Death wasn't self-inflicted
Re: Solvent abuse cited in ER death (Aug. 9). Dr. Marc Del Bigio's assertion that Brian Sinclair's death was partly self-inflicted is an outrageous attempt to deflect ultimate responsibility and liability for a malfunctioning component of the Canadian social safety net in realizing that systemic procedural failures were direct contributing factors in this totally preventable death.
The blame-the-victim tactic shows that a damage-control process has been invoked and the health-care system truly requires a comprehensive review with service-delivery personnel having appropriate social, cultural and historically appropriate sensitivity training in dealing with both First Nations and persons with disabilities.
The lens through which Del Bigio based his assumption is based on a myth, which has since been proven to be false, but is still being introduced as evidence to deflect attention and blame from a malfunctioning system to a helpless human being who paid the ultimate price with his life.
One could take the position that his testimony is exactly like blaming an injured passenger in a car accident for injuries sustained through the failings of others.
Giving credence to this presenter and his submission does no justice for Brian Sinclair or any other human beings who will be utilizing health care services in the future.
Grand Chief Murray Clearsky
Southern Chiefs Organization
A four-hour testimony cannot be completely reflected in a brief news item. However, the article in the Free Press by Kevin Rollason, as well as the televised and online print items by the CBC, offer a fair and balanced view of what I said at the inquest into the death of Brian Sinclair.
The death of an individual with chronic and complex medical problems cannot fully be understood by analyzing only the last hours of life. Please note that since the time when my letter was written in 2009, there has been a gradual shift to viewing chronic addiction less as a choice and more as a disease.
The purpose of an inquest is "to determine the cause of death and to make recommendations that would likely prevent deaths in circumstances similar to those that resulted in the death that is the subject of the inquest," it is not to find fault. As a physician, one of my roles is to advocate for health of individuals and society.
As a neuropathologist, I am not in a position to advocate for an individual's health after his or her death. However, I can advocate for similarly affected people in the hope of avoiding future disease and death.
Marc R. Del Bigio
Solving the doctor problem
Re: Doctors are working less for more (Aug. 6). Livio di Matteo raises an important point when he says we must do something about the costs of primary care. The answer is simple, though not easy. Doctors will oppose the change and probably threaten to strike. I say, let them; they can be easily replaced.
The solution is what has come to be called capitation. Under this system GPs are paid an annual stipend of say $600 per patient registered with them. At 2.4 doctors per 1,000 population, evenly distributed, each doctor would have 415 patients. Their annual income would thus be $250,000. This is a reasonable average income, even though it may be much less than some doctors are now receiving. Surgeons and specialists would be on salary, to be negotiated.
The advantages of the system are manifold. The first, and most important, is that the cost of primary care is capped at total of population-X-stipend dollars. Another huge advantage is that there will be an incentive for doctors to promote wellness instead of treating sickness. If all of the patients feel that they are healthy the doctor is getting money for nothing. Under the present system if the patient is cured, the doctor's income disappears, so it is important to have the patient coming back regularly for more prescriptions to assure a regular income for the doctor. This also increases the cost of drugs, as I am convinced that many drugs are prescribed unnecessarily.
Another of the savings is the cost of double-doctoring. One person, in Winnipeg, was found to have visited 57 doctors 143 times in one year. Under capitation, 56 of those doctors would have told him, "I'm sorry, you're not my patient." The other one would have told him, "You're a hypochondriac. Get a life."
There is also the matter of the re-distribution of doctors. There are too many doctors in the cities and not sufficient in the rural areas. With double-doctoring abolished some of those doctors will have to move out into the suburbs.
There are more advantages to the system, but these should be enough to convince most people it is imperative that we make the change right now.
Town's demolition disgraceful
Re: A town goes down, Aug. 8. Pointe du Bois, a community intricately linked to Winnipeg's early history, is demolished to return the area to its "original state."
What a joke and what a sin. Let's not forget the City of Winnipeg's supporting role in this ridiculous drama. It was the city that allowed the town to deteriorate to its present run-down state when they held the owner's keys for most of the 100-year history.
Pointe, as those of us who love the town still call it, was home to hundreds, if not thousands of past and present employees. Many others have had a lifetime relationship with the town through fishing, hunting and the love of the outdoors. Most of us, past employees as well as friends, have asked for decades why the two Hydros (the now defunct Winnipeg as well as provincial utility) would not sell the homes to people who wanted them.
Former employees first and then the public would have been the best and probably the fairest strategy, and would have removed Manitoba Hydro's worry about "being in the business of running a town."
I have supported Hydro for most of my adult life. I spoke of Hydro to friends and family all over the world and bragged about its efficiency and its potential; about our low rates and Manitoba's green energy vs. the filth produced by the oil companies.
Count me on the other side of the ledger now.
Re: Scientist miffed Tory MP takes credit for saving ELA (Aug. 8). Joyce Bateman's actions certainly signify a new low for the Conservatives. First, the party chose to cut funding for the Experimental Lakes Area because the research stemming from the project showed the Tory vision for the environment was truly murkier than Lake Winnipeg.
Secondly, they have the audacity to try and convince the public otherwise.
Bateman should reconsider her party's environmental record on the subject and other issues; I would hope that the residents of Winnipeg South Centre will choose to do the same.