Doctor and Nurse Shortages...

The Doctor and Nurse shortage in Ontario has been well documented for some time now.

I feel there are two main issues at the root of this problem. The first being we simply are not educating and training enough people for these positions. The second being the large number of graduates who move to other countries to pursue more lucrative practices. (There is a third factor to this shortage and that is not having enough graduates who want to practice in rural Ontario, which I will also address).


The first part of that problem has more to do with the willingness of the universities and colleges to increase enrollment for medical programs. From there my proposed solution should easily be able to fill them with well qualified candidates.

One of the main road blocks in becoming a doctor, and a nurse to a lesser extent, is the cost involved. It is usually takes what, about 7 years to become a doctor? Unless you are getting it paid for by someone, who really wants to go to school for that length of time only to have a debt load the size of a small country? So right now I think it is fair to say that most doctors probably come from upper middle-class or affluent families. You need to find a way to open up that field to absolutely anyone who is both qualified and interested without turning it into an unreasonable financial burden.

What I propose is to start offering a medical education contract program. Basically this is how it works:
- Everyone who reaches the predetermined minimum grade requirements is eligible.
- All tuition fees and residence costs are covered.
- Doctor programs would require a 10 year practice commitment within Ontario
- Nurse programs may only require 4-5 year work commitments within Ontario
- During the contract periods, their pay would be slightly reduced to help recoup some of the education fees (but certainly nowhere near 100% cost recovery). For a doctor maybe $2500 less a year, and a nurse $1000 less a year. (To be determined upon further investigation)

So basically what we would be doing is saying we will completely pay for you to become a doctor or Nurse in Ontario if you agree to practice here for 10 years (4 or 5 for a nurse) after you have completed your schooling at a slightly reduced salary.

This would serve a couple purposes. First you would start to tap those students who have the desire and the grades to become doctors or nurses but simply would not otherwise be able to afford it. Secondly, since you require them to practice here for 10 years, they would be setting up shop somewhere for that length of time and the likelihood that they would simply up and leave after being established for that length of time greatly decreases. Also, since making it more affordable would probably attract more students from rural areas to enroll, it would stand to reason that they would, with a greater frequency, return to their rural communities to set up practices where they grew up.

Now I know what you are thinking; What happens if someone agrees to this initially, and then wants out 2 or 3 years into their contract to go elsewhere? Well you would have certain out/penalty clauses built into the program. The main one being that if you wish to either drop out of school or quite before the 10 years is up, you would simply be responsible for the entire cost of your education. This would make it quite prohibitive cost wise to cut out on the program. You may even wish to include a penalty clause on top of the education reimbursement fee within the first half of the contract.

Now I am not saying that you would run all of your medical programs this way, if someone still wanted to pay for their own education using current methods and have the freedom to practice where they wanted, and earn a full wage when they were finished, by all means, let them do so. I would simply put forth that this would be a good way to entice new qualified applicants into the medical field who would have otherwise found the barriers to be unmanageable. Of course this is all predicated on the Universities willingness and ability to handle an influx of new students.

The Auto Insurance Conundrum

Imagine this for a moment.... someone approaches you and asks if you would like to start a business, they tell you that everyone who owns a car will need it and the marketplace almost guarentees a profit. What's the catch you say? It's the law that people have it!!

That in a nutshell is Liability Auto Insurance coverage in Ontario. First the government of Ontario legislates that you must buy this coverage and then they open it up to the "free" market for pricing and deployment. That has trouble written all over it.

Here is my Reform proposal:

The Province provides the mandatory amount of Liability Insurance for all licensed drivers.

First some facts:

• 15,549,879,000 Litres of Gasoline used in Ontario (2003)
  
  
• 4,943,297,000 Litres of Diesel used in Ontario (2003)
  
  
• Therefore, for every penny of tax levied on the sale of these fuels, $200 million would be generated.
  
  
• Sample : The annual cost to a person consuming an average of 60 litres of fuel per week would amount to $156. (Based on a 5 cent tax.)

The Basic Logistics of the Plan:

• Levy a per litre fuel insurance tax/surcharge on all commercial gas sales.
  
  
• The coverage would be administered and monitored via current valid drivers licenses.
  (A Valid Drivers License = Coverage)

Benefits of the Proposal:

1. Unavoidable:
• You Drive ---> You Buy Gas ---> You Contribute to the Insurance Fund
• If you drive without a Valid Driver's License, you still contribute to the insurance fund even though you are not covered.
  
  
2. Usage Based:
• The more you drive ---> The more gas you use ---> The more you contribute
• You can own a vehicle, and if you choose not to drive it for a week, a month, a year or whatever, you aren't needlessly paying for Liability coverage.
  
  
3. Realistic Driver Evaluation:
• Government already tracks your driving history
• They alone would determine whether you are fit to drive or not (not the Insurance Companies)
• Point system already determines at what infraction level you are no longer fit to drive.
• The system measures the amount you drive and if you are qualified to drive, not things like what kind of car you drive.
  
  
4. Unbiased:
• Does not discriminate against sex
• Does not discriminate against age
• Both of which run rampant in the current system
  
  
5. Misc. Benefits:
• Easier for government to crack down on Insurance fraud (increased penalties etc.)
• More competition among regular Insurance companies for optional coverage. (Since you don't HAVE to have it, you can take your time to shop around or wait for a better price on the extra coverage you are looking for)