Wednesday Night Salon # 943
29 March 2000
INTRODUCTION
Montreal International Literary Festival
5 April to 9 2000 The impressive schedule for the Blue Metropolis Montreal International Literary Festival was a great event and Linda Leith was warmly congratulated for her superb organization.
Although the invitation had requested nominations for Wednesday Night topics in categories resembling the Oscars, the conversation bore more resemblance to a review of the Great Canadian Soap Operas of the past several years.
AS THE WORLD TURNS
Who will lead the newly formed Canadian Conservative Reform Alliance Party? Will
Stockwell Day beat
Preston Manning for the leadership? To the Wednesday Nighters present, the principal difference will be the eastern limits of support for the party. It is the main task of any politician to be elected. Day's choice of advisors does not appear to favour this, which should be his primary area of concentration. In either instance, there is probably little support for the Alliance's brand of conservatism west of Québec, very little more in Ontario.
THE WEST WING
The question of
Jean Chretien's tenacity in holding on to his job remains a fruitful source of speculation. One hypothesis proposed is that although the Liberals will have no problem winning the 2001 election (albeit possibly forming a minority government), they will not have an easy time during that mandate, perhaps facing a defeat in 2005. In anticipation of that event and in an effort to forestall it, it might be convenient to change leaders at that time, thus renewing the fortunes of the Liberal Party of Canada.
M*A*S*H* / ER
From the alleged federal underfunding of medicare, to the patent controversy surrounding the imminent completion of mapping of the genome, to the wisdom of establishing the
McGill University Health Science Centre, health care is becoming an increasingly popular topic on Wednesday evening. The definition of intellectual property and its distinction from common non-patentable property must be accomplished in short order. Consideration should at the same time be given to shortening the period of patent protection, especially in the field of pharmaceuticals. These of course require wide consultation and planet-wide agreement.
Is Medicare going down the drain? Is the Federal Government at fault for having retreated from its original 50% cost-sharing agreement with the provinces? The answer to both questions is probably not. The latter arrangement made it politically profitable for provinces to spend fifty-cent dollars, reaping the political benefit of having spent impressive sums, half financed by another level of government. As for the future of Medicare, Canadians will certainly punish any government that attempts to kill Universal Health Care. The Americans spend 14% of their Gross Domestic Product on a health care system that leaves fifty million people uncovered. Some countries spend as little as nine to ten percent of G.D.P. Canada falls in between. Part of our problem appears to be the willingness in Québec, but in other provinces as well, to negotiate collective labour agreements which favour politicians rather than patients, yet do little for individual employees. Other problems appear to stem from a top-heavy bureaucracy. The overriding problem is the increasing cost of new technologies. In the assessment of new technologies, the public should accept the probability of success in treatment and in the expectation of the prolongation of life as criteria for adoption.
The necessity for or even desirability of establishing a new combined tertiary care university centre with some primary care remains controversial. Apart from those citizens in the immediate vicinity of the proposed site, the arguments brought forward in opposition to the project by professionals within the present institutions and academics as well as interested citizens, are impressive.
- The tremendous investment in bricks and mortar would be better spent on improved patient care. Abandon those buildings that are obviously decrepit and modernize those that are in relatively good condition.
- The costs of construction projects of this magnitude funded by government are usually underestimated, leaving a gigantic gap in funding that will ultimately translate into poorer service.
- The designated regional trauma centre now located at the Montreal General Hospital should be located in the downtown area.
- Most of the proposed changes can be achieved by a unified governance and merging of low volume services in various institutions.
- The new Centre will have very little more bed capacity than either of the two largest hospitals in the proposed merger.
The proponents of the new centre counter with the following:
- The current buildings are not functional. The Royal Victoria Hospital was built towards the end of the nineteenth century. The Montreal General, completed in 1954 was of pre- World War II design, when labour was cheap and the additional cost of transporting food, supplies and employees vertically was more than compensated by the magnificent view of the city or the mountain, especially to the benefit of the private patients. The layout of the Royal Victoria is a logistical nightmare. Labour savings will more than compensate for construction costs over time.
- The proposed University Hospital Centre will facilitate teaching.
- Expensive new technologies will no longer be duplicated.
- A new University Centre adopting the most recent U.S. design features will be much more patient-friendly than possible in any of the existing institutions.
QUOTES OF THE EVENING
- "A day in the life of Stockwell (Day) is a nightmare in the life of Ontario."
- "Any medicare system is a bottomless pit."
- "A larger percent (of the population) work in hospitals than are sick."
- "We have a very uneven system (of health care) in Canada ). You don't get very good medical care (in rural areas), but you don't know it."
Note to the legions of Harry Mayerovitch Artist fans - not only does Harry turn 90 on the 16th of April, but a restrospective exhibition of Harry's work will be held at Victoria Hall starting April 12th and a second one opens at the Maison de la culture on Côte des Neiges on May 4th.
THE DISCUSSION
Notes by Herb Bercovitz
Edited by Diana Thébaud Nicholson
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