Month: September 2023 Page 2 of 3

As regular readers know, I live in Ontario and because I have cancer (no worries, my odds of dying are about 2%) I’ve been in and out of the hospital system a lot from about 2018 to now.

That means I’ve gotten to see what happened to hospital care, albeit mostly in two hospitals; but two important, well funded research and teaching hospitals.

And it has been bad. Getting imaging tests which I would have had within a month to two before Covid took almost a year. A surgeon I know told me how he was fighting to get people urgent care. I’m lucky, I have a slow growing type of cancer, if I’d had something fast, odds are I’d be dead.

Diagnosing early is important for all sorts of diseases, not just cancer, and so is getting people quick care.

The union responsible for health care workers in Ontario (CUPE) put out a report on Ontario’s hospital care situation. I read it. It’s based entirely only publicly available numbers from various agencies like Statistics Canada, so even though CUPE has an obvious axe to grind I find the report accurate . And those numbers confirm what was obvious anecdotally.

(As an aside, the federal government gave Ontario billions of dollars to help with Covid which it did not spend on Covid.)

It starts with a section showing that Ontario has less health care workers (except research types) than other provinces. It’s not that they’re doing great, it’s that Ontario is worse and was even before Covid. It then shows how many vacancies there are:

The effect of Covid is pretty clear.

We then move to the reduction in number of surgeries (but, alas, no report on imaging wait times.)

Given the population is increasing (massive immigration) and getting older this is pretty significant, and…

So, yeah, less surgeries, increased wait times and not just for elective surgeries. In visual format:

And….

So, what’s the government doing about this? I’ll just quote straight from the report (excuse the images, the report is a pdf and it’s easier to just show a picture.)

In other words, the government plan will make things worse. To keep service levels where they are (not to get back to pre-Covid levels) would require a little over 3,000 beds.

To go back to pre-Covid levels of care would require 8,170 beds over 4 years. The beds have to be staffed:

A 5.18% annual increase in staff means 13,986 extra staff added in the first year. (Assuming we start with 270,000 hospital staff). This would mean 60,000 extra hospital staff over 4 years (a 22.39% increase). This is not the number of staff that needed to be recruited, this is the number of extra staff needed to be added to the existing complement.

So, health care in Ontario hospitals, unless government changes course (they aren’t going to, at least not under this government) will keep getting worse, and it’s already bad in many ways (the actual care in the hospitals I go to is good, once you get past the wait times, though I haven’t been an in-patient since Covid started.)

CUPE has a bunch of other suggestions about how to fix this, you can read them all if you want, but I’ll highlight a couple:

Ban the use of nursing agency staff. These agencies charge 2x and 3x what hospitalspay their own staff, and they bleed away resources from round the clock and weekend staffing, worsening morale and weakening the continuity of care.

Real wages must increase. In any other labour market with skill shortages, wages would increase to retain and recruit. But real wages are being cut for Ontario’s health care workers and this policy is leading to an exodus of staff and to demoralization

There are about 15,000 licensed nurses who don’t practice in Ontario and thousands of frontline support staff have quit and to lure them back you’ll need to pay.

Anyway, what’s Ontario doing, in addition to not increasing beds enough? (If you guessed their non-solution starts with P, go to the front of the class.)

Now CUPE charming notes that the percentage increase is of such a small amount that it can’t fix the problem, but we all know that the real plan is simple: keep making public care shitty and eventually increase the private share massively, splitting the system into a shitty one that poor and middle class people have to use and a good system that the upper class and rich (and politicians who somehow get discounts) use.

The Ontario privatization plan is in its infancy, but the bones of it are clear. Get the people with power and influence to stop supporting public health care by letting them avoid its problems and get good care, make the care in the public system bad to make the mass population support privatization thinking they’ll get to use it when they really need it (as in the US, if you’re really sick and middle class or even lower upper class, you won’t be able to afford private health care), and eventually make politically connected friends very rich while destroying effective public health care.

You may be thinking “who cares what’s happening in a single Canadian province? I’m not Canadian, and don’t live in Ontario.”

But this is a general pattern. It’s happening in multiple countries including the UK (where it’s much further along), Canada, Australia and others. I highlight this one because of just how clear the report is, both on the effects of Covid and the longer term issues and because my personal experience supports it.

If you want good health care you have to pay for it. Public health care is cheaper than private (this isn’t even remotely in question, but beyond the scope of today’s post) and the only way to get good health care is if people are treated equally. If people with power or wealth can skip the queues and get better, faster care, then they don’t care what’s happening in the system you use and that system will get shit fast.

The first stage of privatization was creating a very tiny alternate system where the richest could get everything from private hospital care to bespoke MD care. I spent a tiny bit of time in that system around 2013/2014 and I can tell you, the care is better, by far. (Among other things, the doctor isn’t trying to rush you out of the office in fifteen minutes max and hoping for five minutes. I spent an hour and a half with a doctor during my first intake and often 30 minutes on other occasions. In the US they are offering two day complete check-ups seeing multiple specialists at a major hospital. Don’t worry, not 1-in-100 of my readers can afford that.)

Everyone gets treated the same for the same problem, or care will suck for everyone who isn’t powerful and rich.

As for Covid, we all knew it had a massive effect on the hospital system, and I guarantee that is true almost everywhere, not just in Ontario.

If you want good healthcare, the care the upper classes get can be no better than yours.

And Covid isn’t over and even if you never get it, it can still kill you, your kids, or someone you care about because they don’t get the care they need, when they need it.

(Read the full Ontariot Hospital Care report.)

Folks, it’s your donations and subscriptions which make it possible for me to keep writing (since I need to eat and pay rent and the cost of both have skyrocketed) so please (if you aren’t struggling) DONATE or SUBSCRIBE.

by Tony Wikrent

Civic republicanism

The Pedagogy of Power

Chris Hedges, September 10, 2023 [scheerpost.com]

The ruling classes always work to keep the powerless from understanding how power functions. This assault has been aided by a cultural left determined to banish “dead white male” philosophers…. It is not that the criticisms leveled against these philosophers are incorrect….

What can these philosophers say to the issues we face — global corporate domination, the climate crisis, nuclear war and a digital universe where information, often manipulated and sometimes false, travels around the globe instantly?  Are these thinkers antiquated relics?….

But the study of political philosophy, as well as ethics, is different. Not for the answers, but for the questions. The questions have not changed since Plato wrote “The Republic.” What is justice? Do all societies inevitably decay? Are we the authors of our lives? Or is our fate determined by forces beyond our control, a series of fortuitous or unfortunate accidents? How should power be distributed? Is the good statesman, as Plato argued, a philosopher king — a thinly disguised version of Plato — who puts truth and learning above greed and lust and who understands reality? Or, as Aristotle believed, is the good statesman skilled in the exercise of power and endowed with thoughtful deliberation? What qualities are needed to wield power? Machiavelli says these include immorality, deception and violence. Hobbes writes that in war, violence and fraud become virtues. What forces can be organized to pit the power of the demos, the populace, against the rulers, to ensure justice? What are our roles and duties as citizens? How should we educate the young? When is it permissible to break the law? How is tyranny prevented or overthrown? Can human nature, as the Jacobins and communists believed, be transformed? How do we protect our dignity and freedom? What is friendship? What constitutes virtue? What is evil? What is love? How do we define a good life? Is there a God? If God does not exist, should we abide by a moral code?….

“It is indeed difficult and even misleading to talk about politics and its innermost principles without drawing to some extent upon the experiences of Greek and Roman antiquity, and this for no other reason than that men have never, either before or after, thought so highly of political activity and bestowed so much dignity upon its realm” Arendt writes in “Between Past and Future.”….

If we cannot ask these fundamental questions, if we have not reflected on these concepts, if we do not understand human nature, we disempower ourselves. We become political illiterates blinded by historical amnesia. ….

The Orphan Among Revolutions

Lynn Hunt [The New York Review, October 5, 2023 issue]

Reviewed:

Revolutionary Spring: Europe Aflame and the Fight for a New World, 1848–1849

by Christopher Clark

Crown, 873 pp., $40.00

…Judgments of the multiple eruptions of 1848 have not strayed all that far from Marx’s fuming disillusionment. In 1922 the British historian G.M. Trevelyan rendered the verdict that is still cited: “The year 1848 was the turning-point at which modern history failed to turn.” The “military despotisms” of Central Europe survived the challenge, he concluded, thereby laying the groundwork for the “misfortunes of European civilisation in our own day.”  In other words, the ultimate defeat of the Central European revolts of 1848 made it possible for Germany and Austria to follow the disastrous policies that led to the carnage of World War I.

In his new book, Revolutionary Spring, Christopher Clark, the Regius Professor of History at Cambridge, wants to counter these negative views by emphasizing the many beneficial outcomes of the insurrections, but like others who have tried to put a more positive spin on the events of those years, he faces a daunting task. His likening of 1848 to the Arab Spring of 2010–2011 suggests the difficulty, since these recent uprisings largely failed to produce lasting democratic reforms. If anything, the Arab Spring seems to have reinforced the lesson taught by 1848 that divisions within revolutionary and democratic coalitions offer an opening to autocratic leaders, whether those already in power or those waiting in the wings for their opportunity.

Restoring balance to the economy

Can the UAW Transform America Again?

Timothy Noah, September 15, 2023 [The New Republic]

But while a 35 percent pay hike may sound audacious, under the current contract, starting pay—at $18 per hour—is about 36 percent below where it would be if the 2007 starting wage had kept up with inflation. Regardless, pay packages for the Big Three’s chief executives all rose 40 percent over the past decade. Fain’s ambitious wage target appears to be having the desired effect. It pushed Ford’s offer up from a 9 percent wage hike to 20 percent, GM’s from 10 percent to 18 percent, and Stellantis’s from 14.5 percent to 17.5 percent. Still, Fain said on Facebook Wednesday night, “their proposals don’t reflect the massive profits that we generated for these companies.”….

Since 2013, profits at the Big Three have risen 92 percent, according to the nonprofit Economic Policy Institute. During that time period, the companies paid out nearly $66 billion in dividends and stock buybacks, $14 billion of that in this year alone. One of the UAW’s more creative demands is that workers receive $2 in profit sharing for every million dollars the Big Three spend on stock buybacks and dividends. That would mean at least $28,000 per worker this year.

The Big Three car companies have authorized $5 billion in stock buybacks over the past year….

On top of the stock buybacks, the Big Three have reported $21 billion in profits in just the first six months of 2023. Despite the enormous gains, the companies have cried poverty in response to union demands for wage increases to make up for decades of pay stagnation.

Use to discuss topics unrelated to recent posts.

by Tony Wikrent

Strategic Political Economy

The Green Great Game Is This Century’s Space Race 

[The Diplomat, via Naked Capitalism 9-3-2023]

The rivalry for access to raw materials to facilitate the energy transition will turn the “Green Great Game” into one of the defining geopolitical features of the 21st century.

The tax extreme wealth to increase funds for government spending narrative just reinforces neoliberal framing

William Mitchell [Modern Monetary Theory, via Mike Norman Economics, 9-7-2023]

Despite the rabble on the Right of politics that marches around driven by conspiracies about government chips in the water supply or Covid vaccines and all the rest of the rot that lot carry on with, the reality is that well-funded Right that is entrenched in the deepest echelons of capital are extremely well organised and strategic, which is why the dominant ideology reflects their preferences. That group appears to be able to maintain a united front which solidifies their effectiveness. By way of contrast, the Left is poorly funded, but more importantly, divided and on important matters appears incapable of breaking free from the fictions and framing that the Right have introduced to further their own agenda. So, the Left is often pursuing causes that appear to be ‘progressive’ and which warm their hearts, but which in reality are just reinforcing the framing that advance the interests of the Right. We saw that again this week with the emergence of the Tax Extreme Wealth movement and with the release of their open letter to the G20 Heads of State – G20 Leaders must tax extreme wealth. This ia the work of a group which includes the so-called Patriotic Millionaires, Oxfam, Millionaires for Humanity, Earth4All and the Institute for Policy Studies. It demonstrates perfectly how these progressive movements advance dialogue and framing which actually end up undermining their own ambitions.

[TW: Proponents of Modern Monetary Theory are edging closer to the argument by civic republicanism that a primary purpose of taxation in a republic is to prevent concentrations of wealth of the rise of oligarchs.]

Teardown of Huawei’s new phone shows China’s chip breakthrough 

[Reuters, via Naked Capitalism 9-5-2023]

How Sanctions Failed To Hinder China’s Development 

[Moon of Alabama, via Naked Capitalism 9-5-2023]

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