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Looking for Solutions in Health Care for 2006 and Beyond

Our health care system needs to change to accommodate new demographics, new technologies and new pharmacologic advancement.

The roots of compassion and caring in health care should not change however, and it is with this in mind that the dialogue of change should be had surrounding health care.

How can we adapt to different needs that emerge as our population ages?

How can we  find sustainability in the midst of so many new advancements?

How can individuals become more empowered in serving their own health care needs?

What role does the individual have in enabling the  health care of others  beyond paying taxes?

Many questions like these need to be answered and if we are willing to look with open minds at the problems within our health care system, and beyond political posturing, then we can find new  solutions to take us further into this century. 

 

 

 

 

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Main | Ontarians Should Be Very Wary of Bill 41- "The Patients First Act" »
Tuesday
Feb072017

Resignation of the OMA Executive-What Now?

So, the Executive of the Ontario Medical Association has resigned...sort of. The Executive is resigning to sit on the Board of Directors and then will go through an electoral process. At least that is what we are told currently.

This follows after a 55% non-confidence vote in the OMA Executive at a special meeting of the OMA Council but at which other motions failed to win the required two thirds majority to pass. These other motions if they had been successful would have led to the resignations at the individual executive level.

In the face of the quasi-win by the groups challenging the OMA's representative performance, there had been murmurings of requiring the OMA to hold another General Meeting of Council to address the non-confidence vote which had initially been arrogantly passed off by the OMA as a demonstration of support. Another General Meeting of Council would have been disastrous for the OMA. It managed to avoid that through this resignation process.

However, the OMA should know that this result was not the end of this non-confidence wrangling. It is just the beginning.

The Ontario Liberal government should also understand that the advocacy efforts of front-line physicians are not going away. These physicians are not dissidents as they have been labelled by some reporters. They are simply aware that the Liberal government's cuts to front line health care and patient care in Ontario will cause more and more hardship for patients as time goes on. It's not the 1990s anymore.

Fact is that we are up against the demographic wall made even more challenging due to a sluggish economy affected by the shift in aging--a double whammy. Instead of cuts to care, government ought to be planning how to allow more care for more people. Cuts do the exact opposite of what is needed. Even if the deficit is eliminated for 2018, growing health care need will not be eliminated. The pent-up demand for care will be even greater after 2018 due to the current Liberal cuts.

Physicians are becoming more vocal. Despite government-created positions for paid "Physician Leaders" to push through the government's self-serving and short-sighted version of transformation, many physicians see the negative impact of government's efforts to balance its budget on the backs of patient services.

Physicians I know and have known care deeply about their patients. They see that health care access is becoming more and more difficult. They want to continue to provide much needed services but they may differ on how those services can best be provided. We should be able to differ on the "How" and value different perspectives and approaches and still be united in providing quality patient care.

We must ask the "What if" questions.

What if the government is not forthcoming with more and more funding for care to adequately serve citizens who are dependent on it?

What if government providing  more funding leads to higher debt and greater interest payments resulting ultimately in fewer services?

Billions of dollars going to interest payments every month are one reason why Canada has fewer physicians and hospital beds per population than most developed countries and which results in lack of timely care, delayed diagnoses, and patient hardship--even death.

A couple years ago a fellow physician told me not to worry--all that was needed was a Liberal federal government and the money would flow. They were surprised to discover that the Trudeau Liberals are no health care saviours.

So what now?

I have no doubt that some of the former OMA Executive members will be re-elected to a new Executive. That will change nothing. Some new MDs may find themselves elected and in a position to create change from within the OMA but it is external factors beyond the OMA that have brought us to this point of upheaval. It is only by addressing external  structural health care system issues BEYOND the OMA that substantive, sustainable change can occur.

I'm hoping that a new OMA Executive will understand that their most important role is not to align with the government transformation flavour of the day. Instead, it is to give critical input on how more care for more patients can be realistically achieved while supporting our human providers who deliver that very necessary care.

We need to be asking the hard questions.

As always, thank you for your continued insights and thoughtful comments.

 

Reader Comments (724)

OMA contract.

Just watch the budget, when it gets announced, and one can identify the 3 year plan on resources.
February 20, 2017 | Unregistered CommenterMovingforwardOntario
I don't believe that moving care out of hospitals will make UK NHS costs more sustainable. I expect it will just shift costs. On what evidence, I wonder, is this being done?

http://www.bbc.com/news/health-39031546
February 21, 2017 | Unregistered CommenterMerrilee Fullerton
Sounds familiar.

excerpt:


"Hospital services in nearly two-thirds of England could be cut or scaled back, BBC analysis of local plans shows.

The proposals are part of a programme to transform the health service and save money across 44 different areas.

The BBC found 28 proposals affect hospital care, from full closures to centralising services, such as A&E and stroke care, on fewer sites.

NHS England argue patients will receive better care in the community to compensate for the hospital cuts.

The proposals also include the creation of "super" community hubs of GPs, care workers and district nurses, seven-day access to GPs and getting hospital specialists to run clinics in the community."
February 21, 2017 | Unregistered CommenterMerrilee Fullerton
"“Health care is an area of provincial jurisdiction, and it is provincial governments that must face their electorates and justify their actions. Provincial politicians should be able to make decisions that are contrary to the federal government’s wishes and that would please their voters,” says Germain Belzile, Senior Associate Researcher at the MEI and the author of the publication.

From an economic point of view, this federal interference poses a problem, he notes. Health transfers, with federal conditions attached, make Canada’s public health care systems less efficient. “When the federal government imposes its priorities, it limits potential innovation,” points out Mr. Belzile."
February 21, 2017 | Unregistered CommenterMerrilee Fullerton
R

We need more tax money. The federals could drop tax rates, and allow the provinces to raise theirs, thus making health care locally funded and determined.
February 21, 2017 | Unregistered CommenterMovingforwardOntario
Running a big media conference at Queen's Park tomorrow at 10 a.m. Here's a sneak peak at the media release.

Cheers.

SS

Media Release

FOR IMMEDIATE RELEASE

DR. DAVID WEBSTER CALLS ON PREMIER WYNNE TO FUND MOBILE PET SCANS

(February 22, 2017, Toronto, Ontario) – Dr. David Webster, former president of the Ontario Nuclear Medicine Association, today called on Premier Wynne to do the right thing and make funding available for mobile PET scans so patients in the province who need a PET scan don’t have to put their lives at risk by travelling on Ontario’s roads during the winter months. Dr. Webster made his appeal to the premier during a media conference held at Queen's Park. Joining Dr. Webster at the media conference were France Gélinas of the NDP and Bill Walker of the PC Party.

"By now, most of you will be familiar with CT scans and MRIs, and the role they play in diagnosing health problems doctors can’t detect with the naked eye," Dr. Webster said. "However, neither of these diagnostic tools can hold a candle to positron emission tomography, or PET, when it comes to determining if a mass is actually cancer or just scar tissue.”

Dr. Webster explained that cancer cells can only use glucose for fuel, and that they do so very efficiently, which is why they stand out when compared with normal tissues. This information is crucial in determining what stage the cancer is at, and figuring out the proper course of treatment for a patient. By increasing the use of PET scan technology in Ontario, Dr. Webster believes we can save lives and money, as patients will no longer need to be subjected to numerous costly CT scans and MRIs before a mass can be spotted, nor will they be exposed to unnecessarily high amounts of radiation.

"Currently, Northern Ontario patients needing a PET scan must travel to Toronto in order to access PET technology," Dr. Webster said. "And while it’s true the Ministry of Health covers a significant amount of the costs through the province’s travel grant program, the fact is, each winter the government forces 700 northern Ontarians who are very sick to traverse dangerous, snow-covered roads, often in the dark, simply because Health Minister Dr. Eric Hoskins refuses to embrace the mobile PET option.”

Minister Hoskins and local MPP Glenn Thibeault have agreed to help fund the construction of a new facility to house a permanent PET scan in Sudbury, which hopefully will be ready by June of 2018. However, Dr. Webster thinks the real purpose of this announcement was to silence the people of Sudbury, who, along with six other communities like Kingston and Kitchener-Waterloo, have long lobbied for mobile PET. If the government truly believes in putting patients first, as the recently passed Bill 41 seems to suggest, then why is the health minister so determined to block so many ailing Ontarians from accessing mobile PET scans? Maybe he doesn’t believe in putting patients first after all.

"Dr. Hoskins has done everything he can to discredit mobile PET," Dr. Webster said. "But Ontarians—especially those of us in the north—see through his political gamesmanship. This is why I’m calling on Premier Wynne today to over-ride the decision made by her health minister and make funding available for mobile PET scans—not just for Sudbury, but for the other six communities as well—before someone suffering from cancer dies tragically on one of Ontario’s many wintery roads. The premier can’t afford to have blood on her hands. None of us can.”

Dr. David Webster is the former president of the Ontario Nuclear Medicine Association. For more information, please visit his website at www.petontario.org (website goes live March 1, 2017).

- 30 -

Contact:

Stephen Skyvington

Phone: (416) 859-2239
February 21, 2017 | Unregistered CommenterStephen Skyvington
I recall phoning a private PET provider a number of years ago. I was told that the government managed to stall them for 5 years from opening in BC...not by stopping them from using the machine but by stopping them from acquiring the specially marked glucose needed for the PET scan.

It's amazing to me how much effort is spent by government along with our tax dollars to stop people from accessing care and diagnostics. It's indefensible yet the public is sold a stream of "right care at the right time at the right place along the continuum of seamless care".....

I find it almost unbelievable.
February 21, 2017 | Unregistered CommenterMerrilee Fullerton
Good luck Stephen!
February 21, 2017 | Unregistered CommenterMerrilee Fullerton
"Minister Hoskins and local MPP Glenn Thibeault have agreed to help fund the construction of a new facility to house a permanent PET scan in Sudbury, which hopefully will be ready by June of 2018. However, Dr. Webster thinks the real purpose of this announcement was to silence the people of Sudbury, who, along with six other communities like Kingston and Kitchener-Waterloo, have long lobbied for mobile PET."

Interesting timing.
Next provincial election in Ontario expected to be June 2018.
So message from Hoskins and Thibault then is really, Be Quiet...we will deliver at election time. Don't fuss or it might go away again. Shhh.


Quite condescending not to mention highly politicized health care.
February 21, 2017 | Unregistered CommenterMerrilee Fullerton
So the government has agreed to look at binding arbitration. Where have we heard this before ? Which begs the question. Why offer the government praise when they clearly cannot be trusted ?



Toronto, ON, April 25, 2016 – Ontario’s doctors are pleased to learn that the Ontario government is now prepared to agree to binding arbitration with the Ontario Medical Association (OMA). In light of the government’s new position on binding arbitration, Ontario’s doctors are ready and eager to meet with the Minister of Health and Long-Term Care tomorrow to agree to the terms of binding arbitration.

Over the past 12 months, Ontario’s doctors have said that strengthening patient-focused care requires moving forward with a long-term, permanent and stable negotiations process. However, over that same period, the Ontario government has repeatedly denied the OMA’s request for binding arbitration. That is why in October 2015 the OMA launched a challenge under the Charter of Rights and Freedoms against the Government of Ontario that asks the court to declare that physicians have a constitutional right to a binding dispute resolution mechanism.

Throughout this impasse, Ontario’s doctors remain dedicated to providing patient-focused care, and believe a fair and predictable physician agreement is the best way to strengthen the quality care patients need and deserve. The OMA looks forward to the Minister of Health and Long-Term Care accepting our invitation to meet tomorrow.

Dr. Mike Toth,
President
Ontario Medical Association
February 22, 2017 | Unregistered CommenterERDOC
So the government has agreed to look at binding arbitration. Where have we heard this before ? Which begs the question. Why offer the government praise when they clearly cannot be trusted ?



Toronto, ON, April 25, 2016 – Ontario’s doctors are pleased to learn that the Ontario government is now prepared to agree to binding arbitration with the Ontario Medical Association (OMA). In light of the government’s new position on binding arbitration, Ontario’s doctors are ready and eager to meet with the Minister of Health and Long-Term Care tomorrow to agree to the terms of binding arbitration.

Over the past 12 months, Ontario’s doctors have said that strengthening patient-focused care requires moving forward with a long-term, permanent and stable negotiations process. However, over that same period, the Ontario government has repeatedly denied the OMA’s request for binding arbitration. That is why in October 2015 the OMA launched a challenge under the Charter of Rights and Freedoms against the Government of Ontario that asks the court to declare that physicians have a constitutional right to a binding dispute resolution mechanism.

Throughout this impasse, Ontario’s doctors remain dedicated to providing patient-focused care, and believe a fair and predictable physician agreement is the best way to strengthen the quality care patients need and deserve. The OMA looks forward to the Minister of Health and Long-Term Care accepting our invitation to meet tomorrow.

Dr. Mike Toth,
President
Ontario Medical Association
February 22, 2017 | Unregistered CommenterERDOC
How will this work? Obviously the OMA and the MoHLTC can not apply to Labour Relations Board as we are not covered by the regulation.

"The procedures and process of interest arbitration are governed by the Public Service Labour Relations Act and Public Service Labour Relations Board (PSLRB) Regulations. To trigger the start of the arbitration proceeding, a Request for Arbitration will be filed with the PSLRB Chairperson."
February 22, 2017 | Unregistered Commentereklimek
Five years!
My guess is no charges and swept under the carpet for eternity.

https://www.thestar.com/news/queenspark/2017/02/20/five-year-ornge-criminal-probe-wrapping-up.html
February 22, 2017 | Unregistered CommenterCanary in a Coal Mine
My understanding is that interest arbitration is not binding arbitration.
February 23, 2017 | Unregistered CommenterMerrilee Fullerton
Not going anywhere. Binding arbitration is not going to be granted. Under the "new think", central is not releasing ANY control.
February 23, 2017 | Unregistered CommenterMovingforwardOntario
More evidence of deep Apotex connections to the Liberal party. It really makes one wonder about a lot of the regulation introduced around generics in Ontario.

http://www.theglobeandmail.com/news/politics/lobbying-commissioner-probing-fundraiser-hosted-by-apotex-chair-democracy-watch/article34111267/


In the meantime the MedsCheck gift to the pharma chains by Matthews is getting abused. I won't mention the chain but it would seem that suddenly I'm receiving a flood of these MedCheck reviews and I suspect the pharmcists are being incentivized to do them. The patients often complain after the fact that they were duped into having one done. The patient signs the form but doesn't really understand what is going on and certainly is not told that OHIP is getting billed for the service.

Funny how that gift occurred when David Peterson was on the board of Shoppers.
Anyone know what the MedsChek program is costing Ontario per year?
February 23, 2017 | Unregistered CommenterCanary in a Coal Mine
CICM,
Good question.
I read that pharmacists are being given the go-ahead to provide point of care screening for adverse events related to medications...DNA tests for genetic variations that could mean greater risk for adverse events.

This is something MDs could do. Point of Care testing should not just be in pharmacies. Physician leadership in Ontario is not involved...is that because government won't pay?
February 23, 2017 | Unregistered CommenterMerrilee Fullerton
Here we go https://www.bcpharmacy.ca/genome
February 23, 2017 | Unregistered CommenterMerrilee Fullerton
"Latest News: Pharmacogenomics Testing Available to Canadian Community Pharmacies – BCPhA Joins Forces with Australian Company

February 15, 2017

In November 2013, the BC Pharmacy Association (BCPhA) Board of Directors committed to explore the potential to offer pharmacogenomics testing (PGx testing) in community pharmacies. Consistent with the Association’s mandate, the decision was taken to determine whether community pharmacies could be the natural conduit to making this valuable information available to patients.

Since then, the BCPhA has undertaken many activities to advance a commercial launch of a service that would be accessible to Canadians in communities big and small. The primary objective has always been to position community pharmacies as the first and best place for the testing to be offered to the millions of patients taking the most often prescribed medications.

In the first phase of our research project, the BCPhA has worked in partnership with the University of British Columbia (UBC) and Genome BC to develop standard operating protocols to ensure this service can be delivered in a variety of pharmacy environments. We determined that indeed PGx testing can be delivered in pharmacies both in urban and rural areas. As part of our work, we have also undertaken significant stakeholder engagement talking with prescribers, benefit providers, regulators and pharmacy owners about the potential to offer PGx testing through pharmacies.

Every step we have taken has made it clear that pharmacists are the obvious professionals to capitalize on the wealth of information PGx testing provides to patients and how best to determine the use of its findings. Every day pharmacists talk with prescribers and patients about the impact of medications on their personal health. Offering PGx testing through community pharmacy adds another layer of information. It is an essential element in delivering on the promise of personal medicine."
February 23, 2017 | Unregistered CommenterMerrilee Fullerton
R

Of course the phamacists want this. No assumption of responsibility. If testing contraindicates doctors prescription who has to deal with it?.

Its another of example of government policy towards a consumer-lead health structure and away from evidence-based medicine. Satisfying consumers has a higher priority than enhancing the economic well-being of physicians.
February 23, 2017 | Unregistered Commentereklimek
It seems:

International law is one can present at a border station and apply for refugee status. If you applying from a "safe" country, that country can refuse the application.

With around 11 million "economic" refugees in the USA, the USA has started a process to identify some or all of these individuals for removal back to their country of origin. They left to get to the USA as it was preferable to where they are from.

If they are in the USA, and have the risk of being deported to their country of origin, or cross the Canada-USA border, not at border stations, so that they can declare refugee status in Canada, what would a rationale person do, looking for a better life?

This appears to be a big deal as of February 21, 2017 with the change in USA policy.If say 50,000 tried this in 2017, the demands on the system for economic support would be massive. Canada seems not to be isolated from the refugee issues now that the USA has considered addressing the issue they've avoided for decades.

We think health care is a mess. Canada appears now to be part of the USA in dealing with refugee issues and borders.
February 23, 2017 | Unregistered CommenterMovingforwardOntario
Looks like more cutbacks to physicians to pay for the 4% teacher wage increase.

"The provincial government has struck a deal with Ontario’s high school teachers, making that union the last one to reach a tentative agreement that would extend its current contract by two years and pave the way to labour peace through the next election."

https://www.thestar.com/yourtoronto/education/2017/02/23/ontario-reaches-an-agreement-with-high-school-teachers-to-extend-contract-by-two-years.html
February 23, 2017 | Unregistered CommenterCanary in a Coal Mine
If Patrick Brown wants to win the next election he needs to make housing affordability the main issue because that one issue alone crosses the political divide and will get the Millennial vote out in his favour. Forget about hybrid health care until after he wins.

The ratio of average detached house price to family income in Toronto is now in the 13 to 15 range when historically it has been 3 to 5. At some point there is going to be a lot of hurt.

"You would have thought that the worldwide attention Vancouver received over its housing emergency might have served as a cautionary tale for other jurisdictions, especially in Canada. But apparently politicians in Ontario, at least, missed the news.

What is happening in the Toronto housing market currently is almost a mirror image of how things played out in Vancouver, minus the citizen outrage. (Strangely.) You have: A real estate industry insisting there is no problem; a government holding that it doesn’t want to use policy tools that would hurt the equity in people’s homes; the same politicians contending they need more conclusive data before making any kind of move; foreign buyers moving in to park their money in real estate and many of those same purchasers leaving vacant houses behind. Oh yeah, and we shouldn’t forget: Governments (provincial and local) benefiting financially from tax revenue raised through house sales and ever-intensifying prices."

http://www.theglobeandmail.com/opinion/wake-up-toronto-to-your-housing-crisis/article34122980/
February 24, 2017 | Unregistered CommenterCanary in a Coal Mine
https://drive.google.com/file/d/0Bxbt83N7zYaVS05tN0F6bWFJU0U/view
February 24, 2017 | Unregistered CommenterStephen Skyvington
https://drive.google.com/file/d/0Bxbt83N7zYaVS05tN0F6bWFJU0U/view
February 24, 2017 | Unregistered CommenterStephen Skyvington
CICM,
The affordability of LTC solutions mesh with affordable housing overall. Unfortunately, the Ontario Liberal energy policies are driving up the costs of living and will continue to do so.

"Hybrid" health care will be decided by the Courts.
February 24, 2017 | Unregistered CommenterMerrilee Fullerton
" Better medicare, rather than the elimination of medicare, is what Ontarians need and deserve."

https://www.thestar.com/opinion/commentary/2017/02/23/better-medicare-the-prescription-for-ontario-opinion.html

And the day when all men are equal and the dead are resurrected is also awaited.

In the mean time, with medicare underfunded and over administered, we have asked the doctors, but not others, to shoulder the burden of responsibility of providing care within inadequate resources. Until the wages of toil are found in the afterlife, only then will the staunchest supporters be satisfied.

It is a liberal that is keenest to help others, but not with their own money.
February 24, 2017 | Unregistered Commentereklimek
The changes south of the border are causing rethink at central. Things have shifted. The issue on immigration is hitting big time at both the federal and provincial level. It seems that Canada may not be able to isolate itself from the issues of population growth if the USA shifts its policy. There is rapidly growing concern that by summer, Canada may have a significant problem with refugee claims.

Health care growth has slide down the list of concerns.
February 25, 2017 | Unregistered CommenterMovingforwardOntario
Mfo the bulk of those people walking across the border are not refugees rather they are economic migrants. Most are from Africa such as Ghana which is not a country at war. The CBC had a short documentary the other night showing that these guys fly into Brazil or Central America and then make their way north on foot or using local transportation. Up until Trump was elected their destination was the USA, but now it is Canada for their asylum shopping.

Many are now having to use human smugglers to get them across the US/Mexico border and up to the Canadian border. That adds about another $US5,000 onto the trip from Central America which the first leg if using smugglers costs in the ballpark of $US20K to 30K.

While I'm supportive of looking at assisting true refugees from war torn areas such as Syria if we don't stop the economic migrants very shortly we will have a flood of them coming in by the time the weather warms up. By flood I mean hundreds crossing at all border crossings a day by July/August.

So we have seniors who can't afford their rental housing due to Wynne's high hydro costs, and we have Millennials now priced out of the detached home market in the GTA and GVA likely forever, and we are about to offer full social support for economic migrants when the country is running large deficits.

The optics of the soon to be wave of border jumping will not go over well with the immigrants who came in through proper channels and those who have been in the country for many generations both of which want to see strong action taken in order to prevent illegal entries.

You can be sure for every arrest we witness on television there is an equal number walking in and just disappearing into the woodwork. I see them from time to time in the office where they pay cash and give bogus information. Many are working under the table in construction.

Housing and hydro costs, wait lists, and now a flood of border q jumpers is going to make the upcoming election a very volatile mix. The anger out there is palpable especially in the rural areas.
February 25, 2017 | Unregistered CommenterCanary in a Coal Mine
CICM

All means likelihood of the MDs getting more money is close to zero.

The changes in the USA are going to alter how Canada will need function in a world where constraining migration within North America now has become a priority. Canada may be forced to adjust its migration rules to match those of the US.
February 25, 2017 | Unregistered CommenterMovingforwardOntario
What is accepted as a " refugee" these days bothers me.

As a child I found myself as a refugee in West Germany having escaped the advancing Red Army and NKVD, as a refugee I had spent my first birthday being firebombed in Dresden, before spending almost 4 years in West German refugee camps.

My mother and I reached the UK in late '48 as displaced persons ( DP's) , my mother was to be a house keeper for a magnificent old lady, a Welsh university lecturer....not as refugees from Allied occupied West Germany who had not done us any harm....then I went on to enter Canada as a legal immigrant in '68....not as a DP, nor as a refugee but as a legal economic migrant if you wish.

Most true refugees from the Middle East entered an initial safe haven country and then morphed into being DP's....they were not chased out of their safe havens by hostile armies , but left as economic migrants seeking the best opportunities, moving from country to country looking for the best deal.


We are seeing mainly economic migrants illegally penetrating Canada's Southern soft underbelly , they did not have to cut through razor wires, traversing personnel mine laden death strips with border guards perched in watch towers machine gunning them as they were being chased by armed US security forces.

February 25, 2017 | Unregistered CommenterAndris
Music to many an Ontario physician's ears. Let's just hope Patrick Brown does not pull a Hudak or Tory and blurt something stupid out.

The only effective reset will be to dump both Wynne and Hoskins.

"Kathleen Wynne and Ontario’s Liberals could be on the verge of electoral disaster in 2018, according to a new poll.

The poll also shows that Premier Wynne’s personal approval rating has sunk to a new all-time low – 11%"

http://www.torontosun.com/2017/02/25/pcs-poised-to-win-super-majority-forum-poll
February 26, 2017 | Unregistered CommenterCanary in a Coal Mine
From our perspective , this is the most dangerous time of all, what a desperate vote hunting, short term thinking, career politicians determined to get reelected will do.

The Ontario Liberals will sell their souls in order to get reelected---they did so before---one recalls the Ontario power/ gas plant scandal of 2011 with the cancellation of the Mississauga and Oakville gas plants, at a cost of $1 Billion, to satisfy the local Liberal NIMBY electorates and which contributed to today's soaring hydro cost crisis.

It was gas plants then, the consequent surging hydro costs and deteriorating health care today...it is more than evident that they will try to pay for the gas plant/ hydro cost blunder off the backs of the health care system, in particular off the backs of the " greedy, rich, grasping " medical profession.

There is an ominous silence from the OMA / Ontario government negotiations---when I last heard the both sides were organizing their negotiation teams and I've heard of squat since.

In theory if binding arbitration is not placed on the table , the OMA negotiation team is supposed to walk off.

The Government floated the word " arbitration" in order to attract the OMA to the table--- however I gather that there are different kinds of arbitration---voluntary and mandatory arbitration, binding and non binding arbitration, institutional arbitration, statuary arbitration, ad hoc arbitration and contractual arbitration--- I'm not a lawyer, but I sense that the more capable and cunning government team will play a shell game with the OMA side, the three shells and a pea confidence trick, fooling to OMA into picking the wrong shell so dooming the profession.
February 26, 2017 | Unregistered CommenterAndris
Whatever party rules is stuck with economic reality, there is insufficient resource, to provide the wanted entitlements, thus they must play off the voter groups. We keep ignoring the fact we are going to have to face the fact, how much resource are we prepared to collectively pool, to support those who can not make it on their own in the changing world.

The migration issue may be bringing this to a head. We need clear policies on how to redistribute wealth. The current absent of policy is not helpful.
February 26, 2017 | Unregistered CommenterMovingforwardOntario
JFK believed that " rising waters lift all ships"---our governments believe in lowering the waters, lowering the ships--- the only problem are the unseen rocks, which will pierce the keels of some and expose the other vulnerable ships .
February 26, 2017 | Unregistered CommenterAndris
These kinds of reports that sell something to the public without understanding the reality of the related challenges give me great cause for concern.
This study is backwards looking, fails to recognize new personalized medicine, or the repercussions as drugs are not listed by the public plan while private coverage will have been distorted.

None of the above can be quickly or simply explained do the lopsided media reports continue.

https://beta.theglobeandmail.com/news/national/with-universal-drug-coverage-canadians-could-save-billions-study/article34141670/?ref=http://www.theglobeandmail.com&service=mobile
February 27, 2017 | Unregistered CommenterMerrilee Fullerton
R:

Sadly, the public believes all can be free, and votes for the free stuff they are being sold.
February 27, 2017 | Unregistered CommenterMovingforwardOntario
If I remember years ago, a lot out of BC social policy experts confirming, aging wouldn't impact health care delivery. Seems even BC has abandoned their social policy experts now a days.
February 27, 2017 | Unregistered CommenterMovingforwardOntario
Hey ELB,
You out there?
February 27, 2017 | Unregistered CommenterMerrilee Fullerton
A recent report stated that the loss of manufacturing jobs in the US was 85% due to automation and only 15% due to trade. In other words Trump may bring the factory back but he is not going to bring the blue collar jobs back.

And despite Bill Gates positing last month that a robot should have to pay the equivalent in income taxes that the displaced worker used to pay this is not going to happen.

So as more and more jobs in society are automated and poorly educated workers are displaced permanently (which is why we do not need uneducated economic migrants) where is that loss in tax revenue going to come from to pay for free healthcare, education, and interest on our debt?

Robots don't purchase cars or trips to Cuba so think of the downstream losses automation will cause.

Automation like previous disruptive technology is coming fast and likely will drive much of the social unrest we currently see. Governments are woefully unprepared as are societies in general.


"Much of the current political upheaval in the United States and other Western democracies can be traced to how threatened we feel when faced with this future. Central to Donald Trump’s presidential campaign, and presumably to his victories in manufacturing states like Michigan, Ohio and Pennsylvania, was his promise to bring back the 10 percent of factory jobs that have disappeared in the wake of the Great Recession. But the fact is, American manufacturers are producing more products now than they were before the crash, with fewer workers, which suggests that those missing jobs have been automated. And while collaborative robots are showing up on factory floors first — where automation has always debuted, taking on repetitive, heavy and hazardous work — they are likely to find their way into other workplaces soon. (The “collaborative” label, widely used to imply coexistence, is a bit misleading; robots that can learn, problem-solve and simulate human emotion are still confined mostly to laboratories.) Already, surgical robots make it possible via remote control to perform low-risk operations in outpatient settings; robot home-health aids may soon help people with limited mobility get out of bed, cook meals and perform other routine tasks; and driverless vehicles are poised to take over the transportation and trucking industries. It doesn’t take much imagination to see how similar algorithms, or operating instructions, could enable robots to do many of the tasks required of waiters, maids and hospital workers. A few years ago, Amazon purchased Kiva Systems, which coordinates warehouse robots whose job is to move heavy boxes to stations where human stockers, whose fine motor skills have yet to be affordably mechanized, transfer the boxes to shelves."

https://www.nytimes.com/2017/02/23/magazine/learning-to-love-our-robot-co-workers.html?hpw&rref=magazine&action=click&pgtype=Homepage&module=well-region&region=bottom-well&WT.nav=bottom-well
February 27, 2017 | Unregistered CommenterCanary in a Coal Mine
Interesting comments on this Globe article.

The public is making the distinction between true refugees and economic migrants, but the politicians have yet to catch up to what the majority of Canadians think and feel on the issue of hundreds of migrants (soon to be thousands) entering our back door and who will likely consume a good deal of social and medical resources before their asylum application is heard and concrete action taken.

In the meantime we can't afford to pay for LTC, joint replacement, hydro, and the rapidly increasing third line item on provincial expenditures, interest on the provincial debt. We need to set these politicians straight about what our priorities should be here.

http://www.theglobeandmail.com/opinion/tolerance-for-refugees-has-limits-even-in-canada/article34132569/
February 27, 2017 | Unregistered CommenterCanary in a Coal Mine
Hi Dr. F. I'm out here...still lurking. Flabbergasted about what has been happening on-line between physicians in this province.

Admittedly, I must have missed the trend for physicians to aspire to mimic Trump-loving Alt-Right Internet trolls. Some of the language in the recent Toronto Star article is downright sickening...in English and in Spanish (dude - like you know we have Google translate, right?).

And one overly concerning threat made one interventional radiologist <<I hope none of your patients need to come here to have any kind of (test) done>>. What the "F" is that? Seriously? A physician threatens to punish a patient because they were referred by a doctor who does not agree with their medical politics?

Disgusting. The profession must be so proud that this is being covered blow-by-blow in the Toronto Star. And it gets worse...threatening medical students by barring them from a family medicine residency? Holy crap on a cracker!

Some physicians in Ontario are dangerously close to the edge of selling out the entire profession, only to enable Central (without lifting so much as the finger on one hand) to swoop in and do something so drastic that it would make Mussolini say, "Wow, that's harsh".

So stop doing whatever it is that you`re doing based on the advice of anyone from Kingston (except Hugh Segal...he`s cool), suck it up, organize and get your heads out of your collective lower discharge pipes and get back to doing what you do best.

It certainly isn`t politics, anymore.
February 27, 2017 | Unregistered CommenterExecutive Lead Blogger
R/ELB

For those who don't get it, anything you do electronically can be tracked. The issues described in the Toronto Star are not acceptable, but also feeds those involved on the wealth redistribution side.

Central will not be "blinking" on this. The budget is fixed, MD "in pocket' revenues are being driven done. Some groups will see large drop in incomes. The list has been made. The good times are in the past. MDs will still be well compensated, but will be tracked and rewarded on patient satisfaction reports.

Just wait for the new "residency"programs determined by what central believes the 10 year needs are.
February 27, 2017 | Unregistered CommenterMovingforwardOntario
Those comments are unacceptable from any source.
February 27, 2017 | Unregistered Commentereklimek
R:

Again, I wish to thank you. The site has always impressed me with its ability to address significant, emotionally, driven issues, but has shown civility.

Thank you.
February 27, 2017 | Unregistered CommenterMovingforwardOntario
It goes without saying internet trolling and bashing, let alone bringing the discourse into personal situations, is ridiculous...but i have to say it does bother me that, once again, there is Berger, who has spent decades bashing most other doctors in public based solely on his own ideologies, and now is (ironically) crying about being criticized too 'meanly'...has this guy no shame or insight at all into how he comes across to the bulk of the profession? A Star rolodex doctor bashing star now complains that he is being picked on? Seriously?
February 27, 2017 | Unregistered Commenterksy11
I haven't seen the Red Star article.

Having crossed swords with some of these pompous silver spooned Marxist ivory towered over the decades , it is interesting to see that they are now being hoisted on their own petards.
February 27, 2017 | Unregistered CommenterAndris
Just read the Red Star.

The establishment bullies are getting bullied---and evidently can't take it, so they run to a Pravda which is sympathetic to their ideology.

There is evidently a vicious struggle going on in the murky world of cyberspace , reflecting the stresses and strains within the profession.

The next move for the establishment is to pull the CPSO into the battle ....reminds one of Animal Farm where Napoleon trained puppies into becoming vicious attack dogs to intimidate the others...killing some animals and driving out "Snowballs".

One senses that this is a part of the greater battle over health care, with the collectivists determined to reassert themselves on the membership and the to be collectivized resisting.
February 27, 2017 | Unregistered CommenterAndris

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