Archive for September, 2008

Death by mismanagement: the Canadian way to die

This weekend, Brian Sinclair, a 45-year-old Winnipeg man with a complicated medical history, died in the waiting room at Winnipeg’s major teaching hospital after waiting for 34 hours. He was referred to the ER after being seen at a clinic four blocks away. Nobody at the clinic saw fit to help him get to the hospital, beyond putting him in a taxi, despite the fact that he was (obviously) hours from death. The ER has stated that it is the responsibility of the patient to get in touch with the triage desk, and claims that Sinclair failed to do so. Since then, it has been disclosed that Sinclair died of complications from a bladder infection, and that a catheter change and antibiotics would almost certainly have saved his life.

Already, the great responsibility shuffle has taken place, with spokesmen for the clinic and hospital tacitly or explicitly blaming the victim, the system, and anyone but themselves. While the medical inquest, which will be overseen by a doctor who isn’t afraid to point fingers, may identify individuals who are at fault, there can be no question that poor management of ERs is largely culpable for this death. My editorial on the topic, published in the Winnipeg Free Press today, is here.

Comments

Dion in Winnipeg - reflections

On Tuesday, Stephane Dion spoke to a packed hall in Winnipeg South Centre, a riding that is expected to be fiercely contested in the next election. Instead of demonstrating strength and vision, the Leader of the Opposition exposed his weaknesses and the fragility of his platform.

The topic of the meeting was Dion’s Green Shift plan. Despite promoting this tax on carbon production, Dion conceded that a market-based cap and trade system would likely be in the works under a Liberal government. He spent as much time slamming Harper’s policies as he did explaining his own, and in the process revealed a fundamental lack of understanding of economics and government.

His major criticism of the government’s approach to limiting pollution was that it would make emissions more expensive without benefiting the environment. The fundamental purpose of any incentive program, though, is to decrease pollution, and raising the cost of carbon production would intrinsically encourage industry and consumers to look for carbon-neutral alternatives, thereby benefiting the environment.

Dion’s grasp of economics seemed even shakier when he excoriated the government for ending the days of budgetary surpluses. A surplus results when the government has collected more taxes from Canadians than it needs, money that Canadians could be saving or spending themselves. Eliminating surpluses by cutting taxes is therefore an excellent sign, indicating that the government has learned how to get by with less, and is leaving more money in the pockets of Canadians.

The reality of a carbon tax is that it would raise the price of necessities. Most Canadians eat food that has been transported some distance, which would cost significantly more under a carbon tax scheme than it does now. Heating a home is not a luxury, nor is it cheap even today. Few cities provide public transportation adequate to truly replace driving. For everyone but condo-dwellers in the downtowns of big cities, Dion’s carbon tax would dramatically raise the cost of living.

In Winnipeg, Dion argued that this would balance out. The carbon tax, he claims, would be used to finance income tax cuts, including refundable tax credits for households too poor to pay much tax. This may or may not work on paper. In reality, though, there is very little precedent for governments eliminating taxes. The major exception in Canadian politics has been the Harper Conservatives, who followed through on their promise to cut the GST. Dion, on the other hand, pledged to renew efforts to create a national daycare program, and increase subsidies for home renovations. Plans like that don’t come cheap, and make it less likely that a carbon tax would be the basis for a revenue neutral tax reform, rather than simply a massive tax hike.

The standing room only audience cheered enthusiastically whenever Dion slammed Harper, but couldn’t summon up much energy for the man himself. Dion came across in Winnipeg as the stereotypical academic that he used to be: brainy but disconnected from the people he hopes to lead, uncomfortable speaking off the cuff, and more suited to lengthy discussions about theory than to implementing solutions.

A platform can’t be built entirely on the environment when Canadians are dealing with healthcare waits, increasing costs of living, and an incipient economic slowdown. Unless Dion and the Liberals figure this out and add some substance to their campaign, the Conservatives could well win a majority this time.

Comments

Rationing and universal healthcare

Bill Murray (not that Bill Murray) was 57 years old when the province of Alberta refused to pay for his hip resurfacing, which would restore his mobility and greatly reduce joint pain, because he was too old to benefit from it. This is going to happen increasingly often to the Boomers, as they enter their peak medical care consumption years. Single payer, universal healthcare means that the market does not guide supply or demand. This means that bureaucrats do. Inevitably, this means that somebody other than you is going to decide what medical care you are entitled to. This should frighten all of us, and nobody more so than the entitled, wealthy and aging Baby Boom generation. Pajamas Media has my column on the Murray case, and others in which life, not just quality of life, was at stake, here.

Comments