SpankyMcFarland

I think the medical establishment is finally changing its attitude to foreign doctors: For Poilievre this is a good campaign topic for the general public and a great one in immigrant communities where many IMGs are unable to practice their profession:

I see PP has said similar things before:

There is an argument for that as long as these ‘private carriers’ are able to deal with the complications that occur post-op like a regular hospital would. With our current crisis in medical and nursing manpower we are stretched thin already.

I don’t think Morneau got into politics to enrich himself. However, his apprenticeship as an MP before high office was too brief. We complain about professional politicians but it is a very difficult job to master, quite different from the business world despite superficial similarities. Competing each day with people you dislike intensely while maintaining an amicable exterior, taking ferocious and often unfair criticism without apparent emotional response - these are skills which usually have to be learned. Did Morneau ever watch the British drama ‘The Thick of It’? This lays out graphically that cabinet ministers are in a brutal daily struggle with the PMO in addition to the PM, each other and civil servants. Nobody can expect a comfy ride.

Yes. All things going well, one shouldn’t be in hospital too long after a hip replacement. However, anyone who has seen one would not call it ‘simple stuff’. You’re way inside the body and the forces required are considerable.

I got a laugh out of this quote: Cataract removal is generally very straightforward (and still highly paid because of what I call fee inertia) but having a hip done is a traumatic business, hardly simple stuff one knocks off. If you’re considering one, bear in mind that illness can result. Death is unusual, around 0.6%, but it does occur.

I’m not sure a text is available yet. He proposed a more individualized system of assessing IMGs, i.e. more on their personal performance and less on their country of origin which is exactly what should happen. This also suggests a more uniform approach to assessment rather than the 13 systems we have at the moment. He said that more funds would be available to upskill these doctors, a far cheaper resource than putting students through med school here. Lastly, the process of assessment would be radically shortened and speeded up instead of taking months to years as it currently does.

In the UK that happened with the chaos produced by Brexit. Trudeau has been successful in three elections. MPs punish failure.

Poilievre made some good points about health care today. I would suggest more of this and less, actually zero, on Bitcoin and the Convoy. https://www.cbc.ca/news/politics/trudeau-health-care-deal-1.6715534

A PM surrounded by advisers and deaf to Cabinet colleagues is a system problem in the British model. It long predates the current Trudeau and can be seen in the UK and Ireland as well.

I’m not exactly the biggest fan of Pierre Poilievre but he had some interesting things to say today about reviewing the credentials of IMGs more quickly and, very important, assessing their skills more as individuals rather than on their country of origin. Not much detail is available on his speech yet. https://www.cbc.ca/news/politics/trudeau-health-care-deal-1.6715534

Across the countries that follow the British parliamentary model, power has shifted relentlessly to the PMO. It’s terrible for democracy. MPs must fight back.

Our democracy is healthier than the US in at least one respect: provincial politics here has not yet been completely federalized. Even the parties aren’t necessarily the same. However, as our local newspapers and tv coverage disappear, expect more of the national, and American, scene to be fed to us wherever we are. It’s a good time to be a dodgy provincial or municipal politician. We’re all reading about Kim and Kanye instead of the mayor.

There is a place and time for diversity of views in any political party but not with key votes like this which should have been considered a vote of confidence. It is true that since Trudeau père both governing parties in Canada have tightened their grip on MPs to a depressing extent. Do you think Stephen Harper encouraged debate and members’ bills on abortion within his caucus? The best place to see such individual freedom expressed by MPs is in parliamentary committees. Unfortunately, the PMO has taken these over as well and MPs have very few decisions to make between elections.

It is a historic failure that doesn’t happen too often. The remarkable bitterness on display between House Republicans augurs ill for the future. And as it may well affect us in Canada, it is a newsworthy item..

Some suggestions for the improvement of our system, from two physicians: 1. Increase spending on primary care. Australia is a great country to compare ourselves with: big, sparsely populated, similar expectations from the public. 2. Team-based models of GP care. The Brits are way ahead of us on this. 3. Much more long-term care. 4. A national EMR. Why on earth hasn’t this happened already? 5. Licensing reform. One of my hobby-horses. Not sure about the second one, though, as a more level playing field may merely increase the supply of docs to already popular places. And a good conclusion. https://www.theglobeandmail.com/opinion/article-dont-blame-family-doctors-for-the-current-health-care-crisis/

Here’s a Canadian study which describes an increased risk of car crashes in the unvaccinated. https://globalnews.ca/news/9345291/covid-vaccine-hesitancy-ontario-crashes/ Some quotes from the scientific paper itself: https://www.amjmed.com/article/S0002-9343(22)00822-1/fulltext I suspect Dr. Redelmeier will be in for a fair bit of feedback on these findings.

I’ve noticed that Canadian politicians and senior medics are much keener to talk about the bright future of rural recruitment that awaits us rather than the dismal record of a past we’ve just been through. For example, my local med school hired a chief who was going to work wonders on this issue. Alas, not only did he screw up on that, he never publicly admitted the province was doing ever worse while he was in charge. This is a common enough situation. So what to do? An annual scorecard on rural recruitment and retention should be produced and the Dean of Medicine should then be invited to discuss the results. If we are going to fail at this - and there are many reasons beyond the control of med schools for this trend - we should at least be kept up to date on the magnitude of our failure. Not much to ask.

The causes of Republican underperformance have been well described by rightwing pundits, e.g. abortion, Trump, crazy candidates and a refusal to move with the times on new ways of voting. Many sane Republicans did well e.g. DeWine, Sununu. Independents are more interested in competence than culture war: https://thehill.com/homenews/campaign/3743167-sununu-says-gop-should-stop-supporting-crazy-unelectable-candidates-in-our-primaries/

Like Russia’s communists, the current regime had a ringside seat and decades to study how the previous one fell and to prevent a recurrence. Many nasty people have a lot to lose with reform and won’t give up their privileges easily.

As has been noted, SADS per se is not a new syndrome: https://www.healthing.ca/diseases-and-conditions/heart-health/sudden-adult-death-syndrome-not-a-post-covid-phenomenon The syndrome describes sudden death due to cardiac arrhythmia in apparently healthy young people. In such cases, no structural cause of death is found at autopsy (unlike the much commoner situation where coronary artery disease causes death) and the toxicology screen is negative. There are many causes, including a large and ever growing number of inherited disorders. https://www.sads.ca https://www.sads.org.uk Here’s one inherited cause of SADS that is particularly common in Newfoundland: https://genomeatlantic.ca/sga-heart-disease-gene-discovery-still-saving-lives/ In young men who die of this disorder, ARVC Type V, the autopsy changes can be subtle. The gene abnormality may have arisen in Denmark or Germany many centuries ago. https://academic.oup.com/eurheartj/article/36/14/872/539634

I was pleased to see Trudeau making Xi’s day a little less comfortable but we should be realistic about how much our PMs can influence the most powerful man in the world given that they seem to have no sway over the families who run our own telecom industry. The tyrannical regime in Beijing rightly feels threatened by freedom anywhere and will work tirelessly to undermine it.

Give the PRC the credit it deserves. These ‘police stations’ in Canada are merely part of a worldwide effort to control expatriate Chinese.

One can say it’s too little too late etc. but this is surely a move in the right direction. Canada orders China to divest from country’s mining companies Move comes after ‘multi-step’ review by Canada’s national security and intelligence agencies www.theguardian.com

I would argue it encourages members of the public to speak and write this way to elected officials and public servants generally. People are becoming less grown up all the time.