Wednesday, March 21, 2007

Operación Puerto -- the fiasco that never ends

Cyclingnews published the latest in the lunacy that is Operación Puerto. Today, Spanish paper El Pais accused judge Antonio Serrano who is overseeing the case, of mistakes that derailed the investigation. According to El Pais, judge Serrano permitted police to "wiretap phone lines so that they could continue with their investigations, something that is considered as violation of the Spanish citizens' rights when there is no indication of an offense."

Among other things "the Spanish paper points out that Serrano was opposed to DNA exams to identify the blood bags nor did he allow the use of information contained in mobile phones or SIM cards. This meant that many rumours, like the implication of other sportsmen in football, tennis or athletics, could not be proved." Hmm, guess he was too much of sports junkie to allow this thing to go any further. After all with sports gone he'd probably be forced to talk to his wife.

While it's somewhat comforting to see that incompetence can be found elsewhere, this is not good for cycling. The result may be that the more than 50 cyclists who were implicated in the affair may get off Scott free. And that wouldn't be good for riders like Michael Barry and teams like T-Mobile and CSC that are making strong stands against doping. As one Spanish rider complained bitterly to El Pais: "Now you can say we're getting it from all sides," said an unnamed cyclist to El País. "The cheater says that the shelving is like exoneration, like proof that they were innocent, so that they will continue doing what they did before, and even with more impunity. A further difference will between us, who are riding cleanly, and them. They will not only beat us again, no, they will also laugh at us."

Will all that Conservative pork help in Quebec?

Well you've got to hand it to Harper and Mr. Flaherty. Their plan to target voters in suburban and exurban areas in the hopes of making significant headway in Toronto, Vancouver and Montreal may well pan out. This budget, like everything Harper does, is done with a view to realizing his goal of a majority government and making the Conservative party the natural governing choice for years to come.

The question is will all of that pork really help in Quebec? As Chantal Hebert has said many times, winning Quebec is no guarantee of winning Canada, but it's just about impossible to win Canada without Quebec. Harper (and Mr. Dion as well) may be well served in reading Ms. Hebert's new book "French Kiss". In a chapter entitled "The End of Pork", Ms. Hebert recounts the chronology of patronage in Quebec by governments from Trudeau to Mulroney and Chretien. She attributes the Liberals loss to the Block in the 1990 by-election of Laurier -- Sainte-Marie, to the "misguided notion that Quebecers would put proximity to the honeypot of the federal government above their strongly held views on a defining issue such as their political with the rest of Canada".

And she later points out that like "their counterparts in Mississauga and Calgary, urban Quebecers are impervious to the politics of pork. Their ballot-box issues, especially at the federal level, are more likely to have to do with macropolicies such as taxes, child care, clean air and urban transport." If she's right then maybe Harper has miscalculated and Mr. Dion, who has been much more focused on policy and vision, may yet win the day.

Harper doesn't mind if Taliban kill Canadian troops

Sometimes I wonder how the Liberals can resist getting down in the sewer with Harper. How about something like this from Mr. Dion:

Mr. Speaker, Harper accuses me of having more passion for Taliban prisoners than Canadian troops(Harper goes for jugular - again). But the reality is that the government's own actions have put our troops at risk. According to reports, 4 detainees have completely disappeared. Maybe they were tortured or killed. Or maybe they bribed their way to freedom and are now back out killing Canadian troops. Since we're not tracking them we don't know. Harper doesn't seem to care if our troops are being killed or people are being tortured. All he cares about is getting re-elected.

Tuesday, March 20, 2007

I have seen the future -- and it ain't pretty.

Once again displaying how far behind the mainstream I am, I just visited the Dominion Institutes' Canada in 2020 website. The idea behind the site is worthy enough -- to get Canadians to think about the challenges that will face our country in the coming years. Sounds good to me. Even better, the Institute invited some of the country's leading thinkers (academics, journalists, economists mostly) the opportunity to write about their vision of the future.

For the most part it's pretty depressing. Maybe not depressing enough to make me want to end it all now but certainly depressing enough to make me not want to get out of bed for a long, long time. So, if you're in the mood to find out how bleak our future might be, and you haven't already read any of the essays then be sure to visit the site here. I guarantee you a night of misery. My only hope is that John Ralston Saul's installment will be more hopeful. Please, please, please Mr. Saul save our country!

Monday, March 19, 2007

Do we need to rethink healthcare delivery?

I know today is budget day but the Globe and Mail published this editorial on private delivery of health care in Ontario (Ontario's dismissal of privately provided care). With all of the talk in reducing wait times and the growing concern for providing quality care for a population that is rapidly aging, it's disconcerting to see governments (in this case the Ontario Liberals) dismissing delivery options that will solve these pressing issues.

In this case Health Minister George Smitherman rejected the possibility of a private clinic, Don Mills Surgical Unit Ltd., providing knee replacement services to reduce wait times. This seems odd given the stated commitment to reduce wait times and the fact that other procedures are outsourced to the same company.

The environment has dominated the national agenda over the course of the past few months, but health care is the monster that's still under the bed waiting to jump out and scare us all. We need to rethink our entire health care system and relatively quickly. Alternative delivery mechanisms under medicare are option that should be considered where it makes sense. Allowing private companies to specialize in niche areas may not only shore up gaps in the current system but make it more cost effective and efficient. The Shouldice Hernia Centre in Markham, ON. is one example. It's been operating since the late 1940's and is so good it attracts patients from around the world. The operation is efficient and most patients are discharged within a couple of days of surgery.

And best of all, the entire cost, except for the semi-private room is paid for by OHIP. When I was there the rooms were about $125 and I was there for a total of 3 nights, so the cost was by no means prohibitive. Why shouldn't we consider this type of delivery? Just because it's private? In reality, as long as mechanisms are put in place to rate providers as is done by for profit payers in the U.S. it seems an excellent way to improve the system as a whole.

Governments should also looking to innovate in other areas. Implementing or expanding funding for community clinics and the role of nurse practitioners, as the Ontario government has done in several communities (I went to one in Toronto when I lived there) provides excellent service and reduces emergency room visits.

Where the Ontario Liberals have fallen short is in supporting preventive health care such as nutritionists and physiotherapists which were delisted over a year ago. And what about making individuals more responsible for their own health care? If we are going to reduce health care costs then individuals must be made to bear some responsibility when they have been negligent. After all, why should I pay for someone who eats fried food every day and doesn't exercise and then develops diabetes and chronic heart disease? At risk patients should be put on a program by their doctor and then made to pay increasing deductibles if they don't adhere to the regimen set by their physician. This has been done to good effect by some private payers in the United States. As long as we maintain these programs under medicare I don't see why we should do some of these things. They will save us substantial health care costs down the road.

Then there's a national pharmacare program which could rationalize the drug industry in this country and make many more drugs affordable. Again, we can see in the U.S. that scale means lower costs.

Whatever we do we need to begin to explore new delivery models if we are going to save medicare in this country. And, as difficult as it may be, it also means that minimizing political pandering even in an election year as Mr. Smitherman has done here.