Relatives, experts call for accountability in wake of Joyce Echaquan's death

Guests: Alice Echaquan, Mary Hannaburg, Dr. Lisa Richardson

MG: When Joyce Echaquan went into hospital in Joliette, Quebec, over the weekend, she was prepared for the worst. The Indigenous woman had experienced racism from medical providers before. And so, in the last moments of her life, she livestreamed the insults from nurses who were treating her. Medical staff, called Joyce stupid, told her she was only good for sex and better off dead. That is what Joyce Echaquan was forced to hear in her final moments. A nurse has subsequently been fired in a coroner's inquest will look into this death. Joyce Echaquann's husband, Carol Dubé, spoke out about the treatment, his wife injured. Here are his words in translation.

SOUNDCLIP

My wife went into hospital on Saturday with stomach pains. Two days later, she died. On Facebook, we hear her asking for help. And the person who responds is degrading towards her. I have seven kids who now have no mother. I hope the inquest figures out who is responsible for this. After the [unintelligible] commission, we can see things still aren't improving for us. What are we waiting for? More victims?

MG: Alice Echaquan is Joyce's cousin. Alice Echaquan, good morning.

ALICE ECHAQUAN: Good morning.

MG: I'm sorry for what your family has gone through.

ALICE ECHAQUAN: Thank you.

MG: Tell me about Joyce. Who is she?

ALICE ECHAQUAN: Joyce was an incredible cousin, sisters leaves smiling. Always saying Hi Alice, how sister, how are you today. I was laughing at the same time. Taking care of the kids and taking care of her husband. She's my sister. She's a loving person too, because she's my, she's my, she's my sister.

MG: She had seven children.

ALICE ECHAQUAN: Yes, seven children.

MG: So you watched the video that Joyce posted from the hospital. What was that like for you to watch that?

ALICE ECHAQUAN: When I saw that, it shocked me very, very much in my heart, you know. I sent this video to the chief of my community, and my cousin. He is a nurse in my community too. And the chief, he said, can you go to see Joyce in the hospital to see what's happened with her and why she is in the hospital? And I say, OK, I'm going to go right now. I go to the hospital. And it shocked me. I can't drive, because I see, I heard she cried and she said, come to take me out of the hospital. And I cry in my heart, and I cry in my heart, and I went to see Joyce in the hospital. And I see somebody there, a nurse. And she said, it's impossible to see Joyce at this moment. The doctor will come to see you later. And I was alone. I was alone in the room, OK. And I wait, I wait. And I say, oh, it's a long wait. And a woman come to see me. And then she said to me, hello, what are you doing here? I said, I've come to see my cousin, my sister. And she said, Oh, you don't know yet. And I said, What? And she says, she's died. She's died. And my heart stopped.

MG: One of those nurses that's in the video has been fired. Is that enough in terms of trying to get some answers when it comes to what happened to you?

ALICE ECHAQUAN: It's not enough. To change this racist to my community, to my sister, or my sister and my brother. It's not enough. We need to have more [unintelligible] more respect for our nation, you know?

MG: What is this going to. What is this going to mean for the community? Do you think?

ALICE ECHAQUAN: I think that really in my heart, that's mean that wake up, stand up all my sister and all my brother. Stand up together all of us and say, that's enough. We're going to do something to stop the racism, you know. Look what's happened. That's enough.

MG: What will this mean for you the next time you need to go to a hospital? How will this affect you? Will you think differently about going to a hospital now?

ALICE ECHAQUAN: I don't want to go back in this hospital. Never. And in my heart, never. Because a lot of my partner, my sister, my brother live the same thing that lived Joyce, you know.

MG: They've gone through the same thing.

ALICE ECHAQUAN: Yes. Yes. I lot of my sister and brother lived the same thing that Joyce, OK. I don't want to go there. I'm scared to go there. I don't want to pass near of this hospital, you know. But, you know, that's what I'm- that's what I live in this moment. I don't want. And it's very hard to take off in my memory what I hear from Joyce. It's all the time in my mind, when I eat, I don't eat a lot. I don't sleep a lot since Monday. It's like that.

MG: I'm really sorry for what you've gone through and what your family has gone through. And I really appreciate you speaking with us. It's important, Alice. Take care of yourself. And thank you.

ALICE ECHAQUAN: OK. Thank you so much.

MG: OK. Bye bye.

ALICE ECHAQUAN: Have a good day, bye bye.

MG: Alice Echaquan is Joyce Echaquan's cousin. Mary Hannaburg is the vice-president of Quebec Native Women. It's an association that advocates for Indigenous women in that province. She's from the Mohawk nation. Mary, good morning to you.

MARY HANNABURG: Good morning.

MG: You were at a vigil on Tuesday for Joyce. Echaquan, just briefly, tell me what that was like.

MARY HANNABURG: Well, first of all, it was a very, very emotional drive because I had seen the video. I had listened to the words that were said and those stayed with me during the trip there. But I knew I had to go. I just felt compelled to go. So I made the trip. And when I arrived there, it was a large gathering in front of the Joliette Hospital. And people were gathering and they were giving voice to, you know, to call on for actions. The prayers were said. There was a lot of grief. I saw her husband. I met her children. That was the very sad part of it, the hard part. And even when I came away from there, it's it's been quite hard to know that seven children have lost their mother at that hospital.

MG: What does it tell you? That Joyce recorded herself, that this was the kind of treatment in some ways that she was expecting?

MARY HANNABURG: Well, she was a you know, she was apprehensive to go to that hospital in the beginning. And, you know, and stated that, you know, she went because she couldn't tolerate the pain. She had experienced similar, you know, prejudice remarks midst towards her in the past, about a month ago, prior to that. At the same type of problem. But, you know, she went back because she couldn't take that pain. She kind of, you know, knew she had she was protecting herself in a way, because when she did the video live, that was her way of communicating what was happening. That was what she left to us to show what was happening. She recorded that. She did a live streaming and that no one can deny that was her method of communication and the survival. The survival kicked in. And, look, I have to do this because if I do this, maybe someone will come in and help me now. Her way of communication where she was strapped down on a gurney and not able to call for help, that was her call for help.

MG: People have called on the premier of Quebec to address this in a meaningful way. He admitted that there is racism within the province, but said that this is not- he wouldn't say that this is an example of systemic racism. What do you what do you make of that?

MARY HANNABURG: Well, I want to just say that governments cannot say they don't know where to start in addressing the issues within their systems. Since 2015, five years ago, five years ago, they've been presented with 94 calls to action through the Truth and Reconciliation Commission, among which were calls to act regarding the health-care system, OK. They were calls to action. They're not just recommendations. And these call to action and also to the United Nations on the declarations of the rights of indigenous people was similarly done in 2007. That's 13 years ago. I mean, that's a long time. And this is not new. This is not just one incident that has happened. There is there's reports against that hospital previously, too, that were made. We know that needs to be looked at. So 13 years ago and in Canada, you know, this is not some country far away. This is in Canada. They were told what their responsibilities were. The minimum standards, they were told the minimum standards in order to better the conditions with Indigenous people within Canada. We also had the Viens Commission. This is a report on the missing and murdered indigenous women and girls and the calls to action presented through those, both published last year. So I don't understand, you know, how they can say, well, they don't know. They don't know how to fix it. They don't know what to change. They know.

MG: What would what would the first step in fixing this be for you?

MARY HANNABURG: Well, stop denying. Stop denying in this province, the denial was a big issue. Stop denying. Stop putting your head in the sand and we don't need, you know, billions of dollars on another enquiry. They already have what it takes to make it work, to make it, to fix it. And the racist things that were said to Joyce, you know. If you first of all, the truth and reconciliation, if you want to be in the truth to reconcile the truth comes first. So let's get become truthful. So those racist things that were said to Joyce, who was a patient of that nurse during the time of the treatment at that hospital, those things that were said, that's the truth. And Joyce died during the time of treatment. That's the truth. In today's health-care system, this is what is going on. So to start, Francois Legault speaks the truth about the systemic racism. And that is going on within the Quebec system.

MG: Just before I let you go, are you confident that this. It's an awful moment and it's incredibly painful for her family and for her community and people who are just learning about her. Do you think that this could help create that change that you're calling for?

MARY HANNABURG: Well, all the work in this process that they like to call reconciliation has been done on one side. It has been done only on one side. If reconciliation is a bridge, then this bridge has been built only half way. No more apologies. We need to see actions. And this is not the first situation I must speak on. It's not. This is not my first interview. And I'm tired of repeating myself. We are tired of repeating ourselves. So, you know, we want to see action. And, you know, they know they know what has to be done. They have all those reports that have been done. They have all those investigations that have been spent long time. And we're still here today into in 2020. We're still here facing this. Only this time they cannot sweep it underneath the rug. This has been exposed now. It has a face. And you know what? There are other faces out there and that need to be weeded out. So I want to see that. It's really important that we continue a joint effort that the women's like what her cousin was saying, stand up together and demand change. We want several and cheque of what has happened there and not just some report. Oh, while this no, we want we want to be to look and see if there's criminal negligence there, then be dealt with it the proper way.

MG: We're going to talk next about what that change could look like. In the meantime, Mary, I really appreciate your time this morning. Thank you.

MARY HANNABURG: I want to say thank you very much for giving me this opportunity. And it's important for Canada to know we need everyone to ask for these changes, to urged the governments to put these changes. And it's not only in the health care system, it's all throughout. It's systemic racism. It's not our first time. And, you know, we don't want to see another face. We don't want to have another Joyce. We don't have to lose another life. I've seen her little son. And it breaks my heart. That little boy that's holding his mother's picture. He doesn't know she's not coming back, you know. This is the heartbreak. This is the cost. That's the human cost. And it's got to stop.

MG: Mary Hannaburg, thank you very much for your time.

MARY HANNABURG: Thank you very much.

MG: Mary Hannaberg is the vice president of Quebec Native Women and its association that advocates for indigenous women in that province. She was and kind of stocky, OK. Mohawk Nation near Montreal. Dr. Lisa Richardson is a professor and a mixed Anishinaabe physician who is a strategic lead in indigenous health for the Faculty of Medicine at the University of Toronto and Women's College Hospital. Doctor, good morning to you.

DR. LISA RICHARDSON: Good morning, Matt.

MG: What does it tell you about how Indigenous people are treated by the health care system in this country when you hear a story like this?

DR. LISA RICHARDSON: You know, firstly, I just I feel sad. And I want to acknowledge that in hearing hearing Alice, Joyce's sister, Joyce's cousin, and hearing Mary and understanding the ripple effects of an experience like this, not just on Joyce's family, not just on her community, but on Indigenous peoples across Canada. It's very sad. And the other piece is that it's not new. As we've heard, these are repeated stories. And as Indigenous docs, we have people reaching out to us almost weekly, Matt, with stories of mistreatment in the system. And sometimes stories leading to misdiagnoses, oversights and deaths. Sometimes stories of a lack of dignity, outright racist treatment. It's just, it is commonplace, unfortunately.

MG: I want to hear one of those stories. This is Yvonne Houssin, who's 23 years old. She's a student in Victoria. In the summer of 2018, she went to. Hospital after having a high fever and vomiting.

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I was asked repeatedly and aggressively by various care providers about how much I drank and what drugs that I've taken. And they only believed me and stopped asking me once I had taken a blood test. So it was the mom of a non-indigenous patient that I was sharing the overnight room with who would bring me a blanket and bring me water. And it was when she mentioned that there was a lot of people in the emergency room that night with heat stroke. But I realised that I was the only one that was yelled at about alcohol and drugs. Despite others with the same symptoms as me.

MG: Dr. Richardson, what do you make of Yvonne's experience?

DR. LISA RICHARDSON: It's heartbreaking. And again, common and so upsetting and upsetting as Indigenous peoples, but upsetting on behalf of my profession, too. And of the health-care system and what has happened, or what is happening that when we are trained to provide care as the central component of all of our professions, whether it be in nursing or medicine or social work, how is it that this treatment, which is a basic lack of respect, is missing?

MG: Mary pointed to the reports whether it's the truth and reconciliation report that contain calls to action. We also heard about the Vien commission reports in Quebec that found systemic racism against indigenous peoples. There have been federal ministers from the health minister to the minister of Indigenous Services, to the minister of Crown Indigenous Relations, who have all said, yes, this is a systemic issue. So why in 2020 does it continue to happen?

DR. LISA RICHARDSON: We have not seen a coordinated system-level response to actually hold institutions and individuals accountable. We need to see accountability measures. As Mary said, this cannot keep happening. So with an incident such as this one with a terrible tragedy such as this one, an enquiry or an administrative probe is not enough. There needs to be, yes, an understanding of what happened in this specific context. But there needs to be transparency and then direct action to address what is happening in that specific hospital, but then in the larger system.

MG: What does that action look like? How do you go about creating a system that the people aren't afraid of?

DR. LISA RICHARDSON: So, I mean, there are, I often think about the prevention and then the treatment. So from a prevention perspective, how do we prevent this from happening going forward? We need to hire more indigenous care providers. We need indigenous clinicians, physicians, nurses, social workers. But we also need indigenous peoples in leadership roles in these institutions, at the governance level on the executive team. We need robust training for all clinicians and all hospital and health-care institution members. So, you know, whether it's when you're checking in with your health card, whether it's when you're having your radiology test done your lab test done, all of those people who are entering a part of this system need education. And it's not a one stop. Oh, you've done your cultural safety and anti-racist practise training. You're done. It is ongoing development. It's spiral over and growing all the time. We need self-determination. So we need indigenous peoples know how to respond and what their needs are. And we need to see indigenous people guiding and leading these responses. And then, as I said, when these things happen, we need to have systems where we are collecting the data, where we know what's happening and where we are responding.

MG: We have a just a few seconds left. Are you. Are you seeing any real movement in that direction right now?

DR. LISA RICHARDSON: You know, it's, um. It's like that one step forward, two steps backward. It's constantly changing for me, Matt. I was feeling hopeful with the Black Lives Matter and Indigenous Lives Matter movement and the robust sort of change across all of our systems in the last little while. And then this happened. So I think I think that we are that we are getting to a place of change. One has to be hopeful. We can't afford not to be.

MG: I really appreciate your time this morning.

DR. LISA RICHARDSON: Thanks, Matt.

MG: Dr. Lisa Richardson is a professor and mixed Anishinaabe physician who is a strategic lead in indigenous health for the Faculty of Medicine at the University of Toronto and Women's College Hospital. Your experience in this system would be welcome. We'd love to hear your stories. You can email us thecurrent@cbc.ca. Or reach us through the Web site cbc.ca/thecurrent. Click on the contact link. We're back in six minutes. Stay tuned. 2

Road to November: Illinois, manufacturing and bringing back jobs

Guests: Dan Simmons, Keith MacDonald

MG: Good morning. I'm Matt Galloway. You're listening to The Current.

[Music: Theme]

MG: Still to come, Alberta's doctor exodus in the midst of a pandemic. But first, rolling through the Rust Belt.

[Music: Theme]

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TRUMP: Together, we will make America great again.

VOICE: You're going to vote by mail. Vote early.

TRUMP: But you don't hear them talking about COVID. I saved hundreds of thousands of lives.

VOICE 2: The only thing you could tear apart is America itself. And we let that happen.

MG: We are one month and two days away from the 2020 U.S. election. And so here at The Current. We have been winding our way down the banks of the Mississippi River in a series we're calling Road to November. A few weeks back, we put our radio RV into gear and then took off across Minnesota, then through Wisconsin and Iowa. We've been pulling over to speak with Americans about what this election means to them. And today, the Radio Roadshow pulls into Illinois. Just in time for the aftermath of the first presidential debate. That was something.

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VOICE 1: They said it would is a miracle to bring back manufacturing. I brought back 700,000 jobs. They brought back nothing. They gave up on manufacturing.

VOICE 2: We did not.

VOICE 1: Standard fare. He totally gave up on manufacturing.

VOICE 2: We brought back. I was asked to bring back Chrysler and General Motors brought him back right here in the state of Ohio.

MG: Things always get a little hot under the collar when manufacturing comes up. Illinois is part of the Rust Belt swath of the United States where manufacturing rules, or at least used to. Over the years, this area has seen factories shut. People move away and entire towns dry up. Long before Donald Trump. Manufacturing jobs have come and gone. Then come back and left again, repeating an endless cycle of lows and highs, hopes and despairs. Keith McDonald knows this cycle well. Keith is director of operations at a steel product manufacturer in Rockford, Illinois. He's also the county board Republican caucus chairman for Winnebago County. Keith, good morning.

KEITH MACDONALD: Good morning, Matt. How are you?

MG: I'm well, thanks. I really appreciate you joining us. How would you describe the state of manufacturing in your county right now?

KEITH MACDONALD: Of state of manufacturing and when they go county and the state of Illinois is a challenge currently for a couple of different reasons. One, finding people that are willing to come into manufacturing, I think that's a difficult part. And another side is the taxes. There's many companies that have left the state of Illinois just because Illinois's tax policies. And that just makes things hard all around.

MG: What's the pandemic done to all of this?

KEITH MACDONALD: It's really hit or miss the business in which I'm in. We have remained solid. Our numbers are on pace with last year's numbers. We're very fortunate. I've talked to other vendors that say a lot of shops are down to part time or are completely getting rid of shifts as well. So we're fortunate.

MG: How long have you been in the community?

KEITH MACDONALD: I've lived here my entire life.

MG: Your entire life. And so what is it like to see layoffs at plants in the area?

KEITH MACDONALD: Oh, it's disappointing. Those are jobs that'll probably never return. You know, not just the job climate, but just Illinois in general. People, we have an exodus. I'm sure you've seen we have our census going on. And I look forward to those numbers just so I have some to point out on the county boards. And we need to do something to make our area better. We're fighting the state of Illinois, but we need to know people who want to stay close to their grandchildren or nieces and nephews. Let's make go Winnebago County, the place to go.

MG: And when you say you're fighting your state representatives, that's. Is that around the taxation issue that you raised?

KEITH MACDONALD: Mostly, you know, workman's comp is extremely expensive in Illinois. Taxes are crazy in Illinois. Those are some of the things that we're fighting.

MG: You heard Donald Trump at the debate talk about his job creation record from your perspective. What is your take on on how he has done? I mean, people debate whether governments can actually create jobs or not. But when you hear what he says, what's your reaction?

KEITH MACDONALD: I think President Trump is doing the best that he can to create jobs or bring jobs back even to the United States. We've got a challenging climate, meaning EPA and all these other regulations, all the hoops you have to jump through just to be in business.

MG: There are real questions around his job creation record. The United Steel Workers Union has said that 40 steelmaking operations have closed in the last few years. 8000 people have been given the boot from their jobs. That goes against what the president is saying. How do you square that? How do you explain the different messages that are out there?

KEITH MACDONALD: I think one thing that we're fighting is wages. You know, we're trying to compete in a global market, meaning most people, the United States, you know, we all want to make as much as we can and provide for our families. And so our wages are higher than China or India or other places where they can bring products to market for much less than we can. You know, historically, you know, look at the Amazon is the Wal-Mart. The business models provide something for as low as possible cost. We are also getting the lowest possible quality with that as well. And I think a lot of people just don't mind that anymore, though. They'd rather spend 19 dollars for a pair of jeans, five times than 60 dollars for a good pair of jeans.

MG: When the president put tariffs on steel, what did that do to your company?

KEITH MACDONALD: We unfortunately had to pass those costs along to the customers.

MG: So when he says that the steel tariffs are meant to to protect and bolster the American industry. But you say that you have to pass the cost on to your customers. Does that ring true to you that that he's protecting your industry?

KEITH MACDONALD: It's not just my industry, it is the steelworkers, it's the no workers trying to incentivise us to to keep jobs in America rather than buying the cheap Chinese steel, which I can tell you from personal experience, you know, going back to my quality point when you cut it, you can tell there's a difference.

MG: And that idea of protecting American jobs, I mean, he's talked about America first. Is that something for you in the industry that you're in, in the community that you're in? Is that something that rings true to you?

KEITH MACDONALD: Absolutely. I think we need to take care of America first.

MG: Do you see evidence that he brought jobs back, manufacturing jobs, back to the United States? This was a huge promise. And people have disputed this, saying that the jobs never returned, that the promise was not fulfilled on the ground where you are. Have you seen any evidence of that promise being fulfilled?

KEITH MACDONALD: I've not seen that in the state of Illinois, no. Again, Illinois, very Democratic led. We almost have an anti business climate.

MG: What do you mean?

KEITH MACDONALD: There's tons of examples of businesses that have moved to Indiana, Wisconsin, just for the better tax situation.

MG: Did you watch the debate?

KEITH MACDONALD: I did.

MG: What did you make of it?

KEITH MACDONALD: Oh, man, what a disappointment. I would say that Biden did better than I expected, and I wish President Trump had remained a little bit more presidential.

MG: Does it give you any pause about voting for him? I know you voted for him four years ago, and I don't mean to pry into personal life or what have you, but does it give you pause about voting for him again, given not just what you saw in the debate, but how he has behaved as a president over the last four years?

KEITH MACDONALD: And no one, I'll explain why is because, you know, being Democrat critically led Illinois. I've seen the tax policies that we have in our state. I think Biden will create a country of Illinois, meaning that we'll just actually out of whatever problems we have. And that scares me. And that's why I won't be supporting Biden. I've earned everything that I have. I'm sympathetic to people who have been down on their luck. And there are some people that we do need to help. Absolutely. But to have generations of welfare, I don't think it's proper.

MG: And so even given what you saw there, as you said, it was disappointing in the debate. Would you still vote for Donald Trump this time around?

KEITH MACDONALD: I still am voting for Donald Trump, yes.

MG: These are, and you saw it in the debate, it's a really divisive time in your country. And I'm just wondering, on Election Day, what are you hoping for?

KEITH MACDONALD: It's really unfortunate that this is my primary hope is for a peaceful election, that it doesn't get stained with violence and non peaceful protests, which with the mailing voting, voting and everything that we have coming towards us. Obviously, we're not going to have an answer on November 3rd. It's going to take at least 10 days for all the votes to get counted that come in by mail. I hope that we can remain calm and respect one another. And I think that's something we're losing in the United States is respect for one another. You and I can have different opinions on things. And because we do nowadays, we have to hate each other. And I have to call you names you have call me names. I don't understand why we can't respect one another for our different opinions.

MG: Do you worry that the person that you voted for and that the person that you just said you'd vote for again, that he adds fuel to that fire?

KEITH MACDONALD: I don't think that he does. I know he's painted into that picture that that's absolutely who he is and he's dividing the country. I don't see that as reported in the media. I think he's good for our country. He's not a political correct person. And I can appreciate that. We've gotten to where we're too worried about each other's in-depth feelings, everything touchy feely. Obviously, President Trump is not very touchy feely. He's very blunt.

MG: Just the last point is, could you have ever imagined that that you would worry about a peaceful election in your country?

KEITH MACDONALD: No, no. I never dreamt that we would have to worry about a peaceful election.

MG: I wish you the best. These are going to be really difficult days ahead, certainly. And it's not just even up to the voting day, but it's the days, as you say, after the voting day, there could be some of the trickiest. Keith, I really appreciate talking to you this morning. Thank you.

KEITH MACDONALD: Thanks for your time.

MG: Keith McDonald, director of operations for his steel product manufacturer in Rockford, Illinois. He is also county board Republican caucus chairman for Winnebago County. We will steer the current RV up the road from Rockford into Freeport. Laurie Thomas has lived here for almost her entire life. She was working a couple of jobs actually there until last month when her entire shift of 80 workers was laid off. Laurie was an inspector for Honeywell working with aeroplane parts. Now she has more time to spend at her elderly mom's house helping out. And that is where we caught up with her.

SOUNDCLIP

LAURIE: We didn't get any warning. It was devastating. They had a meeting in the cafeteria. They came. We came to work the team. We came up to me and he said, Laurie, I don't know what's going on, but something is going on. And she's like, no, they want everybody. Now, we're supposed to come right straight down to the to the cafeteria. I knew then I said, oh, they'll lay us off. There were people that were crying, there were people that were really angry, like the guy next door for my mom. He had been there for what did Bobby say? 28?

LAURIE'S MOM: 29 years?

LAURIE: 29 years. I'm 60. So I had planned on I thought to myself, if I can just last here till I'm 62, I'm good because I can retire. Well, I'm a half probably work three to fill the gap. The thing like I was telling her that with Honeywell, there's not another place that's going to start people off at, you know, 15 dollars, you know, and then you get we got a nice bonus and all of that. Where are they going to find jobs? And you think about people that's been around 20 years.

LAURIE'S MOM: You can not support a family on a minimum wage job.

LAURIE: This is what I'm talking. I'm probably not going to stay in Freeport right now. Everything that I'm doing, I put in my resumé. It's been like Texas, in Atlanta. And some people are never coming back. Like Honeywell, our division. It probably will never be back.

VOICE: Can you tell me about the signs?

LAURIE: That's the Joe Biden side. And then this one right here is the bolt for the fair tax. And I think most people don't understand that. They think that it means their taxes is gonna go up. Well, if you're not making over two hundred and fifty thousand dollars a year, 80 percent of Freeport don't have to worry about that. There's houses out there, there's a trump, and then there might be a Biden. But I think that they'd never knew each other's politics. The Trump guy has a dog. Now, the Biden guy told him he better not catch any dog poop in his yard. If he does, it's gonna be problem with a lot of people got dog. But every time he find dog poo, where do you think he puts it? On the Trump drive. So it's kind of funny to me that people, it's just like everybody is tribal at this point.

MG: Laurie Thomas lives in Freeport, Illinois, lost her manufacturing job recently. As we make our way towards the Illinois border and back over the Mississippi River. We pull into Granite City, where a U.S. steel plant sits on the river's edge. Dan Simmons is president of United Steelworkers Local 1899. He's worked at the U.S. Steel plant for 42 years. Dan, good morning to you.

DAN SIMMOMS: Good morning to you, Matt.

MG: How important is manufacturing in your town?

DAN SIMMOMS: This town is built around the steel mills, the steel mill was built back in the early 1900s. So organisations and groups and schools, and I usually start out by, you know, raise your hand if you know someone who works at that steel mill or a relative to that steel mill or, you know, close relative and the [unintelligible].

MG: What has COVID-19 meant for the plants and for the city.

DAN SIMMOMS: Actually, we've been deemed essential workers. And originally, we had just minimal impact. But then you start to see in the decline where the auto industry plants were shutting down for COVID and a ripple effect, just like, you know, pebble in the water, you start feeling the impacts. And ultimately, U.S. Steel made the decision that we were one of the facilities that were going to bank one of their two furnaces. So right now, we're operating on just a single furnace resident old firm.

MG: And that means that people are laid off.

DAN SIMMOMS: Yes.

MG: What does that mean? I mean, you talked about, you know, the show of hands where everybody knows somebody who knows somebody who works in the plant. When people get laid off, what does that mean for life in in your town?

DAN SIMMOMS: We still have about sixteen hundred employees still work. And currently today we get about 38 of them right now currently on layoff. We've been slowly bringing them back in through attrition and also some a little bit of mark-ups and improvements. But when we were idle back in 2015, the U.S. Steel idled this facility. It was like tumbleweeds through this plant. It would be like a ghost town. You know, you and the employees inside was about all there, was there. And it was just a different eerie feel about this, this location, because we were idled approximately over two years, little over two years.

MG: We hear so much about manufacturing and it's, you know, in the lead up to an election. But obviously, it's an important issue day in and day out. Have a listen to Anthony Jackson. He's 44, lives in Chicago, is a disabled veteran and a father of three.

SOUNDCLIP

I used to work in Mont Lee, which makes orios, risk crackers and other snack items. Mont Lee had a plan to lay off 600 employees and shipped the jobs down to Mexico. They ended up laying off 400 plus people. I was one of the people who got laid off. I had a working for the union to try to get the jobs back. We got about 200 jobs back and forth. That was not one of the people. It was, it was able to get back due to lack of seniority. Since then, I've been working temp jobs, trying to get a hold of a permanent job. But because I worked for a union, the BCTGM, which is the bakery, confectionary, tobacco in Grey Mills International Union, as a spokesperson, as an organising, a lot of 19 companies won't touch me. So they have a fear that I may come in and try to unionise the plant so they won't hire me. I guess I have to say it is what it is because I have family to feed. I just have to provide. So I can't dwell on it. That's not a good film. But I can't dwell on it. We were already losing jobs and wit COVID that does, a lot of small companies have folded completely so bad cause more jobs to be lost. And now there's a fight for the few jobs that are left. I haven't seen any sizeable manufacturing coming back to Illinois or Chicago in particular. Hopefully Illinois will be at the forefront of some new technology. The old days of working at a plant and making a living to take care of your family, not accessible for most people.

MG: Dan Simmons, we heard Keith McDonald talking earlier about the president being good for manufacturing. You hear a little bit about what Anthony Jackson has to say. And he thinks that in some ways that the days of working in the plant and being able to feed your family, coming out of those jobs are over and done with. Do you think your sector is better off now than you were four years ago?

DAN SIMMOMS: Absolutely not.

MG: It's a pretty blunt answer. Tell me more about that.

DAN SIMMOMS: Well, I'm aware of some of the numbers in the figures. And I was also one that was, when we were idle that was testifying Congress and caucus committees in the Commerce Department out in D.C. for all the trade cases, along with the 232 tariff case and the holes that was left into the 232. The foreign countries are still able to cheat the system. And it had a temporary help for us in the industry. But since then, they've had the loopholes wide open enough that they're able to still continue to cheat, dump steel. So we have seen actually a spiralling down still and our manufacturing sector jobs and the steel industry as a whole since Donald Trump's been in office.

MG: So when he says that that he has helped bring manufacturing jobs back to the United States and Keith was saying he's done what he would. He can do that. He's up against a lot. But he's trying as hard as he can. Does that square with you?

DAN SIMMOMS: What jobs I've seen created in my area here where we live is Amazon jobs. And they're 12, 13 dollar an hour jobs. They're not just sustaining jobs that can sustain a family. You know, they're low income jobs. He has not created the jobs that he promised.

MG: Again, Keith talked about that idea of supporting the America first, the Buy American belief to understand why. When Donald Trump says that that that could be attractive to people, that people four years ago might vote for that and they might vote for it again because they want to protect what they have.

DAN SIMMOMS: I absolutely I think it's a great statement to make, but you got to back it up and he's got proof that he didn't back it up. And I heard what he said and I was kind of back and forth. He was going to walk both sides of the line a little bit where he was taken advantage of was fine and comfortable with by American were his facility was an impact because it's American, by Americans. But at the same time, he was also talking about the ability to still he still like the idea of buying some of the cheap products for 19 dollars, jeans.

MG: It feels like there's a lot at stake. I mean, everybody that we have talked to in this this trip down the Mississippi has talked to us from their perspective about what's at stake. Does this election feel different to you?

DAN SIMMOMS: Yes, it is. It is. I don't how to frame it any other way. And the debate probably bolstered my opinion. This is the ugliest and most decisive election I've ever been involved with. And I'm sixty years old as well. I've been in the steel mill industry for 42 years. More than 42 years. I'm a second generation. My father worked here. And when I look it back at all the elections, I've never seen anything more uglier. It's a train wreck and it's an embarrassment to the country.

MG: Keith talked about the need for people to be able to talk to each other. That even if you disagree. There used to be a point where you could disagree and it didn't turn into a shouting match. It didn't turn into people calling each other names. What have you lost in that inability for people to talk to each other?

DAN SIMMOMS: He hit that one on the head. That is exactly right. I have good friends of mine. I used to sit there and drink a beer with them. We'd say, OK, let's get it over with the first 10 minutes the most. We do our little politics back and forth. And then after that, we were still friends for the evening. But he's actually right. This president has brought so much hatred and divisiveness that it is a shouting match now. It is very narrow, and I hate to say this, but the ones that really are staunch supporters of him is like they got horse blinders on and they see no wrong. And everything he's doing that there isn't any president alive that would just be chastised for some reason. He gets a get out of jail free on anything he does.

MG: I mean, there's a lot of darkness that's easy to end up in that kind of downward spiral if you follow that logic. Where do you find any degree of optimism or hope in this?

DAN SIMMOMS: Well, I do hope, I hope a couple of things. I hope it did. It is quite a one sided election. So it will minimise some of the debates and challenges and, you know, the false accusations and the cheats and whatever else, frauds. I hope for that because I think that would happen and I think that the American people will still stand up at one point, everyone stands up to say enough's enough and put some dignity back in an office, put some dignity back into our country. And we are not the embarrassment to all the other countries who watch this sideshow.

MG: Dan Simmons, I really appreciate your time this morning. Good luck. And I hope things are as safe and peaceful as they can be. Thanks again.

DAN SIMMOMS: Thank you very much. Have a good day.

MG: And you. Bye bye. Dan Simmons is president of the United Steelworkers Local 1899 in Granite City, Illinois. That's it for our time in Illinois. Next week, we pull The Current RV, such as it is into St. Louis, Missouri. Budweiser beer country. Chuck Berry Country. Spareribs Country and the gateway to the West. St. Louis, Missouri. The Current is coming for you and you'll hear us next week there. You can catch up on all of our road to November. Stops by heading to the Web site to cbc.ca/tehcurrent. Your regional update is next. And then in Tuesday's U.S. presidential debates, Donald Trump told the Proud Boys who have been called a hate group to stand back and stand by in the hours after that debate. The Proud Boys made that phrase into a new logo. We will talk about what that means for the rest of the election campaign and the future of that country. There is a lot of tension when it comes to the president's comments or lack thereof on white supremacy and other matters of race. I Matt Galloway The Current is back in 90 seconds. Stay with us.

David Neiwert on Trump saying ‘Proud Boys, stand back and stand by,’ Dispute between doctors and Alberta provincial government

Guests: Dr. Amy Tan, Tom MacIntosh, David Neiwert

MG: Hello, I'm Matt Galloway, and you're listening to The Current.

SOUNDCLIP

VOICE: You have repeatedly criticized the vice president for not specifically calling out ANTIFA and other left wing greenness groups. But are you willing tonight to condemn white supremacists and militia groups and to say that they need to stand down and not add to the violence? And a number of these studies, as we saw in Kenosha and as we've seen in Portland,.

TRUMP: Sure I'm willing to do that.

[Cross tallk]

VOICE: Well, go ahead, Sir.

TRUMP: I would say almost everything I see is from the left wing, not from the right wing.

VOICE: So what are you saying?

TRUMP: I'm willing to do anything I want to see peace.

VOICE: Then do it , Sir. He didn't do it, sir. Say it.

TRUMP: You want to call them- what do you want to call them? Give me a name.

VOICE: White supremacists.

[cross talk].

Proud Boys, stand back and stand by. But I'll tell you what. I'll tell you what...

MG: Stand back up and stand by. Those words are still reverberating after Tuesday night's presidential debate. President Trump was talking about the Proud Boys, a right wing group that has been designated a hate group by the Southern Poverty Law Centre. David Neiwert has been studying hate groups in America for more than three decades. He's a staff writer for the Daily Kos and the author of Alt-America The Rise of the Radical Right in the Age of Trump. David, good morning.

DAVID NEIWERT: Good morning.

MG: What went through your mind when you heard the president on Tuesday night telling a far right group to stand by?

DAVID NEIWERT: Here was a moment I'd been fearing for a long time coming into reality. I mean, we've known for a long time that these white supremacists and right wing extremists have been marching in the streets and creating violence for the last two years in the name of Donald Trump. And Trump has always kind of assiduously avoided making that connexion clear. But he made it very clear less that night. And unfortunately, he also really kind of did what a lot of us had feared he would do, which was sort of to take command of them to be the person who, you know, basically claimed to charge of them.

MG: He specifically referenced the Proud Boys just briefly to explain who this group is.

DAVID NEIWERT: They're basically a street brawling group that was created in the aftermath of protests in early 2013 in Seattle and Berkeley. And we saw them come out at a at a big event in April of 2017 at Berkeley. That was one of the most violent events that are covered.

MG: Created by Canadian Gavin McInnes.

DAVID NEIWERT: Yes. Ah. Cocreator. Yes. Yes, of course. McInnes really was the guiding light for their foundation and made them wildly popular because he had a huge platform. And then once, of course, the Southern Poverty Law Centre designated them a hate group, he stepped down and then filed a lawsuit against the SPLC.

MG: You wrote a piece in the Daily Post yesterday in which you compared the proud boys and other U.S. right wing militia movements to the brownshirt enforcers in Nazi Germany.

DAVID NEIWERT: Yeah, well, they're essentially playing the same role, filling the same role, which is to go out and engage in street violence on behalf of their political cause and to create an image of leftist violence. I mean, the whole purpose of the problems in these events that they've created has been to create violence. They have created events in Portland and Seattle and Berkeley and elsewhere, including, of course, Charlottesville, that were ostensibly about, you know, that it was the cause de jure on the right. Usually it was frequently free speech. But but we also saw them marching on behalf of men's rights and on behalf of, you know, opposition to Sharia law and you very, very flexible. But what they're really out there for is to go bash heads. They come pretty heavily armed. They come hard armoured, and they all come eager to fight.

MG: The president has faced a firestorm of criticism for not condemning groups like the Proud Boys in Tuesday night's debate. Yesterday, he was asked directly about this group. Here's what he had to say.

SOUNDCLIP

TRUMP: Law enforcement will do the work. More and more as people see how bad this radical liberal Democrat movement is and how weak the law enforcement is going to come back stronger and stronger. But again, I don't know who Proud Boys are. But whoever they are, they have to stand down, let law enforcement do their work.

REPORTER: Do you denounce them?

TRUMP: I always denounce any form, any form, any form of any of that. You have to denounce. But I also add Joe Biden has to say something about ANTIFA. It's not a philosophy. These are people that hate people over the head with baseball bats.

MG: David, he says he denounces all forms. What does that tell you?

DAVID NEIWERT: I'd say it's a good people are, you know, very good people find people on both sides, which is what he said after Charlottesville. Yes. No, it's more of the same. Actually, I did an investigative piece for Mother Jones magazine published in October 2016, examining even before he was elected, Trump's, many multifarious connexions to the radical right and white nationalists. And what we found when we started, we basically compiled a database of all of these various connexions, both from Trump's side and from the white nationalist side. And what we really found was that he has a long history of doing what we called as sort of a three step tango, where he will make a statement that clearly encourages white nationalists and right wing extremists. The next day he comes back and says, oh, no, I didn't really mean that. And then then a few days after that, he'll go back to being, you know, in favour of them. I mean, he did it with David Duke during the 2015 campaign. And if you think about how he did the same thing.

MG: So he said he had no idea who David Duke was.

MG: Yes. Yes. And he's done this over and over and over. And what I think is important and what we have always tried to track is how do the white nationalists, how do these white supremacists respond to this? And uniformly, it's always that take that first signal as being the main one. And then, of course, step back the disavowals and that sort of thing they don't take seriously. In fact, none of them believe it. They just say, oh, he's just trying to do what has to do to maintain his political viability.

MG: Just in the last minute or so that we have, there is not long until the election. What will you be watching for as the vote gets closer?

DAVID NEIWERT: I think all of us are very concerned about street violence and voter intimidation by these right wing thugs. They've said that they're going to do it. And in fact, during the same debate, you know, Trump talked about sending out poll watchers. Well, that's what these people are preparing to do.

MG: And that would mean what people who would be. Yes, voter intimidation. What would that look like?

DAVID NEIWERT: It would mean sending people to polling places and our basically threatening people who don't want vote for Trump. We've already seen this happen in Virginia just a week and a half ago when early voting started in in Virginia. We saw at least in one location, that large trump of a crowd of Trump supporters, supporters come out and actually block people from entering the polling place.

MG: Members of the Republican Party have condemned his comments in the debate. Are you confident that the party itself, if this is what you're worried about, that the party will ensure that people have fair access to vote?

DAVID NEIWERT: No, no, no. This is a party that has enabled Donald Trump every step of the way, has shown absolutely no spine in standing up to him and his degradation of our democratic institutions. And I certainly don't expect them to suddenly show us by now.

MG: David Neiwert, good to speak with you. Thank you. You bet. David Neiwert is a staff writer for the Daily Kos and the author of Alt-America The Rise of the Radical Right in the Age of Trump. He was in Seattle.

[Music]

MG: This is The Current on CBC Radio one. My name's Matt Galloway. Health care systems across this country have been stressed over the past seven months in Alberta. The pressures of COVID, 19, have been playing out against the backdrop of another dark cloud, a turbulent dispute between doctors and the provincial government. For some physicians, the situation is so bad that they're actually leaving the province. Dr. Amy Tan is one of them. She has a family practise in Calgary and was a leading voice in masks for Canada, advocating for more mask byelaws across this country. Next month, she will start a new job in Victoria, British Columbia. Doctor, good morning.

DR. AMY TAN: Good morning. Thank you for having me.

MG: Thanks for joining us. Take me back to February. What was it like for you as a physician working in the face of a growing pandemic and in the midst of this dispute with your provincial government?

DR. AMY TAN: So in February, both things were ramping up as we were watching the news as to what was happening around the world and trying to see what we needed to be prepared for what we were seeing in Italy and in New York City closer to home, we thought I think, my colleagues and myself, we thought maybe that the attention would be where we need to be, which was on saving the lives and health and safety of Albertans rather than the fights that were going on between the government and the army and physicians. And we actually were hopeful that the government was going to stand down on its attacks because we had to work together for the good of Albertan.

MG: What was morale like amongst yourself and fellow doctors in that moment?

DR. AMY TAN: So, you know, I think we're a bit of a fight or flight moment where we were gearing up for this unprecedented event. And, you know, none of us had gone through it before. So I think we were dedicated to our patients who were dedicated to their safety, our own safety, and therefore our family's safety. So I think in February, our morale was while it was down, we rallied for what was to come. I would say now seven months and the morale is on an all time low.

DR. AMY TAN: And why have you decided in the face of that to leave?

DR. AMY TAN: Because I, unfortunately, and I have the privilege of doing this, of witnessing suffering that is out of anybody's control on a daily basis, both in my family medicine practise and as a hospice physician where things are out of people's control. And they suffer. And I have witnessed increasing suffering of Albertans at the hands of the government by the decisions that are making in terms of cutting the social safety nets, cutting health care, attacking physicians. And so all of those things really came to be too much to bear this spring.

MG: Was there a moment- I mean, leaving the province is a big decision, moving at anytime, moving in the middle of a pandemic when you're a doctor is a huge decision.

DR. AMY TAN: And I have a family.

MG: Yes. So was there a moment when you said, you know what, enough, I can't do this anymore and I'm leaving?

DR. AMY TAN: Yes, I think when I realised that my everyday daily stress was actually on what the USP government was going to announce on Twitter on a given day rather than, again, the focus that should have been at hand, which was the pandemic at the time, I was advocating very heavily for mass mandates across the country. And really, the focus should have been the health and safety of Albertans.

MG: How invested were you in in Alberta? Professionally and otherwise.

DR. AMY TAN: Incredibly invested. I my husband and I thought we were retire here at least until our child was out of high school. He's an elementary school. So there were zero plans to leave Alberta. I came in 1999. I did medical school here. I did residency here. I've seen faculty at two universities up Alberta in Calgary. So this was our life. This was home.

MG: What about the conversations that you had with your patients when you told them that you were leaving, that you are shutting down your practise and you're moving to Victoria. How do they react?

DR. AMY TAN: It's been hard. It's been a very hard six weeks or so. As I am winding down my practise here and every visit has been saying goodbye. I apologise to each and every one of my patients for having to leave. I don't go into a lot of specifics because, again, with a doctor patient relationship and mindful of that. But I do say, you know, I'm sorry that it's gone to a point where I can't feel like I can do my best work. And also that I'm very concerned about the future, the health care system with the plans to privatise and how it actually will negatively affect my patients in the practise. And I'm actually talking to.

MG: What do you mean?

DR. AMY TAN: Well, I have a practise in northeast Calgary, and it is the quadrant that is has been the most disproportionately affected by COVID-19. These are it's a demographic that is very multicultural. There's my practise has a lot of essential workers, people of colour, racialized people. And through the pandemic, I was advocating on a one to one basis for my essential workers patient safety in terms of having their employers allow them to wear masks. And that's actually how I got into mask advocacy. Now, with a plan to privatise health care, the disparities that COVID_19 has been shining a huge light on across this country. Those disparities are going to worsen if these times go through. And it breaks my heart, to be honest.

MG: This is a loaded word, but I use it deliberately. Do you worry that that in the midst of a pandemic, you're abandoning your patients?

DR. AMY TAN: Yes, I feel that I'm open about that. That I feel that it was not an easy decision. It's something that my family and I struggled with. And at the end of the day, I needed to do the best thing for my family and myself in terms of being able to live according to our values and our intentions. I survived a near-death car accident as a resident. And so I'm not going to squander what I think are going to be my most productive years in trying to help with community based palliative care and bringing care to patients where they live, when the government is making decisions such as decimating rural health care and all the things that would not allow me to do, I think the work that I meant to do.

MG: The Alberta Health Minister, Tyler Shandra, says that this is about money. And we asked to speak with the health minister this morning. We received no response. But have a listen to what he said to CBC Edmonton in July.

SOUNDCLIP

The doctors in this province, there are 10,800 of them. They are less than a quarter of one percent of our entire population. And they receive 10 percent of the Alberta government's budget, 10 percent. We see private sector compensation going down as much as 20 percent for some people. The fact that we are thankful physicians, we want to hold your compensation at five point four billion dollars is more than reasonable.

MG: Dr. Tan, what do you make of that statement?

DR. AMY TAN: So first of all, it's not about money. First of all, the Alberta Medical Association proposed a cut across the board and [unintelligible] as our representation, as our association to work with us to find efficiencies, to cut costs that wouldn't harm patients. And that's, I think, the crux of it. There's no trust. There's no respect about what we can actually bring to improving the system.

MG: The minister said that Alberta doctors are amongst the best paid, if not the best paid in the country.

DR. AMY TAN: And people are still leaving because that is not the thing that actually creates the environment, that we can do our best work. We are here to serve patients. And when we see day in, day out the suffering that patients are enduring over and above the uncertainties of a pandemic. It's too much to witness over time.

MG: We talk about asking people about money. Will you make less money? In British Columbia?

DR. AMY TAN: Short answer, yes.

MG: Do you worry - this goes back to the issue of your patients - do you worry that the difficult situation that you're describing is going to be exacerbated if if doctors choose to leave the province in large numbers? Something like 42 percent of doctors polled by the Alberta Medical Association say that they're thinking leaving is not going to exacerbate the situation.

DR. AMY TAN: It absolutely is. And I'm not going to even try to tiptoe around it. It is. But unfortunately, this is directly because of the decisions of the government. We as physicians at the Alberta Medical Association, we have tried to implore the government to work with us. We do not want to negatively impact patients.

MG: Just the last question was, before I let you go, the last question is just the government says that this is just a bargaining tactic. It's not true that Alberta doctors are choosing to leave in large numbers, that this is really a way to help get what you want. What do you know?

DR. AMY TAN: I have moving truck booked. I have rented a house in Victoria. We're selling one of our cars today. So, our son is being uprooted in the middle of elementary school. So, no, these are these are we are real people. We have lives. We have real decisions that we have to make. This is not a ploy. I am very grateful and very excited that I have a wonderful opportunity to go to. But this was a very difficult decision that was made clear in the spring for me because of the untenable environment that we find ourselves in Alberta.

MG: Dr. Tan, I appreciate speaking with you this morning. Thank you.

DR. AMY TAN: Thank you.

MG: Dr. Amy Tan is a Calgary based physician who's moving to Victoria, British Columbia, next month. Bargaining disputes between doctors and governments may not be new in this country. But my next guest says that what's happening in Alberta is unique. Tom MacIntosh's a professor of politics at the University of Regina, focuses on health care policy. Tom. Good morning to you.

TOM MACINTOSH: Good morning.

MG: Help me understand. I think a lot of people would kind of want to know how is this and why is this playing out in the midst of a global pandemic?

TOM MACINTOSH: Well, that's actually a good question. One would think that I think is your previous guest said that if you are in a dispute with your physicians and you get hit by a pandemic, you could at least get both sides to stand down on the dispute until the pandemic has been gotten under control or has passed. This seems to be a choice of the government to pursue this rather sort of hard line strategy of cost cutting and the like and to continually double down usually on social media in there in the attacks on physician.

MG: The premier has said that this is a scare tactic, that the government is essentially saying doctors are bluffing when they claim that large numbers of physicians will pack up and leave. Do you think that's a wise bet for the government to make?

TOM MACINTOSH: Well, you know, here's the thing. I don't think large members have to leave for it to do serious damage. And it really does depend on- it may depend to some extent on where they leave from. You know, so I'm not expecting, you know, half the doctors of Alberta to suddenly decamp to the rest of the country. But doctors leaving from small towns, from rural communities, from underserved areas in urban centres can cause huge hardship inside the health system.

MG: Well, let's hear about that hardship. I mean, Sundari is a town of about 3000 people in southern Alberta. Five family doctors at the Moose and Squirrel Medical Clinic announced in September that they would leave their practises in the province in the spring of 2021. Nicole Holton's doctor was one of them. Have a listen to what she's been going through. She and her husband have been struggling with infertility over the past several years.

SOUNDCLIP

When I seen the letters on social media basically telling us that our family doctors will be leaving, I was crushed and devastated and frustrated all at the same time. It took my husband and I over four years to finally find a family doctor and not just find one that we are comfortable with. And now that we're losing her, it's just breaking. Now that we're going through all the infertility stuff and going through the process, knowing that when we do start a family, we don't have a family doctor. It's something that people don't really think about being such a big deal. But then when you start trying to start a family, it's actually a big.

MG: Tom Mackintosh, are those concerns typical, especially, as you say, in rural areas?

TOM MACINTOSH: I think yes. And I think, you know, when you think about your rural population is going to be older. They're going to have more chronic conditions that need management. And we haven't done well in alternative forms of primary care through nurse practitioners and things like that in any of the provinces, really. That those are only beginning to sort of take hold. And so if some even relatively small percentage of doctors leave, but they leave from those kinds of communities, you're going to be abandoning all sorts of people. And you've got to remember many of these physicians, you know, that was a case of a fine five physician practise. You may have you know, a lot of these people are doing solo practise. They're already worked very hard, stressed, worried about coverage, not able to take vacations, all those sorts of things. This just pushes them over the edge to say, you know what, I'm done. I mean, they're going to retire if I'm old enough or I'm going to, like Doctor Tan earlier, I'm going to look for other opportunities in other parts of the country.

MG: Just in the last couple of minutes. Two things. One is that Alberta, like a lot of provinces, wants to move some doctors away from the fee for service billing model onto more contracts or salaries. What's so contentious about that?

TOM MACINTOSH: Well, again, as a health policy person, that is a a goal that I think everybody shares. People have been arguing against fee for service for a very long time. And, you know, this has been this has been a perennial issue in the system. Alberta has been very slow, admittedly insulin in moving doctors on to on to alternative payments. They haven't been as successful as some of the other provinces. But, you know, one of the things that the research shows very clearly is that those places that have been more successful, if you have done it in collaboration with their physicians and created incentives. Younger doctors, female doctors, all are much more willing to move off of a fee for service model. So there is an impetus there. And so that goal of the government isn't necessarily wrong the way they've gone about it, to try to browbeat them into this into this just the wrong approach.

MG: And so it has worked, as I say, just in the last couple of seconds, we have is that the cautionary tale for four other jurisdictions in the country that are watching this?

TOM MACINTOSH: Yes I think it is, yeah, most definitely.

MG: Is your sense that the doctors are going to leave? Do you think people that they will actually do take the step that Amy's doing?

TOM MACINTOSH: I think some will. You know, it won't be the 42 percent or whatever the BMA survey said. We're thinking about leaving. But as I said, it only takes a small number of to do some serious damage to the system.

MG: Tom McIntosh, great to talk to you about this. It's important. Thank you.

TOM MACINTOSH: Thank you very much.

MG: Tom MacIntosh, professor of politics at the University of Regina. Love to hear your reaction to this from what Dr Tan is doing, but also the bigger picture that Tom Mackintosh was exploring. You can email us thecurrent@cbc.ca or on the Twitter @TheCurrentCBC or go to the Web site cbc.ca/thecurrent. Click on the contact link. And that is it for the current for today. Q is up next on CBC Radio One. Tom Power speaking with Ebonnie Rowe. You may not know her name, but she would know some of the musicians that her programme, Honey Jam, has helped launch into the stratosphere. People like Ebonnie Rowe have been involved in helping to shape the career of Nelly Furtado, for example. It's a great story and you'll hear all about it coming up on CBC Radio One. I Matt Galloway. Thanks for listening to the current. Take good care. I'll talk to you tomorrow.

The Current Transcript for October 1, 2020

STORIES FROM THIS EPISODE

Prologue

Relatives, experts call for accountability in wake of Joyce Echaquan's death

Road to November: Illinois, manufacturing and bringing back jobs

David Neiwert on Trump saying ‘Proud Boys, stand back and stand by,’ Dispute between doctors and Alberta provincial government

Thursday October 1, 2020 Full Transcript

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