Category: Politics

As you roast marshmallows this summer, you can learn how to roast politicians, too.

Oops. Freudian slip.

You can learn how to roast political ideas (if that inspires you more).

A few of you have asked about great books to go with your tan. Here are some of my favourite non-fiction titles designed to ignite revolutionary thoughts from your hammock.  I included only one healthcare title, for now.

Disclosure: I am an Amazon Associate and get a few pennies, if you end up purchasing items, after clicking on the links below. If you’d rather, just search for the titles yourself! Cheers.

Summer Reading

Free to Choose: A Personal Statement

If you vote, you need this book. It is a must read for anyone who cares about freedom.

It is well written, full of great quotes, and packed with fundamental ideas about freedom and democracy.

If you love the Toronto Star and want to live in China or Cuba, you can skip this title. If you plan to stay in a Western democracy, please read Free to Choose.

Doctors do not usually read Friedman, or any similar books. So it’s no wonder that health policies and legislation come out sounding like quotes from Mao or Castro.

Catastrophic Care

Malcolm Gladwell calls this book,

“A devastating and utterly original analysis of what has gone wrong with the American health care system. Read it, and take a deep breath.”

This book appeals to readers who love to hate the American healthcare system.

It also wins points with those who vote for people like Hillary Clinton and Bernie Sanders.

If you think government-run healthcare could do better, you will find ways to make care more like Apple and less like the Post Office.

Goldhill works as a CEO. He supports universal healthcare, but not universally bad care.

From the flap:

“In 2007 David Goldhill’s father died from infections acquired in a well-regarded New York hospital.

The bill, for several hundred thousand dollars, was paid by Medicare.

Angered, Goldhill became determined to understand how it was possible that well-trained personnel equipped with world-class technologies could be responsible for such inexcusable carelessness—and how a business that failed so miserably could still be rewarded with full payment.”

The Conservatarian Manifesto

This book aims at readers who support freedom and responsible governments, but do not get too worked up about what other people do in private.

Writing for an American audience, Cooke, an Englishman, rips into right-leaning ideas that are popular in the USA. He offers a new label: Conservatarian.

It’s well written and more thoughtful than most political books written in the US.

From the flap:

“There is an underserved movement budding among conservatives, in which fiscal responsibility, constitutional obedience, and controlled government spending remain crucial tenets, but issues like gay marriage and drug control are approached with a libertarian bent.”

What is Government Good At?

Savoie knows Canadian governments and tears apart the federal bureaucracy, during the Harper years.

It is not another anti-Harper diatribe.

Savoie exposes bureaucracy and shows how it bloats and rots, even under a leader who campaigned against government waste.

This title offers grist to fuel your angst about bureaucracy’s inherent waste.

The Road to Serfdom

If you love everything you hear on the CBC, you will hate Hayek.

It is a sacred text for those who support limited government and free markets.

Please do not read Hayek, if you want higher taxes and more government regulation. You will just grow smarter and make life worse for the rest of us.

The Road to Serfdom is not as easy to read as Friedmans’ Free to Choose, but still worth the effort.  Written in 1944, Hayek reminds us that Hitler came to power democratically.

Roasting Ideas

These titles are dangerous. They will change your thinking about almost everything that goes on in Canada and the US.

As you relax in your lawn chair, cold beverage in hand, I hope you let these authors subvert the messages that bombarded you throughout the rest of the year. I hope you get a chance to scrape off the mushy thinking that sticks to our brains like marshmallows, between September and June.

Enjoy the roast!

Kids want to stay up late, eat whatever they want, and do homework when they feel like it.

Little bohemians let Mom and Dad pay the bills, repair the car, and keep the house running.

Government wants it both ways, too. Politicians tell doctors how to practice, how many hours to work, and which tests should not be ordered.

Politicians are happy to let doctors pay for medical offices and do everything else to keep clinics running.

Government Wants It Both Ways

If government wants self-motivated, entrepreneurial knowledge workers, who take responsibility for private practices, they cannot control doctors’ professional lives and treat them like employees.

If government wants employees, who follow rules and deliver ‘high quality’ care dictated by government, then politicians cannot expect doctors to assume the cost and responsibility of managing care.

Please Premier Wynne, make up your mind. Do you want employees or professionals?

New Medicine

Centrally controlled healthcare systems often have outstanding prevention and screening. The Soviet system had advanced public health for its time. Soviets solved gender inequality in medicine 40 years ago: 73% of family doctors were women in the 1970s.

Maybe doctors should support the radical, Liberal healthcare reform? Let’s see where it leads.

If politicians want bureaucrats running healthcare, let them have it. Put doctors on salary.

Salaried doctors could see a set number of patients.

Government could fund private clinics and hire the staff.

Government could pay for all the management work doctors now do for free.

Many docs would love to show up at 9, punch a clock, take coffee and lunch breaks, and then punch out again at 5.

Public Employees

After years working with police officers, I grew to envy their lack of freedom and the inherent inefficiency of their jobs.

They were forced to sit for hours waiting for a coroner to show up. They drank coffee after coffee just because a silly rule said they could not leave the emergency department until one detail was signed off.

Did they complain? Sure.

But were they stressed? Not really. They were bored to death.

Faced with a choice between bored-to-death with a great pension and early retirement, versus stressed-and-burned-out with no pension or retirement, many doctors would choose the salary.

Negotiations

Doctors in Ontario want to get back to negotiations with government. It’s the same old thing: negotiators will try to get as much money as possible out of government, while compromising as much freedom and autonomy as doctors will ratify.

Maybe the days of doctors, as independent contractors, have ended in Ontario?

Maybe doctors should consider a salaried and government-runs-everything model?

What could doctors lose, at this point? Even the Soviets had some great healthcare until their money ran out.

Government wants it both ways. Politicians want to control doctors and, at the same time, let doctors finance and manage clinics.

Doctors should not keep fighting to work as independent contractors, if government insists on managed care. Many doctors would be much better off, not just financially.

Private clinics currently offer the most efficient part of Canadian Medicare. But why should doctors be the only ones fighting to keep them?

The only thing doctors would lose, if they gave in to government, is their professionalism. But no one sees much value in professionalism anymore, besides doctors.

Social leaders, like the Toronto Star and the Ontario Human Rights Commission, want medical technicians, not professionals, with personal opinions and clinical judgment.

If government wants it both ways, doctors should stop supporting the current, dysfunctional relationship.

No one wins when spoiled kids sponge off weak parents. Let the kids own the consequences of their actions.

Doctors should let politicians own their own mess. I wonder how patients would like the outcome?

photo credit: today.com

Pick an analogy: a frog slowly boiling, a camel’s nose inside the tent, a slippery slope. Too often, we accept small changes and wake up with disaster, a camel in our tepee.

Canadians hate rigid thinking. We avoid fights and love compromise. This makes us pions to activist governments.

Medicine faces an existential threat in Ontario.

Do not listen to the wise, old doctors who say,

“Relax. The pendulum swings. Seven fat years followed by seven lean. Don’t get your knickers in a knot. All good things come to those who wait….”

People who spew such nonsense, in light of the current Ontario government, are, with great respect, deluded.

Premier Wynne is no pendulum; she’s a juggernaut.

The Wynne Liberals propose changes faster than anyone can respond. The Liberals want a revolution in healthcare; a completely different way for patients to access care.

And they want the government at the centre of their new world order.

The examples of this government’s abuse of power would run pages long. Consider just the following:

Bill 210 completely revolutionizes primary care. The government wrote this with no input from working physicians. Bill 210 turns doctors into civil servants beholden to local bureaucrats.

Doctors will be paid to do what bureaucrats tell them to do, not what patients want. Every schedule change, every hour of patient care, must be reported, and approved by, local bureaucrats.

The government will hire an army of bureaucrats to staff the new ‘sub-LHINs’ and manage all the doctors under their care.

Bill 119 gives government broad access to patient records. Defenders of this bill insist that the government always could come to a doctor’s office and look at charts, but this is not clear (or even true apparently).

Even so, in the days of paper charts, sensitive bits of data, for example, an HIV test, might not be handed to the bureaucrat demanding a chart. With electronic medical records, it’s all available to government with a mouse click.

As with Bill 210, the government ignored input from physicians.

On top of this, the Liberals have cut hospital funding 9 years in a row and have cut 1400 nursing positions despite a growing and aging population.

Will Medicine Survive?

The Ontario Liberal government is attacking medicine. They want voters to believe it’s all about doctor and nurse incomes, but it’s not about money.

It’s about control.

Of course money is involved. It always is.

But politicians and social reformers love power more than money. They want command: absolute jurisdiction over how and when doctors work.

They believe that they know best whether a doctor should stay late in the office, or go on a house call. They want to control when doctors take breaks and how they pay clinic staff.

Government wants to make doctors accountable to government. They want to force doctors to order fewer tests, and do more preventive care, in return for little bonuses.

Patients’ needs do not matter; government knows what patients need.

Honest Politicians

Coercive Utopians won a majority in 2014. Voters gave most of the seats in parliament to an activist government. Honest politicians are humbled that only a minority of citizens vote. They know that a ‘majority’ government gets control of parliament from the support of a minority of citizens.

Honest politicians believe that forming government means serving and listening to all the people.

But not the Wynne Liberals. They act like any other democratically elected dictatorship.

Premier Kathleen Wynne is not a centrist. She’s a woman on a mission with a long list of things she wants to get done. She does not believe that representative democracy carries the duty to represent all voters.

She thinks that a ‘majority’ gives her the right to trample on anyone who does not agree with her. She steamrolls her bills through parliament without any adjustments or feedback from others.

Fair and Reasonable

Doctors need to assess how ‘fair and reasonable’ is working with this government. They need to look beyond negotiations and consider what’s crumbling around them.

• Who should lead medicine?
• How should decisions be made?
• Have unilateral actions, sham ‘consultations’, and cowboy legislation ever worked well, outside of totalitarian regimes?

Canadian doctors hate fighting. I get it. I am Canadian. I thrive on diplomacy. But, how’s that working for you, doctors?

I’m at my wits end. I am tired of making excuses for doctors being ‘fair and reasonable’ in the face of tyranny.

Things will change irreversibly in Ontario, over the next 12 months. Doctors could make a difference. But I suspect they won’t.

Will medicine survive, as we know it, in Ontario? Will patients appreciate the doctors they find in their tent when Premier Wynne gets done with her revolution?

photo credit: bbc.com