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When government holds monopoly control over any system, and the means of production of key suppliers have been nationalized, there’s no market to help patients, doctors and health-care managers make decisions. The only option for the system is to constantly increase bureaucratic control and progressively reduce the freedom for everybody else.

If doctors vote Sunday to accept the agreement, they will be pulling the first string that will allow the Wynne government to bring in reforms that will, among many other things, greatly reduce the already constrained freedom of doctors, hospital managers, and other organizations and individuals. As the OMA itself said in response to Bill 210, the legislation gives the minister of health and the government-controlled Local Health Integration Units (LHINs) “a significant increase in their command and control of the health system and many of the providers within it.”

To get that command and control, Ontario is using the oldest legal dodge in the command-and-control handbook: give the minister the power to do anything the minister wants so long as it can be said to be in the “public interest,” an undefined legal grab bag that provides command-and-control freaks near-unlimited power. “This is problematic,” says the OMA in an understatement.

As the all-powerful commissar of patient care, the Minister of Health (MOH) can reach high and low through the system in search of the public interest. The Ontario Hospital Association, in its response to Bill 210, calls the MOH’s new public-interest powers “quite broad” — another understatement. It would, for example, permit the minister to issue direct orders to hospitals to lower parking fees — something the government has tried to do in the past but had no legal authority to enforce. Now it will.