Canadian Diplomat: Caution "flag" on Iranian invasion...needs public support

By Paul Heinbecker, Globe and Mail, November 21, 2011
Paul Heinbecker is a former Canadian ambassador to the UN. He is author of Getting Back in the Game, director of the Laurier Centre for Global Relations and distinguished fellow at the Centre for International Governance Innovation in Waterloo, Ont. This article does not necessarily reflect the views of these institutions
It is not clear whether Tehran intends to cross the nuclear weapons threshold, or merely position themselves to do so relatively quickly at a later time. Either way, the Iranian effort raises potentially grave (albeit differentiated) issues for the international community, including Canada, which joined the United States and Britain on Monday in applying new sanctions against Tehran.

Israeli newspapers have been reporting efforts by Israeli Prime Minister Benjamin Netanyahu and Defence Minister Ehud Barak to muster senior ministers’ support for an attack on Iranian nuclear facilities. These reports have coincided with tests of an Israeli long-range ballistic missile capable of reaching Iran, air-to-air refuelling exercises with the North Atlantic Treaty Organization, and civilian readiness drills in Tel Aviv.
Mr. Barak, who met with Canadian National Defence Minister Peter MacKay last week, told CNN on Sunday that if it isn’t stopped within months, redundant facilities in the Iranian program will render an attack ineffectual. He asserted that a nuclear-armed Iran would use its nuclear umbrella to intimidate Persian Gulf countries and sponsor terror with impunity. He also warned of a Middle Eastern nuclear arms race involving Saudi Arabia, Turkey and Egypt.
The Israeli positioning may be designed to get inside the heads of Iranian and Western leaders. Perhaps it is deadly serious. Either way, U.S. Secretary of Defence Leon Panetta warned publicly against unilateral action during a recent visit to Israel, during which he also reportedly asked – in vain – for a guarantee that Israel would not carry out a unilateral military strike without Washington’s clearance. In Halifax over the weekend, Mr. Panetta warned that a military strike could have severe global economic consequences.
In Israel, cabinet officials and others remain divided. Meir Dagan, the recently retired head of the spy agency Mossad, called an attack against Iran “the stupidest idea I’ve ever heard.”
Indeed, such a war would be no piece of cake, as the invasion of Iraq was misleadingly portrayed. The world is unlikely to just move on after a strike and an Iranian response. Unless an attack is authorized by the United Nations Security Council, a distant prospect at best, it would almost certainly plunge the Middle East deeper into turmoil, roil Western relations with the Muslim world, refuel Islamist extremism, disrupt the Arab awakening, damage the international oil market and weaken the precarious international economy.
Assuming the likely near-term inadequacy of sanctions, the essential question boils down to this: Which is worse, the bomb or the bombing? Relying on post-facto deterrence, as we do with U.S., Russian, British, French, Chinese, Indian, Pakistani, North Korean and (presumed) Israeli weapons? Or attacking Iran to destroy its capability, or at least delay a nuclear breakthrough?
Separately, there is another casus belli developing in Syria, where Bashar al-Assad’s regime has evidently decided to destroy the country’s opposition, killing as many as it takes in the process, using military force against the civilian population. Will the world stand by and let it happen? Should it?
Where does all this leave Canada, with its comparatively small but not inconsequential and quite capable military? On CTV’s Question Period this weekend, Mr. Mackay recalled the centrality of the Security Council to any intervention in Syria. And regarding Iran, he described the military option as “the least preferable.” Last week, Foreign Minister John Baird said Canada “will continue to work with its like-minded allies to take the necessary action for Iran to abandon its nuclear program. … It is not a question of if, but to what extent, we will act in response to this report.” Prime Minister Stephen Harper has repeatedly portrayed Israel as an ally. What is this government, the most pro-Israeli in Canadian history, planning to do?
Major Canadian interests are potentially at risk, including the integrity of the international nuclear non-proliferation regime, respect for international law, the safety of friends and kin in the region, the health of the global economy and the preservation of the public peace at home. Canadians need to engage and come to as common a view as possible on how to protect our interests and project our values in the Middle East before we find ourselves drifting into war. This issue is too important to be left to politicians and politics as usual.
One of the real dangers, from our perspective, in developing a Canadian response to Iran, is the trigger-like mind-and-tongue of the prime minister and his Minister of Foreign Affairs. Success in Libya will only have emboldened them in their pursuit of support for Israel, without due regard to the impending consequences. In a recently published book on the Liberal demise, Peter C. Newman, writes this about Harper:
It (the Liberal Party) never had faced a Conservative leader with the mind and the eyes of an assassin, like Stephen Harper. Wordsmith Newman describes him as being the owner of “the best medieval mind in the Commons.” The writer has studied Canadian leadership since the 1950s, but this PM’s “ideals and goals seemed antithetical to the country I thought I knew.” (From Lawrence Martin, Globe and Mail, November 21, 2011)
What is most distressing is to have Mr. Harper leading a government in such a dangerous world, with so many "hot-spots" and the availability and willingness of rotating coalitions to bring significant military thrust to carrying out what might appear to be limited objectives, as in Libya.
"With the mind and eyes of an assassin," is not the way Canadians want their Prime Minister described, by someone with a long history of watching Canadian political leaders. If Newman's description fits, ever so slightly, (and certainly Harper's performance on the national stage would give an observer little reason to doubt the characterization), then such a 'mind and eyes' will be seriously tempted to engage in what might come to be an invasion of Iran, using Canadian troops, in a conflict the outcomes of which could be disastrous for the world community.
Heinbecker's warning is one that needs to be heeded by Canadian leaders, and that might only happen if cooler minds than the Prime Minister's prevail, and even with Canadian public push-back to the notion of Canadian participation in an invasion of Iran by the Canadian people, the Harper gang is unlikely to be willing to resist their own predilections to join such an attack.

Super-committee fails, as expected...Pledgers hold U.S. hostage

By Ted Barrett, Kate Bolduan DeidreWalsh, from CNN website, November 21 2011                                                                                    
Washington (CNN) -- Members of the congressional "super committee" -- the bipartisan panel tasked with finding at least $1.2 trillion in budget savings over the next decade -- will likely announce Monday that they have failed, according to both Democratic and Republican aides.

"No decisions or agreement has been reached concerning any announcement or how this will end," one senior Democratic aide said. "But, yes, the likely outcome is no agreement will be reached."
Markets dropped as news spread of the panel's apparent failure. The Dow Jones Industrial Average had declined over 300 points by noon Monday.
Legally, a majority of the 12-member committee has until midnight Wednesday to reach an agreement, but any deal needs to be announced for legislative reasons by the end of Monday.
The failure of the committee -- evenly split between six Democrats and six Republicans -- sets in motion an alternative timetable for $1.2 trillion in spending reductions starting in January 2013. Leaders on both sides of the aisle are unhappy with the nature of the fallback plan, which cuts evenly from domestic and defense programs.
The 'Super Committee' Social Security, Medicaid, food stamps, veterans' benefits and other politically sensitive programs are spared the budget ax.
Pressure has already started to build to undo a number of cuts included in the fallback plan, which was a product of last summer's debt-ceiling agreement. Defense Secretary Leon Panetta and key Republicans argue that the military will be undermined by excessive reductions to the Pentagon budget.
Anyone who happened to watch the CBS program, 60 Minutes last evening, will be aware that 279 Republican members of both the House and Senate have signed the "PLEDGE" from the Americans for Tax Reform, the non-profit foundation, thereby committing themselves to blocking any attempt at raising taxes.
All 6 of the Republican members of the super committee have signed the pledge.
Norquist acknowledges that anyone who has signed, and subsequently engages in any vote to raise taxes, will be effectively targetted in the next election, and can be virtually assured of electoral defeat. Neither the names of the donors to the foundation, nor the dollars available to it for its "work" is public, and will be unlikely to become public anytime soon.
Also on 60 Minutes, former Republican Senator from Nebraska, Alan Simpson, co-chair of the Simpson-Bowles Committee in 2010 to make recommendations on deficit reduction and debt reduction, expressed deep disdain for Norquist.
(From the CBS 60 Minutes website, November 21, 2011
Simpson gleefully accepts that he is one of Norquist's Republican rat heads in the Coke bottle. He got there by serving as co-chairman of the National Commission on Fiscal Responsibility, which recommended that some tax increases would be necessary to solve the nation's debt problem. Simpson has no use for Norquist.

Simpson: He may well be the most powerful man in America today. So if that's what he wants, he's got it. You know, he's -- megalomaniac, ego maniac, whatever you want to call him. If that's his goal, he's damn near there. He ought to run for president because that will be his platform: 'No taxes, under any situation, even if your country goes to hell.'
Simpson also wants to know where Norquist and Americans for Tax Reform, with its multimillion dollar budget gets its money.
Simpson: When you get this powerful, and he is, then it's, 'Where do you get your scratch, Grover?' Is it two people? Is it 10 million people? The American people demand to know where you get your money, Grover babe.
Now that we all know, as we suspected all along, that the Super Committee will fail in its task to find and recommend some $1.2 trillion in cuts to the U.S. Budget, and we also know that the Republicans on the committee have all taken the "Norquist PLEDGE," we also know that Norquist's foundation is holding both the signatories and the nation hostage to those pledges.
For example, the Bus tax cuts to the most wealth Americans, an important sticking point for the committee, will, on their own, disappear at the beginning of 2013, shortly after the next presidential election.
Failure to complete its task by the super committee will trigger automatic and equal cuts from the defence budget and the social assistance budgets.
It was the Head of the International Monetary Fund, Christine Lagarde, also on 60 Minutes last evening, who expressed hope that the committee would accomplish its stated goals.
From the CBS 60 Minutes website, November 21, 2011
(Reporter Lara) Logan: And if you look at the U.S., what are you most worried about here?

Lagarde: Political bickering. Certainly I would hope that on a bi-partisan basis both Democrats and Republicans can come to terms in their Supercommittee, about the deficit objectives and the deficit cutting measures and the debt. And there is a degree of certainty that is so much needed for markets.
When the economy, and thereby the people, of the richest and most powerful nation on earth are both held hostage by the pre-adolescent, pledge-signing, ideologues known as the Tea Party, while the whole world watches, and their "guru" Norquist smugly (and extremely arrogantly) applauds from the sidelines, as "the most powerful man in America," in the words used by 60 Minutes' Steve Croft, then the whole world knows that the U.S. political system has not only ground to a halt, it has also blown four tires, the transmission and the engine. It is hardly worth sending the tow-truck to haul it into the scrap-yard.
During the campaign to remove the dictator from Libya, the U.S. "lead from behind"....
On the world stage, regarding the current debt/deficit crisis, the U.S. is no longer leading from anywhere.
Nor is the U.S. following in the more responsible and mature steps of both Greece and Italy, under the supervision of the I.M.F.
When investors sell off American stocks, and bond dealers raise the interest rates on U.S. bonds, and make the repayment of U.S. debt and deficit out of reach for the U.S. government, it will be the Tea Party and the Republican Party on whose shoulders will lie total responsibility, no matter how hard they attempt to paint the villain as the Democrats.
The hope, for the rest of the world, is that the U.S. voter can see past the mirage of deceit painted on the canvas of political discourse by those same Republicans, and decimate the Tea Party and the Republican candidate(s) for President, and send some moderate from both parties back to Washington to restore confidence and trust in the American government and its word.

Robert Redford: Reason and Sanity on Environmental treats of pipelines

By Robert Redford, Globe and Mail, November 21, 2011
Working in Vancouver for the past several months has allowed me to spend fall in one of the most spectacular cities in the world, amid the natural splendour and wilderness wonder of British Columbia.

It’s been a reminder to me of the close partnership Canadians and Americans have forged as neighbours, bound by geography, history and culture reaching back to our national beginnings. Over the generations, these bonds of common experience and identity have combined to create something even more important: the values we share around the need to stand up for the lands we treasure and love.
Today, together, we need to stand up once more, because the lands we treasure and love are imperilled by a threat we must meet as one.

In Alberta’s great boreal forest, one of the last truly wild places on Earth, tar-sands producers have turned an area the size of Chicago into an industrial wasteland and international disgrace.
Where spruce and fir and birch trees once rose and waters ran fresh and clean, tar-sands production has left a lifeless scar visible from outer space, a vast repository of enduring pollution that threatens fish, birds, animals, public health and an entire way of life for native people.
And for every single barrel of oil produced, at least two tons of tar sands are excavated and tapped, a processing nightmare that generates three times more carbon pollution than is released to produce conventional North American domestic crude.
Not only is tar-sands production laying waste to Canada’s forests, polluting waterways, air and land, but the resulting carbon emissions are threatening Canada’s long-time commitment to reducing the greenhouse gases that are warming our planet and threatening us all.
This is unsustainable. It doesn’t make any sense. It’s another shameful example, frankly, of the oil industry doing whatever it takes to make a profit and leaving it for the rest of us to bear the costs and put up with the mess.
I want to be very clear that I’m not pointing a finger at the people of Canada; neither is any American I know. We’re all in this together, and that’s the only way we’ll turn it around. We need to stand up, Canadians and Americans as one, to draw the line at tar sands.
The United States is the largest consumer of oil in the world. Americans are a big part of what’s driving this scourge. That means we need to do more to reduce our demand.
Our oil consumption is down about 9 per cent since 2005. That’s a good start, but we need to do more. We’re pushing for cars that get better gas mileage, more efficient workplaces and homes. We’re investing in wind, solar and other forms of renewable energy. And we’re developing communities that give us more choice in how we live, shop and go to work.
Big Oil is fighting us every step of the way. In Washington alone, the oil and gas industry has spent more than $400-million over just the past three years lobbying our elected officials.
They’ve put enormous pressure on President Barack Obama to support tar-sands production by approving the Keystone XL pipeline, which would carry tar-sands crude from Alberta to refineries and ports along the Gulf of Mexico.
Instead of caving in to the lobbyists, Mr. Obama stood up and put on the brakes. He wants to make sure his administration takes the time for a thorough review. Those of us who care about our future are using that time to let him know this is a bad idea that needs to be stopped.
The same is true, by the way, of the Northern Gateway pipeline being proposed to move Alberta tar sands crude to Canada’s west coast for export by tanker. Crossing the territories of more than 50 first nations groups, slicing through rivers and streams that form one of the most important salmon habitats in the world and putting at risk the coastal ecosystem of British Columbia? Americans don’t want to see that happen any more than Canadians do, and we’ll stand by you to fight it.
“O Canada, our home and native land,” Canadians sing in the national anthem. “The True North strong and free!” Like so many other Americans, I’ve looked northward much of my life and found inspiration here.
We’ve found it in the wealth of creativity and talent showcased each year at the Toronto International Film Festival, the steadfast commitment of a devoted ally and the political conscience of a people determined above all else to honour and defend perhaps the richest storehouse of natural resources of any country in the world.
Now we’re looking to Canada once again, and searching for True North.
We need Canadians everywhere to join us in this fight. We need to call on the history and values we share and stand up, Canadians and Americans as one. We need to draw the line at tar sands. We need to reject the Keystone XL.
During four decades of environmental advocacy, actor and filmmaker Robert Redford has received numerous honours, including the United Nations Global 500 award.

Endorsements for Occupy Movement: Kristof, Spence, Mosco, church officials and web

By Nicholas Kristof, New York Times, November 19, 2011
You have to wonder: Could Mayor Michael Bloomberg and police chiefs around the country be secretly backing the Occupy Wall Street movement?

The Occupy protests might have died in infancy if a senior police official had not pepper-sprayed young women on video. Harsh police measures in other cities, including a clash in Oakland that put a veteran in intensive care and the pepper-spraying of an 84-year-old woman in Seattle, built popular support.
Just in the last few days, Bloomberg — who in other respects has been an excellent mayor — rescued the movement from one of its biggest conundrums. It was stuck in a squalid encampment in Manhattan’s Zuccotti Park: antagonizing local residents, scaring off would-be supporters, and facing months of debilitating snow and rain. Then the mayor helped save the demonstrators by clearing them out, thus solving their real estate problem and re-establishing their narrative of billionaires bullying the disenfranchised. Thanks to the mayor, the protests grew bigger than ever.
I watched in downtown Manhattan last week as the police moved in to drag off protesters — and several credentialed journalists — and the action seemed wildly over the top. Sure, the mayor had legitimate concerns about sanitation and safety, but have you looked around New York City? Many locations aren’t so clean and safe, but there usually aren’t hundreds of officers in riot gear showing up in the middle of the night to address the problem.
Yet in a larger sense, the furor over the eviction of protesters in New York, Oakland, Portland and other cities is a sideshow. Occupy Wall Street isn’t about real estate, and its signal achievement was not assembling shivering sleepers in a park.
The high ground that the protesters seized is not an archipelago of parks in America, but the national agenda. The movement has planted economic inequality on the nation’s consciousness, and it will be difficult for any mayor or police force to dislodge it.
A reporter for Politico found that use of the words “income inequality” quintupled in a news database after the Occupy protests began. That’s a significant achievement, for this is an issue that goes to our country’s values and our opportunities for growth — and yet we in the news business have rarely given it the attention it deserves.
The statistic that takes my breath away is this: The top 1 percent of Americans possess a greater net worth than the entire bottom 90 percent, according to an analysis by the Economic Policy Institute.
A new study by Michael I. Norton of Harvard Business School and Dan Ariely of Duke University polled Americans about what wealth distribution would be optimal. People across the board thought that the richest 20 percent of Americans should control about one-third of the nation’s wealth, and the poorest 20 percent about one-tenth.
In fact, the richest 20 percent of Americans own more than 80 percent of the country’s wealth. And the poorest 20 percent own one-tenth of 1 percent.
It would be easier to accept this gulf between the haves and the have-nots if it could be spanned by intelligence and hard work. Sometimes it can. But over all, such upward mobility in the United States seems more constrained than in the supposed class societies of Europe.
Research by the Economic Mobility Project, which explores accessibility to the American dream, suggests that the United States provides less intergenerational mobility than most other industrialized nations do. That’s not only because of tax policy, which is what liberals focus on. Perhaps even more important are educational investments, like early childhood education, to try to even the playing field. We can’t solve inequality unless we give poor and working-class kids better educational opportunities.
The Occupy movement is also right that one of the drivers of inequality (among many) is the money game in politics. Michael Spence, a Nobel Prize-winning economist who shares a concern about rising inequality, told me that we’ve seen “an evolution from one propertied man, one vote; to one man, one vote; to one person, one vote; trending to one dollar, one vote.”
James M. Stone, former chairman of the Commodity Futures Trading Commission, said in a recent speech that many members of Congress knew that banks needed to be more tightly regulated, perhaps broken into smaller pieces.
“So why was this not done?” he asked. “One obvious piece of the answer is that both political parties rely heavily on campaign contributions from the financial sector.”
The solution to these inequities and injustices is not so much setting up tents at bits of real estate here or there, but a relentless focus on the costs of inequality. So as we move into an election year, I’m hoping that the movement will continue to morph into: Occupy the Agenda.
In Kingston, Ontario, the city and organizers of the Occupy Movement reached an early agreement that they could remain in the highly visible Confederation Park on the city's waterfront for the winter, and would move to a less visible site come Spring 2012. This agreement may be a model of both civility and maturity for the movement; certainly it is not the conventional treatment of a "two-months" leash on the Occupiers in cities like New York, Portland, Oakland, Toronto,Vancouver, Victoria, Edmonton, London UK, where police have moved in to remove the tents, the sleeping bags and hopefully, (from the city's viewpoint) the people.
Also in Kingston this week, Emeritus Professor of Sociology, whose research and scholarship focuses on the relationship between media and political culture, Vincent Mosco, called the movement "the most important movement for social change in the last two generations" and also urged that it be permitted to "protest" as the central required ingredient of a healthy democracy.
The Canadian media and the political establishment have paid the movement barely a moment's notice; they have criticized the lack of leadership, the lack of specific goals, the amorphous nature of the movement, to denigrate its relevance and significance.
The fact that the Toronto Occupy Movement marched to City Hall yesterday in a protest entitled "Evict Ford (Rob Ford is the Mayor of Toronto) because of his role in invoking police action to remove the protesters from the city-owned property next to St. James Cathedral, an Anglican church whose leaders are reported to be in some sympathy with the protest movement, and officials have been reported to have urged the protesters to stay on church property.
A personal footnote, from one of the signs among protesters, (name of city unknown)
"You cannot evict an idea!"....a fact and attitude with which we concur wholeheartedly!

Peter C. Newman: Liberal regional fiefdoms destroy campaign...along with $23 m

In this week's Macleans magazine, Peter. C. Newman writes that the Liberal Party had a war-chest of some $23 million on the date the election writ was issued, for the vote on May 2, 2011. Additionally, Newman writes, $5 million was donated in small contributions, more than at any time in recent memory.
However, according to Newman, the Regional desks of the party demanded that money as their "share" of the budget leaving literally nothing in the bank for the party to counter the negative advertising blitz directed at discrediting Micheal Ignatieff's leadership..."because he came back to Canada only for his own personal self-interest to be Prime Minister, and is not here for you."
Furthermore, according to Newman, no polling was done in Ignatieff's riding of Etobicoke-Lakeshore on the outskirts of Toronto, and very little campaigning was done there to assure his victory, something clearly within reach, given an inexperienced candidate for the Conservatives. According to the same piece, (excerpted from a forthcoming book by Newman), Ignaiteff knew he and his party were going down to defeat at least two weeks prior to voting day, and that Ignatieff hoped the party would end up with 50 seats, not the 34 it eventually won.
As for the rumours that Ignatieff would not and did not prepare for the televised debates, Newman counters that rumour with evidence of considerable preparation on Ignatieff's part, without overcoming a perceived inability to "connect" with the audience.
If Newman's story is factually verified, then the Liberal Party owes a public apology to Mr. Ignatieff, immediately, unreservedly and in all major news outlets in the country. This debacle is another example of personal greed, personal fiefdoms coming before the "good of both the party and the country" and, as one of those 'small contributors' in the $5 million, (for the first time in my six decades) I am both ashamed and extremely angry that there is/was not sufficient control at the top, in both party executive and the party leader's office to resist the demands of the "fiefdoms" in the "regions" and at least neutralize the toxicity of the Harper personal attack ads against Ignatieff.
Like thousands of others contemplating the future of the party, I will withhold a decision on whether to renew my association with the party, pending the outcomes of the Convention in January. Meanwhile, I will neither support nor counsel any Liberal party activity, nor will I invite anyone to consider membership.
The party, at its core wreaks of a stench that can only be removed with a complete housecleaning, a public apology, a transparent convention free of backroom manipulations and control and  a list of policy proposals, including proposals to research select subjects prior to formulating policy on those files and a road map on how it proposes to move forward assuring all Canadians that no additional "lambs to the slaughter" will be the epitaph of the currently fast-fading Liberal heritage.

Economist: No to two-tier health care...base doctor's pay on quality of care

By Karen Howlett, Globe and Mail, November 17, 2011
Canada should remain committed to publicly funded health care, and not open the door to two-tier medicine, says a new report by a top economist.

Governments can improve efficiencies in the system, including changing the way doctors are compensated, without allowing patients to pay for some services, Don Drummond, former chief economist at Toronto-Dominion Bank said in the report released on Thursday.
“A great deal can be done to improve efficiency in the system before privatization is considered,” Mr. Drummond says in the report prepared for the C.D. Howe Institute. “It seems best to simply leave this issue aside for the moment.”
The report, titled Therapy or Surgery? A Prescription for Canada’s Health System, amounts to a staunch defence of Canada’s public health-care system that guarantees universal coverage for many services, including hospital care and prescription drugs for the elderly.
It will likely provide a road map for reforms to health care in Canada’s most populous province. The economist is conducting a review of all program spending in Ontario.
Mr. Drummond’s report for the Ontario government will not be released until early next year. But he says the government won’t meet its commitment to erase the province’s deficit by 2018 unless it caps annual growth in spending on health care, education and other programs at 1 per cent for the next six years. The province is facing a projected deficit of $16-billion this year.
Reducing spending will not be easy. Canadians spent $192-billion on health care in 2010, accounting for just under 12 per cent of the country’s economic output or GDP, the report says. In Ontario alone, government spending on health care has climbed an average of 7.6 per cent a year over the past decade.
The grim reality is that provincial revenues will not grow fast enough to offset rising health-care costs, the report says. The report is the latest foray into public policy by Mr. Drummond, one of Canada’s most influential advisers to governments. In a report last year, he warned that left unchecked, health-care costs are set to reach between 70 to 80 per cent of total program spending by 2030, up from just over 40 per cent today.
In the earlier report, Mr. Drummond and TD Bank economist Derek Burleton proposed that the provinces bill affluent seniors for their drugs and pay doctors based on the quality and cost-effectiveness of their care.
Reporting to the right wing C.D. Howe Institute recommending improved efficiencies and leaving privatization aside is like telling your local policeman he really doesn't need a taser in order to do his work effectively; it is a form of heresy to the institute.
Nevertheless, Mr. Drummond's proposals for basing doctors' pay on the "quality and cost-effectiveness of their care" has considerable merit.
In other posts on this site, we have argued that the National Health Act runs on a premise of sickness, paying doctors to "treat" sickness but not to prevent illness. Waiting until many conditions become emergencies, and thereby failing to intervene with a little more muscle as the "health care monitor and coach" of the patient renders the health care system somewhat handicapped, not to mention far more costly than it might otherwise be.
Doctors do, indeed, have considerable potential clout in their recommendations to patients about issues like lifestyle, physical exercise, diet and occupational health and safety. We do not have to wait until a convergence of influences creates a crisis before putting some pressure on the doctor to exercise diplomatic and precautionary negotiating skills in order to effect changes in a person's habits to generate both a healthier patient and a more cost-effective and efficient health care system.
If the doctors' pay were to be measured by "outcomes" to which both the College of Physicians and Surgeons and the health care practitioners could and would agree, rather than a mere monitoring of "wait times," and office or clinic visits, or surgical operations, not only would the expertise of the doctor be more fully deployed potentially enhancing the work-satisfaction of the doctor, and the patient health potentially enhanced, but the drain on the system would be reduced.
The only people who are advocating for privatization of the Canadian health care system are those ideologically entrenched in a capitalist model for the provision of all services, and who thereby turn a blind eye to the merits of universality. Canada has never fallen prey to the dictates of those who call our system a "nanny state" because they believe only the pursuit of rugged individualism without government intervention will generate a society worthy of their support. We know that we have one of the best systems in the world, albeit with some overlaps and some waste and some inefficiencies, all of which can be reduced, if not eliminated, through more discipline and more teeth and muscle in the monitoring systems.
 If we can and have designed and deployed software that monitors the wait times between the initial consult and the date of a surgical procedure, to satisfy the political need for accountability, we can certainly design and deploy software that monitors changes in a patient's specific blood pressure, weight gain or loss, exercise regime and a host of other impacting variables for a doctor's practice to generate a percentage of his/her pay.
Prevention cannot and will not remove the final outcome of death; however, it can and will go a long way to assuring both a higher quality of life and enhanced remuneration for those whose oath "not to do harm" could be reframed to "do all that is possible to prevent the onset of long-term and costly illness".
The idea of billing affluent seniors for their drugs, while worthy of implementation is a far less significant change, but likely more easily implemented, than a reversal of the premise of which doctor remuneration is calculated.
Nevertheless, with medical schools transforming their curricula for medical students into a far more "team-based" approach for diagnosis and treatment plan design, there is no reason that such a change will not also lead to improved consideration of all variables in the patient's life and all variables in a patient's treatment. No single person will be 'holding the bag' for the  medical treatment of any patient, and the effectiveness of each team could be monitored both for research purposes and for calculating their pay.
Let's hold up the responsible reports, like the Drummond report, to the light of day and public debate, as a way of staving off the tsunami of ideological rhetoric that seeks to privatize the system.

Political incest: before we destroy it, we must name it!

Am I  the only one thinking about the two new government leaders in Italy and in Greece, from the perspective that:
1) the new Italian leader is an economist
2) the new Greek leader is a banker from the European Central Bank....
Was I sleeping over the last two years, or am I mistaken that it was economists and bankers (and hedge fund managers) who actually got us into this mess?
Why would those countries approve leaders with the qualifications of the "band" that got us into this mess?
Isn't that just like President Obama appointing Timothy Geithner as his Secretary of the Treasury, the same man who, immediately prior to his apointment, was working on Wall Street?
With Bush's Secretary of the Treasury coming from Wall Street, and Obama's coming from Wall Street, does it not harbour ill for high-level support for regulation of the financial services sector of the eonomy? Does the pattern not also demonstrate a kind of incestuous relationship between government and Wall Street? And the pattern could be repeating itself in Europe.
There is an operating principle in govering that change is best in an evolutionary mode whenever and wherever possible. Consequently, what's past is always prologue to the present and to the future. That includes both people and policies. Those who are often considered most "capable" are those with the most experience in the specific sector, culture and professional group, bringing the useful and inevitable "list of contacts" necessary to deploy the instant network of "cronies" (or less cynically, "associates") when once in office.
The financial markets hate (HATE!) surprises and they react to surprises more feverishly than a neurotic Wheaton terrier to an impending thunder storm. And, from the outside, it would appear that the people who control the financial markets are now in control of the potential treatment of the debt/deficit crisis in both Greece and Italy.
However, the appearance of incest between the bankers/economists/fund managers and governments is rife with  the appearance and reality of cronyism, and the root causes of the nearly bottomless tumble of the markets in 2008-9.
However, there are times when those "on the inside" need to be replaced by "outsiders" for the sake of the public interest, and that kind of political courage, to make such a dramatic change effectively, apparently requires more "hutzpa" than we have seen from political leaders in the recent past, in all western countries.
I think it might be time, if not long past due, for those in government to sever their suckling ties to the teats of the financial services sector, through campaign finance reform, through legislation that mandates such a separation, through all measures available to them, in order that "trust," that immeasureable quality so necessary to a healthy functioning economic system, regardless of its text-book name, might be restored.
Or am I totally mistaken once again, thinking out loud that they would put the goal of the attaintment of trust ahead of the priority they assign to their own bulging portfolios and profits and bonuses? How naive must I be to think that!