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Prescription for a broken health care system can’t be more politics

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Maybe you’re on an interminable wait list for elective surgery. Maybe you’re one of the growing number of Canadians who have had to head to an overcrowded ER because you don’t have a family doctor. Maybe you’re a parent, panicked because your child is having difficulty breathing because of a respiratory ailment that is surging and overwhelming pediatric hospitals.

Maybe you are rightly wary of an approaching winter and the warnings of a brutal flu season or an assault from another COVID variant. Maybe you’re a health worker who is simply burned out. Maybe you’re a nurse who has already left, feeling overburdened and underappreciated.

Whatever your personal experience, you know that Canada’s once-lauded public health care system is broken and urgently needs a remedy.

When Canada’s health ministers convened in Vancouver this week, they all agreed our health care system was in “crisis.” They all agreed the situation was urgent.

So, they prescribed politics.

Not what the doctor ordered.

Federal Health Minister Jean-Yves Duclos arrived promising an increase in health care transfers to the provinces in return for agreement on national health care indicators and creation of a health care data system.

Duclos left Vancouver blaming premiers for undercutting the work of their health ministers by issuing a statement that the Vancouver meeting was a failure, even as the meeting was ongoing.

 

The provincial and territorial ministers and Duclos met with reporters separately.

The federal minister says that before anyone can start talking about the means to health care reform, we need to talk about the ends. In other words, results. The premiers talk only about money, he said.

According to Duclos, that is not a plan. “That is the old way of doing things. If there was anyone still doubting it, the current crisis is the undeniable proof that the old way doesn’t work. We need to do things differently.”

Duclos was no doubt mindful of the great Health Accord brokered by former Prime Minister Paul Martin in 2004 when Ottawa pumped $41 billion over 10 years to the provinces for health care, heralding the transformative change in our health care system. Provinces awash in such federal largesse delivered no such thing. No federal government has dared take that path again.

The premiers insist Ottawa’s share of health care funding has dropped to 22 per cent and they are demanding an annual unconditional injection of $28 billion more bringing that share to 33 per cent. Ottawa counters that when tax points available to the provinces are taken into consideration, the funding is at 33 per cent. Canadians don’t want to hear about math. They want to hear about solutions.

British Columbia Health Minister Adrian Dix, even before the meeting began, chided Trudeau for his lack of commitment to a first ministers conference, saying the Prime Minister was not a “potted plant.”

After this week’s breakdown, Dix said the premiers have asked for a national health care conference “1,420 times.” Even accounting for the embellishment for emphasis, perhaps Dix and his colleagues should remember the old adage about doing the same thing over and over and expecting a different result.

No prime minister would sit down with 13 adversaries (and make no mistake, premiers have ensured that would be the tenor of such a meeting). The 13 leaders, many of them running budget surpluses, would look across the table and see, not a prime minister, but an ATM. Trudeau would need the parameters of a deal before he sat for such a meeting.

 

This matter is urgent. The way to break this impasse might have to be Ottawa making individual accords with co-operative provinces. That is not, as some characterize it, ‘divide and conquer,’ nor is it a threat. It’s a way to get much-needed results at a critical time for our health care system.

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Is Ivanka Trump plotting a return to politics

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If you’re a woman freaking out about the imminent possibility of another Trump term, don’t despair quite yet. Yes, Project 2025 is hoping to turn the US into a Christian nationalist country. Yes, JD Vance, Donald Trump’s running partner, has been primed for the job by Peter Thiel, a man who has mused that women having the vote is problematic. Yes, experts are raising the alarm that “a Trump-Vance administration will be the most dangerous administration for abortion and reproductive freedom in this country’s history.” But it’s not all doom and gloom: there may well be a beacon of light and female liberation coming into the White House as well. Signs suggest Ivanka Trump is considering a return to politics. Ladies and gentlewomen, the patron saint of female empowerment may selflessly serve us once again!

To be clear: the younger Trump hasn’t explicitly said that she’s interested in another go at being Daddy’s special adviser. In fact, she’s spent the last few years getting as far away from politics as possible. A renaissance woman, Trump has sold everything from handbags to shoes to real estate – but her most valuable product has always been herself. The former first daughter has always been very careful about protecting her personal brand. And, for a while, that meant staying well clear of her father.

With Donald Trump now formally the nominee, it can be hard to remember just how bad things looked for the former president a couple of years ago. After an underwhelming performance by GOP candidates in the 2022 midterm elections, a lot of Trump’s former acolytes started turning on him. High-profile Republicans complained that Trump was a drag on the party. Even the New York Post, once Trump’s personal Pravda, thought he was a joke: “TRUMPTY DUMPTY”, a post-midterm front page crowed. And then, of course, there were Trump’s mountains of legal problems. A lot of people wrote Trump off.

Ivanka was noticeably not by her father’s side during his hours of need. The moment that Donald got kicked out of the White House, Ivanka and her husband, Jared Kushner, followed him to Florida but kept a safe distance from the political goings on at Mar-a-Lago. Can’t have an insurrection ruining one’s image, after all.

A company called College Hunks Hauling Junk helped them clear out their DC mansion and the pair decamped to Miami’s “Billionaire Bunker”. They didn’t go empty-handed, of course. The couple reported between $172m and $640m in outside income while working in the White House and Saudi Arabia gave Kushner’s private equity firm $2bn to invest. Enough to keep them busy for a while.

For a long time, Javanka stayed fairly under the radar. Ivanka Trump would pop up in headlines now and again in Fun-loving Mother and Caring Philanthropist mode. Behold, a flattering headline about Ivanka helping deploy medical supplies and meals to Ukraine! Look: here’s an Instagram slideshow of the whole family skiing! Now here’s a fun picture of the Javanka family at the flashy Ambani wedding!

A cynic might say these carefully curated images were designed to humanize Trump and erase her messy political past. Aiding this was a consistent drip-drip of mysterious sources telling the press that Javanka had no desire whatsoever to return to politics. Even this year, when Donald Trump became the presumptive nominee, media “sources” kept insisting that the former first daughter wanted nothing to do with the White House. “She is very happy, living her best life,” a source told People in March. “She left politics totally in the rearview mirror and so this time around, even if her dad is the leading Republican candidate, she basically doesn’t care. She told him when he said he was going to run again that she didn’t want to be involved.”

Mary Trump, the woman who has made a career out of being Donald Trump’s disgruntled niece after a legal battle over her inheritance, has been blunt about why Ivanka seems to have retreated from politics. “I think Ivanka made very clear that she doesn’t get enough out of [her relationship with her father] any more,” Mary Trump told CNN at the end of May. “She’s barely been heard from for months; she could not be bothered to show up at [her father’s] trial [over falsifying business records].”

As the election inches closer, however, Ivanka seems to have reassessed the value of her relationship with her father. In early May, the media outlet Puck reported that she was “warming to the idea of trying to be helpful again … She’s not like ‘Hell no’ any more”. A similar report from Business Insider soon followed: according to a “friend of Ivanka”, the entrepreneur wasn’t ruling politics out. A spokesperson for the couple told Puck that this was all nonsense but rumours of a political comeback kept mounting.

Then, a couple of weeks ago, Ivanka jumped back into the spotlight with an appearance on Lex Fridman’s highly influential podcast. (Fridman has more than 4 million subscribers on YouTube.) In this she opened up about how working at the White House was “the most extraordinary growth experience of my life” and how privileged she was to have been asked by her father to help so many people. During the conversation, she also carefully recapped some of (what’s she’s claimed as) her key achievements in the White House, such as boosting the child tax credit. It wasn’t so much an interview as it was a hype project by a friend. It felt lot like it was teasing Trump’s return to political life should her dad be re-elected.

So, after years in the Floridian wilderness, has the Maga Princess officially returned to the family fold? It’s a tad too early to tell but it increasingly looks that way. As one would expect, Trump has spent the last few days close to her father after the attempt on his life: she’s very much thrown herself into the role of doting daughter again.

And while Ivanka has been absent from the Republican national convention so far, she and Jared are expected to be at Donald’s side on Thursday when he formally accepts the party’s nomination. And if that happens and images of Ivanka standing next to her father hit the headlines, it won’t just be a celebratory photoshoot – it’ll be a preview of Trump’s second term.

 

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Are assassination attempts getting more common?

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“There’s no place in America for this kind of violence,” President Joe Biden said on Saturday, following the shooting at a Donald Trump rally in Pennsylvania that left the former president hurt and killed an audience member.

But the fact is, this type of violence has a long history in American politics: Four US presidents have been killed in office and virtually all of them, in the modern era, have been targeted by assassination plots of varying levels of seriousness.

Along with the general atmosphere of political turmoil of recent years — Trump himself, Covid, police violence and the resulting protests, January 6 — attacks targeting public officials of both parties in the US also seem to be becoming more common.

Recent examples include the 2017 shooting by a left-wing extremist at a Republican Congressional baseball practice that critically injured Rep. Steve Scalise; the Donald Trump supporter who sent mail bombs to more than a dozen prominent Democrats in 2018; a right-wing militia’s plot to kidnap Michigan Gov. Gretchen Whitmer in 2020; the abortion rights supporter who attempted to kill Supreme Court Justice Brett Kavanaugh at this home in 2022; and the QAnon adherent who attacked Paul Pelosi, husband of House Speaker Nancy Pelosi, while attempting to target her, in 2022.

That violence is having a clear impact on how American politics is conducted. Spending on security by House and Senate campaigns increased by 500 percent between 2020 and 2022, according to the Washington Post.

Nor is this just an American phenomenon: There’s been a global wave of recent assassinations as well. The UK has seen two members of parliament killed in recent years: Jo Cox, a Labour MP murdered by a right-wing extremist days before the Brexit vote in 2016, and David Amess, a Conservative MP fatally stabbed by an Islamic State supporter in 2021. Former Brazilian President Jair Bolsonaro survived a stabbing during his campaign for president in 2018. In 2021, Haitian Prime Minister Jovenel Moïse was assassinated by mercenaries.

Last year saw the killing of Ecuadorian presidential candidate Fernando Villavicencio, and former Japanese Prime Minister Shinzo Abe. In January of this year, South Korean opposition leader Lee Jae-myung survived being stabbed in the neck, while Slovakian Prime Minister Robert Fico was shot and nearly killed in May. In Mexico, where political violence is rampant on a scale far beyond most other countries, at least 36 candidates seeking offices throughout the country were killed ahead of the country’s recent elections, according to the New York Times.

Then there are the numerous alleged plots targeting Ukrainian President Volodymyr Zelenskyy since Russia’s full-scale invasion of Ukraine.

The growing threat of assassination

Despite all that, it’s difficult to say for sure if political killings are on the rise. There’s a data problem: Assassinations are still relatively rare compared to other forms of political violence — violent protests, terrorist bombings — and attempts that succeed in killing their target, or even come close enough to succeeding, are even rarer.

But there is some data to suggest they’re getting more common. According to the University of Maryland’s Global Terrorism Database, which includes incidents of political violence from 1970 to 2020, the number of assassination incidents around the world fell dramatically from more than a thousand per year in the early 1990s to less than 100 per year in 1999, then started to creep up again, jumping to more than 900 in 2015. This trend has roughly corresponded with a global uptick in international armed conflict, which also dipped through the 1990s before rising more recently.

Threatened acts of violence have increased even faster. In the United States, the Capitol Police reported 9,625 threats against members of Congress in 2021, compared to just 3,939 in 2017.

What could be driving this trend? Political violence researcher Rachel Kleinfeld of the Carnegie Endowment for International Peace argues that political violence, including assassinations, becomes more common in countries where there are highly competitive elections that could shift the balance of power, where partisan politics becomes a dominant social identity, and where there are weak institutional constraints on violence. All of those reasons fit the US now, which is why Kleinfeld suggests the country is particularly vulnerable to a surge in political violence.

Kleinfeld also notes that a difference between today’s political violence and previous periods where it was common — such as the 1970s, the high point of terrorist violence within the US with more than 1,470 attacks compared to 214 in the decade following 9/11 — is that today’s perpetrators are more likely to not belong to any formal organization, but rather to self-radicalize via online engagement.

The Georgetown University terrorism researchers Bruce Hoffman and Jacob Ware argued in an article published two years ago that political assassination is becoming more common around the world in part to the emergence of so-called “accelerationism” — the deliberate effort to foment political chaos or societal collapse in order to accelerate political transformation — as a more prominent strategy for extremists. They write, “For extremists seeking to sow chaos and speed up some cataclysmic societal collapse, high-profile politicians provide an attractive target” because they personify the political order these extremists are trying to tear down.

Previous waves of political violence happened in eras when security was more lax and politicians more accessible. Think of John F. Kennedy’s open motorcade in Dallas, which no president would think of doing today. But Hoffman and Ware also note that even as politicians and governments invest more in security, new technologies are making assassination attempts easier. Consider the homemade gun used to kill Abe, which the assassin put together with parts and instructions he found online, or the attempted assassination of Venezuelan President Nicolás Maduro using explosive drones in 2018.

In an email to Vox, Hoffman said that the attempt on Trump “does fit into the trend … where attacks on elected officials are becoming more commonplace and, dare one say, even accepted as a norm in our politically polarized/divided country.”

What comes next

Political violence is a phenomenon that tends to feed on itself. Attacks create justifications for more attacks, leading to long periods of violence, such as Italy’s infamous “years of lead,” from the late ’60s through the ’80s, when assassinations, kidnappings, and bombings by right-wing and left-wing extremist groups were disturbingly common.

Another very inconvenient fact about political assassinations is that when successful, they often accomplish their political goals, if not always in ways the assassin might intend: The murder of Abraham Lincoln and his replacement by pro-states rights Southerner Andrew Johnson utterly changed the course of post-Civil War Reconstruction. The right-wing Israeli who killed Prime Minister Yitzhak Rabin in 1995, in the wake of the historic Oslo Accords, dealt a serious, perhaps fatal, blow to the Israeli-Palestinian peace process. The killing of Abe led to a dramatic political reckoning in Japan with the assassin’s primary target: the controversial Unification Church.

We still don’t know the specific motivations of the shooter who attempted to kill Trump, or what impact the event will have on the upcoming election or American politics generally. But it’s safe to say the impact, whatever the gunman’s intentions, would have been far greater if he had adjusted his aim by just a few inches.

When the stakes of political contests start to seem existential, and political violence of all kinds more permissible, an increase in assassination attempts — in the US and abroad — seems almost inevitable.

 

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July 14, 2024, coverage of the Trump assassination attempt

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Pesident Joe Biden gave an Oval Office address Sunday — a rare form of presidential remarks reserved for the most solemn times — and urged Americans to unite and take the temperature down on politics following an assassination attempt on former President Donald Trump during a campaign rally in Pennsylvania.

Here’s what else to know:

Biden’s speech: The president condemned political violence and said “disagreement is inevitable and American democracy is part of human nature, but politics must never be a literal battlefield or, God forbid, a killing field.” He warned against the normalization of this violence and urged Americans to step out of their political silos “where we only listen to those with whom we agree, and where disinformation is rampant, where foreign actors fan the flames of our division to shape the outcomes consistent with their interests, not ours.”

Trump’s movements: The former president said on Truth Social that he is going to Milwaukee, Wisconsin, on Sunday for the Republican National Convention after initially considering delaying his trip. After the assassination attempt at the rally in Butler, Pennsylvania, on Saturday, Trump flew to Newark, New Jersey, and spent time with his daughter Ivanka at his golf club in Bedminster, sources told CNN. The Secret Service said Sunday that there are no plans to tighten security plans for the RNC, saying it is confident in the plans that are in place.

What happened at the rally on Saturday: Trump’s rally speech in Butler, Pennsylvania, Saturday evening began just as it had at dozens of rallies previously – his attendees chanted “USA! USA!” and the former president clapped and pointed to faces in the crowd before taking the lectern. About 150 yards to the north, a gunman was climbing onto the roof of a building outside the rally security perimeter. He had an AR-style weapon with him. Six minutes into the former president’s speech, the gunman took aim at Trump and squeezed the trigger. Here’s a timeline.

Gunman was spotted: A local police officer saw the gunman on a rooftop during campaign rally but was unable to engage him, Butler County Sheriff Michael Slupe told CNN on Sunday. Slupe said that Butler Township officers received calls about a suspicious person outside the perimeter of the rally and went looking to find that person. He said the initial calls that came in did not indicate the suspicious person had a gun.

New investigation details: The shooter, 20-year-old Thomas Matthew Crooks, had no prior contacts with the FBI and had not been previously on its radar or databases. Investigators are struggling to understand his motives. Crooks used an AR-style 556 rifle purchased legally by his father, FBI officials said, and one of the things that investigators are still looking to understand is how Crooks gained access to his father’s firearm. He also had “rudimentary” explosive devices in his car, an official said.

About the shooter: A former classmate and co-worker told CNN they remember Crooks as “the sweetest guy.” The colleague said Crooks was “not a radical” and never expressed any political views at work. “It’s hard seeing everything that’s going on online because he was a really, really good person that did a really bad thing. And I just wish I knew why,” the colleague said.

Congress: House Speaker Mike Johnson on Sunday called for the country “to get back to civility” and said he hasn’t gotten a “satisfactory answer” yet from US Secret Service on the “security lapse” at Trump’s Pennsylvania rally.

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