My wife and I watched a renovation show. A makeover program responded to a woman’s request to renovate the garage and surprise her husband for his birthday.
Before renovation, the garage looked like a grownup’s version of a teenage bedroom.
Garage sale treasures hung from the ceiling and covered every corner. Work stations looked used: grinders had grit; saws had sawdust. The man worked there.
A makeover crew turned the workshop into Sesame Street. Giant red and white checkers on a polished floor bounced stadium lighting off aluminum cabinets.
The dirt was gone. So were the tools, lumber, and workstations. Designers packed the old garage into pretty bins on shelves high up on the ceiling. Two cars fit with extra room for bicycles and picnic baskets.
My wife cheered. I cried. So did the husband. He couldn’t face the camera. The show’s hostess said he must be too happy to speak. Hi-Fives everyone!
“Happy families are all alike; every unhappy family is unhappy in its own way.’
New political leaders are all alike. They consult. They observe. Then they diagnose. Hopefully, they fix problems that everyone hates.
But sooner than hoped, too many politicians start on their legacy. Politicians think that voters want them to tackle problems. Voters do. But many things that politicians fix are only problems for politicians, not voters. They make voters unhappy in their own ways.
There’s a form of conservatism that sees life as economics, mankind as homo economicus. For these econo-cons, everything is money and metrics. Measurement determines reality. Performance comes from crisp construction blueprints with sharp deliverables.
Except, unlike the business world, a central bureaucracy makes up the plans and the deliverables are dictated, not negotiated by tender.
Government is not business. Government can spend, create programs, and write laws. Or it can cut spending, close programs, and repeal legislation.
But government cannot implement. It cannot develop personnel, drive efficiency, or support innovation. Government can only let this happen by getting out of the way.
Government can convene a tournament, but it cannot play the games.
Political business-speak can become a managerial revolution. A new ruling elite then dictates accountability while being accountable to no one for is outcomes.
Premier Ford seems more like the guy with the ‘messy’ garage than the hostess with Sesame Street intentions. But Ford is not the government. Will his need for change bring changes that no one wants? Will the bureaucracy let him make good change? Will it make changes of its own?
Please do less
If I could ask the Premier to do one thing, I would ask him to do less.
Less legislation, like Wynne’s Bill 41.
Less oversight and reporting — Well done, Premier Ford, on scrapping the immunization reporting!
I would ask him to restore Medicare to public funding with privately owned clinics instead of public funding and public management.
I would beg him for less innovation by bureaucracy.
I’d ask him to reflect on the nature of medicine. Clinics and classrooms are different, no matter what the Price-Baker report says.
If Ford wants more accountability, then he must give more freedom. Too often, government wants it both ways. Either doctors are employees with pensions and benefits, or they are independent contractors with freedom and accountability.
I look forward to new ideas from our new government. We expect big things, hopefully not Sesame Street.
Well said. Unfortunately our political system tends to favor the candidate that offers the most goodies to the beaten down and near bankrupt electorate. We perversely elect those who make the most outrageous promises and then ignore them after getting elected. I agree we need less from government, less bureaucracy, less interference in our daily lives. We need to be able to eliminate the swaths of government employees that do nothing and know nothing. Our socialist and monopolistic medicare system is not the envy of the world. The infringement on the rights of both patients and doctors known as the Canada Health Act must be challenged.
Great comments, Ernest.
I’m at a loss on how to convince people to not support the candidate who bribes us with our own money. I guess that’s part of it. With the top tax bracket paying over 50% of the total tax revenue, most voters aren’t really being bribed with their own money. They’re being bribed with other people’s money.
I believe that we need good government. A big part of good government is knowing what it cannot do. I do not understand why so many politicians would want to take ownership for things that they can never control.
The CHA has locked us into permanent stasis.
Taoism teaches that “ governing a country ( a province, a health care system) is much like frying a small fish…too much poking can spoil it….it should be done lightly”.
Those governing our Ontario health care system have been persuaded ( by the MOHLTC’s Humphrey’s ?) to take the opposite tack…the intention is to poke “ the fish” heavy handedly and vigorously with a rod.
Historically , to induce a required behaviour, the “ carrot and stick” approach has been proven to be quite effective….the carrot held in front with a stick wielded gently from behind…the powers that be are intending to reverse the process …not being able to afford carrots and with rods being quite inexpensive …the future approach will be the beating the medical professional about its head whilst ramming a replica of a carrot up its rear end.
The decision has been made ( at the ministry level) to utilize fear and intimidation as a motivator …fear doesn’t generate genuine commitment, creativity or loyalty on the part of the recipient…the result will be less confident burned out medical practitioners suffering poor morale, less empathetic medical practitioners, less forthright medical practitioners, …the traditional therapeutic relationship between medical doctor and patient is about to be shattered like Humpty Dumpty, never to be put together again no matter how many Ministry MBA’s are hired.
Orwell nailed it …” If you want to see your future as a medical practitioner, imagine a boot grinding in your faces….for ever”.
You always offer such creative comments, Andris. Thank you!
I had never heard of that Taoist analogy. Very good. I also liked your comments about the cost of carrots versus sticks. At first, I agreed with your comment. Then I wondered…it depends on how you define carrots and sticks. Carrots are treats, not the whole meal. Carrots are the marginal costs of offering tiny incentives to encourage different behaviour. The stick could be the threat of punishment, but I think it has become increased regulation and oversight. Increased management costs a tonne of money.
I also like your comments about how the system changes the doctor-patient relationship. Third party payers make providers beholden to the third party in the room. But aggressive oversight changes things even more, as you say. We sometimes called the chart the real patient in the ED. Doctors get judged by the chart, not by the clinical situation at the time care happened.
Thanks again
I recall an old cartoon in which a donkey has a fishing rod attached to its back with the carrot dangling before it…the donkey moves in the required direction but never acquires the carrot.
The geniuses at the ministry are dangling a club in front of the donkey and will wonder why it dosesn’t want to move in the required direction.
Over the years I warned my colleagues not to follow the trail of carrots that led to , what I perceived to be , a collectivist abattoir …the doors of which are now closing….next?… “ the silence of the lambs”.
The collectivist abattoir, a trail of carrots, dangling clubs… Andris, you need to write. I am enjoying Stephen King’s On Writing. You might enjoy it too. Do not let your imagination go to waste!