Medical tools in an exam room at a health clinic in Calgary, on July 14, 2023.Jeff McIntosh/The Canadian Press
Medical bills
Re “Changes to capital-gains tax may prompt doctors to quit, CMA warns” (Report on Business, April 23): It is disappointing to read that some well-compensated doctors object to paying a bit more tax (which is still less than tax on interest, dividends or earnings) on the amount of capital gains they receive. I thought billing on average more than $330,000 annually would be the basis for a decent income, even without benefiting from a lower tax rate on capital gains.
However, if family physicians are going to leave their practices because of this, then I urge the government to modify the budget and exempt active practising family physicians, and only them, from the increased capital-gains tax. If this incentivizes new or non-practising physicians to open a family practice, this alone would be worth it.
Its impact on revenues would be minor.
Lewis Auerbach, Retired director, Office of the Auditor-General of Canada Ottawa
Re “Medical schools raise alarm over declining interest in family medicine” (April 24): Justin Trudeau and Chrystia Freeland say that physicians are at the “very‚ very top” of the income scale, and so can afford to pay more taxes. That comment is likely a reflection of looking at doctors’ gross billings rather than net pay.
Physicians were disproportionately harmed by the GST when they were deemed to be “end-users” and could not claim expenses for rent and supplies, unlike other businesses. Now, lumping medical corporations into the capital-gains tax increase is another disproportionate financial hit.
This intersects with the shortage of family physicians, who today are an aged group. Many are still working into their 70s and 80s. Harmful changes in government fiscal policy lead elderly professionals to re-evaluate their work life; many physicians retired when income caps were applied in the 1990s.
The capital-gains tax will further exacerbate the health care crisis, and there is no backfill coming from younger doctors.
Harry Birman MD Toronto
In 2024, Justin Trudeau says that “it’s fair to ask those who have succeeded extraordinarily well to be there to make sure that a lot more people have the opportunity to succeed.”
In 1875, Karl Marx said, “From each according to his ability, to each according to his needs.”
How did that work out for the Soviet Union?
Jonathan Bamberger Toronto
Doctor in the house?
Re “The failure of Canada’s health care system is a disgrace – and a deadly one” (April 19): How do we address unacceptable wait times in health care? Doug Ford’s solution of out-of-hospital surgical clinics is a good idea, but to privatize them is, I think, dumb.
There are about 17,000 family physicians in Ontario – on paper, enough to meet the province’s needs. But they don’t. Why?
If Ontario spends about $90-billion a year on health care, would it not be wise to assess how the money is spent and what changes are needed? Significant privatization has increased costs without addressing wait times. Why not?
A partial solution might be to reserve 40 per cent of medical-school places for individuals who wish to be family physicians, with obligations to be in general practice for a defined number of years.
Fifty years ago, I practised as a family physician. I and my colleagues felt obligated to try seeing urgent problems within 24 to 48 hours. Why not now?
Ross McElroy East Zorra-Tavistock, Ont.
The ultrasound clinic recently called to schedule three separate appointments from the August, 2023, requisition from my family health team doctor (lucky me): one for the shoulder, one for the elbow and one for the wrist.
Three trips on three separate days. Loss of time, gas (cost and pollution) and productivity. Oh, and nine months after the requisition. Yes, I still need the ultrasounds done as the symptoms have not gone away.
On whose head should that liquor-store paper bag go?
J.C. Olsthoorn Ottawa
Canadian content
Re “If pension funds can’t see the case for investing in Canada, why should you?” (Report on Business, April 20): We have entered an economic period that is unlikely to mirror the past.
Globalization is fracturing, and the global monetary system is in the middle of its biggest transformation in 50 years. Lack of investment means physical commodity prices are positioned to continue rising. This is inflationary and investors should be defensive.
Canada is home to most of these primary materials and foodstuffs. Canadian companies also own global mining assets.
These companies are seeing exceptional cash-flow growth that benefits shareholders via dividends. Earnings growth is now set to accelerate across the energy and materials sectors. Canadian investors should be seeking a selection of those companies where management is incentivized to win.
As investment literature always remarks, “Past performance is not indicative of the future.” Rarely have financial market valuations reached such extremes.
This statement should be at the front of Canadian investor minds, including our pension funds.
Avi Hooper, CFA St. Catharines, Ont.
Family first
Re “New condo sales in the Toronto area hit 15-year low” (April 23): This report inadvertently says a lot about the sad state of development economics.
A recent Toronto condo monitor revealed that 50 per cent of condos built in the city since 2002 are one-bedroom units. When the bulk of new housing stock comprises studio and one-bedroom condos, this does little to serve the needs of young families.
Delivering desirable housing should be more than a numbers game.
Glenn Miller Toronto
Closer look
Re “The stain of Nazi science pushed one anatomy book off the shelves. A UBC professor has now found another” (April 20): As a surgeon, I was interested in reading about doctors William Seidelman and Claudia Krebs and their work deciphering the identities of Nazi victims whose bodies were used for anatomical texts.
This was first brought to my attention by the publications of doctor Susan Mackinnon, a Canadian plastic surgeon known for her nerve reconstruction techniques. She became concerned about the ethical dilemmas of using Pernkopf’s Atlas of Topographic and Applied Human Anatomy for Jewish patients and consulted rabbi Joseph Polak about disclosure to the family and patient. Her revelations and concerns were widely disseminated in 2019.
Recently, medical schools in Canada have begun teaching about the Holocaust in terms of ethical, moral and professional subversions by the Nazi medical profession in Austria and Germany, where scientific achievements had been so prolific and important in earlier years.
Bernard Goldman, CM; emeritus professor of surgery (cardiac) University of Toronto
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