Can Conservatism Save Healthcare?

I roamed the limits of libertarianism and found a bunch of guys having a party on a cruise ship.

It was fun. It was free. But no one could explain how the ship got there.

I started asking, Who made the boat? Where should we sail? And what should we do when we get there?

These are dangerous questions. Anything with ‘we’ in it can trigger a libertarian. (I have even been called a communist recently!)

What exists beyond the libertarian party ship?

Panem’s Peacekeepers stand guard back on shore. (If not Hunger Games, insert Stormtroopers or some other symbol of authoritarianism.)

Does anything exist beyond ship or shore?

Conservatism in Healthcare

I wish we had a better word.

Conservatism is so old and plastered with bad ideas promoted by bad actors, many find it useless. One friend spit out his coffee and teased about his smoking jacket and corduroy slippers. Point taken.

If we can get over the goofy images associated with the word, conservatism offers ways to think which will sound radical to our liberal ears.

As I argued in How to Get Canada of the Healthcare Teeter Totter, we need to start looking beyond liberalism.

The Accad-Koka Report picked up the article and had me on the show to discuss how political conservatism might help healthcare.

If you prefer podcasts, you can listen below:

Or you can watch the interview:

More work …

I realise this falls outside the training and comfort of most doctors. But nothing changes in healthcare unless doctors help lead it. As such, we need to spend time with political philosophy.

Just because you do not take an interest in politics does not mean politics will not take an interest in you.

Pericles, 430 B.C.

Thanks for checking it out!

 Photo credit: Cruise Deals Expert

Why we need a flexible, prudent approach to vaccine mandates

CBC: Vaccine mandates are post-election priority (link below)

We will look back on COVID as a time when we had to pick sides. Do you support vaccine mandates? Or do you oppose them? You must choose your position on principle, for or against.

This confuses policy with morality. It makes any change immoral, by definition.

There is a better way.

A Prudent Approach To Vaccine Mandates

Here’s a short piece I wrote for The Hub, which suggests prudence instead of principle. You can read the first part below, or click on the link to take you to the full article right away.

Enjoy!

Shawn Whatley: Why we need a flexible, prudent approach to vaccine mandates

Pandemics create fear, and fear extinguishes appetite for balanced discussion. Instead, governments take bold, expansive action. Prime Minister Justin Trudeau’s “sweeping federal vaccine mandate” to “target last holdouts” offers a case in point. The public supports vaccine travel passports, but broad mandates fuelled by emotional rhetoric create affective polarization: partisan groups with anger and frustration on each side.

To date, most discussion on vaccine mandates reflects a principled approach. People must choose a side, for or against. Some argue mandates are a necessarily good thing; mandates will get us back to normal; and they serve the greater good. Others argue mandates are intrinsically bad. They insult individual autonomy—the greatest good any country can ever get.

But a principled approach turns policy positions into moral absolutes. If mandates are good on principle, there should be no limit to their scope. We should pursue them with vigour for all the various diseases for which we have vaccines. Restrictions to freedom of movement “should be tailored to verifiable risk,” according to one opinion in the New England Journal of Medicine.

Prudence offers a better way to craft policy. It avoids turning policy into morality. Prudence uses current circumstance to create policy, in the same way we might choose to carry an umbrella if the sky looks grey. Prudence applies general principles, with nuance, based on the particular need at hand. It makes policy flexible and responsive—something pandemic policy too often lacks.

Michelle Mello, Ross Silverman, and Saad Omer tackled this concept in an article that appeared in the New England Journal of Medicine. They suggested guidelines for mandates based on experience in other infections and pandemics: the 1976 Swine Flu, H1N1, and others. Using past experience, they suggested a five-level rubric to help policy-makers decide whether or not we need vaccine mandates at this time. … (Continues here)

 

Photo credit CBC article: Trudeau says post-election priority is vaccine mandate for public servants, travellers

How to Get Canada Off the Healthcare Teeter-Totter

Canadian medicare teeter-totters between two kinds of liberalism: classical and modern. We will never improve until we inject new ideas.

Inside the right-of-centre political parties, the classical liberals fight with the philosophical conservatives for supremacy.  For the last two decades, the classical liberals have won.

If we want medicare to improve, we cannot keep using the same tired ideas. I suggest the right-of-centre political parties need to draw on classical liberalism plus conservatism.

This article published in The Hub explains what I mean and offers a concrete policy problem to start the discussion.

Enjoy!

Shawn Whatley: How to get Canada off the health-care teeter-totter

Liberalism works when you are healthy but fails when you fall ill.

Classical liberalism emphasizes autonomy, individual freedom, and free markets. These ideas have fuelled centuries of wealth and prosperity.

Modern liberalism, in contrast, pursues central decision-making and equality of outcome. Despite similar names and obvious differences, neither type of liberalism provides arguments for everything patients need.

When classical liberalism fails in patient care, it creates space for modern liberalism. Modern liberalism then applies central decision-making which creates inefficiency and bureaucracy. This in turn creates a call for efficiency, deregulation, and policy based on economic liberalism.

This seesaw creates a policy teeter-totter with each type of liberalism pumping furiously at either end.

The failure of liberalism cannot be solved by more liberalism. Only a coalition of classical liberalism plus conservatism will allow Canada off the health policy teeter-totter.

How Liberalism fails

Successful ideas explain reality and suggest solutions to life’s messiest problems. Political ideas fail when they do not reflect reality or cannot explain human experience.

Given liberalism’s dominance in Canadian politics, we should ask how it performs for patients. Does it make sense when patients need it most? Classical liberalism delivers advanced technology, therapeutics, and almost magical cures, but can it deliver care to patients?

Classical liberalism fails to fit patient care in two areas. First, it fails in trauma and acute care. Car crashes and strokes often create dependent, comatose patients. Free agents lose control, and agency passes to a third party.

An unconscious patient is not a rare or special case of information asymmetry, common in professional relationships. Unconsciousness is not a theoretical gap market thinking can overcome; it is an infinite and insuperable knowledge gap. And it occurs hundreds of times each day across Canada. …

Continue reading at The Hub.