, including doctors. The government offered another take-it-or-leave-it deal, like they had in 2012, 2014 and 2015.
The government sweetened this offer a bit. They promised to fund 2.5% of growth, double what they had been funding, but still less than the historic 3.1% growth to cover new patients and doctors.
Most importantly, government offered the Ontario Medical Association (OMA) a spot in ‘co-managing’ healthcare. They offered doctors a spot on the raft.
Thick as Thieves
The Wynne government faces 5 criminal investigations. Premier Wynne’s approval rating sits at 18%. The Ontario Liberals are famous as the most indebted sub-sovereign government in the whole world, having borrowed to win votes and fund windmills, gas plants and pension plans.
Health Minister Hoskins boasted for two years that his government has given 1.25% percent more to medical services. He sounded like a deranged parent boasting to Children’s Aid that he gave another 1.25 oz of formula to his baby, even though the infant needed at least 3.5.
Now the government – under criminal investigation! – has offered desperate doctors a spot on the government raft.
The OMA rejected a deal in 2014 because it underfunded growth and offered a fixed budget.
The board faced a sharp decision this time: Do we choose more unilateral cuts, uncertainty and no voice in the system? Or do we choose collateral cuts, less uncertainty and trust that we will get a ‘voice at the table’?
If the OMA is shunned from all decisions, how can it advocate for members?
Aren’t predictable cuts better than unilateral ones?
Isn’t it better to sit on the raft, while government throws Bills like 210 and 119 into the water?
Or should doctors fight back, on principle?
Regardless of the pros and cons, or what you think of this contract, government has doctors over a barrel. Either way, doctors must dance. They lost their say in the matter in 1967.
Doctors Vote
The OMA has done everything – short of parades and door prizes – to convince doctors to accept this deal, leveraging every ounce of good faith in the process.
A large group of doctors has called for a ‘General Meeting of the Membership’, the second one ever. The last Meeting occurred in 1991 over a similar, less than ideal tentative contract. It foretold a decade of cuts. Doctors accepted the contract, and the next one in 1995. By the end of the 1990s, 2 million patients had no family doctor. Bestsellers like, Code Blue, predicted the collapse of Medicare.
Not Cool
After nearly drowning, I sat on the raft and hugged my bony knees all afternoon. The kids ignored me. I was not cool. I do not remember getting back to shore, or ever going back to the raft.
Desperate, divided, powerless and panicked, doctors must make a terrible decision. The government will do what it wants. Doctors can be part of a dysfunctional government or have dysfunction forced upon them.
Faced with any other option, everyone chooses to not drown. People get that. But it’s a terrible way to make an important decision. Surely, patients deserve better than this?
(Disclaimer: In case it was not obvious, this post tackles the nature of the decision, not the content. Please do not read into this any more than it says. My official, approved, public opinion on this deal can be found here.)
