Stopping the Gravy Train

It has been a year since Rob Ford was elected Mayor of Toronto. I point this out because he won a large plurality promising to get rid of municipal government waste, and over spending, without cutting services.
My view is that Toronto, is like any Western democratic government in microcosm. The city  government has grown by leaps and bounds, taking on more and more responsibilities: sewage, water, electric power, schools, transit, affordable housing, waste removal, roads, entertainment, parks, recreation, and on and on. Ford's mantra in the election was to: "stop the gravy train." So, one year in, hows he doing?
Well, yesterday he managed to punish one of the larger municipal unions for having a garbage strike two years ago. One half of the city will now have "privatized municipal garbage collection." Projections are, that money will be saved and the possibility of a city wide strike will be diminished. Chalk one up for Ford.
In many ways Ford has the typical conservative view of government: we need it, we need lots of it, but we can cut the waste and make it efficient too.
He was serious, he hired a large independent auditor to find ways to cut government spending without affecting core services. Well, I've written about that issue, here and here. To me that sounded like having your cake and eating it too, but Ford will beat you to the cake. ;-)
After several months in office looking for the "gravy," Rob Ford discovered that he was standing in it. There was little waste in the actual machinery of government, the waste turned out to be the very services he had sworn not to cut. The libraries, the pools, the theatres, the zoo, and all the "freebies" the citizens of Toronto came to expect, paid for by other people's money. Let's not even talk about the bloated salaries city workers make so that they may have a descent living wage. The city has a fair wage policy where it will over pay workers because it's really not their money is it? Someone else is paying, so we can be magnanimous.
When citizens got wind of Ford's plan to downsize government by cutting their precious "free" services, there was lots of  blowback. His popularity plunged. Even the "Occupy Toronto" protestors, very new on the scene, and with little to actually protest about, decided Rob Ford's plans presented a large juicy target. Indeed it does.
So, will Ford prevail? Does Ford actually have a better idea? Short answer, no. I'm betting he tweaks the system a bit, makes some cuts and declares victory. The unions are starting to target their guns on him, not yet with attack ads, that will come later. Right now they are using media to deliver the message that unions are made of regular people, your neighbours, your friends, and they care! They care about Toronto, soon they will say Ford doesn't.
   

Penn Jillette: Libertarianism

A snapshot from my Ontario healthcare family album

For the past month I've been watching and negotiating my way through the Ontario healthcare system on behalf of my elderly mother. Fortunately the initial problem was not that critical, but when one is injured in a fall, at 92 years of age, even little problems get magnified.

For all of its faults, and there are so many, the Ontario Health Insurance Plan or OHIP system seems to function, but at such a poor level of service and timeliness, that no one would tolerate it if it were in any other service area. In healthcare, most Ontarians choose to ignore or excuse the long worrying waits, or the pain endured before treatment is available because somehow, they view the system as part of their definition of what it means to be Canadian.

When the paramedics brought my mother to the local emergency department, she was "triaged" rather than "served" even though the emergency room was not busy by any stretch, I was there. Most of the "treatment" she underwent was done by the paramedics en route. When she arrived at the hospital she was viewed as an elderly patient who may or may not survive, and she was treated as a costly liability rather than an opportunity to make profit. What other service industry do Canadians interact with, that treats you like that? Imagine a dentist being so cavalier with someone's pain, how long would they be in business? Of course in dentistry, people have choices. This was a major regional hospital, yet my mother was not even given pain medication for over 3 hours when the doctor on-call finally saw her.

You would think that the supposedly compassionate physicians of Ontario (or anywhere in Canada for that matter) would collectively rise up and challenge the government health care model, but you would be wrong. 

In the editorial introduction to a recent FP Magazine, the editor Terence Corcoran, writes that the Canadian Medical Association (CMA) has "essentially abandoned their customers," and "Canadian doctors, the state-nationalized victims of health-care delivery, are also its official defenders." This is cronyism of the worst kind, and all Canadian doctors should be ashamed.

I think Mr. Corcoran's editorial was not widely read or discussed, because I've barely heard a peep out of the rest of the media, but it is worthy of your time to read it. 

Regenerative medicine and longevity

When I first heard that Steve Jobs had pancreatic cancer I remember hoping to myself that the cancer was discovered early. I knew that survival rates for this type of cancer were low, but this guy was wealthy and could afford the world's best treatment. Little did I know what was revealed this week in Jobs' official biography by Walter Isaacson, that Jobs refused conventional treatment for nine months: "Instead of opting for surgery, he took on a vegan diet, acupuncture, herbal remedies and other treatments he found online, and even consulted a psychic." That revelation diminishes the respect I had for his genius, but not for his accomplishments.
People are funny that way, I guess technological and marketing savvy don't go hand-in-hand with scientific good sense. Maybe it wouldn't have made any difference but you would think the odds favoured the team with the best performance on the field, that is the medical scientists versus the herbalists and psychics.
Medical science of course is part of the reason for the increasing human life span, though most people fail to appreciate that the biggest advances came with the introduction of what is unfortunately called "public health." Simple things really, like separating sewage waste from drinking water, that was huge. Mass vaccination of populations was also huge. Death rates really dropped when those two practices became widespread.
But the big improvements of yesteryear have been replaced by medical tinkering in more recent years, even though the technology exists for human lifespans to take another great leap foreword. See that ear growing from the mouse's back? That's not a new story, that story goes back more than 20 years now - replacement parts.
Below is a recent video from ReasonTV that presents a new book by Sonia Arrison author of 100 Plus: How the Coming Age of Longevity Will Change Everything, From Careers and Relationships to Family and Faith, "because everyone has an interest in living healthier longer." The book purports to show how replacement parts may change things.
After watching the video think about the major impediments to some of this work, especially for the people that really need and want it. This is likely to be expensive treatment and with all of the regulatory barriers set up by various governments, it will become more expensive, not to mention hard to get (probably impossible in Canada unless drastic changes take place). Imagine being given the choice possibly between life and death, as the author describes in the video, and then being told treatment is disallowed by some government rules or bureaucrats? Not funny, right?
The expense side of organ replacement is also interesting and recalls a movie I saw recently called Repo Men. In that movie, people buy artificial organs on credit then fail to make regular payments. The movie puts a whole new spin on "repossession."