The elephant in the room with respect to Ontario is truly the cost of utilities and now it's become a problem for Alberta too. Two of Canada's economic engines are being run by idiots and the third hasn't had enough time to wreck their own economy yet as they've not been in power long enough.


Solutions? Ideas?

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Steve Fleck @stevefleck | Blog

Don't do stupid things with power plants when clearly not ready.

A family member is a health team doc and wow is it ever free money.

Every time I hear the OMA cry poor on behalf of family doctors I laugh to myself as I think about how much my relative gets paid for so little - esp as compared to the old days.

http://www.cbc.ca/news/canada/toronto/ontario-liberals-daycare-election-budget-1.4594803 Wynne is now promising free daycare (well paid for with borrowed money) for children from 2 and half until junior kindergarden. That's a 2.2 billion dollar cost. If you are opting to be a stay at home parent with young children you may as well shoot yourself I guess. Add to the 2.2 billion rebuild of Sick Kids. I'd vote NDP before I'd vote for her. As I have said before as I am in quasi rural riding my vote won't count. I may be voting with my feet in a few years though. I think the liberals are worried about losing though and that is why they are making so many spending announcements.

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They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

It is rather sad really. The average gp who was doing quality work used to see 5-6 patients per hour in a mixed family practice doing physicals, bp check sore throats ear infections some mental health stuff etc. Four an hour is pretty standard now, when they are there. The average family doc used to be in their office 4 to 4 and a half days a week from 9 to 5. Now 2.5 days a week is pretty standard. I'm not making this stuff up.

The doc beside me in the fht works monday afternoon from 1 to 4. Tuesday 10 to noon and 1 to 4. Wednesday off. Thursday is a repeat of Tuesday and Friday is 930 to noon. For that she gets 300 K a year minus about 100K of overhead. If she knew how to bill properly she would probably clear 250 K a year. No weekends. One evening clinic for three hours once every three weeks. Eight weeks of holiday in a year and its unusual for a day of clinic to be not cancelled at least once every 2 weeks. Another doc at another site was in his office monday and tuesday only and had 50 percent more patients than I do. Don't know what the patients are supposed to do from Wednesday to Friday. He recently quit to start a pain clinic.

I looked at our NPs schedule yesterday. 8 patients in a day . The only one that would take me more than 15 minutes to complete was a first prenatal visit.

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They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

I dunno - i'd be curious to see this costed out. maybe it's just about location or age, but i personally know a fair few people who have dropped out of the work force because of child care costs. if you make, say, 40k per year, spending 20k to send your kids to day care, it doesn't add up. so you leave work and stay at home for several years, and then re-entering the workforce is really tough.

meanwhile the state loses that Labour, and it's its tax revenue. plus, it sort of loses the money it spent training you for a career you've left.

anyway.

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____________________________________
https://lshtm.academia.edu/MikeCallaghan

http://howtobeswiss.blogspot.ch/

Wynne is now promising free daycare

I'd like to ask Wynne how she defines "free".

Of course she's offering tax payer funded daycare, she knows she's in deep shit and now they're throwing "freebies" at the wall to see what sticks. Of course "free" daycare will be a big one with tight money families, unfortunately they don't realize that either the provincial or federal government will figure out some way to claw back the 'free' daycare.

I work in banking and insurance (premises/cap/maintenance/etc) as it relates to the above...also live in BC where they are looking at doing the same thing....

We have about 500 employees and about 90% are women, the advantage or correlation is that banking hours often coincide with daycare/school hours.

I would support this if some how I could square the circle that Wynn/Horgan and (likely) Notely won’t eff it up.

Side note, wife and I don’t have kids, and pay a lot of taxes. (Relative)

If this increased hours to work for already qualified and trained people as opposed to the rabbit hole of recruitment/retention....

2c

Maurice

The doc beside me in the fht works monday afternoon from 1 to 4. Tuesday 10 to noon and 1 to 4. Wednesday off. Thursday is a repeat of Tuesday and Friday is 930 to noon. For that she gets 300 K a year minus about 100K of overhead. If she knew how to bill properly she would probably clear 250 K a year. No weekends. One evening clinic for three hours once every three weeks. Eight weeks of holiday in a year and its unusual for a day of clinic to be not cancelled at least once every 2 weeks.

What I'm going to say here is going to sound very un-progressive and not-2018

I recall reading something a few years back, about how the big push to get more women into medicine in Canada, that started back in the late 1980's, and saw a huge surge in women as practicing doctors, has had a dramatic impact on the delivery of medical services across Canada - most of it not good. Note this is NOT questioning the skill of those women doctors in ANY way, more their work habits as it relates to other things and this is where it get's awkward.

1. Many women GP's, prefer NOT to have a clinic of their own, just working Part-Time or doing locums here and there, as well as the need to take time off when they have children of their own. This has lead to the hop-scotch patterns of availability that you speak of for GPs.

2. On the specialists side, many women doctors have not chosen to go into the harder-core surgical specialties, things like Orthopedic Surgery as an example, leaving those specialties vulnerable to shortages of surgeons and specialists, and thus longer wait times. The women doctors who do chose to specialize have, tended to chose the less demanding specialties.

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Steve Fleck @stevefleck | Blog

no, that was my understanding too. more women than men in med school, and women disproportionately choosing general practice over the specialities. (i wouldn't say 'less demanding,' though - i knew lots of people desperate to get into things like dermatology and radiology because the hours are easy and the pay is great, whereas general practice can actually be a real slog.)

anyway, then more women working part-time, especially since, as you say, they're having families.

there's a lot going on here. the medical education system is just busted, for a start, but beyond that you could cite family leave policy too. lots of female MDs might have to take leave because their husbands can't - even in 2018 it's common enough to find that women get several months for mat leave and dads get a few days for pat leave. open that system up and maybe (maybe?) more women would be back to the workplace sooner and more men would be sharing the childcare load.

-mike

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____________________________________
https://lshtm.academia.edu/MikeCallaghan

http://howtobeswiss.blogspot.ch/

I'd like to ask Wynne how she defines "free".


Wynne's getting beaten up on all fronts, but a really BIG one for me that I can actually see legit, measurable progress on is Transit. I actually see stuff getting done now, physically with GO-Transit.

The numbers here are daunting, and big, but the fact of the matter is the GTA was woefully behind the time in terms of the public transit infrastructure that it had. It had been let drift for too long. It's worth noting that the last time the Conservatives were in power, was when Mike Harris, killed the Eglington Subway, and made huge other cut-backs in transit spending. Because these projects have 5 - 15 year time-lines, it often takes that long to see the negative impacts of changes made . . or the positives of positive impacts.


Traffic congestion in the GTA is collectively costing in excess of $6billion. It's also having a dramatic negative social impact on many people's lives. We've kind of reached Maximum Car Capacity, so the only way to improve things is to make the Public Transit system better.


It should be noted, that when it comes to transit, Doug Ford has no idea what he's talking about. This is a file, where he has been certifiably, and easily proved, completely incompetent and wrong! He supported his Brother Rob Ford in killing the Transit City plan for the City of Toronto. He's been factually wrong on numerous other transit issues. It's still unclear if he actually knows what an LRT is!

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Steve Fleck @stevefleck | Blog

she very obviously means 'free at point of sale, and comp'd/heavily subsidized by the state, which in turn is funded by taxes and revenues from state properties.'

this should be apparent. but several successive waves of politicians at all 3 levels of government (and many loud media voices) have succeeded in convincing people that stuff shouldn't cost anything, and that the government only taxes you to be mean. stuff costs money. our mission is not to debate that fact, but to decide what stuff we want and how much we're willing to pay for it. it's strange and sad that the discourse is increasingly just ending at incredulity about taxes rather than some decision about spending priorities.

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____________________________________
https://lshtm.academia.edu/MikeCallaghan

http://howtobeswiss.blogspot.ch/

this should be apparent. but several successive waves of politicians at all 3 levels of government (and many loud media voices) have succeeded in convincing people that stuff shouldn't cost anything, and that the government only taxes you to be mean. stuff costs money. our mission is not to debate that fact, but to decide what stuff we want and how much we're willing to pay for it. it's strange and sad that the discourse is increasingly just ending at incredulity about taxes rather than some decision about spending priorities.


Yes, and two main perpetrators of that, have been Rob Ford and Doug Ford.

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Steve Fleck @stevefleck | Blog

How much has Wynne really had to do with this? Correct me if I am wrong, but isn't this progress the product of Metrolinx's Big Move (i.e., Dalton McGuinty) as well as John Tory's SmartTrack initiative (to say nothing of his ability to be less acerbic than his predecessor and negotiate with the other levels of government)? I wholeheartedly agree with you on the progress itself though and that any reprise of the "War on Cars" rallying cry must be shouted down.

These things are true. Having said that male docs are working much less as they used to as a group. They see their female counterparts and are starting to say, "Why am I busting my ass?" In a family health team docs are paid per pt per year payment for the most part is de-coupled from how many times you see pts. So your pay is governed by how many pts you have. For the most part docs who are in their office three or less days per week don't seem to enroll many less patients than those that are there 4-5 days per week. (What a surprise eh?) The go getters spend the rest of their time in the emerg or hospital making extra money.

If the liberals were smart they would have done something like said for every 500 patients in your practice you must actually be seeing people say 8 hours per week. The male and female specialists are still fee for service for large part. The female specialists I see tend to work very hard as hard as their male counterparts.

On the transit front the first day it was open I rode the subway from Vaughan to downtown. That was long overdue. They should run that line parallel to the 400 all the way to Newmarket.

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They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

Geez, thats sounding pretty neanderthal-ish... (/pink / not pink)

To some, this would be a perfect example of why pushing for 100% gender equality is not a smart move. As long as women get pregnant and have the babies, and not the men, society overall will benefit in some ways from a lack of "equality". Note, I am not talking wage or benefits, just that requiring a 50/50 male/female balance in all occupations may not be a realistic goal.

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Starting from scratch...

On the transit front the first day it was open I rode the subway from Vaughan to downtown. That was long overdue. They should run that line parallel to the 400 all the way to Newmarket.


There's no need for that, as we now have more or less all day GO-Train service on the Union-Barrie line. There is a link station with the GO-Train line at theDownsview station on the Spadina line which is brilliant for those further north who wanted to go to mid-town Toronto, say to Yorkdale Mall*

I live a 10 min. walk from the Aurora GO-Train station. I can be at Union Station, from my front door in Aurora in just over 60 min - skipping completely over the traffic mayhem, and bedlam in between. I go downtown for meetings maybe ounce a week. It's so civilized.

*Wynne just proposed better integration and savings for those (like myself) who use the Presto cards

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Steve Fleck @stevefleck | Blog

The great thing about people like you is that you think these things through. Gov't types particularly those who never worked in the private sector (I think that is Wynne) don't see the pitfalls and their implementation sucks. I'm not saying Doug Ford has any private sector talent to speak of either though. Another Liberal fiasco in Ontario was efforts to built a province wide electronic medical record a number of years ago. They didn't have the in house talent to do it so they hired all sorts of consultants. The consultants proceeded to bill all sorts of things as business expenses including massages etc. And then they never produced the system. Something like a billion dollars wasted.

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They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

Why do you hate Ontario?

They won’t win.

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How does Danny Hart sit down with balls that big?

People in Alberta said that too.

Remember Bob Rae? I think he was as shocked as anyone that he won

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They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

Meet Alberta's "Health" minister...

On the bright side the BC NDP/Green coalition is doing a pretty good job of teaching our premier about the value of 'social license'. She's probably going to be another cynical conservative after BC's done with her. Oh well, reality sucks.