Rx for MD pay
There have been recommendations to change our standard method of compensation for medical services (fee for service) for more than 30 years (Provinces, Doctors Need To Defuse Compensation – Jan. 27).
Both the academic literature and special reports to government have emphasized the urgency of introducing alternative models of physician remuneration. Several provinces have done so, but this is not the norm across the country.
It's important for policymakers to realize compensation models are complex instruments – and only one of the levers required for strong and effective management of our health-care system.
Martine Durier-Copp, faculty of management, Dalhousie University; former executive director, N.S. Royal Commission on Health Care
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André Picard notes that "there are more doctors than ever … but access remains poor and waiting lists are a constant problem." I can attest to that: We moved from Toronto to Kingston – a regional medical centre – in 2013, and have yet to find a family doctor here.
New billing numbers for family doctors should be allocated to specific regions of the province on the basis of population.
Until rural areas and smaller centres are equally served (same population per billing number), no new billing numbers should be allocated to Toronto and other overserved regions. To obtain the benefits of this model in a reasonable period of time, existing excess billing numbers in Toronto may need to be cancelled with a suitable notice period.
Greta Wemekamp, Kingston
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Politics of justice
Re Tories Seek Tough Penalties For Killers (Jan. 27): With the homicide rate at its lowest level in decades, this move clearly has nothing to do with justice and everything to do with politics.
Leslie Lavers, Lethbridge, Alta.
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Iraq: Same mission
NDP Leader Tom Mulcair and Liberal Leader Justin Trudeau don't seem to get it: The mission in Iraq has not changed (Canadian Snipers Kill IS Militants – Jan. 27). The people on the ground are supporting the air strikes and providing training. Sometimes that involves on-the-job training out in the field. If they happen to be fired upon, they have the duty and the right to return fire.
Unless there are amphibious craft full of Canadian troops landing on the beaches or Hercules aircraft full of troops setting down on an airfield nearby, the mission has not changed!
Graydon Chretien, Bon Accord, Alta.
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Take your seat?
There is no such thing as a "fair" way to bump a passenger from a seat (Bumping Logic – letters, Jan. 27). Whether a passenger is first or last to arrive at the airport (before cutoff times, of course), if they've paid for a seat, they have a reasonable expectation that a seat will be theirs.
What other industry routinely gets away with selling one widget to two buyers, relying on the greedier of the two to accept a bribe to wait for the next available widget? The only "fair" – and ethical – course of action for any airline is to stop selling seats when a flight is full.
Jim Foster, London, Ont.
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Why not address the bumping issue and the obesity issue with one policy: most obese, first to go. Need to bump six people to get the total plane weight down before takeoff? Remove the six most portly from their seats.
How would airlines know passengers' weights? Weigh not only luggage at check-in, but us, too. Bumping people by their weight is no more or less embarrassing than the humiliating and crazy policy of removing – right in front of everybody – the six people who paid the lowest fare. Honestly! Can't we do better than that for paying customers in our supposedly civilized, courteous country?
Nancy Manning, Chelsea, Que.
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Solution? Density
It makes no sense to blame anti-sprawl policies for the increase in home prices (What's So Smart About Unaffordable Housing ? – Jan. 26). The Pembina report that Konrad Yakabuski references shows that other factors – particularly low mortgage rates – are primarily behind the increase in home prices.
The problem isn't density – density is the solution, not the problem – but that the condos being built are designed for singles and couples, and cities have been unwilling or unable to increase the number of family-sized condo units.
I strongly object to the idea that increased density confers insignificant environmental benefits. According to Statistics Canada's report on greenhouse gas emissions from cars, exactly four major Canadian cities had per capita emissions – from private vehicles – below 1,500 kg per capita: Montreal, Quebec City, Vancouver and Toronto.
The differences that Stats Canada cited between these cities and cities with higher emissions, such as Kingston and Sudbury? Higher population density, the availability and use of public transit, and the average age and efficiency of private vehicles in those cities.
Steven Sherman, Thornhill, Ont.
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Get it done. Now
Re Ottawa To Miss Aid Deadline Set By Thalidomide Survivors (Jan. 26): The pride I felt when our federal government unanimously voted to provide support to thalidomide survivors was tainted upon learning of the missed deadline. If I am feeling demoralized, saddened and so completely disappointed in our government, think of the wounded hearts and trust of these 100 people. Is this the best we can do?
Patricia Bain, Thunder Bay, Ont.
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Storm fizzle
After days of dire warnings, flight cancellations, panic buying, business and school closures and a total shutdown of the Big Apple's subway system, it turns out to be not so much a case of storm and thunder as storm and blunder.
Kevin Riemer, Pointe-Claire, Que.
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Predicting exactly where the heavy snow will fall is a mug's game. Could have been New York, could have been farther north or south. Forecasters tend to warn of the most serious possibility, as it is better to have everyone stuck at home than stuck in snowbanks.
Then there are the media, many of which are based in New York, which is why a snowflake there is worth a snowdrift anywhere else.
Michael Moore, Toronto
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A gift of sidewalk
I, too, used to keep measure of sidewalk space (Man, Slammed – letters, Jan. 26). Then one day, just as I was about to hip check a little old lady, a white dove of peace flew over my head. Now, when the sidewalk is too crowded, I step behind my wife and let the others pass. It's not about competing for public space. It's about freely giving the gift of sidewalk to a stranger. I even share toys now.
Richard Bronstein, Calgary