I remember a few years back when I first started hearing about “The Deep State”. It sounded very dark and conspiratorial. Of course, it was just the “fringe minority” who called it that, so any right-thinking person was supposed to dismiss it. But is it just a more negative name for “the administrative state” or “bureaucracy” or “the civil service”? Since Trudeau Jr. came to power in 2015, we have 40% more federal employees. A whole new department to collect and administer carbon taxes. A whole department to deal with Phoenix Payroll System issues. More regulation. More taxes. Higher debt.
When I started med school in ‘93, healthcare was “in crisis” but the newly elected John Savage liberals in Nova Scotia were set to fix things. They were succeeded by NDP who were going to fix things, then by liberals and conservatives who were going to fix things.
After 30 years in medicine, I can definitively say that no government, no matter what its political stripes, has “fixed” anything. Nurses and doctors and other staff make lots of money, but are less and less happy with their jobs. Patients get less service. Patients die and suffer from lack of care.
The only bright spot is for healthcare managers. We have way more of them and they seem to be better and better paid. When I have a problem with something, it is never clear who is empowered to make the decision required to fix it. There are so many layers that the buck stops nowhere. Fighting with management is like punching a cloud. The Nova Scotia Health Authority org/management flowchart is more complex than many of the ones that I learned about when studying nuclear physics in grad school.
From the point of view of managers and politicians, is this massive, useless, unwieldy, and expensive bureaucracy a feature or a bug? If you read Thomas Sowell (who at age 93 just published his 40th book and is still awesome and articulate), this has not happened by accident. The real purpose of a bureaucracy is not to solve problems but rather to protect their positions and proliferate. And their fecundity is incredible.
How did we manage to so quickly produce “consensus” on our approach to COVID - a brand new virus that we knew nothing about? Suddenly we all agreed on new public health measures: “Lockdown” - until 2020 a term used only in prisons. Universal mask mandates. A brand new “vaccine” that was immediately known to be “safe and effective”. An all-powerful administrative state that can shut down and censor any dissenting voices is required to create The Science™ in such a short time.
Aris has some deep insights into these issues, which he touches on in the podcast and will expand on in his talk at FSIM 2023. We hope you consider coming.
In our chat, I refer to my first experience of running into the guardrails of “professionalism” as defined in our modern age. Thanks to the JCCF I got through it.
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