Will Ontario’s plan to boost surgeries at private clinics work?

If Doug Ford’s doing it, it can’t be good so the thinking goes. But his idea deserves examination.

Private clinics can work if they are run by non-profit societies.

image: Kelly Funk

An example of a successful non-profit clinic is STEPS (Supporting Team Excellence with Patients Society) in Kamloops.

The clinic in Valleyview is owned and operated by the society. Doctors work on a collaborative basis. When my doctor went on maternity leave, another doctor took over. It’s a model that can be used elsewhere according to their website:

“[STEPS] was incorporated on April 11, 2017 as a British Columbia Society whose purpose is to lead innovation in the provision of interdisciplinary team-based primary health care with the goal of developing a successful model of primary care delivery that can be adopted by others.”

 Ford unveiled his government’s plan on Monday. Ontario plans to increase the use of private clinics to tackle Ontario’s surgery waiting lists which is more than 200,000. He claims that clinics would be paid for by the public health system.

Ford says that 50 per cent of surgeries could be done outside hospitals.

Just how for-profit private clinics will be paid for by the public health system is a bit of a mystery. Surely he can’t be suggesting that public money go into the pockets of for-profit clinic operators?

Is Ford suggesting a familiar model by which doctors have operating on since the inception of Canada’s health care?

Some doctors make a good, well-deserved, living by operating private clinics. They bill B.C.’s MSP for each patient visit and if they get enough visits, there will be enough left over after paying staff, utilities, equipment and supplies, rent or mortgage, to live on.

But that model is broken. Not many doctors want to run the business of a private clinic in which they have to work long hours and squeeze in lots of patient visits.

Most doctors would prefer the STEPS model which allows for flexible working hours without the worry of operating a business.

It’s hard to imagine a for-profit private clinic operating with only the income of per-patient visits. They would have to grind through a lot of patients to make it work.

It hasn’t worked for many existing for-profit private clinics. They have had to resort to illegal measures.

“Private surgeries and medical imaging are big business in BC,” says Andrew Longhurst, researcher for the Canadian Centre for Policy Alternatives. “Over the last two decades, this for-profit sector has benefited from increased outsourcing of publicly funded procedures and unlawful patient extra-billing.”

For example, False Creek Healthcare Centre in Vancouver received $12.2 million in health care contracts between 2015 and 2020 despite having been audited by the BC government and found to have engaged in unlawful extra-billing, says Longhurst.

Kamloops Surgical Centre received $15.4 million between 2015 and 2020, also despite having been audited and found to have engaged in unlawful extra-billing. Interior Health continued to contract with the clinic during and after the period of unlawful extra-billing. CCPA Policy Note August, 2022.

Not-profit private clinics have demonstrated that they can function successfully to the benefit of patients and doctors alike. But a for-profit clinic funded by the public purse? Dream on.

Will Ontario’s plan to boost surgeries at private clinics work?

If Doug Ford’s doing it, it can’t be good so the thinking goes. But his idea deserves examination.

Private clinics can work if they are run by non-profit societies.

An example of a successful non-profit clinic is STEPS (Supporting Team Excellence with Patients Society) in Kamloops.

The clinic in Valleyview is owned and operated by the society. Doctors work on a collaborative basis. When my doctor went on maternity leave, another doctor took over. It’s a model that can be used elsewhere according to their website:

“[STEPS] was incorporated on April 11, 2017 as a British Columbia Society whose purpose is to lead innovation in the provision of interdisciplinary team-based primary health care with the goal of developing a successful model of primary care delivery that can be adopted by others.”

 Ford unveiled his government’s plan on Monday. Ontario plans to increase the use of private clinics to tackle Ontario’s surgery waiting lists which is more than 200,000. He claims that clinics would be paid for by the public health system.

Ford says that 50 per cent of surgeries could be done outside hospitals.

Just how for-profit private clinics will be paid for by the public health system is a bit of a mystery. Surely he can’t be suggesting that public money go into the pockets of for-profit clinic operators?

Is Ford suggesting a familiar model by which doctors have operating on since the inception of Canada’s health care?

Some doctors make a good, well-deserved, living by operating private clinics. They bill B.C.’s MSP for each patient visit and if they get enough visits, there will be enough left over after paying staff, utilities, equipment and supplies, rent or mortgage, to live on.

But that model is broken. Not many doctors want to run the business of a private clinic in which they have to work long hours and squeeze in lots of patient visits.

Most doctors would prefer the STEPS model which allows for flexible working hours without the worry of operating a business.

It’s hard to imagine a for-profit private clinic operating with only the income of per-patient visits. They would have to grind through a lot of patients to make it work.

It hasn’t worked for many existing for-profit private clinics. They have had to resort to illegal measures.

“Private surgeries and medical imaging are big business in BC,” says Andrew Longhurst, researcher for the Canadian Centre for Policy Alternatives. “Over the last two decades, this for-profit sector has benefited from increased outsourcing of publicly funded procedures and unlawful patient extra-billing.”

For example, False Creek Healthcare Centre in Vancouver received $12.2 million in health care contracts between 2015 and 2020 despite having been audited by the BC government and found to have engaged in unlawful extra-billing, says Longhurst.

Kamloops Surgical Centre received $15.4 million between 2015 and 2020, also despite having been audited and found to have engaged in unlawful extra-billing. Interior Health continued to contract with the clinic during and after the period of unlawful extra-billing. CCPA Policy Note August, 2022.

Not-profit private clinics have demonstrated that they can function successfully to the benefit of patients and doctors alike. But a for-profit clinic funded by the public purse? Dream on.

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The depth of Freedom Convoyers’ discontent is misunderstood

It’s easy to dismiss motives of supporters of the Freedom Convoy that paralyzed Canada’s capital last January. Their grievances seem so inchoate, like a primal howl.

image: Vox

There must have been more to it than a lark; more than a fun time in bringing Ottawa to a standstill and blocking the Ambassador Bridge to the U.S. for six days resulting in a loss of $3 billion in trade.

What motivated so many to give up their time, energy and resources? They were so determined. The media’s reporting on their behaviour has been largely empty of meaningful explanations.

Some of the supporters felt that vaccine mandates were an imposition on their freedom; others wanted Prime Minster Trudeau to resign.

That’s all superficial -their anger is deep-seated.

Many Canadians supported the sheer audacity of the convoy. In a survey taken during the occupation of Ottawa, nearly half (46%) of Canadians said that while they “may not agree with everything the people who have taken part in the truck protests in Ottawa have said but their frustration is legitimate and worthy of our sympathy.”

The highest support came from18-34-year-olds (61 per cent) and Conservative voters (59 per cent).

A year later, support for the freedom convoy is still substantial at 25 per cent. Prime Minister Trudeau dismissed them as a “fringe group.” Some fringe.

In an attempt to explain the deep support for the freedom convoy, Conservative leader Poilievre offered:

“I don’t like the flags, and I don’t like the rage,” said Poilievre in response to former Conservative leader Erin O’Toole’s tweet. “But I think we have to ask ourselves: ‘Why are people so angry?’ And the answer is that they are hurting.”

Poilievre was responding to O’Toole’s wish for fewer ‘f–k Trudeau’ flags. ‘These flags and the hyper-aggressive rhetoric that often accompanies them are slowly normalizing rage and damaging our democracy,” said O’Toole.

Indeed, we have to ask “Why are people so angry?” as Poilievre suggests. But his answer “that they are hurting,” doesn’t go deep enough.

Freedom convoy supporters are hurting because they feel disconnected and betrayed to society.

They are lashing out in a way they have seen effective. American social psychologist Jonathan Haidt has attributed Donald Trump’s improbable rise to the U.S. presidency in 2016 to his mastery of the dynamics “in which outrage is the key to virality, stage performance crushes competence.”

The roots of these new forces are complex but ultimately laid bare by the collapse of shared prosperity and inclusive economics says pollster Frank Graves:

“Those drawn to this new movement are most likely to be males under the age of 50 who are lacking university educations and are experiencing an erosion of social status. They are dramatically more likely to lean toward an authoritarian, or ordered, populist outlook, be dramatically less trusting of institutions such as government, media, academics and other professionals, dramatically more disinformed – and they are also dramatically more economically insecure.”

For freedom convoy supporters, the middle-class dream has collapsed – the dream of doing better than their parents, buying a home, retiring with a pension and having their children inherit a secure middle-class future.

In the winter of their discontent, recognition of a lost future is the key to understanding their visceral anger.

The pandemic changed the way we view external threats

We have become nonchalant about viruses for too long.

The war on viruses was declared over in 1969 according to one quote: “it is time to close the book on infectious diseases and declare the war against pestilence won.” We had defeated the invisible killers. Now the focus should be on chronic diseases such as cancer and heart disease.

Guess what? Viruses are not some distant threat. They are back with a vengeance.

image: Los Angles Times

The above quote was wrongly attributed to U.S. Surgeon General William H. Stewart. No one is sure just where the quote came from but as we let our guard down, a seemingly ordinary virus punished the world with the COVID pandemic.

How blithely we forgot the pandemic of 1918 when the microscopic killer circled the entire globe in four months and claimed the lives of more than 21 million people.

For the longest time, we didn’t take viruses (and other pathogens that cause infectious disease outbreaks) all that seriously.

Now a deadly assortment of viruses is raining on our parade of indifference.

For example, Respiratory syncytial virus (RSV), human metapneumovirus, rhinoviruses are taking their toll writes medical reporter Andre Picard (Globe and Mail, December 27, 2022)

And while HIV/AIDS has been quietly forgotten, it’s still with us. Polio, which was on the verge of eradication, has popped up in New York. Ebola reared its ugly head anew in Uganda. Monkeypox is spreading in strange new ways. Measles and other vaccine-preventable illnesses are making a comeback.

We may want to forget COIVD-19 but the coronavirus has not forgotten us. We long for “prepandemic” normalcy, but 2022 was actually the deadliest year yet for COVID-19.  In 2022, Canada surpassed 17,000 deaths, more than the 14,642 deaths we recorded in 2020 or the 16,489 in 2021.

We still don’t know if SARSCoV-2 will mutate further. A fifth wave of Omicron is just beginning.

One misconception is that exposure to COVID-19 may actually provide a benefit of immunity. Antivaxxers hope exposure will protect them against further infection.  Now it’s becoming evident that the opposite is true.

COVID-19 infections cause “immune dysregulation” in which the body either underreacts to foreign invaders, causing infections to spread quickly, or it overreacts to foreign invaders.

Even at the best of times, we know that viruses mess with the immune system, making it easier for secondary infections to strike. Pathogens interact with each other in strange ways.

We had become nonchalant about coronaviruses. Ordinarily, they only cause colds. That COVID-19 could kill 6.7 million globally was unexpected.

The pandemic changed the way we interact with the world in ways that only events such as the attacks on the World Trade Center in New York and the Pentagon did on September 11, 2001.

The attacks on 9/11 spawned conspiracy theories and denial in a way that the pandemic has.

In addition to strict boarding procedures on planes put in place by 9/11, there is the additional threat of viral invaders while flying.

The pandemic has shifted our view of foreign threats. Before 9/11, attacks on North America were incomprehensible.

With COVID-19, the threat is closer that we imagined.

Look out Google, here comes chatbot

Warning: not all of this article was written by a human

Google was a game-changer when it first came out. I started using the browser in 1998.

image: Call Centre Helper

I was hooked on Google from the start. Unlike other browsers, Google had an uncluttered screen with a simple search window. And it delivered results.

Google’s parent company, Alphabet, has revolutionized the tech industry with so many reliable products like Translate, Maps, Earth, Street View, and Docs. Alphabet made what came before it look like lumbering dinosaurs.

Now Google is threatened by a creature of its own making.

Three weeks ago, an experimental chatbot called ChatGPT made its case to be the industry’s next big disrupter. Using technology created by Google, ChatGPT can serve up information in clear, simple sentences, rather than just a list of internet links. It can explain concepts in ways people can easily understand.

Technology reporters Nico Grant and Cade Metz warn that chatbots threaten Google –somewhat akin to the monster swallowing up Frankenstein.

The release of ChatGPT led Google’s management to declare a “code red.” For Google, this was akin to pulling the fire alarm. Some fear the company may be approaching a moment the arrival of an enormous technological change that could upend the business.

Google’s chatbot received enormous attention in the summer when a Google engineer claimed it was sentient and should therefore have its “wants” respected.

The engineer must have been convinced that Google’s chatbot passed the Turing test. Alan Turing came up with the test in 1950 as a means of determining whether a machine can exhibit intelligent behaviour equivalent to, or indistinguishable from, that of a human.

For his temerity, Google fired the engineer.

Google may be reluctant to deploy this new tech as a replacement for online search because it is not suited to delivering digital ads -which accounted for more than 80 per cent of the company’s revenue last year.

“No company is invincible; all are vulnerable,” said Margaret O’Mara, a professor at the University of Washington who specializes in the history of Silicon Valley. “For companies that have become extraordinarily successful doing one market-defining thing, it is hard to have a second act with something entirely different.”

I decided to ask ChatGPT to write 100 words about the future of chatbots in 2023. Here’s what it came up with:

“It is difficult to predict exactly what the future will hold for chatbots in 2023, but it is likely that they will continue to evolve and improve. As natural language processing (NLP) and machine learning technologies advance, chatbots will become more sophisticated and able to understand and respond to a wider range of inputs.

“They may also become more integrated into everyday life, potentially being used in a variety of contexts such as customer service, healthcare, education, and more. It is also possible that chatbots will be used to facilitate communication and collaboration in a variety of settings, such as work teams or online communities.

“Ultimately, the future of chatbots will depend on the ways in which they are developed and utilized by businesses and individuals.”

Not bad, although it took 126 words and it’s a bit bland.

I don’t think chatbots will replace me any time soon. Or maybe I’ve already been channeled by forces that I’m unaware of?

The use of ‘gaslighting’ stretches beyond original meaning

Merriam-Webster picked ‘gaslighting’ as Word of the Year for statistical reasons only. Merriam-Webster saw a staggering 1,740 percent increase in searches for “gaslighting” in its online dictionary in 2022.

image: The Hindu

The word comes from a 1930s play called Gas Light that was turned into a 1944 film starring Ingrid Bergman. In it, the protagonist’s husband secretly dims and brightens the gas-powered indoor lights and insists she is imagining it, making her believe she is insane.

Gaslighting is broadly defined as a type of psychological abuse that makes someone seem or feel “crazy.” It resembles other forms of psychological abuse. Sociologist Paige L. Sweet says:

“We know that psychological abuse, and ‘crazy making’ in particular, is a core feature of domestic, or intimate partner, violence. It functions in part by convincing victims that what they are experiencing is not real or important and then blames them for their experience (Scientific American, October, 2022).”

Professor Sweet gives “Selah’s” experience as an example of gaslighting. After suffering years of abuse from her husband, Selah left him and got her own apartment. Her husband broke in while she was at work and made himself comfortable. When Selah arrived home, he pretended that nothing was amiss and asked what they were having for dinner. He distorted Selah’s reality (she had left him) by insisting on his own reality (they were still together). He peppered subtle threats throughout their conversation and wouldn’t let her leave the house to get groceries.

As often happens with perfectly good words, gaslighting has become popularized to the point that the original meaning has vaporized.

People suffering from long COVID took up the term “medical gaslighting” to describe the medical establishment’s inappropriate dismissal of their symptoms. Patients demanded that their version of reality be recognized and that “experts” held gatekeeping power over their medical care for producing a distorted version of reality.

Then U.S. Congresswoman Carolyn B. Maloney claimed that “Big Oil was ‘gaslighting’ the public.”

 “As we face more deadly, extreme weather around the globe, fossil fuel companies are reaping record profits and ramping up their misleading PR tactics to distract from their central role in fueling the climate crisis,” said Chairwoman Maloney.  “My Committee’s investigation leaves no doubt that, in the words of one company official, Big Oil is ‘gaslighting’ the public.

Over the past decade gaslighting has become extremely popular. This is partly a result of the success of the #MeToo movement, which illuminated how victims of sexual violence and harassment are systemically doubted and discredited when they go public. Commentators have also used it to describe the mind-bending denials of reality coming out of the White House during the Trump presidency.

But those suffering from diseases that are difficult to diagnose are not suffering from gaslighting. Malevolent health care workers are not distorting patient’s sense of reality.

Big Oil is promoting its own interests when it resists anything that would reduce profits. But they are merely taking care of business, not gaslighting.

The word has exploded online among Twitter, Instagram and TikTok users interested in mental health, as well as among political and culture writers and popular psychologists.

All examples of a good word stretched so thin that it loses any consistent meaning.

Provinces don’t want/want to meet with feds over health care

Provinces are sending mixed messages. First they meet but reject previously negotiated terms. A month later, they want to meet but are unwilling to negotiate.

Make up your mind. Meetings require negotiations, not a hand-out.

It seemed like a done deal when provincial and federal health ministers met in Vancouver in November.

Federal Health Minister Jean-Yves Duclos had negotiated in advance of the meeting with his provincial counterparts and all seemed to be going well. In a proposed deal, the feds would give the provinces more money in exchange for two things: a human-resources action plan which would see the credentials of health care workers recognized from province to province; and the sharing of health care statistics across Canada.

Provincial health ministers had voiced no objections just days before the meeting.

Image: CTV Montreal

Then the premiers got involved.

It’s hard to know just which premiers pulled the rug from under the proposed agreement.

British Columbia Health Minister Adrian Dix, co-chair of the get-together, seemed disappointed. He told a news conference that the federal offer had moved the parties “a sound bite further ahead.”

New Brunswick Premier Blaine Higgs was ready to deal. He said there should be talks and “let’s see where the discussion goes.”

Other premiers categorically dismissed the federal plan. Quebec Premier François Legault rejected any transfer from the feds that came with conditions.

It seems reasonable to me that data on diseases and successful treatments be shared nationally. It’s reasonable to make the movement of health care workers across the country as seamless as possible.

Now, only a month after rejecting the fed’s modest proposal, premiers want to meet again to ask, again, for money without conditions. It would be a short meeting because the feds won’t, and shouldn’t, hand over money unconditionally.

Even before any new money is negotiated, the provinces and territories are already on track to get a 9.1 per cent boost next year – a $4.1-billion increase.

Federal Health Minister Duclos is ready to talk but belligerent premiers only have their hands out. What the feds want to talk about is data and indicators that measure results. “The problem is, until now, the premiers refuse to speak about those results,” Duclos said.

The problem is that money transferred to the provinces is not necessarily spent on health. The feds can specify targeted transfers for things such as mental health but provinces will do what they want with it. Ontario Premier Doug Ford was candid. He said provinces need flexibility to move money between different “buckets.”

In other words, provinces will do want they want with federal transfers.

“All that premiers keep saying is that they want an unconditional increase in the Canada Health Transfer sent to their health ministers,” said Duclos. “That is not a plan; that is the old way of doing things.”

Money alone will not fix our health care. More national data would make the system more efficient by putting resources where they are needed. Health care workers should be able to move easily from province to province where the need is greatest.

Bluffing on the part of premiers is so tedious, as Alberta Premier Smith has demonstrated so well. Let’s get past the BS and get down to honest negotiations.

Smith is an amateur at separation compared to Quebec

Alberta’s Premier Smith is desperately trying to appeal to her populist base by introducing her loony sovereignty act. Smith is trailing NDP leader Rachel Notley in the vote-rich cities of Edmonton and Calgary according to recent polls.

image: CTV News Edmonton

But her sovereignty act will not sway urban voters any more than her antivaxx conspiracies do.

Smith’s apparent strategy is to capitalize on the notion that Alberta is hard done by and that the threats contained the sovereignty act will get Ottawa’s attention just as Quebec was able to push a separatist agenda and win concessions.

Bloc Québécois Leader Yves-François Blanchet was amused. “If she does succeed and make a country out of Alberta,” he fantasized, “I will be a bit jealous, but I would say, ‘Good for you.’”

Smith fails to realize Quebec has won concessions through persistent defence of its unique culture and language. Montreal is the second largest French-speaking city in the world.

In 2006 Prime Minister Stephen Harper tabled a resolution, passed by parliament: “That this House recognize that the Québécois form a nation within a united Canada.”

Quebec has its own pension plan, tax collection, health insurance and immigration policies.

In her attempt to free Alberta from the iron chains of Ottawa, Smith has come up with what can only be considered a joke.

The bill proposes to give cabinet the power to unilaterally amend legislation via orders in council. Cabinet can do so if they decide that a federal law is unconstitutional, or even just “harmful.” No need to test the constitutionality of the law in question. No need to even define the word “harmful.” Cabinet can also order provincial bodies not to enforce specific federal policies or laws. It verges on insanity.

Jason Kenney, former premier and member of Smith’s party, made it clear what he thinks of this lunacy. He called the proposed act “risky, dangerous, half-baked” and “banana republic.” To punctuate his comments, he resigned his seat on the day the sovereignty act was passed.

The bill is written so as not to take itself seriously: “Nothing in this Act is to be construed as … authorizing any order that would be contrary to the Constitution of Canada.” Not only that, but the act says it would “respect” a court ruling to the contrary.

Smith tries to assure us that the bill does not do what it plainly does.

She has gone down the rabbit hole.

“The Sovereignty Act says it can do what it can’t,” the March Hare said to Alice, very earnestly.

“It can do what it can’t?” Alice replied in a puzzled tone.

“Anti-gravity principles are a heart,” said the Hatter, waving a flag with a maple leaf in her face.

It all makes sense to Smith’s populist base. The confounding and untrue are the true indicators of their veracity.

They imagine that Smith is only doing what Quebec separatists have been doing for years – that is, making threats so they can get a better deal from Ottawa. Populists like a feisty leader who will take the fight to Ottawa.

Except Quebec was never this bad at it.

Poilievre repeats misinformation about B.C.’s safe drug supply

I just watched Conservative leader Poilievre’s tacky video set in front of a tent city in Vancouver. For dramatic effect, his video is interspersed with drive-by shots of street people. Grainy effects, except when Poilievre speaks, are added to provide a supposed gritty vérité.

image: The Hill Times

He makes sweeping statements in which he claims these people in the background are hooked on drugs. And some probably are.

But it’s more likely they are homeless because they have no homes: they can’t afford to buy and the rents are outrageous.

Rather than exploit the homeless as props for his populist rant, he could explain just who the homeless are. Rather than characterizing them as drug users, he could tell the truth but that wouldn’t suit his sensationalized video. The fact is that Vancouver’s homeless are overrepresented by indigenous Canadians and racial minorities.

The sad reality is that the homeless are victims of racial discrimination.

Despite accounting for only 2.5 per cent of Vancouver’s population, Indigenous people make up one-third of all those experiencing homelessness.

He could point out that Blacks and Latin Americans are disproportionately represented among the Vancouver’s homeless population.

But no, Poilievre prefers to ignore the racial and Indigenous discrimination represented by the tent city in his seedy video. He exploits those already discriminated by further tarring them all as drug addicts.

Poilievre spouts more populist drivel when he claims and that the “tax funded” safe supply of drugs is a failed experiment.

The opposite is true.

Prescribing drug addicts a safe supply of drugs saves tax dollars. The drugs are far cheaper than the cost of policing and to our health care system of treating addicts who overdose.

In fact, no one has died from a drug overdose at a safe consumption site. The BC Coroners Service looked into illicit drug toxicity deaths between 2012 and 2022 and found that no one had died of an overdose at a supervised consumption site. They said there was “no indication” they were contributing to the rise in narcotic-related fatalities. In fact, 56 per cent of overdose deaths in B.C. this year happened in private residences.

The safe supply of drugs to addicts saves lives because it lowers the rates of overdose and reduces in the use of fentanyl and other street drugs. It reduces the cost to the taxpayer of health care for addicts through reduced hospital admissions and emergency room visits. It improves connections to care and treatment for people who have not had support services in the past. The safe supply of drugs reduces police costs by decreasing criminal activity.

Poilievre adds to his misinformation but saying that injection sites are also to blame. B.C.’s safe injection sites do not use “tax paid drugs.” Users bring their own drugs and staff stand by in case of a bad reaction.

B.C. is leading the country in fighting the stupid laws that led to the problem in the first place.

Starting in January, 2023, adults in B.C. will not be arrested or charged for the possession of up to 2.5 grams of opioids (including heroin, morphine, and fentanyl), cocaine (including crack and powder cocaine), methamphetamine (meth) and MDMA (ecstasy).

Drug abuse is a medical issue. Shame on Poilievre for exploiting the homeless and spreading misinformation.

Is the 1.5 C target on the climate emergency still possible?

I’d like to feel optimistic that we can limit the amount of carbon we are pumping into the atmosphere but a number of things are conspiring against a target of 1.5 C.

image: DW

Delegates at the recent climate conference in Egypt reflected those conflicting things. Unable to come up with anything positive to say after the conference was supposed to end, they spent extra days just to come up with something to agree on. In the end, a pretty timid agreement, a “loss and damage” fund was established with no money in it.

What delegates at the COP27conference didn’t say was deafening.

They failed to build on the pledges made a year ago at COP26 in Glasgow to eliminate coal. In effect, oil and gas has been given a new lease on life.

They struggled to prevent COP27 from being the conference where the target of 1.5 C dies. But I have to wonder. The target is on life support.

In the face of our conspicuous climate emergency, the target of 1.5 C was supposed to slow the cauldron of ever-rising, heat-trapping carbon emissions. The target refers to the goal, set out in the 2015 Paris climate agreement, to limit global average temperature increases to 1.5 C above preindustrial levels.

Most climate scientists agree that allowing temperatures to rise beyond that level will destroy some low-lying countries as polar and mountain ice melts and water levels rise – and even pose an existential threat to the whole planet.

Delegates made no fresh pledges to ramp up their carbon-reduction plans, nor did the final statement call for the phasing down and eventual elimination of all fossil fuels.

Calls at the conference to keep 1.5 alive were futilely repeated. On the day before the official end of the conference, the Brazilian head of climate and energy policy for WWF International, said: “This cannot be the COP where we lose 1.5. … It is in danger, and we need an energy transition fast.”

The Foreign Minister of the Marshall Islands said allowing temperature increases to surpass 1.5 degrees would deliver a “death warrant” to his Pacific island country.

One of the things that’s put a target 0f 1.5 C in doubt is Russia’s invasion of Ukraine. Europe, on the road to green energy sources, hit a detour. Germany had invested heavily in wind and solar energy with natural gas from Russia as backup.

Now Germany uses coal to generate one-third of electrical needs.

The disastrous effects of a rise in 1.1 C has already been felt. B.C. has suffered from a trio of disasters: wildfires that decimate land and contribute to respiratory disease; the heat wave of 2021 that resulted in the death of 619; the atmospheric river -Canada’s 8th worst natural disaster- cost $675M in insurance losses and $1 billion to repair the Coquihalla.

Twenty seven per cent of the greenhouse gasses that we produce comes from transportation. One-half of that comes from the vehicles we drive to work and to go shopping.

Most discouraging, our car culture is built into society. Suburbs are dependent on cars. Public transit is not an option for many.

We are locked into an increasing consumption of fossil fuels and the concurrent greenhouse gas emissions.

It’s hard to see how we can limit carbon emissions to 1.5 C when the burning of fossil fuels is built into our way of life.

Is the 1.5 C target on the climate emergency still possible?

I’d like to feel optimistic that we can limit the amount of carbon we are pumping into the atmosphere but a number of things are conspiring against a target of 1.5 C.

Delegates at the recent climate conference in Egypt reflected those conflicting things. Unable to come up with anything positive to say after the conference was supposed to end, they spent extra days just to come up with something to agree on. In the end, a pretty timid agreement, a “loss and damage” fund was established with no money in it.

What delegates at the COP27conference didn’t say was deafening.

They failed to build on the pledges made a year ago at COP26 in Glasgow to eliminate coal. In effect, oil and gas has been given a new lease on life.

They struggled to prevent COP27 from being the conference where the target of 1.5 C dies. But I have to wonder. The target is on life support.

In the face of our conspicuous climate emergency, the target of 1.5 C was supposed to slow the cauldron of ever-rising, heat-trapping carbon emissions. The target refers to the goal, set out in the 2015 Paris climate agreement, to limit global average temperature increases to 1.5 C above preindustrial levels.

Most climate scientists agree that allowing temperatures to rise beyond that level will destroy some low-lying countries as polar and mountain ice melts and water levels rise – and even pose an existential threat to the whole planet.

Delegates made no fresh pledges to ramp up their carbon-reduction plans, nor did the final statement call for the phasing down and eventual elimination of all fossil fuels.

Calls at the conference to keep 1.5 alive were futilely repeated. On the day before the official end of the conference, the Brazilian head of climate and energy policy for WWF International, said: “This cannot be the COP where we lose 1.5. … It is in danger, and we need an energy transition fast.”

The Foreign Minister of the Marshall Islands said allowing temperature increases to surpass 1.5 degrees would deliver a “death warrant” to his Pacific island country.

One of the things that’s put a target 0f 1.5 C in doubt is Russia’s invasion of Ukraine. Europe, on the road to green energy sources, hit a detour. Germany had invested heavily in wind and solar energy with natural gas from Russia as backup.

Now Germany uses coal to generate one-third of electrical needs.

The disastrous effects of a rise in 1.1 C has already been felt. B.C. has suffered from a trio of disasters: wildfires that decimate land and contribute to respiratory disease; the heat wave of 2021 that resulted in the death of 619; the atmospheric river -Canada’s 8th worst natural disaster- cost $675M in insurance losses and $1 billion to repair the Coquihalla.

Twenty seven per cent of the greenhouse gasses that we produce comes from transportation. One-half of that comes from the vehicles we drive to work and to go shopping.

Most discouraging, our car culture is built into society. Suburbs are dependent on cars. Public transit is not an option for many.

We are locked into an increasing consumption of fossil fuels and the concurrent greenhouse gas emissions.

It’s hard to see how we can limit carbon emissions to 1.5 C when the burning of fossil fuels is built into our way of life.

Mentally ill Canadians deserve the right to die with dignity

Mentally ill Canadians have been excluded from medical assistance in dying (MAID) but that is about to change in a few months.

image: Eastside-online

When that option arrives in March, 2023, Canada will have one of the most liberal MAID laws in the world, joining only a few other countries that allow access for the mentally ill.

As it now stands, only those with a “grievous and irremediable medical condition” can apply for MAID; not just if you are about to die from a fatal or terminal condition but if your life is insufferable.

The distinction between a medical and mental suffering is arbitrary and archaic. There is no mental suffering that isn’t physical. To suggest that we live in a world other than the physical is to perpetuate the ancient notion of a mind/body duality.

To prevent mentally ill Canadians with a “grievous and irremediable” from access to MAID is to further discriminate against the mentally/physically ill. Like the notion of a mind/body duality, made popular by Rene Descartes in the 17th century, mental illness has been characterized in voodoo terms, such as possession by demons.

Mental/physical illness is stubbornly difficult to treat and those afflicted pay a price. The mentally/physically ill are often deemed unemployable and, as a result, are often poor and homeless. Their pain often has physical origins outside the body; victims of trauma, childhood abuse and addiction; symptoms compounded by financial stress and loneliness.

In contrast, those who now access MAID come from a position of privilege.

They tend to be wealthier Canadians. More likely, as an Ontario study found, to fall into the highest income bracket. They have been, in other words, people of relative privilege, wanting the same control in death that they had in life.

The same group of wealthy Canadians who have access to health care also have access to MAID, and the numbers are growing.

In 2021, there were 10,064 assisted deaths in Canada – an increase of 32 per cent over 2020. The average age of Canadians who received MAID last year was 76. Two-thirds have a cancer diagnosis, and nearly one-fifth have a heart condition.

Doctors critical of MAID suggest that assisted dying for the mentally/physically ill will become an easy out for a broken health care system, offering death rather than hope and treatment to society’s most vulnerable and marginalized citizens.

Yeah, right. If you happen to be living an insufferable and irremediable life, just wait for us to fix the broken health care system. Shouldn’t take more than a few decades. Meanwhile, just grin and bear it.

Can doctors, a privileged group of people living in a society that routinely stigmatizes people with disabilities, objectively judge what makes life worth living?

Some worry that there will be a flood of new applicants for MAID but if the Netherlands is any example, the number of mental/physical cases will be a tiny fraction of the total. The Netherlands has had psychiatric illness available for MAID for two decades.

Expanding MAID is about not discriminating between mental and physical health, but seeing patients as whole people capable of making their own decisions.

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