Have we reached the limits of liberal tolerance?

Have we reached the limits of liberal tolerance?Liberal tolerance fails without a shared sense of its limits Liberal elites delight in showing tolerance for things their neighbours cannot stand. Liberalism demands embrace where many people, by nature, might recoil. However, even committed classical liberals and libertarians find some things beyond the pale, but they have lost the language to say why. Consider…

B.C. stuffs doctors’ mouths with gold: $135,000 raise

B.C. stuffs doctors’ mouths with gold: $135,000 raiseWill they take the money and run or stick to their principles? Family doctors in British Columbia seem to have struck gold this week. The province offered a $135,000, 54 per cent raise in return for a change from fee-for-service to a rostered – or what’s known as capitation-style – practice. This means average total…

Are we witnessing the end of liberalism?

The liberal consensus is dead, and liberalism faces attack from all sides

Are we witnessing the end of liberalism?For some reason, physicians love this line: “I am socially liberal but fiscally conservative.” It sounds moderate, prudential, even sophisticated. “Socially liberal” suggests individual choice about sex, marriage, and life in general. “Fiscally conservative” suggests spending restraint and market freedom. Both statements come from the same philosophy. The first is social liberalism, the second economic…

Bureaucracy may be necessary, but it is never harmless

There is nothing that bureaucracy cannot make worse

Bureaucracy may be necessary, but it is never harmlessBureaucracy begats bureaucracy, building its own demand and transforming people into managers designed to meet bureaucratic needs. A bureaucracy designed to serve patients ends up serving its creators instead and protects those who work inside. Economist William Niskanen offered a definition of bureaucracies in his book Bureaucracy and Representative Government. Roughly speaking, he says, 1)…

Health care user fees promote equity and efficiency

Offer a small step to solving overconsumption and waste

Health care user fees promote equity and efficiencyTwenty-eight countries have universal healthcare. Twenty-two of them have some form of cost sharing. User fees offer one example. User fees work best as a small, flat fee paid at the point of service. Even a few dollars discourage (rational) people from booking an appointment for what they asked twice previously. User fees shorten the line…

Why health care can’t change

When it comes to fixing health care, governance matters more than policy

Why health care can’t changeFew voters had first-hand experience with hallway medicine or Canada’s world-famous wait times before the pandemic. Lockdowns changed everything. Health policy failure moved from fear-filled headlines into a tangible crisis everyone could feel. Failure begs for better, or even new policy, to fill gaps. Planners and policy writers jump to offer solutions: surgicenters, funding reallocation,…

Wokeism is leading to the fall of fact-based medicine

Patients suffer if society reshapes the medical mind and how doctors process information

Wokeism is leading to the fall of fact-based medicineA medical mind is precious and fragile: hard to create, easy to corrupt. Doctors invest over 10,000 hours learning how to diagnose and treat. The medical mind exists to help patients and should serve no other purpose. But it is easily corrupted and distracted from its primary purpose. If patient care matters, we must protect…

Why Canada can’t reform its ailing health care system

Government, medical professionals, and public-sector unions each hold veto power over any innovation

Why Canada can’t reform its ailing health care systemThe Honorable Monique Begin wrote in 2009, “When it comes to moving health care practices forward efficiently, Canada is a country of perpetual pilot projects.” Governments need “financial control” and remain “leery” of committing to programs. Pilot programs are easy to shut down “to avoid criticism” or if “budget priorities shift.” At first glance, we…

Patient care is too important to suffer under central planning

Canada rations care with wait times, limited investment in technology, and by using family doctors as “gatekeepers” to service

Patient care is too important to suffer under central planningDoctors frustrate governments. They think too little about how much health care costs and too much about their patients who need help. The government of Ontario and the Ontario Medical Association arrived at a mediated Proposed Physicians Services Agreement (PPSA) this month. Doctors started to vote on it yesterday, with voting ending on March 27.…

7 reasons why some doctors become bossy

Pandemic chaos and fear turned some otherwise rational doctors into dictators

7 reasons why some doctors become bossyLeadership carries a high risk for bossiness. Some medical Chiefs gain humility from caring for sick complex patients. It shapes their approach to leadership. Unfortunately, many forget their failures. Others never learned in the first place. Many Chiefs of Staff have never seen sick patients at all. But as chief, they see all the medical…