introduction/confession

i am going to confess a very important thing.

i work for a major financial company. it is big, the largest in Canada by some measures, and pervasive in the torontréal region. i work in the dungeon, albeit, but i am in a way complicit with a whole lot of things i don't agree with.

now, i live in a historically fortunate time, so i'm not being asked to shoot people or burn schools or anything horrendous like that. but there are times, where, to put it nicely, i'm engaging in processes that are causing needless delay and inconvenience to people in very unfortunate positions. 

you see, i work very closely with something that most people claim to be passionate about- health care. now, working for a major financial company offering services related to health care in canada seems like it should be impossible. sadly, it is not. 

your prescription drugs are not paid for by your taxes, and are thusly not covered by your province (except au Québec, mais quand-même l'adhésion au plan privé qu'offre votre employeur est obligatoire). your dental work (which i can tell you for a fact is expensive) is not covered either. if you need to see a psychologist, the government will not pay for it, a physiotherapist neither. my private company will, if you pay into a trust which acts on behalf of the largest shareholders.

now, there is the obvious argument that if the government does not fund these services, they are not necessary. in a manner of speaking, this can be considered true- leaving out rare exceptions, one doesn't die of a toothache or a bum knee. this argument, however, ignores the point- our public health system is not comprehensive, and there is significant demand for treatments outside of them, and hence private companies that fill in the void.

you don't need to be told why this is bad. companies with shareholders need to keep up their short-term profits so as not to lose value- in a financial company with relatively little physical infrastructure to back their net worth (RIM's facilities on their own are worth billions) the question is increasingly pressing. why it's financial companies, specifically, who have taken over covering medical treatments (rather than, say, a trust acting in the interest of the practitioners themselves) is left as an exercise to the reader.

pursuing short-term profits in 2011 is anathema to long-term investment, because of the sheer uncertainty in the field (uncertainty is defined here as 'things look certain to collapse, will we be stuck holding the bag?'). this financial instability and rapidly rising demands leave financial companies in a uniquely bad position to be supporting/controlling this important part of our total health infrastructure. who should fill in the void?

i have elucidated three options. one is paying into a trust that acts in the interests of the largest shareholders, two is paying into one run by elected officials deciding policy on ideological grounds, and three is paying into one that serves the interests of the practitioners alone. 

in the next five columns, over the next week, and informed by my personal experiences, observations, and anecdotes, i will discuss the fourth option at length.