Citizen right: governments cannot force citizens to pay for substandard services

[myata]

In a working, functional democracy it has to be daily reality. We should have a bill to this extent. This may be the only way to assure one of the sane outcomes:

a) You get a quality service, or

b) You don't pay for a service that is below reasonable standard or does not exist.

One in four Ontarians will have no family doctor by 2026. The situation is similar across the country. Shortages of nurses and hospital places are common.

Is it public universal healthcare or some kind of a lottery? Does a citizen applying for a job in the government for which he is paying out of their pocket have to pull a lucky ticket to even be considered?

Governments are responsible for delivering results, not drawing scribbles, promising and smiling on camera. Only they forgot. It's been close to generation after the Romanow report (2002) and see what it fixed?

Carbon charge is not a "service". One cannot pay service tax for a service that doesn't exist. Citizens are not obligated to pay for non existent services, or those that do not satisfy a minimal reasonable standard.

Discuss?

[RedDog]

We’re surrounded by substandard services. Are streets not paved anymore?

[myata]

On 10/25/2023 at 7:04 PM, RedDog said:

We’re surrounded by substandard services. Are streets not paved anymore?

The next step is we accept it as normal. And then?

The local municipality decided to fix some structure in a popular nature path. The path is closed from August to next spring (the earliest). In four months so far managed to install a new deck - a two day work. Last year construction of 20 m retaining wall took more than a year. Am I seeing things or it's already heading straight there, to the third world reality? From occasional issues, to widespread to pretty much nothing works as it should - in a G7 country.

[ExFlyer]

Just because it is not being done the way you like does not mean it is not good service.

Your perception of good service is biased to what you think you should get.

A comment like "One in four Ontarians will have no family doctor by 2026. The situation is similar across the country. Shortages of nurses and hospital places are common. " is just plain thoughtless.

Do you or anyone with a brain really think that the government opens a bag of doctors and nurses and lets them out? It takes years to become a doctor or nurse. And then there is the shortage of them in municipalities ....where do you think the government has the right to tell them where to work?

Edited October 29, 2023 by ExFlyer

[Michael Hardner]

31 minutes ago, myata said:

The next step is we accept it as normal. And then?

The local municipality decided to fix some structure in a popular nature path. The path is closed from August to next spring (the earliest). In four months so far managed to install a new deck - a two day work. Last year construction of 20 m retaining wall took more than a year. Am I seeing things or it's already heading straight there, to the third world reality? From occasional issues, to widespread to pretty much nothing works as it should - in a G7 country.

This is straight up awful project management.  It happens because projects are governed by an array of stakeholder groups with different aims and the delivery of value at cost and budget isn't prioritized.

 

They should move to having public stakeholder groups manage small Agile deliveries, trying different approaches.

I once took a course with a woman from a Toronto municipal government and she explained that it took them a year to staff some projects before they start.

 

 

[I am Groot]

2 hours ago, myata said:

The next step is we accept it as normal. And then?

The local municipality decided to fix some structure in a popular nature path. The path is closed from August to next spring (the earliest). In four months so far managed to install a new deck - a two day work. Last year construction of 20 m retaining wall took more than a year. Am I seeing things or it's already heading straight there, to the third world reality? From occasional issues, to widespread to pretty much nothing works as it should - in a G7 country.

Everything takes forever to do in this country. Stuff done in Asia and Europe in a matter of days or weeks takes weeks or months here. We had a sinkhole in one of our major cross streets that took months to repair. Japan had a bigger one that they fixed in a few days.

We built the Trans Mountain pipeline in 8 months back in the 1950s. We've been working on twinning it for years now with no end in sight.

[I am Groot]

2 hours ago, ExFlyer said:

Just because it is not being done the way you like does not mean it is not good service.

Your perception of good service is biased to what you think you should get.

A comment like "One in four Ontarians will have no family doctor by 2026. The situation is similar across the country. Shortages of nurses and hospital places are common. " is just plain thoughtless.

Do you or anyone with a brain really think that the government opens a bag of doctors and nurses and lets them out? It takes years to become a doctor or nurse. And then there is the shortage of them in municipalities ....where do you think the government has the right to tell them where to work?

This is a strange complaint. I thought by now everyone realized the shortage of doctors and nurses is entirely the creation of government, which spent decades deliberately limiting the number of medical and nursing school positions, as well as the number of sponsored coop (nurses) and residency (doctors) positions needed to complete their training.

There is no shortage of dentists. There is no difficulty accessing dental services of any kind. Why is that? Perhaps because the government hasn't been in control of dentists. Same goes for optometrists. You won't have difficulty getting a new one or getting an appointment. Try that with ophthalmologists. The numbers trained for the former don't need government approval, but the latter do. 

[myata]

2 hours ago, Michael Hardner said:

This is straight up awful project management.  It happens because projects are governed by an array of stakeholder groups with different aims and the delivery of value at cost and budget isn't prioritized.

But the inevitable result is: next to nothing works as it should, in a G7 (supposedly) country. In Holland, they built a completely new road, under an existing bridge, without closing it, in two weeks. And it wasn't even the capital.

The first subway opened in 1863, almost two centuries back.. yet we're having surprises and revelations and huge project delays and budget overruns, constructing it in the national capital.

In a decade or two we'll simply forget how the things are done in this century. G7 only in the name, another beaver tail.

[ExFlyer]

35 minutes ago, I am Groot said:

This is a strange complaint. I thought by now everyone realized the shortage of doctors and nurses is entirely the creation of government, which spent decades deliberately limiting the number of medical and nursing school positions, as well as the number of sponsored coop (nurses) and residency (doctors) positions needed to complete their training.

There is no shortage of dentists. There is no difficulty accessing dental services of any kind. Why is that? Perhaps because the government hasn't been in control of dentists. Same goes for optometrists. You won't have difficulty getting a new one or getting an appointment. Try that with ophthalmologists. The numbers trained for the former don't need government approval, but the latter do. 

Well, looking at that realistically, all university medical schools have been pumping out as many as they could. Every new class has been full (not saying that they all graduated).

Again, realistically, saying just to add more makes no sense either. There are only so many professors or doctors or nurses willing to teach.

You can't just make more medical classrooms. they are very technical and complicated. They are not Grade 14 or 15 lecture halls.

From a university point of view, it is much easier (and profitable) to get students through a leisure studies or music or liberal arts degree and less cost than medical. Even engineering requires less technical equipment than medical.

Then, as you bring it up, there is the internship. For every medical student or intern, you need to have supervisory medical staff and that robs the hospitals of active service staff. Nurses, 4 years, doctors 8 + years to be able to work. I am not sure of the enrolment to graduating percentage but my daughters graduating nurses class was 50% of the ones she started with. I am pretty sure there are lots of doctors that do not graduate too.

As for dentists, yes, there are many, so many. In my area there are as many dentist as offices as cannabis shops lol.   No explanation.

 

[myata]

2 hours ago, ExFlyer said:

You can't just make more medical classrooms. they are very technical and complicated. They are not Grade 14 or 15 lecture halls.

So you have to bring in more folk with totally unknown qualifications from seriously unknown places like Umbabwe that can train their doctors and hope it will work, anyhow? That's the best the system can do, and it's exactly what it has been doing. Will it, forget improving, even sustain the condition at the level say two decades back? You can sure pray and hope, but is there a grain of rational reason to expect that? You can also look around.

You are repeating the bureaucrats word to word: no we can't do sane things here here's a reason and more, so we have to try it the other way and see what happens! You sure see that Joe? Now, just sign here and here.

[I am Groot]

3 hours ago, ExFlyer said:

Well, looking at that realistically, all university medical schools have been pumping out as many as they could. Every new class has been full (not saying that they all graduated).

The numbers they are permitted to admit were restricted by the government. So yes, they were all filled, but many capable people were rejected from both nursing and medical schools. Some went on to American nursing and medical schools, or those in other countries. Others gave up and took something else. They set the bar extremely high for both groups because they had so many applicants and could only accept so many.

3 hours ago, ExFlyer said:

Again, realistically, saying just to add more makes no sense either. There are only so many professors or doctors or nurses willing to teach.

You can't just make more medical classrooms. they are very technical and complicated. They are not Grade 14 or 15 lecture halls.

That is the issue in ramping it up. Ontario has increased the numbers three times in the last year as they find resources to train them but they can only increase the seats so fast without the quality of the education dropping measurably.

3 hours ago, ExFlyer said:

Then, as you bring it up, there is the internship. For every medical student or intern, you need to have supervisory medical staff and that robs the hospitals of active service staff.

Which is one of the roadblocks and which only the government can increase with more funding. Which they have done in Ontario. I don't know about the other provinces. The feds have put in more money for hospital residencies, as well. But it's going to take a while to make up for a 25 year freeze.  And that freeze is entirely due to government policy to limit numbers based on faulty assumptions and formulas.

[ExFlyer]

1 hour ago, myata said:

So you have to bring in more folk with totally unknown qualifications from seriously unknown places like Umbabwe that can train their doctors and hope it will work, anyhow? That's the best the system can do, and it's exactly what it has been doing. Will it, forget improving, even sustain the condition at the level say two decades back? You can sure pray and hope, but is there a grain of rational reason to expect that? You can also look around.

You are repeating the bureaucrats word to word: no we can't do sane things here here's a reason and more, so we have to try it the other way and see what happens! You sure see that Joe? Now, just sign here and here.

Smell the classrooms and professors girl...it is a fact. You cannot snap your fingers and have dozens more classes and you cannot ensure they all pass.

As for bringing them in...there are tests that licence doctors and nurses. Every province has them (and they are all different that is why Canadian medical people have troublemoving  between provinces.)

[ExFlyer]

37 minutes ago, I am Groot said:

The numbers they are permitted to admit were restricted by the government. So yes, they were all filled, but many capable people were rejected from both nursing and medical schools. Some went on to American nursing and medical schools, or those in other countries. Others gave up and took something else. They set the bar extremely high for both groups because they had so many applicants and could only accept so many.

That is the issue in ramping it up. Ontario has increased the numbers three times in the last year as they find resources to train them but they can only increase the seats so fast without the quality of the education dropping measurably.

Which is one of the roadblocks and which only the government can increase with more funding. Which they have done in Ontario. I don't know about the other provinces. The feds have put in more money for hospital residencies, as well. But it's going to take a while to make up for a 25 year freeze.  And that freeze is entirely due to government policy to limit numbers based on faulty assumptions and formulas.

BS, all classes are full. Have been since my daughter started over 10 years ago. Thing is, less than half graduate. they quit.

Cannot snap your finger and make more classes and teachers and equipment for teaching, let alone dumping interns into the hospitals.

No amount of funding will have any impact without straining the existing medical workers system now. Also, if they dump a truckload of money now, no impact for at least 10+ years.Years to build schools, buy equipment, 4 to 10 years of study and then, the graduates will choose where they want to work, not where you want them .

Government did not freeze anything, infrastructure and demand is the restriction. There are only 17 medical schools in Canada and 6 of them in Ontario. Been that way for decades. Smell the reality.

 

 

[myata]

1 hour ago, ExFlyer said:

Smell the classrooms and professors girl...it is a fact. You cannot snap your fingers and have dozens more classes and you cannot ensure they all pass.

So another government screw up you have to eat Joe and be happy, because its the normal order of public business. Public. Whatever we do (or don't) just eat it and be happy.

Where do you think that story works great? In the first world? Or in Mexico?

[myata]

1 hour ago, ExFlyer said:

There are only 17 medical schools in Canada and 6 of them in Ontario. Been that way for decades. Smell the reality.

So the government cannot solve this issue. There wouldn't be many takers in the Europes and Australias so the rescue has to come from Umbabwes of the world. And now look at this: if the governments cannot assure quality of the resources it controls, right here how could it do that with arrivals from the most godforsaken places on the planet? How would they know even who wrote the paper? This is the most incredible idea I'm hearing. Trump with his just elect me and all your problems will be fixed instantly sounds about as plausible or a bit more. We're screwed either way. And why not?

[ExFlyer]

12 hours ago, myata said:

So another government screw up you have to eat Joe and be happy, because its the normal order of public business. Public. Whatever we do (or don't) just eat it and be happy.

Where do you think that story works great? In the first world? Or in Mexico?

Whaaat?

Sober up and try posting again. LOL

12 hours ago, myata said:

So the government cannot solve this issue. There wouldn't be many takers in the Europes and Australias so the rescue has to come from Umbabwes of the world. And now look at this: if the governments cannot assure quality of the resources it controls, right here how could it do that with arrivals from the most godforsaken places on the planet? How would they know even who wrote the paper? This is the most incredible idea I'm hearing. Trump with his just elect me and all your problems will be fixed instantly sounds about as plausible or a bit more. We're screwed either way. And why not?

No, government cannot solve graduation rates at universities...... unless they lower the standards.

So, are you saying that if they pass the licences exams they should still not be able to practice in Canada because they come form a country you don't like?

Control?? The Licentiate of the Medical Council of Canada (LMCC) is a part of the Canadian Standard for independent practice, the set of requirements such as passing the MCCQE1 exam for an award of a full unrestricted license to practice in Canada. The Medical Council of Canada (MCC) grants the LMCC to doctors. All doctors in Canada must pass.

What paper??

Most importantly is that neither the government or you can force a graduating (or practising) medical doctor or nurse to work anywhere. They choose, not you.

 

 

 

[myata]

6 minutes ago, ExFlyer said:

such as passing the MCCQE1 exam

A bureaucratic procedure and a paper gives you all the answers? You see it pained on a page so it has to be real, right? And the reality, only a distraction?

Good luck. It's not fun to go any further in this direction.

Edited October 30, 2023 by myata

[ExFlyer]

5 minutes ago, myata said:

A bureaucratic procedure and a paper gives you all the answers? You see it pained on a page so it has to be real, right? And the reality, only a distraction?

Good luck. It's not fun to go any further in this direction.

So, you are saying that the MCCQE Part I is a summative examination that assesses the critical medical knowledge and clinical decision-making ability of a candidate at a level expected of a medical student who is completing his or her medical degree in Canada and all doctors practising in Canada must take and pass is not sufficient validation and verification?

What do you have that is a better standard??

You may think you are a smart ass but the gas that passes still stinks.

[myata]

50 minutes ago, ExFlyer said:

MCCQE Part I is a summative examination that assesses the critical medical knowledge and clinical decision-making ability of a candidate

Exists on paper. Paper is not the reality. Yes, it may have remote, little or no relevance to the reality: just as seen. The reality is not the paper; it's what you see and experience. Some understand that. And some, fail to grasp the difference.

[myata]

56 minutes ago, ExFlyer said:

is not sufficient validation and verification?

Of course not! How slow one has to be to not see the difference: qualification is earned is six years of dedicated study and some more, internship. While a paper can be obtained in a matter of hours. Especially in some remote places that have astounding capacity to produce qualified professionals (on paper at least) that we here don't.

Who fails to get it? How? Wow. All the mysterious things you encounter in this world.

Edited October 30, 2023 by myata

[ExFlyer]

40 minutes ago, myata said:

Exists on paper. Paper is not the reality. Yes, it may have remote, little or no relevance to the reality: just as seen. The reality is not the paper; it's what you see and experience. Some understand that. And some, fail to grasp the difference.

Licensing paper is reality. Like all professional licences, they are as real as it gets.

fortunately, you do not need a licence to be stupid...you prove that in all your posts.

 

36 minutes ago, myata said:

Of course not! How slow one has to be to not see the difference: qualification is earned is six years of dedicated study and some more, internship. While a paper can be obtained in a matter of hours. Especially in some remote places that have astounding capacity to produce qualified professionals (on paper at least) that we here don't.

Who fails to get it? How? Wow. All the mysterious things you encounter in this world.

Errr, wrong.

There is no such thing as qualification during study and internship.  that only means you attended.

All professions have licensing and qualification exams to ensure that you did not just attend your studies but remember and can apply what you have learned. Even in elementary and high schools you have to pass exams to move forward.

You are seriously ignorant of standards and requirements.

[blackbird]

On 10/29/2023 at 6:56 AM, ExFlyer said:

Do you or anyone with a brain really think that the government opens a bag of doctors and nurses and lets them out? It takes years to become a doctor or nurse. And then there is the shortage of them in municipalities ....where do you think the government has the right to tell them where to work?

  The government is entirely responsible for the mess.  They seized control of the health care for Canadians.  That makes them completely morally responsible to provide it.  Saying that it is not the government's fault that there are not enough doctors and nurses, etc. is a cop-out.  The government is the one responsible as they control the system.

[ExFlyer]

1 hour ago, blackbird said:

  The government is entirely responsible for the mess.  They seized control of the health care for Canadians.  That makes them completely morally responsible to provide it.  Saying that it is not the government's fault that there are not enough doctors and nurses, etc. is a cop-out.  The government is the one responsible as they control the system.

You are an !diot.

The health care system and university medical schools (of which there are only 16 and have only been 16 for many decades) are very very separate.

Every year all medical schools are full of applicants, and upon graduation, 4 years or more later, there are less than 1/2 that started. The government has no control over how many pass the requirements or courses.

So, your solution is to force the government to lessen the requirements and standards and allow more to graduate?? By the way, the government does not set the standards or exams....that is the national and provincial medical associations made up of doctors and nurses.

[myata]

G7 National capital. Night transit, lightrail closed. The night bus arrives at 4.42, the last connection to the airport leaves at 4.40. Enjoy.

%#$? How? Why why even a simplest, trivial thing in this century of information must take some serious volume of bureaucratic thinking (you can almost hear the gears screeching), and other way?

[blackbird]

56 minutes ago, ExFlyer said:

You are an !diot.

The health care system and university medical schools (of which there are only 16 and have only been 16 for many decades) are very very separate.

Every year all medical schools are full of applicants, and upon graduation, 4 years or more later, there are less than 1/2 that started. The government has no control over how many pass the requirements or courses.

So, your solution is to force the government to lessen the requirements and standards and allow more to graduate?? By the way, the government does not set the standards or exams....that is the national and provincial medical associations made up of doctors and nurses.

Your first sentence tells what kind of character you are.

Of course the government is responsible for the medical schools, number of doctors and nurses.  It is all part of the health care system which the government controls.  The government has the power to determine how many medical schools exist and everything else.  Medical schools and associations are not sovereign countries.  Wake up!