SpankyMcFarland

It will not be. The reality of what Republicans have done has yet to fully sink in.

America’s neighbours, especially the First Nations, might disagree with that assessment. For them it was always a dangerous nation, constantly expanding across the continent until it could go no farther.

The other party nearly always does well in mid-terms and inflation is higher than it has been for decades so Republican wins in this election are not hard to explain. In abortion, however, pragmatic Republicans, sadly a dwindling demographic, have put a new issue on the table that they will have to carry for decades.

We wouldn’t but an audience more relevant to the matter would. In an era of constant recordings, the distinction between speech and the written word seems to have broken down.

I’m concluding you’re maybe not female? The issues raised by new red-state laws on abortion which, among many other things, threaten the privacy of women seem to matter quite a bit to that demographic as we have already seen.

Save for some evil chance, Charles could easily see another twenty years. His father also lived to a great age.

China is successful economically despite its appalling totalitarian system, the technology and entrepreneurship of South Korea struggling under a North Korean-style regime. The only way for Xi and his successors to truly ensure their safety is to dominate the world and eliminate attractive examples of freedom elsewhere.

I’m using the word in a fairly generic, asexual way. Those yarns about infidelity are difficult to assess at the moment. It was said Will and Kate used to plant saucy stories to find leakers but who knows?

Poor old Charlie is neither a dignified old-school symbol like Liz nor a sexy photo op factory like Kate, Will and the brood. His Basset Hound brand of tone-deaf, über-toff lugubriousness is not what’s needed these days: O Coronavirus latest: a senior royal wants us to *checks notes* work harder | Joel Golby With Prince Charles urging the public to pick fruit for Blighty, the problem isn’t so much the message as the messenger, says author Joel Golby www.theguardian.com

One obvious pitfall from the UK to avoid when introducing a private system: don’t let the same surgeon control both a private and public list or the temptation to love one and hate the other will become unbearable. I saw this with two of my relatives waiting for hip replacements there: with a straight face Mr. Orthopod says, I can do you in 4 years time on my public list or next week on my private list if you hand over thousands in cash. It’s an invitation to extortion. The problem gets even worse if the doctor is paid on a salary on the public side and fee for service privately. Surgeons start disappearing early from their public posts, sometimes at 8 am, leaving the residents in charge - a common enough scenario in Ireland and the UK.

Speaking strictly for my own corner of the world, we need to consolidate and make a stand where we can. Solo family practitioners should be a thing of the past and call should be at worst, say, 1 in 4 long-term. CMGs prepared to work on the front line and lead these rural groups should be fast-tracked for promotion at the university. They’re doing work of great value, after all, and it should be seen to be valued, not only financially. At the moment, the dept of family practice and indeed the whole medical school seem to exist mainly to sustain themselves despite their mission statements to the contrary. That must change.

Like many aspects of physician behaviour, call flight - the tendency of doctors in high call positions to migrate to lower ones if they can - has been insufficiently examined but it’s up there with a related factor, expert support, and income as a key driver of physician distribution. Even before the cities become irresistibly attractive to young grads, call flight was working its magic and sending doctors towards the hubs. As my link on the situation in Fogo Island illustrated, rural GPs may not only be on 1 in 1 call, i.e. every night, for weeks, months or even years, but can also be in the surreal situation of referring sick patients to their own care in small hospitals. You’re basically talking to yourself on an official basis at that stage. This was bad enough in ye olden days when not much was expected of a medical man but today every practitioner is judged by the same standards which are impossible to keep up under such circumstances. So doctors tend to move to the cities and, even better, to the universities where they have lots of residents and experts around them and can become academics opining from their comfy chairs on the situation in places like Fogo.

I think nearly everyone here can agree his behaviour was a terrible embarrassment for his family. The matter of Andrew’s civil liability is complex to say the least. When payments or other inducements are offered, it has been a criminal offence in the UK since 2003, shortly after these events, to have sex with any person under the age of 18. Suffice to say he didn’t pay up so generously for nothing. What it revealed was a middle aged man no father would want his daughters around, and obviously somebody who should not be in the line of succession to head any civilized state.

Andrew should have spared the family and stayed at home during that procession in Edinburgh. A flu would have been satisfactory for all. His presence merely reminded everybody how risky a hereditary monarchy is.

What is happening is that a crisis requires us to change our way of life but we don’t want to do that so we claim there’s no crisis. Typical human thinking.

There are clear problems in Canada that have been brewing for a long time - healthcare, an uncompetitive telecom sector, unaffordable housing in major cities - that just don’t get addressed by politicians.

Earthquakes we can leave for another day. Do you recall a Canadian town recording a temperature of 49.6C in your childhood?

1. Improve the current system. The government has to reallocate funds. If, say, dermatologists aren’t happy they can leave and GPs will do most of their work. I know a GP who did the UK Diploma in Dermatology. I’d trust him way ahead of many of the local specialists. The point is that no other specialist shortage causes such a crisis in the ERs. We simply can’t have it. 2. Look at a mixed system. I think Canadians are becoming ready for a mixed health system, public and private.

Take a look at the environmental incidents happening around the world at the moment - fires, floods, droughts, storms, melting ice, epidemics. And that’s just the start. The catastrophes are certain, an easy-peasy technological fix much less so.

If we need something as weird as a monarch we can get our own very easily who can spend their time in this country. Norway did that. Otherwise we are going to go through yet more decades pretending the Windsors can’t think of anything but Canada 24/7 which is clearly nonsense. Let’s stand up and say goodbye to another example of offshoring a job a Canadian could do better.

I was quoting the poster you responded to in your post who used that rather over-the-top term. Go back and have a look. Yes, the monarchy is ceremonial but we should still get our own head of state here in Canada. It’s time. We’re not a tiny colony any more.

And how on earth would we overthrow the new monarch under our current constitutional arrangement? Like proper colonials, we’re stuck with him until he, God or the Brits decide otherwise.

If you support Trump the news will always get worse for you. He’s a career criminal with no respect for laws, let alone norms of behaviour, and that ain’t going to change any time soon.

His talent is obvious but getting involved with Bitcoin showed a serious lack of judgment for a senior Canadian politician. That scam has hooked enough desperate young people already.

Another problem is the unattractiveness of family practice to Canadian graduates. They’re not joining the specialty in sufficient numbers with the result that the patients they would have seen now end up in the ER. I don’t see any reason why we shouldn’t rebalance the income gap between the high procedure crowd and GPs who have a far more varied field of work. If young grads want more support in their group practices in terms of NPs, EHRs, physician assistants etc., then we must make it a top priority to provide it for them. Lifestyles and physician expectations have changed; we must accommodate what is now expected urgently if we don’t the situation to get even worse.