28 May 2010

Myths about money and health: who should pay for health-care, and who should be getting it

Revised June 2012

The article I have based this blog comment on is this, from the Globe and Mail - 'Make rich seniors pay for drugs, report says'. A secondary issue is the "cost-effectiveness" of the care given by doctors, which I don't believe is quite the same meaning as "improve the quality of patient care."

So, first of all, I would like to say this: There are certain myths in society that need to be dispelled. The idea that the wealthy are worth more, in their very humanity, than the poor, is one of them.

There are other myths in society that are just as commonly believed, or rather, simply not questioned, but first things first. Some people having more wealth than others is not a good reason why they should be treated better, though of course, in some circumstances, having money enables a person to buy better treatment and health-care.

The slippery slope of the myth of the greater 'worthiness' of the wealthy leads not just to more choices given to them, but also more advantages in their health-care, to the extent that all other things being equal, the wealthy will still receive better treatment than the poor, even when it is available to all, apparently, regardless of class or wealth. Why?

The myth is that the wealthy are internally 'better' in character, in work ethic, determination, decision-making, and all other traits that make for a better citizen in Canadian society. Thus, more is given to them, and more is taken away from the poor. This is how our just society works.

Added June, 2012

According to this article, altering the way ODB (Ontario Drug Benefits program) is carried out could affect “universality of access.” Of course it would. That would be the whole purpose of having those who are better off pay for their own drugs. The only “alarms” likely to be raised would be those in the heads of the wealthy who might be thinking What next? The fears of the rich are so great they can’t help pushing down those in need farther down just to protect benefits they surely know they don’t deserve, much of the time, or need.

In addition to the idea to “overhaul the way doctors are compensated by paying them, not only for treatment, but care that is cost-effective.” If we leave this up to health care staff to determine, there’s no limit to how they might interpret this need. Cost-effectiveness might mean that care and treatment given to people in society who are not contributing in the way they would like, or not reproducing, or not providing various other tasks and functions seen as valuable, or do not own their own homes, might find themselves on the dnt list – do not treat.

It could be requested that staff and doctors treat all patients the same – *objectively* - meaning give each one the same quality of care as another, except that stands the risk of being interpreted as treating the patient as an object (unless of course, they are known to you), with no fair assessment of their needs or what treatment might be best for them.

Finally, the matter of sustainability, or as the article says, “Without such profound changes, suggests a report released Thursday by TD Economics, public health care as Canadians know it is unsustainable.” Yet we can afford F35s, full day kindergarten, sending financial help to countries like Haiti? I don’t see the government telling Michael Ferguson, or the Ministry of Education, or Michel Jean that’s there no money for their causes.

Some people in society have more care given to their needs. And that’s not likely to change, when the cuts come. Many of these would be able to pay for health-care not only for themselves but the healthcare of others. They will never come to see themselves as having enough money to share the wealth because they want to be able to leave a nice inheritance to their children.

Make rich seniors pay for drugs, report says
By Lisa Priest and Karen Howlett
Globe and Mail, and in Social Policy in Ontario
May 27, 2010
http://www.theglobeandmail.com/news/national/make-rich-seniors-pay-for-drugs-report-says/article1582236/  not working


Links updated June 2012

26 May 2010

If Michael Bryant should be judged on his merits, shouldn't we all?

The wealthy and powerful don't always get to know what is meant by the saying, 'life isn't fair,' or 'shit happens.' It's remarkable that the editorial board of the National Post still don't understand what is meant by this. They still seem to believe that bad things don't happen to good people, that sometimes - one more time - life just isn't fair.

And what is this language - militant cyclists? class warriors? Look who are the class warriors in this piece - the journalists, the lawyers and judges, and the politicians who enabled this decision to happen and who decided to blame the guy from the lower class in society and let the privileged one off.

"But no one’s career should be derailed forever by an incident such as this" write the editors of the National Post, as though this kind of tragedy, that forever alters the course of a person's life, doesn't happen very often at all, as though this is an exceptional circumstance, and that it just shouldn't happen. Life is fair, after all, and the good and intelligent always get what they deserve! Right? Wrong. It happens to people all the time - you just don't notice it until it happens to one of you.

Take note of the more than 500 comments on the Globe and Mail article by Christie Blatchford. Not everyone thinks Michael Bryant should have gotten off as lightly as he did - or is it that most people think justice should have been permitted to take its course, through a trial.

Added May, 012

In ‘Michael Bryant should be judged on his merits,’ 2010, The National Post refers to Darcy Sheppard as having engaged in “outbursts of primal madness,” as though that couldn’t have also been explanation for the behaviour of Michael Bryant – reverting to the ‘fight or flight’ syndrome, and in this case choosing a bit of both – attempting to get Mr Sheppard to let go of the car, while trying to remove himself and his car from this situation.

Furthermore, the same piece concludes that “Mr. Bryant should be judged in future — politically or otherwise — according to his merits, or lack thereof.” If this bit of wisdom could also be applied to other people who found themselves in unfortunate, adverse circumstances, instead of having the event used forever as proof of personal, internal failings, the world might be a more just place in which to live.

Christie Blatchford writes,

“He [special prosecutor Richard Peck] went out of his way to speak kindly about the dead man, noting that he brought up Mr. Sheppard’s unlucky background (aboriginal, probably undiagnosed fetal alcohol syndrome, seized by child welfare and placed with his brother David in a staggering 30 foster homes before being adopted) and highlights of his criminal record “not to demonize Mr. Sheppard or for anyone to suggest he somehow deserved his fate,” but rather because in a case where self-defence was claimed, these were relevant facts” (For Mr Bryant, an extraordinary, 2010).

In other situations, bringing in relevant facts may be seen as an attempt to discredit the honourable person being discussed, not as an attempt to discover the truth of the matter. And it’s not simply the words one speaks; it’s the tone in which they are uttered that matter. Running Darcy Sheppard down in a “kindly” fashion, while simply ignoring many of Michael Bryant’s actions that day, can lead others’ understanding of the situation in a certain direction, and not to one that is fair judgement of what happened that day. Bringing in the personal background and past history of Mr Sheppard, knowing that Michael Bryant’s credentials were near perfect, is an unfair comparison. Is this what Mr Peck did, and by doing so imply that the questionable actions taken by Mr Bryant that day were an aberration, unusual considering his personality and background, ie. if he did anything wrong at all?

This must be one of those situations that fit within the realm of the moral dilemma – how to bring justice to this situation. It’s too bad that justice for Michael Bryant could only be achieved by placing the blame on Darcy Sheppard. I suppose, in our world, especially in our legal system, there is no place for matters that fall in between right and wrong, that really are unusual circumstances that need an unusual resolution (and I imagine a lot of cases fall with in that grey area). Whatever Darcy Sheppard’s faults, he didn’t deserve to have this case dismissed so early in the judicial process, leaving Michael Bryant not simply ‘not guilty’ of the charges laid, but completely innocent of anything untoward.

The Toronto Star is right, that Michael Bryant “deserves public understanding,” that “What happened to him could happen to anyone” (Justice in Michael Bryant case, 2010). But the newspaper is not correct in concluding that what happened in the aftermath of the tragedy speaks well of the legal system. For one person involved, the legal system worked well, but not for Darcy Sheppard.

In a similar manner, Franco Tarulli writes, “Ontario did exactly the right thing in this case, and the result is exactly what ought to have happened” (Michael Bryant: “Extraordinary” justice?, 2010). Justice may have been served, for Michael Bryant, but the way the special prosecutor handled the case doesn’t appear to have been fair. Bringing up Darcy Sheppard’s past failings and personal background as evidence that this was what caused the incident to happen was premature. There was no trial, and this should have no more place in the public’s mind than the damage committed, for whatever reason, by Bryant and the car he was driving.

For Michael Bryant, an extraordinary kind of justice
By Christie Blatchford
Globe and Mail
May 25, 2010

Justice in Michael Bryant case
Toronto Star
May 26, 2010

Michael Bryant: “Extraordinary” justice?
By Franco P. Tarulli
The Ethical Lawyer
May 30, 2010

Michael Bryant should be judged on his merits
By National Post editorial board
National Post
May 25, 2010

Links updated May, 2012

23 May 2010

Robin Hood: class warfare

Conrad Black writes: "If the richest Americans are to be enlisted in the fight against poverty, it should be in the form of private-sector anti-poverty projects that wealthy taxpayers could design and administer themselves. This would involve the best financial minds in poverty reduction and would give the wealthiest people an incentive to eliminate poverty, as the rate of tax would decline as poverty declined and would vanish when poverty, as reasonably defined, vanished."

Why does Conrad assume that the wealthiest are the smartest. How is it that myth persists?

Usually the wealthiest are those who conform the most, jumping through the hoops and doing whatever it is that our society wants, and values. Take Lady Gaga, for instance. She knows, as did Madonna, when she started her career.

On another level are the practically mindless folk who actually do attempt to 'shortchange' their customers. Getting their jobs because of some relationship they have formed certainly doesn't lead them to be grateful, it would seem. Stealing from the poor is the other side to all this - including money, careers, educational opportunities.

In 'Robin Hood or the Pope' Tom Cosgrove mentions Father Larry Snyder and the website about Poverty in America, Think and Act Anew. One would think 'Reclaiming the dignity of work' is what our society needs, but I imagine that only works when the worker has earned the right to the job.  'Collateral damage' seems to be the effect, when people are denied the opportunity to earn a living. They don’t really matter.

Conrad himself believes that "we must banish to the proverbial dustbin of history the heirloom of Fabian attitude that any benefit to society’s short-changed must be wrung from the sweat of the diligent and transformed into the penalization of success." Perhaps that statement would make sense if all the wealthy did actually earn what they were paid - according to the time and energy and knowledge they put into their work, instead of the value of work being based on some extraordinary needs of our society, with those who need it most being cast out as virtually unemployable.

Together with nepotism, favouritism, and a sexualized society, these excessively-paid celebrities, entertainers and some might add, politicians, do nothing to help turn our society into a fair and humane place for those struggling for something better.

Collateral Damage
By Fr Larry Snyder
Think and Act Anew website
May 12, 2010

The Lady Gaga guide to capitalism
By Conrad Black
National Post
May 22, 2010

The real Robin never robbed the rich
By John Ridpath
National Post
May 19, 2010
http://network.nationalpost.com/NP/blogs/fullcomment/archive/2010/05/19/the-real-robin-never-robbed-the-rich.aspx link no longer works
Contains original comment made online by Sue McPherson

Robin Hood or the Pope: Who Really Cares About the Poor?
By Tom Cosgrove
Huffington Post
May 18, 2010

Stealing From the Rich: Four Different Approaches
By Dave Kehr
May 21, 2010
NY Times

Links updated April 17, 2012

21 May 2010

Michael Ignatieff: leadership potential in Canadian politics

Revised May 29, 2010
Updated June, 2012

It's astounding that Michael Ignatieff is being treated the way he is, when you look at all he has to offer.

In our society, continuity is seen as normal, and better than discontinuity or separation. The lengthy, continuous career is looked upon as a model for a good work history, while travelling and working in diverse occupations, and in more than one country, can be viewed as a sign of flightiness. In reality, this kind of life can make a person 'more of a Canadian,' (a term attributed to Ignatieff in recent news articles, and not kindly eg ‘Michael Ignatieff thinks,’ 2010), more understanding of different ways of living and working, more able to stand back and look at the entire picture, but it can be detrimental when one comes to trying for a new career in a country that doesn't understand this. Ignatieff was probably right when he said the Conservatives were "provincial" in their thinking - the Conservatives and many Canadians (Michael Ignatieff accuses Conservatives, 2010).

After all Ignatieff has done in his life - teaching, journalism, writing books, serving as professor at universities, he is sometimes criticized for not doing anything substantial, for not showing Canadians what he is all about. But isn't what it's all about is having the "trust and confidence" of the people, and "vision for Canada," as this article claims? Could the problem, in part, be the people working for the Liberals. See this, from the article, apparently a comment by "one senior insider" : “Ignatieff hasn’t unveiled any substance yet and until he does, he can’t move anywhere" (The pressure is on Ignatieff, 2010).

So now we're back to having to have something of substance to convince the people of Canada that Ignatieff would make a good leader, not just knowing that he is able to think, write, do the work, act with determination, and do all the things a leader must be able to do. He actually has to show proof, and not proof gained while working in other countries for non party-political jobs.

To say it's up to Ignatieff to stop the freefall, if that's what it is, is unfair (The pressure is on Ignatieff, 2010).  According to this article, "Mr. Ignatieff has already fired one group of top advisors yet his poll numbers are still dropping." He must wonder what is going on too.

He may be the best thing to happen for the Liberals, and our country, but if people can't change their perspective on his travels out of Canada and return to it, and all the qualities he has proven (though not to us), he may not ever get the chance to be PM.

Ignatieff is not only being blamed for the Liberal freefall, he's the one being forced to take responsibility for stopping it. I think that's not so. It's got to come from the people themselves. If, when one is absent, one takes the time to look at what is going on in Canada, one might see things about it that are truly disquieting. and so, I'm not sure this would make one a "better Canadian" (as Rex Murphy claims Ignatieff said), when being a good Canadian often seems to mean keeping quiet about the norms of our society and the injustices committed here.

In his May 29th column, Rex Murphy becomes rhetorical, saying, "We learn our country by living in it, by absorbing the flow of its events, by acquiring an emotional as well as an intellectual grasp of its rhythms and moods. We inhabit this country, and it returns the favour: It inhabits us" (Michael Ignatieff’s out-of-country, 2010).

In reality, the ideas expressed in this sentence are nonsense. Being that close to a country or a person can make us take its qualities for granted, so much so that people are often advised to take a break from it - a vacation or a separation, to reflect and enable rational thoughts to emerge, where once feelings guided all decisions. No one can know the entire country, or all its people. We all live in our own little worlds, sometimes of our own making, sometimes not. We latch onto pieces of it that we recognize as being 'ours', as Canadian. But most importantly, it is the leaving that enables a person to get a better picture of what is going on - and the returning that holds the promise of something better for the country.

Ignatieff's absence is no obstacle to his ability to do well at the job of PM. In fact, I know that staying away will have given him so much more. Besides having been able to look upon Canada from a distance, he has now undergone critique by his fellow Canadians, who seem unable to grasp the significance of his time abroad. I have said before that leaving and then returning does leave one out-of-touch with prices, and changes in laws, but a read-up of these is usually enough. Does one ever forget how to ride a bike?

Rex asks, "There is an essence to this country. What we have in common, the core, is that which enables the embrace of diversity in the first place. Mr. Ignatieff may understand some of this, but does he feel it? Does he perceive the strength and depth of the common endeavour which has been and is this country since its founding? "

Perhaps not, Rex. I don't feel it. Perhaps it takes something from one's countrymen, after having spent time away, before one can feel it again. Perhaps one does have to take some time going through the motions before people start to see how unjust their behaviour and criticism is.

Added June 2012

In ‘Beyond Workaday Worlds’ (2005) I draw on the work of Mary Catherine Bateson, who wrote:

“continuity is the exception in twentieth-century America, and that adjusting to discontinuity is not an idiosyncratic problem of my own but the emerging problem of our era...In may ways, constancy is an illusion” (Composing a life, 1989).

As I state in that essay under the subtitle Unity, Continuity, and Contradictions, “her aim was to make sense of interrupted and discontinuous lives of the “composite life,” illustrating the importance of responding to change and learning to adapt (p 7). To illustrate what I had discovered about work and about such concepts as continuity, as they apply to real life, I incorporated aspects from life stories of five individuals I had written following interviews and research.

More often than not, in the past, it was men who had the careers that established continuity for them, thus a form of respectability and earned trust, I imagine. In the fairly recent past, it was more often women whose careers lacked that kind of continuity, and not just over childbearing. In some ways, it seems as though this is what’s bothering some people about Michael Ignatieff, that he didn’t have a long continuous career, or keep his focus on politically-oriented positions, instead branching out to academia and tv broadcasting, for instance, thus must have the ‘stability’ factor lacking in his character, I believe they must think.

If so many really are against Ignatieff, then it may be that they hold old-fashioned ideas about work, as well as about what it means to be a Canadian. For his own thoughts on this, see the 2011 article ‘My name is Michael Ignatieff, and I am Canadian.’ As for Rex Murphy’s question, “Does he perceive the strength and depth of the common endeavour which has been and is this country since its founding?,” this is not the way our country is going. The common endeavor has been lost, as people with diverse backgrounds and goals vie for their own place in society and to have their own culture recognized. What chance is there of having that unity back now that Ignatieff has left? See Adrienne Redd’s informed perspective that acts as counterpoint to all those who have expressed doubts about Ignatieff’s ability (Ignatieff, the Best Prime Minister, 2011).

There is no 'essence' to this country, and demanding that a PM encompass traditional values of work and continuity, rather than travelling and working abroad at more than one occupation places a stifling limitation on what a prime minister can or should project to the people.

Michael Ignatieff is currently teaching at the University of Toronto.

Beyond Workaday Worlds: Aging, Identity, and the Life Cycle
By Sue McPherson

Composing a Life
By Mary Catherine Bateson
New York: Plume.

Ignatieff, the Best Prime Minister Canada Will Never Have
By Adrienne Redd
May 7, 2011

Michael Ignatieff accuses Conservatives of “divide in order to rule” politics

By Linda Diebel
Toronto Star
May 18, 2010

Michael Ignatieff thinks he's more Canadian than you are
By Matt Gurney
May 18, 2010
National Post

Michael Ignatieff’s out-of-country experience
By Rex Murphy
May 29, 2010
National Post

My name is Michael Ignatieff, and I am Canadian
By Michael Ignatieff
Globe and Mail
June 29, 2011

The pressure is on Ignatieff to stop Liberal freefall
By John Ivison
National Post, Full comment
May 20, 2010

Links updated June, 2012