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Toronto Star Sat Nov 21 2015

In December 2007, a 91-year-old man left his home in the city of Obu and ambled onto railway tracks, crossing just as a commuter train hurtled into the station. In the eyes of the public, this was a tragic accident. The man had dementia and had wandered away when his 85-year-old wife dozed off.

But to the Central Japan Railway Company, it was negligence. They argued the family had failed to care for the man, and 54 trains were cancelled or delayed as a result. The company sued - and won. Last year, a court ordered the family to pay $39,000 in damages. This is a dramatic example of a collision happening daily in Japan: the clash between people living with dementia and the sharp corners of a fast-paced society that was never built for them.

The Leader-Post (Regina) Mon Oct 26 2015

In the final sitting of the legislature before the spring election, Premier Brad Wall's government plans to pass Bill 179 to facilitate private user-pay MRIs in Saskatchewan. As a longtime family doctor, I see this as a cynical political move that caters to public fears about long wait lists for imaging, but which will actually work to make things worse for patients who truly need an MRI.

There is very clear evidence that, far from relieving pressures in the public system, offering a separate stream for the wealthy to jump the queue actually lengthens public wait lists. This has been shown over and over again, whether it be with cataract surgery, diagnostic imaging or surgical procedures. MRI is no different.

The Sudbury Star Fri Oct 23 2015

Registered practical nurses blaming provincial government health-care cuts for a change in their status at Health Sciences North converged on the office of Sudbury MPP Glenn Thibeault on Thursday to protest government underfunding. RPNs at HSN say their positions were eliminated and they were transferred to the renal program as renal aides, where they are expected to practise on the dialysis unit like nurses, but their status and pay has been downgraded, according to representatives at CUPE Local 1623. "It's a multi-purpose rally today," said Dave Shelefontiuk, president of CUPE Local 1623. "The immediate purpose is over the action the hospital has recently done, which is to reassign 16 RPNs back to the renal (program), freeze their wages and they're no longer going to be used as nursing staff, but we all hear every week there's a nursing shortage at Health Sciences North and they voluntarily took 16 very experienced nurses out of the system and we don't think that's correct. We think that's degrading to these nurses. They went to school, they're professional nurses, they have the skills and now they're not being allowed to use those skills."

The other purpose of the rally, Shelefontiuk said, was to highlight workers' struggles under the current funding model. "We're over capacity now; the emerg has been just jam-packed," Shelefontiuk said. "Everybody who provides direct patient care is overworked, they're stressed out, and the only thing we can see to correct this problem is if Mr. Thibeault and Premier (Kathleen) Wynne realize that the North East LHIN (Local Health Integration Network) needs to be funded differently from the other LHINs.

The Globe and Mail Thu Apr 7 2016

A majority of Canadians do not want minors or people with mental illnesses and psychiatric conditions to be given access to doctor-assisted dying, a new Nanos Research/Globe and Mail poll has found.

The poll suggests Canadians would prefer that the federal government follow a restrictive path as it decides which patients have the right to end their suffering in a medical setting. While there is no doubt that doctorassisted dying will become legal, there is a continuing debate about exactly who will have access, and under which conditions.

The Sudbury Star Fri Oct 16 2015

A bill of almost $6,400 for an air ambulance transfer from one Alberta hospital to another is keeping a 77-year-old Garson grandmother awake at night. Jean Wright simply cannot afford to pay it. The last thing Wright thought she had to worry about when she returned from Alberta after an unexpected hospital stay was a bill for an air ambulance transfer, ordered by a physician.

It was a small facility and, while staff treated her well, a doctor there decided the elderly woman should be transferred to a larger hospital in Edmonton for more complex treatment. She was to be taken by land ambulance, but the vehicle didn't have a connection for the medical support she needed for the two-hour journey. When the doctor ordered an air ambulance, Wright and her daughters asked if the cost of the flight would be covered by provincial health insurance and they were told it would be. Wright, who also has kidney problems, was so ill in Vermillion, she didn't know where she was when she was at the small hospital. When the doctor said he was going to transfer her to "the city," she asked: "Where's the city?" Wright spent seven days in an Edmonton hospital being treated for fluid around her heart, a condition similar to congestive heart failure. Her daughters drove back to Sudbury while she was in hospital. Wright has a son who lives in Edmonton and she stayed with him for several days after being released from hospital before flying home.

Contracting Out Hospital Work to Private Clinics – Backgrounder For years CUPE has been concerned the Ontario government would transfer public hospital surgeries and diagnostic tests to private clinics. CUPE began campaigning in earnest against this possibility some years ago with a tour of the province by British Health Secretary Frank Dobson who talked about the disastrous British experience with private surgical clinics.Unfortunately, the provincial Liberal government has now moved in this direction. The door opened a few years ago with the introduction of fee for service hospital funding (sometimes called Activities Based Funding). Then in the fall of 2013 the government announced regulatory changes to facilitate this privatization, with the government finally announcing Request for Proposals for the summer of 2014.

Hospitals are the main focus of the government’s health care cuts. They do not see community hospitals as providing a broad range of services to the local ... [Read More]population, but instead wish to remove an untold range of services from local hospitals and transfer them to specialized private clinics. The proposal would remove the most lucrative, high volume and easiest procedures from community hospitals. The remaining community hospitals would be left with the most difficult services. If they chose to compete with the private clinics, they would have to specialize in a narrow range of services. The government’s plan is the opposite of one-stop, integrated public health care. This proposed privatization of surgeries and diagnostic tests is in addition to the aggressive attempts to remove non-acute care services from hospitals (e.g. outpatient clinics, complex continuing care, rehabilitation, long-term care, primary care, etc.). As acute care currently accounts for only about 1/3 of current hospital funding, these attacks are a grave threat to the viability of community hospitals, and in fact we are now seeing a wave of hospital shut-downs that is somewhat reminiscent of the Mike Harris era. Despite the government’s rhetoric about keeping care non-profit, services that are being cut from local hospitals now are being privatized to for-profit owned corporations. Even if the private clinics did start out as non-profit (which has not been the case so far) the whole system of private clinics could be privatized with a stroke of a pen.

Ontario Health Care Privatization: The push for health care privatization in Ontario picked up in 2001 when Ontario Health Minister Tony Clement announced two privatized P3 hospital projects, the Royal Ottawa and the Brampton Civic (part of William Osler Health Centre). Spirited community-based campaigns, including P3 plebiscites in many towns, forced the Liberal government to greatly narrow the scope of the privatization of support jobs (i.e. CUPE jobs) in subsequent P3 hospitals. Nevertheless privatization of the hospital financing continues, despite revelations by the provincial Auditor General that confirmed claims by CUPE and others that the Osler project cost hundreds of millions more due to the P3.

Canada Newswire Tue Sep 30 2014

ORONTO, Sept. 30, 2014 /CNW/ - The organization that represents registered nurses, nurse practitioners and nursing students in Ontario has issued a formal request to the provincial government for information related to medical tourism. The Registered Nurses' Association of Ontario (RNAO) is seeking all general records between 2009 to the present regarding the treatment of international patients (also known as medical tourists) not covered by the Ontario Health Insurance Plan (OHIP) in the province's hospitals. The request includes all letters, reports, briefings, agreements, hand-written notes, electronic documents and emails from the Ministry of Health and Long-Term Care, Treasury Board, Finance, Cabinet Office and the Office of the Premier. "Hospitals that are part of Toronto's University Health Network, and Sunnybrook Health Sciences Centre have made no secret that they are open for business when it comes to treating patients from abroad for a fee," says RNAO's Chief Executive Officer Doris Grinspun, adding that the CEO of Windsor Regional Hospital is also pursuing a partnership with Henry Ford Hospital in Detroit to formalize a 'medical free-trade zone' that he says will become the 'envy of the health-care world.'

RNAO hopes the request for information will reveal where else medical tourism is occurring and to what extent the Ontario government is behind this attack on Medicare. Medical tourism is the practice of soliciting international patients for medical treatment within Canada's health system in order to turn a profit. "It will erode the viability of our health system, a cherished part of our social safety net, and shift it from one that understands its mission to treat all according to need, to an Americanized version where health-care services are for sale to those with money and power," says Grinspun. "Allowing hospitals to go shopping for patients to increase their revenue redirects precious resources away from the people who need care the most - patients in Ontario," says RNAO President, Vanessa Burkoski, adding that hospitals that engage in medical tourism are inviting lawsuits from people willing to pay a fee to get ahead of the line.

Shifting Culture, Shifting Care:  From ‘Usual Care’ to Good Chronic Care October 3, 2014 12:00 – 1:00 PM ET

Chronic care challenges the old adage, “We’ve always done it this way” and moves from a fixation on volumes to a focus on value (what matters to patients). A chronic care approach is ultimately about shifting from disease-oriented, provider-centric and hospital-driven care to care that is person- and family-centred and meets people where they are. The success of the healthcare system depends on our ability to develop chronic care in concert with acute care. It requires changes structurally, institutionally and culturally.

Windsor Star Mon May 4 2015

A long-running dispute between Dr. Brian Day, the co-owner of Cambie Surgeries Corp., and the British Columbia government may finally be resolved in the BC Supreme Court this year - and the ruling could transform the Canadian health system from coast to coast. The case emerged in response to an audit of Cambie Surgeries, a private for-profit corporation, by the BC Medical Services Commission. The audit found from a sample of Cambie's billing that it (and another private clinic) had charged patients hundreds of thousands of dollars more for health services covered by medicare than is permitted by law. Day and Cambie Surgeries claim the law preventing a doctor charging patients more is unconstitutional.

Day's challenge builds on the legacy of a 2005 decision by the Supreme Court of Canada overturning a Quebec ban on private health insurance for medically necessary care. But this case goes much further, not only challenging the ban on private health insurance to cover medically necessary care, but also the limits on extra-billing and the prohibition against doctors working for both the public and private health systems at the same time. A trial date was set to begin in 2012, but was adjourned until March 2015 so that the parties could resolve their dispute out of court and reach a settlement. It now appears such a resolution has not been reached and the court proceedings may resume in November. Here's why this case matters.

Edmonton Journal Sat May 2 2015

On Monday, my family was forced to choose the poison with which to kill our 88-year-old mother. I'm referring to the untenable choice we've been forced to make so that Alberta Health Services and Health Minister Stephen Mandel can push forward its restorative care program.

A few weeks ago, Mandel announced the government would devote 311 beds in Edmonton and Calgary to restorative care, which is supposed to help elderly patients recover from falls and other injuries so that they can return home rather than enter long-term care. On the surface, this may seem laudable. The program is supposed to relieve pressure on hospitals because of the number of senior patients in treatment, many waiting to be placed in long-term care facilities, or more often than not, die while waiting for that placement.

The Globe and Mail Tue Jun 2 2015

OPEN MINDS How to build a better mental health care system A weary-looking single mother brought her son into the London, Ont., walk-in clinic where Christina Cookson works on a weekday evening. Her son, who recently attempted suicide in another city, was sent home from hospital with no follow-up. Now, with a doctor they had never met before, they were trying to get help. Dr. Cookson asked a few questions about his current treatment, learned of a new antidepressant that his mother said seemed to be working.

A system that responds nimbly to patients' needs would have clear treatment guidelines, appropriate screening and good data collection to ensure that therapies are working for patients. There should be a role, for instance, for non-profit groups on the ground to be woven into a comprehensive system to provide additional supports, particularly in areas such as housing, employment and mental health promotion - without expecting them to patch up shortfalls in services the system should provide. That should include, says Dr. Goldner, non-physicians with training in psychotherapy who are integrated into the mental health system, so that access to care is based on sound science and the best treatment plans for individual patients, rather than what happens to be available. Canada doesn't have to start from scratch. As Dr. Goldner points out, Britain and Australia have both made huge investments to expand public access for all citizens to psychotherapy, recognizing both its clinical value and cost-effectiveness over the long run. Britain's system, especially, has been designed to be accountable, to track outcomes with extensive data and to be flexible enough to incorporate changes to the system to improve results.

Toronto Star Tue Jun 2 2015

A half-century after its birth, medicare remains a half-measure that has fallen behind the times. Until we deliver medicare's missing other half - a pharmacare program that provides medically necessary drugs to treat illness - our health-care system will remain universal in name only. Canadians who view medicare as a mark of our collective identity are blind to our shared hypocrisy. What good is modern medicine without modern medicines? What use is a diagnosis if the prescription goes unfilled?

Not much - and less than ever. In the five decades since Canadian politicians postponed a national pharmacare program, prescription drugs have become even more essential in treating or managing medical conditions - and ever more expensive. There's a flip side to that fast-growing financial hit, however: The more drug costs increase, the greater the potential savings from pharmacare for the economy - estimated to be in the billions of dollars by study after study.

Toronto Star Fri May 15 2015

You've probably seen the telltale signs. But you weren't sure. You didn't want to embarrass or incriminate anyone. It wasn't really your business. That, says Margaret MacPherson of Western University, is why elder abuse remains a hidden epidemic. Friends, neighbours, relatives and caregivers sense that something is wrong. But they don't speak out or step in.

For the past three years, MacPherson has been spearheading the development of a campaign called It's Not Right! Changing Social Norms for Bystanders of Abuse of Older Adults. The objective is to turn bystanders into first responders. She and her colleagues from the university's Centre for Research and Education on Violence Against Women and Children introduced it to 130 federal and provincial officials, health-care professionals, social workers, police officers and non-profit leaders at a recent conference in Toronto.

The Globe and Mail Mon Sep 28 2015

Canadian regulators may be forced to create new rules to stop pharmaceutical companies from slapping exorbitant prices on prescription drugs and expecting governments and consumers to foot the bill, say several healthpolicy experts. The growing problem of high drug prices reached a boiling point last week after reports of overnight price hikes for old drugs with expired patents. In one case, Turing Pharmaceuticals raised the price of Daraprim, used to treat life-threatening infections, to $750 (U.S.) a pill from $13.50.

CEO Martin Shkreli defended the move in a New York Times interview by saying, "This isn't the greedy drug company trying to gouge patients; it is us trying to stay in business." The company has since backtracked, saying it will reduce the planned price increase, although it has not indicated by how much. United States-based Rodelis Therapeutics was forced to back down last week in the midst of a public backlash after it raised the price of the decades-old tuberculosis drug cycloserine to $10,800 for 30 pills from $500.

Ottawa Citizen Wed Aug 19 2015

Many of those calling for a pan-Canadian pharmacare monopoly undoubtedly have the best of intentions. They want all Canadians to have access to the drugs they need, regardless of ability to pay, and they want to control costs. But good intentions do not guarantee good results - and in this particular case, international experience has much to teach us about the dangers of monopolistic drug insurance plans. Under Canada's current mixed public-private system, administered by the provinces, 42 per cent of prescription drug spending in the country is paid for by public insurance plans. The rest is funded privately, either out-of-pocket by patients themselves (22 per cent), or through private insurance plans (36 per cent). In every province, low-income seniors and children, welfare recipients, and people suffering from certain serious illnesses enjoy complete or nearly complete coverage. In all, about 98 per cent of the Canadian population has private or public drug insurance coverage.

It's true that some people report having to forgo requesting a prescription or skip a dose for reasons of cost. In a recent Commonwealth Fund study, 8 per cent of Canadians with belowaverage incomes said they had not taken a drug because of cost. But this phenomenon is hardly unique to Canada. Indeed, the same study found that this percentage was 11 per cent in France, 14 per cent in Australia, and 18 per cent in New Zealand. What explains these findings is the fact that the public insurance plans in place in other OECD countries, even those that are universal, don't cover pharmaceutical expenses in their entirety. A sensible portion of costs are paid by the insured - and generally a larger portion than in Canada.

Canadian Press Mon Jul 20 2015

NEW YORK, N.Y. - Doris Ranzman had followed the expert advice, planning ahead in case she wound up unable to care for herself one day. But when a nursing-home bill tops $14,000 a month, the best-laid plans get tossed aside. Even with insurance and her Social Security check, Ranzman still had to come up with around $4,000 every month to cover her care in the Amsterdam Nursing Home in Manhattan. "An awful situation," said her daughter, Sharon Goldblum. Like others faced with the stunning cost of elderly care in the U.S., Goldblum did the math and realized that her mother could easily outlive her savings. So she pulled her out of the home. For the two-thirds of Americans over 65 who are expected to need some long-term care, the costs are increasingly beyond reach. The median bill for a private room in a U.S. nursing home now runs $91,000 a year, according to a report from the insurer Genworth Financial. One year of visits from home-health aides runs $45,760.

Goldblum estimates that she and her mother spent at least $300,000 over the last two years for care that insurance didn't cover. "If you have any money, you're going to use all of that money," Goldblum said. "Just watch how fast it goes." How do people manage the widening gap between their savings and the high cost of caring for the elderly? Medicare doesn't cover long-term stays, so a large swath of elderly people wind up on the government's health insurance program for the poor, Medicaid. For those solidly in the middle class, however, the answer isn't so simple. They have too much money to apply for Medicaid but not enough to cover the typical three years of care. Some 60 per cent of Americans nearing retirement - those between the ages of 55 and 64 - have retirement accounts, according to the Employee Benefit Research Institute. The median balance is $104,000.

The Globe and Mail Wed Jul 22 2015

When the Harper government has something to brag about, we hear about it, endlessly. When the government has something to hide, the information comes out without ministerial comment on a Friday afternoon. So it was last week that the Prime Minister's Office buried a long, detailed report about federal innovation in health care that the government itself had commissioned.

The Advisory Panel on Healthcare Innovation, chaired by former University of Toronto president and dean of medicine David Naylor, was to have been released at a news conference in Toronto on July 14. The day before the news conference, however, the PMO cancelled it and decided to release the report without notice on the Health Canada website on July 17. Just as the PMO hoped, the report received little attention. Health Minister Rona Ambrose, who was to have spoken about the report, was gagged. The posting on her department's website was timed so that it appeared only after the provincial premiers had finished their final news conference in St. John's, in case the report gave any or all of them ammunition to embarrass the federal government. Such is the way this government works.

The Kingston Whig-Standard Fri Jun 26 2015

Significant improvements have been made at Kingston General Hospital over the past five years, according to an internal report released by the hospital on Wednesday. "I am thrilled with the very real progress that the teams at KGH have made toward our theme of "outstanding care always" in the past five years," said Leslee Thompson, president and CEO of KGH. The report focuses on some of the quantitative evidence of change over the past five years. For example, the report states that KGH went from a provincial low of 34% hand hygiene compliance to being one of the best, with performance hovering around 90%.

The hospital has also cleared a $26 million operating deficit, which created difficult times for the hospital back in 2010, just as Thompson was introduced as the hospital's new CEO. Thompson said the organization has had to make drastic changes to how the hospital operates, but she's proud with the level of quality that has been achieved, even with provincial health budgets frozen for the past four years. Even under the strict financial budget, KGH has been able to increase investments into technology and equipment that provide better quality care. Over the past five years, the hospital has gone from investing $3 million a year to $20 million a year into its facilities. Thompson said a great deal of savings have come from each department's assessments of efficiency and the ability of staff to change and adapt to taking on new responsibilities.

The Globe and Mail Thu Jul 9 2015

Whether it's to help boost their paycheques, complete a project or satisfy their workaholic spirit, some employees think little of logging extra hours on the job. But experts say significant stretches of overtime without adequate time for recovery could not only result in diminished work performance, but it could also pose potentially serious health risks. A University of Massachusetts study published by the journal Occupational and Environmental Medicine in 2005 explored the impact of overtime and long work hours on occupational injuries and illness.

Researchers cited studies associating overtime and extended work schedules with heightened risk of hypertension, cardiovascular disease, fatigue, stress, depression, chronic infections, diabetes and death. They also noted some studies found evidence of links between long working hours and an increased risk of occupational injuries, including among construction workers, nurses, miners, bus drivers and firefighters. "While some occupations have restrictions on length of work shift, most don't," said Dr. Cameron Mustard, president and senior scientist at the Institute for Work & Health in Toronto.

The Globe and Mail Thu Jul 9 2015

British Columbia's new Ombudsperson says a public inquiry may be the best way to investigate the firings of eight health researchers three years ago, but Jay Chalke said he would only take on the task if the government grants him more powers. In a letter sent to legislators Tuesday, Mr. Chalke said that members of a legislative committee should give "the utmost consideration" to the call for a public inquiry from the employees who were fired. But he said that if he is to proceed, he has some conditions before he takes up the Health Minister's "very rare and perhaps unprecedented" request to investigate the issue.

Among them are his demand for unanimous bipartisan support from the legislative finance committee and the power to get information from people under confidentiality agreements. He stated in his letter that any investigation would be seriously impeded by the legislation binding his office, including the blanket confidentiality clauses that have become the norm for most government employees - especially those working with healthcare data.