Most doctors hate politics and bureaucracy. Doctors do not compete for limited spots in medical politics the way students fight for spots in medical school. Doctors who serve in politics are different. They have unique tastes.
If you are a normal doctor, or you happen to know one, please encourage them to volunteer time in medical politics. Tell them to go to a provincial association meeting or apply for a spot as delegate to the Canadian Medical Association (CMA) council next year.
Normal Doctors
Normal working doctors usually cannot spare the luxury to debate health policy. They do not question why the system functions as it does. They can’t afford the time.
Normal doctors might have between 5 and 25 years of experience. They aren’t new grads, and they aren’t ready to retire. They take care of patients and fill call schedules. They manage offices and staff, spouses and children/dependents. Normal doctors don’t have much time to volunteer, teach, write blogs, Tweet or do all the things that distract some of us.
Medical associations need normal doctors.
We need mid-career physicians who wouldn’t otherwise be involved. We need to hear from the silent workhorses of healthcare.
Provincial associations always attract a group of doctors frustrated with government meddling in clinical practice. They demand answers to illogical rules and regulations that ruin efficiency and harm patient service. These doctor-businesspeople end up injecting a bit of sanity into discussions about high-minded political debate. But they rarely attend national meetings.
Associations must communicate something that regular physicians can support. National associations must speak for Canadian doctors, not just those who apply to be delegates to annual council meetings.
After periods of questionable relevance, all of a sudden the CMA has become critically important, even though many doctors do not belong to the organization. The following issues demand nation attention:
Bullying by provincial governments
Authoritarian regulatory colleges – a coast-to-coast push to dictate physician behaviour; starting in Ontario and Nova Scotia
Failed negotiations
Redefining medicine from “Do no harm” to “Cause death, if patients request it.”
Unchanged patient wait times
Seniors’ care
And much more
We need regular doctors to provide relevance and focus, not just dreams and idealism. We need practical working doctors; people who’ve battled through years of uncoordinated, bureaucratic, over-regulated care. We need you to keep us grounded on patient service, patient need.
The latest phase of Medicare finds governments and courts defining what it means to practice medicine, what defines good care. We need professionals who practice great care everyday to help guide the change. If we don’t get your input, regular doctors might not recognize medicine tomorrow.
Laugh until you cry. Weep tears of joy. Sometimes we feel everything at once; emotions are confusing.
Canadian doctors just finished their annual meeting. Several hundred members of the Canadian Medical Association packed into the Halifax World Trade Centre for 3 days.
We discussed morals, freedom and assisted suicide. We voted against fossil fuels and torture. We called for free prescription drugs and a basic income for everyone on top of current programs. Doctors championed a national seniors’ strategy and a national health-human-resource strategy.
Motions passed with strong support every time.
In addition to paid members, dozens of doctors flew up to 4,000 miles at their own expense to participate as observers. I’ve never seen that before. They spoke during discussions about seniors and assisted dying.
But observers were banned from speaking to main motions, an unusual move. Only delegates were allowed to speak to motions at this meeting. And barely anyone questioned anything.
Emotional About Healthcare
You had to be there. People cheered at removing fossil fuel companies from the CMA reserves (not all MD Financial investments). They pumped both hands in the air and whooped. They moved, seconded and passed big ideas, national plans and central coordination.
In a moment of juvenile cheekiness, I tweeted about the radial left wing at general council. A new grad I know tweeted back:
The millennials are coming…join us!! RT @shawn_whatley@torontokidsmd Whole #CMAGC stacked w radical left wing. Drive policy while we sleep
I love these guys. Meetings are way more fun when they attend. Students, residents and new grads share energy and enthusiasm. They are super smart and bursting with compassion. They always bring fresh thinking. Every association suffers without their input.
Silence
Most doctors at the meeting were either established, or very young: students, residents and early career. Mid-career physicians struggling to pay their staff and run a small medical business were absent or silent.
Doctors apply science, with compassion. Most do not read politics, history, philosophy or economics. They can identify politicians who promote their favourite ideals. But doctors do not know where their big ideas come from philosophically, where they lead, or why anyone would question them.
Earlier in the meeting, members learned of a concerning trend. More and more doctors have declined to renew their memberships. Attendees listened with puzzled frowns. How can we reverse the trend? Why would doctors drop memberships in their national association?
The next few years promise change. I wonder what kind of emotions it will bring?
Every nation gets the government it deserves. – Joseph de Maistre.
A transitional stage in the progression from capitalism to communism.
OR
A broad outlook on the human condition that promotes:
Equality
State as administrator
Elimination of systems of control, privilege, inequality.
When people call themselves socialists, they seem to mean socialism as a broad outlook, not a step towards communism. However, big Labour, and much of the media party, promotes the values of traditional, Marxist socialism.
Critics say socialists confuse impossible ideals. A state powerful enough to eliminate all forms of control and privilege becomes its own form of power and privilege. We just get a new bully.
Better Options? One Example
Traditional liberalism offers a popular alternative. It emphasizes the individual. It places individual rights against those of the sovereign power. Note that liberalism:
shares a history parallel with ideas about limited government
attempts to curtail state powers
seeks to secure for individuals charters, statutes, institutions and forms of representation
works to guarantee individuals rights against the invasion of the sovereign power.
is expressed in the Magna Carta, but usually thought of as a 17th and 18th century creation
Traditional Liberalism Promotes:
Supreme value of the individual, freedom and rights.
Individualism in its metaphysical variant.
Individual has natural rights which exist independently of government and which ought to be protected against government
Recognition of the supreme value of freedom
An anthropocentric, rather than theological, view of human affairs… human potential and achievement as the principal locus of value.
Universalism – a belief that rights and duties are universal and stem from a human condition that transcends place and time
Toleration in matters of morality and religion.
Liberalism cares about, and for, people because it cares about individuals, not vague concepts like equality. It moves to help people because it values people over utopian ideals about political systems.
Again, other options exist.
Canadian Socialism
Western democracies grew up inside liberalism. Political parties – Conservatives, Liberals, Democrats and Republicans – are just different flavours of liberalism.
Socialism stands outside the fold of traditional liberalism. It does not value individuals over political ideals. It cares more about political systems than individual patients. If doctors care most about individual patients, they should stop calling themselves socialists.
In Marxian theory and official communist language, …system of production relations that is supposed to characterize the transitional stage between capitalism and full communism. The means of production are taken into social ownership, and the state persists as an administrative machine, up holding a new order of legality, & a new system of Rights, in such a way as to permit the emergence of true common ownership and the eventual abolition of the state.
The theory and practice of ‘socialism’, construed as a broad and comprehensive outlook on the human condition. Socialism envisions a political system that will be, not transitional, in the manner of 1, but permanent, and fitted to the changed conditions of life since the industrial revolution. As a political theory, socialism is a relative newcomer, and probably lacks both the system of traditional liberalism, and the pragmatic character of conservatism. But it has emerged in the present century as an increasingly ambitious set of doctrines…
The principal ideas:
Equality – this may be variously stated in terms of equal opportunity, egalitarianism, etc. The main consideration is that human beings have equal rights since they are equal in every respect relevant to their rights.
The state as administrator. The state is seen not as the legal and ceremonial manifestation of civil society, but rather as a complex administrative device, designed to guarantee individual rights and to distribute benefits among the citizens in accordance with those rights. This state is therefore, primarily concerned with distribution, and must provide and maintain the institutions which ensure that human goods – food, medicine, education, recreation – are made available to everyone on terms that are as equal as possible. Law is necessary as a means to good order, and to effective administration. But neither it, nor any other aspect of the state machinery, is an end in itself. Moreover the state should be confined to administrative functions, and not, for example, set up as the propagator of religious doctrine, or nationalist ideology.
The elimination of systems of control. People exert control over each other in various ways. For example through the class system, public institutions, political institutions, and hereditary privileges. All systems violate the fundamental axiom of equal rights. Private property is permissible… should not be allowed to accumulate inordinately, lest vast systems of private control should emerge and prove damaging to the interest of society as a whole. Hence the state must always be prepared to nationalize major assets, and should curtail or forbid the transactions that lead to large-scale private accumulation such as gifts and inheritance.
In particular the attempt to eliminate privilege in all its forms, the opposition of hereditary principle, and the defense of the welfare state. Historically socialism has had strong affiliations with the labor movement, for the obvious reasons that, well it promises very little and threatens much of the class of property owners, it promises much and threatens little, or seems to threaten little, to the workers. …Some would add that the attempt to combine number 1 to number 2 with the commitment to representative democracy is what is distinctive of Western, as opposed to communist, socialism, and that this parliamentary road to socialism is a fact is in fact a creature so different from socialism of the communist states has to be only misleadingly called by the same name.
Critics of socialism have argued, for example, that there is a potential conflict between principles 2 & 3. The mass of control that needs to be exerted by the state if it is to be seen as an administrator with full responsibility for everyone’s welfare is incompatible with the attempt to free people from the control of others. All that would be achieved is the transfer of control from an old ruling class of aristocrats to a new elite of bureaucrats. Moreover, some add, a ruling class with a monopoly of government is a better guarantee of freedom and justice than a bureaucracy of self made men…. Finally, it has been argued with great force (e.g., by economists of the Austrian school) that economic failure is generic to the socialist idea of a state-supervised economy. These arguments together with the experience of socialist governments in Europe, have recently led to a decline in support for the socialist idea.
Liberalism (pages 312-314)
In contrast, traditional liberalism, along the lines of j.s.mill, denotes an emphasis on the individual and his rights, as against the sovereign power and the duty towards it, and the shaping of political aspirations. The history of liberalism is contemporaneous with the history of limited government, that is with the successful attempts of those subject to government, to curtail its powers, and to secure for themselves charters, statutes, institutions and forms of representation that will guarantee the individuals rights against the invasion of the sovereign power. There are recognizably liberal thoughts expressed in Magna Carta although the modern idea is usually thought of as a 17th and 18th century creation partly because of the political theory that produced in support of it partly because of the rapid changes in political institutions
The following ideas are fundamental to most forms of liberalism
belief in the supreme value of the individual, his freedom and his rights.
individualism in its metaphysical variant.
belief that the individual has natural rights which exist independently of government and which ought to be protected by and for against government
recognition of the supreme value of freedom
an anthropocentric, rather than theological, view of human affairs regarding human potential and achievement as the principal locus of value.
universalism a belief that rights and duties are universal and stem from a human condition that transcends place and time
advocacy of toleration in matters of morality and religion.
Most doctors hate politics and bureaucracy. Doctors do not compete for limited spots in medical politics the way students fight for spots in medical school. Doctors who serve in politics are different. They have unique tastes.
, (see extended quote below), socialism has two meanings: