Organized medicine is battle-hardened and successful, and when attacked it can mobilize loyal troops

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The best laid schemes o’ mice an’ men / Gang aft agley
— Robbie Burns

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True that — there are few slam dunks in life and almost none in public policy. In any grand enterprise, be it building a subway or drafting a quarterback, uncertainty looms and stuff happens. But when the best-laid schemes turn out to be neither best-laid nor even coherent schemes, failure has barely to fire a shot to win the day. Exhibit One: Super Bowl 2015. Give the damn ball to Marshawn Lynch! (Look it up.)

Exhibit Two: Quebec’s sweeping health care law, enacted on Oct. 25, 2025, a declaration of war on an unsustainable status quo. It held family doctors collectively responsible for enrolling 1.5 million unattached patients within a year. Territorial managers could assign new patients to underwhelmed practices. Fee-for-service payment would largely disappear. There would be fines for unmet targets.

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