Search results

A captivating biography of two famous women whose sons, Winston Churchill and Franklin D Roosevelt, would change the course of the 20th century-by award-winning historian Charlotte Gray. Born into upper class America in the same year, 1854, Sara Delano and Jennie Jerome refused to settle into predictable, sheltered lives as little-known wives to prominent men. Instead, both women concentrated their energies on enabling their sons to reach the epicentre of political power on two continents. In the mid-19th century, the British Empire was at its height, France's Second Empire flourished and the industrial vigour of the USA was catapulting the republic towards the Gilded Age. Sara and Jennie, raised with privilege but subject to the constraints of women's roles at the time, learned how to take control of their destinies, Sara in the prosperous Hudson Valley and Jennie in the glittering world of Imperial London. Yet their personalities and choices were dramatically different. A vivacious extrovert, Jennie married Lord Randolph Churchill, rising politician and scion of a noble British family. Her deft social and political manoeuvrings helped not only her mercurial husband but, once she was widowed, her ambitious son, Winston. By contrast, deeply conventional Sara Delano married a man as old as her father. But once widowed, she made Franklin, her only child, the focus of her existence. Thanks in large part to her financial support and to her guidance, Franklin acquired the skills he needed to become a successful politician. Set against one hundred years of history, Passionate Mothers, Powerful Sons is a study in loyalty and resilience. Gray argues that Jennie and Sara are too often presented as lesser figures rather than two remarkable individuals who were key in shaping the characters of the sons who adored them, and preparing them for leadership on the world stage. A masterful biographer and acclaimed historian, Charlotte Gray breathes new life into Sara and Jennie. Impeccably researched and filled with intriguing social insights, Passionate Mothers, Powerful Sons offers a fascinating and fulsome portrait of how leaders are not just born but made

Obstetricians have been leading the fight against government fee clawbacks and income thresholds in Ontario, but the anger has quickly spread to other specialties. Ontario doctors probably haven't been this angry since their walkout in 1986, and Charlotte Gray warns that job actions, in the form of refusals to take new patients or work in hospitals, lie ahead. If health care funding restrictions continue in Ontario, warns Dr. Dick Johnston, "sooner or later, there'll be a disaster."

Liberty Health is just one player in the supplementary health care field, but its metamorphosis into a managed-care company, when considered alongside a similar evolution by some of its competitors, signals important changes in the health-insurance field. The private sector now represents more than 28% of health care spending in Canada. CMAJ contributing editor Charlotte Gray looks at how Liberty Health is affecting supplementary health insurance in Canada.

When Beryl Gaffney, a Liberal member of Parliament, was told she had a brain tumour, she decided to take control of her own life. Instead of allowing the first doctor she saw to rush her to hospital, she travelled to Montreal and London, Ont., to get a second and third opinion. Then she showed neurologists in Atlanta her test results and asked which of the three options for treatment she had received coincided with their treatment recommendation. Today, she is back in the House of Commons, where she spends much of her time debating health care issues.

The gap between the ideal and the reality of medicare was evident at two recent national conferences. One was the wrap-up consultation of the National Forum on Health, at which it was evident that Canadians are devoted to government-sponsored medicare and want to maintain the status quo. The other, the National Health Care Policy Summit cosponsored by the CMA, indicated that business and health care leaders are concerned that medicare will not survive unless the private sector plays a bigger role. The two conferences, which offered two opinions and two solitudes, indicate that the National Forum faces a daunting challenge as it prepares to issue its final report at the end of the year.

Does the North American Free Trade Agreement (NAFTA) pose a threat to Canada's medicare system? There was a flurry of political activity in March over concerns that US health care companies were eagerly eyeing the Canadian market because NAFTA had opened it to them. The issue disappeared almost as quickly as it arrived, but it caught the attention of federal politicians, who hastened to negotiate to protect all existing health and social services. The rapidity with which the question grabbed the headlines was another reminder that health care remains one of the key political issues in Canada, and politicians will ignore it at their peril.

Canada's health care charities are beginning to feel the pinch as Canadians tighten their financial belts. They are in a struggle to maintain donation levels because of the tough economy, increasing competition for dwindling dollars and changing social patterns that affect traditional fund-raising efforts. Yet as governments cut health care funding and hospitals eliminate services, charities are being asked to play a greater role in patient education, research funding and service delivery. Their response is to explore new ways to raise money and to continue to lobby for changes in the tax system.

In 18 months the Canadian Medical Discoveries Fund (CMDF) has attracted investments worth $180 million to spend on biotechnology and medical research. Although eight initial investments totalled only $9.7 million, Dr. Cal Stiller, chair and CEO of the fund's management corporation, says there are many good Canadian-based technology firms and research projects that merit investment. Examples include a London, Ont., firm that is bringing a 3-D ultrasound-imaging system to market, and world-class genetics research at the University of Ottawa. However, the federal government recently changed tax rules for venture-capital funds, making them less attractive to investors. How will this affect the effort to build a health-research industry in Canada?

The federal government's National Forum on Health is organizing a series of discussion groups across the country to focus on problems facing Canada's health care system. Although a great deal of time and money is being spent on this and other forum projects, Charlotte Gray asks whether anyone is listening. She says many provincial governments are treating the forum with "elaborate disdain" and the only governments that appear willing to give it a chance to work are found in have-not provinces that rely on Ottawa for handouts in the form of transfer payments.

The issues surrounding assisted suicide and euthanasia are now being debated in a new forum, the Internet. Death-NET, the creation of two activists from Canada and the US, provides up-to-date information on court cases and legislation concerning these topics. In Canada, the federal government appears reluctant to bring the issues to a vote in the House of Commons, but John Hofsess, one of DeathNET's founders, says politicians won't be able to duck them forever.

One of Canada's most visible antismoking advocates is Alexander Tilley, founder and president of Tilley Endurables adventure clothing. Many Tilley advertisements include the statement: "We do not welcome to our company-owned stores those who make or promote tobacco products," underlining the sentiment held by many Canadians that smoking is socially unacceptable. However, in the war involving antismoking advocates, smugglers, government, smokers and the powerful tobacco manufacturing lobby, the social cost and health aspects of the debate may have been overtaken by other forces.

The federal government has attempted to downplay the effect its recent budget will have on health care, but observers ranging from provincial governments to health care organizations say there will be a huge impact. Premier Bob Rae said that from 1996 to 1998 Ontario's loss will total $3.6 billion for health care, education and social services, an amount that almost equals the combined total annual expenditures for its drug-benefit program, nearly all cancer treatment in the province and the cost of running almost all 20 hospitals in the city of Toronto. Dr. Léo-Paul Landry, the CMA secretary general, says the budget "is probably the beginning of the end of medicare as we know it."

The Children's Hospital of Eastern Ontario learned that hosting the wife of the US president is more like a military manoeuvre than a typical VIP visit, but Hillary Rodham Clinton brought a unique perspective on universal health care to the Ottawa hospital. CMAJ Contributing Editor Charlotte Gray, who is also vice-chair of the hospital's board of trustees, recounts the experience of listening to "the sharpest, most intense professor of health care management you've ever met."

Member of Parliament John Bryden has introduced a private member's bill that would force 175 000 nonprofit groups to disclose the salaries of their executives. He took particular aim at antismoking groups, a move that has angered many physicians. In April they responded with a strongly worded advertisement in an Ottawa newspaper that attacked Bryden's bill. However, Bryden insists that he is simply seeking greater public accountability from nonprofit groups.