Recognizing community demographics in hospital funding seems a positive step.
Rewarding better-performing hospitals sounds good in theory but will lead to more game-playing and sleight-of-hand by hospital administrations (Ontario To Impose Patient-Driven Hospital Pay – March 19).
To reduce ER wait times, some hospitals created “holding areas,” into which to move patients for whom they have no beds. Voila, shorter ER wait times. We should not reward hospitals and their CEOs for such behaviour.
Reducing wait times for high-profile or “measured” surgeries merely requires reallocating resources and increasing the wait times for other procedures, creating no net benefit to patients. Under the new funding plan, hospitals will be rewarded for discharging patients “quicker and sicker,” as the measure of patient outcomes ends at the hospital door.
Recent hospital closures and consolidations of specialized services into fewer sites resulted in increased waiting time for ambulances, increased travel time in ambulances and increased waiting time at hospitals before patients are transferred into hospital care. These times are crucial to outcomes for patients who require immediate care by an emergency physician – for example, when prompt administration of clot-busting drugs is required to treat stroke – but only the off-loading time at hospitals is counted in the funding equation.
Marie Jacobs, Burlington, Ont.
The move to case- and needs-based funding for hospitals is laudable, but the biggest challenge facing health care will be ensuring a sufficient supply of community services to prevent hospital admissions and readmissions. Only 6 per cent of Ontario’s health spending goes to community health, only 1.31 per cent to community mental health. We spend up to $12,000 for a five-to-10 day hospital stay for someone experiencing serious mental illness, when the same amount would buy two years of support in the community and lower hospital admissions by over 50 per cent.
Steve Lurie, executive director, Canadian Mental Health Association, Toronto Branch
I’m quite vexed by this continual blinders-on focus of blame on young participants in riots with no thought to the responsibility that should be expected of parents (Social Media And The Rush To Single Out London’s Rioters – March 19). St. Patrick’s Day has become more focused on how much green beer one can drink rather than the proud tradition that encapsulates Irish heritage, a perfect storm of youthful ignorance and alcohol marketing at its worst. It’s time for parents to take responsibility for control of their children and provide the guidance and nurturing that the photos from London so painfully call out for.
Daniel Kowbell, Mississauga
This was a case of drunken buffoonery mixed with mindless mob mentality. Calling this asinine behaviour “civil disobedience” sugarcoats it. Civil disobedience is a legitimate way of expressing dissatisfaction with the status quo in an attempt to make clearly defined change. The London riot was not civil disobedience, it was a clear example of idiocy.
Lex Neziol, Simcoe, Ont.
Fit to fly?
I read with disappointment that Air Canada is asking the Canada Industrial Relations Board to declare that the Air Canada Pilots Association authorized strike activity (Air Canada Duels With Pilots – March 19). I’m concerned because I would have offered the same advice that Captain Jean-Marc Bélanger did in his internal newsletter to the association’s members. If you are not fit to fly, don’t fly – which means, don’t show up for work.
These are stressful times for every pilot in the airline. Pilots are experts at compartmentalizing their lives. In day-to-day situations, a pilot working under high levels of personal stress will exhibit few outward signs and will accomplish the flight while committing perhaps only a few minor errors. In an emergency situation, however, those hidden stressors can be debilitating, leading to catastrophe.
Air Canada is safety conscious. Pity it does not see the stressful workplace it created for the pilots and advise them to do a self-evaluation before coming to work every day. Now, let’s reduce the stress level even more by fining them $100,000 per day. Madness.
Daniel Slunder, national chairman, Canadian Federal Pilots Association
Cardinal Keith O’Brien (A Cardinal Confusion – editorial, March 19) is correct that Article 16 of the Universal Declaration of Human Rights (UDHR) limits marriage to opposite-sex couples. The Globe’s view that Article 16 is open to “broader interpretation” to include same-sex couples is wrong.
The reasons are twofold: a general rule of statutory interpretation, namely, that when different language is used in such a document the intention is for it to mean something different; allowing the editors’ contention (which I would challenge) that Article 16 “is not so clear” means that Article 16 must be interpreted in the context of the document as a whole.
None of the other UDHR articles setting out human rights uses the wording “men and women” to articulate the right. Without exception, they speak of “all,” “everyone” or “no one.” For example, “all human beings are born free and equal in dignity and rights.” Consequently, in expressly conferring the “the right to marry and to found a family” on “men and women,” rather than “everyone” or “all,” the drafters of the UDHR intended that the right extended only to opposite sex partners.
Contrary to your argument that the plural nouns “men and women,” rather than a man and a woman, “allows for a broader interpretation” of the right, the plural form was probably chosen to accommodate cultures and religions that allow polygamy.
Margaret Somerville, McGill Centre for Medicine, Ethics and Law
The cardinal’s confusion has confused The Globe. The first rule in interpreting such texts is that you do not interpret them, but simply apply them. Interpretation comes if there is some difficulty in applying a text. There is none here.
The passage is “due to religion” not “due to their religion.” The fewer words used in such texts, the broader the application. Gertrude Stein said of Oakland, Calif.: “There’s no “there” there.” Here, there’s no “their” there.
The attack on marriage between people of the same sex is due to religion. And the whole argument is oxymoronic.
Tony Butler, Montreal
Last year, we lost a dear friend (To Go Gently Into That Good Night – March 17). Norm was a clown – seriously, he went to clown school. Thankfully, he was fortunate enough to get a bed at Hospice Cornwall. What an incredible facility, what an incredible staff. I told many of them I could not fathom the care and dedication they showed. When the end came, the staff allowed us to sit and talk and laugh and cry. When they took Norm out, they asked if we wanted music. I will never listen to Time in a Bottle the same way again.
Hospices save money and beds, provide end of life compassion and dignity but can’t get funding. What are we waiting for? Let’s move forward with this.
Mike Galt, Cornwall, Ont.