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Medicare mess

Roy Romanow, the former Saskatchewan premier who wrote a royal commission report on health-care reform in 2002, bemoans the prospect that, under the new federal health-care policy, rich provinces will be able to experiment with new health services that poorer provinces can't afford (Provinces To Drive Health Reform – front page, Dec. 21). But isn't this how new technology gets introduced?

If we'd forbidden entrepreneurs from manufacturing telephones, cars, TVs and computers until they could make them cheaply enough for even the poorest households to afford, none of us would have these things today. The rich pay for the experimental models, and the poor benefit soon afterward as envy kicks in, demand accelerates, competitive products emerge, and economies of scale drive down prices.

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So what if the poor have to wait a little longer than the rich? Isn't this better than never obtaining these innovations at all?

Karen Selick, Belleville, Ont.


This sleight of hand by the Conservatives will mean, as Jeffrey Simpson rightly notes (Ottawa's Offer And The Provinces' Challenge – Dec. 21), they'll no longer have to spend time or political capital on health-care delivery.

The federal government has an ethical obligation to set standards that will help ensure uniform health-care delivery across the country, to promote synergy through provincial co-operation and to procure goods, services and technologies that have the potential to contain costs.

Linking provincial GDP to transfer payments will only encourage the development of a two-tier system in provinces where this ideology is more likely to be accepted. Once again, there's been a failure of government to act in the public interest.

Dennis Casaccio, Clementsport, N.S.

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Your editorial In Search Of A Health-Care Fix (Dec. 21) gives the federal announcement on health-care transfers two thumbs up. One thumbs up was for lowering the already historically average federal contribution to health care, the other for limiting the federal role to banker.

You were right in noting that much remains to be done on delivering on promises in the last accord, but it's because the federal government walked away from the tables set up to implement a national pharmaceutical strategy and to transfer knowledge to foster a race to the top.

Provinces can't contain cost drivers and ensure comparability of services on their own.

Linda Silas, president, Canadian Federation of Nurses Unions, Ottawa


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Can Community Care Ease Toll On Hospitals (Dec. 21)? Yes, so long as we heed the lessons from our ongoing Canadian pastime to devolve, divest and download health care. Regardless of intent, the message to community agencies that care for the elderly always seems to be "do more with less." Sustainable community care requires greater attention to how these agencies are already meeting this challenge. All we need to do is ask them.

Mark Skinner, Peterborough, Ont.


In your article Efficiency Seen As More Critical Than Funds (Dec. 21), you noted that one radiologist stapled a report 17 times to hide the results until the patient saw his family doctor. Having worked in private clinics and hospitals for more than 30 years as a medical imager, the reason for staples and sealed envelopes is that receptionists and technicians aren't permitted to discuss the contents of a report with patients.

Giving a patient his report right away in a non-emergency is a courtesy, but the imaging department can't delay the treatment of the next patient while explanations are given for medical terms such as "dolichocephalic" or "isoechoic."

Izabella Cresswell-Jones, Toronto


Your editorial on doctoring (Access Should Match Privileges – Dec. 19) explains why none of my kids are interested in following in my footsteps. Thanks.

David Brook, MD, Victoria

Table for one? Yesss!

Re Table For One? (letter, Dec. 21): Being on the road, I often eat alone, sort of. I bring a book. Good food, a nice wine, and a story – my kind of evening.

Ross Crompton, Mississauga, Ont.

Forget a Baluchi split

M. Chris Mason's rationale to redraw Pakistan's map is likely to create more problems than it may ever resolve (The Pakistan Solution: Redraw The Map – Dec. 21).

The Baluchis in Baluchistan have genuine grievances against Pakistan's establishment. While doing research in Pakistan in May, I was approached by several Baluchi human-rights activists alarmed by state-sponsored violence against them. But separating Baluchistan won't resolve the economic problems of the province, which is significantly deficient in human capital and relies on the rest of the country.

The Baluchis, Pashtuns and Hazaras are the province's major ethnic groups, and Pashtuns and Hazaras don't share yearnings for independence. So any foreign intervention to separate Baluchistan would result in a civil war.

Furthermore, the Pashtuns in Baluchistan and the Chinese sponsors of the new port at Gwadar would never permit the use of their territory or infrastructure to be used by NATO to attack Pashtuns in northern Pakistan. The Chinese are wary of NATO's designs in the region, and the Pashtun tribes of Baluchistan hold centuries-old bonds with their fellow Pashtun tribesmen in Waziristan and beyond.

Murtaza Haider, Toronto

Israel at work

Mike Fegelman, of HonestReporting Canada, may have a point when he says the Israelis should be skeptical of Hamas's renouncement of violence as its primary option (Hamas At Work – letter, Dec. 21). But, at the same time, the Israelis should try to avoid actions that will further humiliate Palestinians and result in more violence on both sides.

One of Israel's most egregious actions is the continued expansion of settlements on Israeli-occupied Palestinian lands. Perhaps HonestReporting should look into this.

Richard McFarlane, Edmonton

Rob Ford at work

Re Affable Mayor Pulls Few Punches (Dec. 21): The four words that define Toronto Mayor Rob Ford's year in office are contained in his response to the $65-million cost of cancelling Transit City: "I have no idea …"

Michael Hume, Toronto

Christmas wonder

In our literary tradition, particularly with Charles Dickens, Christmas is a setting where class disparity and poverty are emphasized, then resolved with the spirit of kindness and giving, sometimes in a miraculous revelation.

So here's my question: Would Canadians vote differently if an election were held during Christmas? Would Canadians focus on Attawapiskat, the Occupy movements, unemployment or funding shortfalls? Would all that make a difference?

Peter Lenko, Langley, B.C.


The letter writer who believes Io Saturnalia has too many syllables as a seasonal greeting (Joy To The World? – Dec. 21) can rest assured the texting crowd would soon reduce it to ISat and hmbg.

Geoffrey Pierpoint, Toronto

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