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Three countries we have written about in a new paper for the Macdonald-Laurier Institute - Japan, Korea and Taiwan - are not typically where Canadians look for public policy solutions. They are far away and have very different cultures and histories. But they, like other developed countries, face similar health care challenges.

apan, Korea and Taiwan are leading users of health-care technologies. Their overall health outcomes are comparable to, if not better than, those in Canada, and they do this spending a lower percentage of their GDP on health care than we do. These countries have universal public health care - something Canadians are justifiably proud of - though Japan achieved this about a decade before Canada. These countries' plans cover physician visits and hospitalization, but also dental care and outpatient prescription drugs.

What are the lessons for Canada? First, the countries' policy-makers actively learned from abroad. Japan looked to Germany as it started modernizing nearly 150 years ago; recently Korea and Taiwan studied what worked, or not, elsewhere as they developed their systems. More importantly, politicians and bureaucrats had the fortitude to implement necessary reforms. Changes were made often in the face of protests by entrenched stakeholders, including physicians. And programs were reviewed soon after implementation, making modifications when problems arose. This is in stark contrast to Canada's embrace of the status quo.

More specifically, the systems in Japan, Korea and Taiwan suggest that copayments may be useful to help moderate demand and help fund care. They can be applied and properly designed to recognize income disparities. In Canada's case, they could increase equity if used to help extend coverage to drugs and dental care for more people. Unlike in Canada, where most hospitals are de facto public, in these countries privately-owned hospitals, many of them non-profit, compete with public hospitals, creating dynamism in the sector.

Finally, and most significantly, these proactive governments have moved to introduce Long-Term Care Insurance (LTCI) to address a very predictable problem. Very few people buy LTCI on their own, mostly because they can't predict their future needs and expect long-term care be covered by public funds. However, estimates suggest that about 70 per cent of people who reach 65 will need LTC at some time. In Japan and Korea, and likely soon in Taiwan, LTCI creates distinct insurance funds devoted to supporting appropriate care at home and in institutions.

Asia deserves the attention it is getting. As we build economic links, we should also look for the good ideas of our new partners that can make our health and long-term-care systems better. Ito Peng is Director of the Centre for Global Social Policy at the University of Toronto. James Tiessen is director of the School of Health Services Management at the Ted Rogers School of Management at Ryerson University. They are co-authors of the MLI report An Asian Flavour for Medicare (macdonaldlaurier.ca).

including universal health coverage (UHC.) In recent years the global health priorities spelled out by the Foreign Ministers are the ones the adopted by the G7 leaders. Unfortunately, healthcare workers didn’t make the Minister’s priority list.

There are good reasons for the Minister’s concern. As World Bank President Jim Kim warned in Huffington Post, “We cannot afford to put off action any longer...in the next 30 years, we are likely to face a pandemic like the 1918 Spanish Flu, which could kill as many as 30 million people in 250 days — and reduce global GDP by nearly five percent, or close to $4 trillion.”

There is a worldwide shortage of 10.3 million of the health workers needed to provide universal access including significant regional gaps in Asia (7.1 million) and Africa (2.8 million) according to estimates by International Labor Organization (ILO) experts. They also found understaffing in 97 countries with substantially higher gaps in rural than in urban areas.

In the 1980s, Bayer sold Factor VIII concentrate, a blood-clotting medicine acquired from Cutter Laboratories in 1978. Though Factor VIII carried a high risk of transmitting AIDS and Bayer knew, Bayer continued to sell the drug in Asia and Latin America while selling a new, safer product in the West.

takeover would dilute Bayer’s core drug business currently flush with sales of its blood-thinner Xarelto and Eylea, a drug to treat blindness.

Coalition Against Bayer Dangers

Bayer, a history of unsafe drugs

Monsanto’s first entry into Big Pharma.

Blood clotting drug spread AIDS

all three proposed mergers face antitrust reviews by agencies in the U.S., Europe and China,

In Hong Kong and Taiwan alone, more than 100 hemophiliacs got H.I.V. and “many have since died,” reported the New York Times. 

Statin Baycol recalled

In 2001, Bayer withdrew its lucrative new statin drug Baycol because more than 50 people had died and more than six million patients were at risk from the deadly side effects of rapidly dissolving of muscle tissue.

Yaz birth control pill causes deaths

Xarelto, shady approval of a dangerous drug

underreported bright side: Industries that are doing well generally spin off; industries that are performing poorly generally merge and consolidate.

Millions Against Monsanto movement,

Not a chance, On October 14-16, merged or not with Bayer, the OCA and the global grassroots will expose Monsanto’s crimes against humanity and the environment at the Monsanto Tribunal, a citizens’ tribunal which will take place in The Hague, Netherlands.

he APEC hub, which will be hosted at the University of British Columbia in collaboration with the University of Alberta and the Mood Disorders Society of Canada (MDSC), will serve as a permanent and far-reaching working effort between Canadian mental health researchers across the country and their counterparts in the United States, China, Japan, South Korea, Australia and more than a dozen other economies of the Asia-Pacific region.

One of Mr. Wellner’s first jobs is to develop an expansion plan to add some growth to the company’s profile.

We have the capability to provide high-quality MRI services but, based on our licence restrictions, we are not able to service all the patients we get. We get lots of patients who say that they would gladly pay additional fees if they would not have to wait 100 or more days for an MRI, or to go to a less-convenient location. We could provide that, if we had some loosening of the restrictions.

We could go into a jurisdiction that has a single-payer market [where we could] deliver services very similarly to how we deliver them in Ontario. There are three or four countries that have that type of model in Europe. There are a couple in Asia that fit. Even places such as the United Arab Emirates and also potentially India.

There is now major concern across Canada about long waiting periods, availability of services, shortages of nurses and physicians, specific illnesses (especially cancer and heart disease) and caring for our aging population.

Many other nations today, while providing universal access, charge small user fees for hospitals, GPs, or specialists. Canada is the only member of the rich nations’ club, the OECD, to bar privately funded purchase of core services.

Former heart surgeon Wilbert Keon and Senator Michael Kirby make three suggestions:

David Kilgour is co-chair of the Canadian Friends of a Democratic Iran and a director of the Washington-based Council for a Community of Democracies (CCD)

He is a former MP for both the Conservative and Liberal Parties in the south-east region of Edmonton and has also served as the Secretary of State for Latin America and Africa, Secretary of State for Asia-Pacific and Deputy Speaker of the House.

y David Kilgour | David vs. David – Fri, 29 Nov, 2013

"One of the surprising findings was that when we sequenced all these ... almost half of them fell into the H58 lineage," said first author Dr. Vanessa Wong, an infectious disease specialist with the Wellcome Trust Sanger Institute and University of Cambridge. "That (covered) 21 countries. So we were like, oh no. This is actually kind of everywhere." Typhoid fever is a disease that can be spread by only humans who carry the S. Typhi bacterium in their bloodstreams and intestinal tracts.

The disease is now rare in industrialized countries like Canada - which had 144 reported cases in 2012, probably mostly in travellers - but it is still relatively common in the developing world, especially where hygiene and sanitation are poor. While a typhoid vaccine is available, its efficacy wears off after a few years and many people also can't afford the vaccine in the developing world, where the disease is estimated to cause 21 million cases every year and about 200,000 deaths. Typhoid fever can be treated with antibiotics but the overuse of these drugs has fuelled resistance, as bacteria capable of defeating these drugs survive and proliferate. In a 2013 report, the Public Health Agency of Canada found that S. Typhi infections resistant to the antibiotic ciprofloxacin had increased to 18 per cent from 10 per cent the previous year. When asked if H58 has ever been reported in Canada, the agency said it doesn't routinely analyze the strains of S. Typhi cases since typhoid fever is not endemic here.

In countries where H58 has emerged, the superbug is now crowding out weaker strains, thus dramatically "changing the architecture of the disease," Wong said. She said treating multidrug-resistant strains like H58 also requires intravenous antibiotics - an expensive luxury that many people in the developing world cannot access or afford. Resistance against last-line antibiotics will probably also eventually emerge, she added. "If we carry on and the bug continues to evolve, we'll run out of options pretty quickly." She noted that her study also found H58 in Nepal, where devastating earthquakes have now left the country highly vulnerable to outbreaks of diseases like typhoid fever.

For Virginia Pitzer, a professor of epidemiology with the Yale School of Public Health who was not involved with this study, this "important and interesting" new paper underscores the need to tackle typhoid fever.

Valeant CEO Michael Pearson says the latest results demonstrate the company's ability to grow without acquisitions by boosting its guidance for 2015 after reporting their fourth consecutive quarter of greater than 15 per cent organic growth. "Our M&A strategy will always be a question of tuck-ins or bolt-ons, and opportunistically larger acquisitions. One can never predict the timing of a larger acquisition so when those happen, those happen," said Valeant CEO Michael Pearson on a conference call Thursday. "We don't put them on a timeline."

Valeant released its second-quarter results on Thursday, increasing its 2015 revenue outlook from a range of $10.4-billion to $10.6 billion up to a range of $10.7-billion to $11.1 billion. In the latest quarter, Valeant said organic growth was up 19 per cent on a same-store sales basis, driven by its dermatology, gastrointestinal, contact lenses and dental businesses. Pearson has said he is certain organic growth will continue in the doubledigits at least until the end of 2016. "I think they will continue to see a higher organic growth than they have in the past, but can they sustain that 19 per cent? That's probably one of the high marks," said Stephanie Price, an analyst at CIBC World Markets.

The company reported a total revenue of $2.7 billion in the quarter, an increase of 34 per cent over last year and $200 million over the first quarter outlook. Pearson said the results were driven by strong performances in the U.S. market, as well as sales in Asia, Australia, Canada, Mexico, the Middle East and North Africa. Valeant did take a $173-million hit from the negative impact of foreign exchange in the second quarter. The company completed its $11.1-billion acquisition of Salix Pharmaceuticals Ltd. earlier this year, which contributed $313 million in revenue. The U.S. Food and Drug Administration approved Salix's irritable bowel syndrome drug, Xifaxan, in May. Prior to the acquisition, Salix had issues with an inventory pileup, though Pearson says levels have been reduced from four to five months, to three months to 3.5 months. The company laid off 258 Salix employees in April as part of a $500-million cost-savings plan which Pearson said will reach $530 million by the end of the year.

Valeant has made cuts to sales staff following previous acquisitions, though this is not the case with Salix where the team remains largely intact as the company awaits regulatory approval for its direct-to-customer advertising campaign. A serial acquisitor, last week Valeant said it will buy Amoun, a major Egyptian pharmaceutical company, for about US$800 million as a platform for further expansion in the Middle East and North Africa.

Pearson says so far the company has signed eight tuck-in deals this year and says Valeant is looking for opportunities to grow in Latin America. "I think there are a lot of smaller guys out there they can continue to consolidate, so we're not worried about a lack of targets," said Price. "At the high end there is a limit to the number of large acquisitions out there, but I don't think we're anywhere near that limit right now." Financial Post, with files from Bloomberg News DvanderLinde@nationalpost.com

Fifteen years later, the “movement of movements” has another opportunity to strike a dramatic blow to neoliberalism — this time by stopping the Trans-Pacific Partnership (TPP). The TPP is a deal the United States is negotiating with 11 countries in the Asia-Pacific region (Australia, Brunei Darussalam, Canada, Chile, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore, and Vietnam) allegedly to boost “free trade.”

access to medicines

But labor and environmental standards are just the tip of the iceberg. The GAO studies don’t even touch upon the rules found in modern “trade” pacts’ chapters on financial services, food safety, public procurement, medicine patents, investment, and so-on, all of which the TPP would expand to an estimated 40 percent of the global economy — with a built-in mechanism to cover more countries still.

Given the smaller number of negotiators at the TPP table than at the WTO — and the fact that so many seem willing to sell out their nations’ public health programs, family farms, financial stability measures, and just plain sovereignty in order to cut a deal with the United States — it’s unlikely that protests in the United States are going to appeal to their sense of morality. Thus, the anti-Fast Track strategy is not only more feasible than centralized mass protest; it’s probably more effective.

TPP supporters and opponents alike both know that, with the U.S. presidential elections gearing up in the latter half of 2015, the window of opportunity for concluding the TPP is fast closing. Neither political party in the United States wants an unpopular trade debate on its hands while it’s trying to take the White House.

£7 an hour, receives an extra £1 an hour for a night shift and £2 an hour for weekends.

"The NHS encourages you to have these NVQs, all this training, improve your knowledge, and then they [private care companies] come along and it all comes to nothing.

Care UK expects to make a profit "of under 6%" by the end of the three-year contract

£700,000 operating profit in the six months between September last year and March this year,

In 1993 the private sector provided 5% of the state-funded services given to people in their homes, known as domiciliary care. By 2012 this had risen to 89% – largely driven by the local authorities' need for cheaper ways to deliver services and the private sector's assurance that they could provide the answer. More than £2.7bn is spent by the state on this type of care every year. Private providers have targeted wages as a way to slice out profits, de-skilling the sector in the process.

1.4 million care workers in England are unregulated by any professional body and less than 50% have completed a basic NVQ2 level qualification, with 30% apparently not even completing basic induction trainin

Today 8% of care homes are supplied by private equity-owned firms – and the number is growing. The same is true of 10% of services run for those with learning disabilities

William Laing

report on private equity in July 2012

"It makes pots of money.

Those profits – which are made before debt payments and overheads – don't appear on the bottom line of the health firms' company accounts, and because of that corporation tax isn't paid on them.

Some of that was in payments on loans issued in Guernsey, meaning tax could not be charged. Its sister company, Silver Sea, responsible for funding the construction of Care UK care homes, is domiciled in the tax haven of Luxembourg

Bridgepoint

.voterDiv .ob_bctrl{display:none;} .ob_pdesc IMG{border:none;} .AR_1 .ob_what{direction:ltr;text-align:right;clear:both;padding:5px 10px 0px;} .AR_1 .ob_what a{color:#999;font-size:10px;font-family:arial;text-decoration: none;} .AR_1 .ob_what.ob-hover:hover a{text-decoration: underline;} .AR_1 .ob_clear{clear:both;} .AR_1 .ob_amelia, .AR_1 .ob_logo, .AR_1 .ob_text_logo {display:inline-block;vertical-align:text-bottom;padding:0px 5px;box-sizing:content-box;-moz-box-sizing:content-box;-webkit-box-sizing:content-box;} .AR_1 .ob_amelia{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_16x16.png') no-repeat center top;width:16px;height:16px;margin-bottom:-2px;} .AR_1 .ob_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_67x12.png') no-repeat center top;width:67px;height:12px;} .AR_1 .ob_text_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_text_logo_66x23.png') no-repeat center top;width:66px;height:23px;} .AR_1:hover .ob_amelia, .AR_1:hover .ob_logo, .AR_1:hover .ob_text_logo{background-position:center bottom;} .AR_1 .ob_org_header { border-top: 10px solid #D61D00; display: block; font-family: georgia,serif; font-size: 14px; font-weight: bold; padding-bottom: 10px; padding-top: 5px; } More from the guardian Rogeting: why 'sinister buttocks' are creeping into students' essays 08 Aug 2014 Theatre's decision to ban Jewish film festival is 'thin end of wedge' 09 Aug 2014 Sir Paul Nurse: 'I looked at my birth certificate. That was not my mother's name' 09 Aug 2014 Adventures in contraception: eight women discuss their choices 10 Aug 2014 Child prison deaths 08 Aug 2014 [?] .voterDiv .ob_bctrl{display:none;} .ob_pdesc IMG{border:none;} .AR_2 .ob_what{direction:ltr;text-align:right;clear:both;padding:5px 10px 0px;} .AR_2 .ob_what a{color:#999;font-size:10px;font-family:arial;text-decoration: none;} .AR_2 .ob_what.ob-hover:hover a{text-decoration: underline;} .AR_2 .ob_clear{clear:both;} .AR_2 .ob_amelia, .AR_2 .ob_logo, .AR_2 .ob_text_logo {display:inline-block;vertical-align:text-bottom;padding:0px 5px;box-sizing:content-box;-moz-box-sizing:content-box;-webkit-box-sizing:content-box;} .AR_2 .ob_amelia{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_16x16.png') no-repeat center top;width:16px;height:16px;margin-bottom:-2px;} .AR_2 .ob_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_67x12.png') no-repeat center top;width:67px;height:12px;} .AR_2 .ob_text_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_text_logo_66x23.png') no-repeat center top;width:66px;height:23px;} .AR_2:hover .ob_amelia, .AR_2:hover .ob_logo, .AR_2:hover .ob_text_logo{background-position:center bottom;} .AR_2 .ob_org_header { border-top: 10px solid #D61D00; display: block; font-family: georgia,serif; font-size: 14px; font-weight: bold; padding-bottom: 10px; padding-top: 5px; } /* updated via mysql on 2014-04-08 */ .AR_2 .ob_what { display: block; } /* added via mysql on 2014-06-20 */ .OUTBRAIN:hover .ob_what a { text-decoration: underline; } .ob_box_cont.AR_2 { padding-bottom: 5px; } /* end mysql add */ /* added via mysql on 2014-07-14 */ .AR_2 .ob_org_header span { color: #999; font-family: arial; font-size: 11px; font-weight: normal; display: block; } /* end 2014-07-14 */ More from around the webPromoted content by Outbrain http://paid.outbrain.com/network/redir?p=0iZOm4XuGW6R5uuT6ZFciNevzJlIfmxs0SRwpiMrH7gWrMXoPie4vIA9PlhaEW%2BXNi57pCgl9j8yOE3HuJT75pwCLNj4n18v3EKQDEV0YFQjOBxc46mOs

"Of course, there is no such thing as a perfect health system and it certainly doesn't reside in any one country," Mark Britnell, global chairman for health at the consulting giant KPMG, writes in his new book, In Search of the Perfect Health System. "But there are fantastic examples of great health and health care from around the world which can offer inspiration."

As a consultant who has worked in 60 countries - and who receives in-depth briefings on the health systems of each before meeting clients - Mr. Britnell has a unique perspective and, in the book, offers up a subjective and insightful list of the traits that are important to creating good health systems. If the world had a perfect health system, he writes, it would have the following qualities: the values and universal access of the U.K.; the primary care of Israel; the community services of Brazil; the mentalhealth system of Australia; the health promotion philosophy of the Nordic countries; the patient and community empowerment in parts of Africa; the research and development infrastructure of the United States; the innovation, flair and speed of India; the information, communications and technology of Singapore; the choice offered to patients in France; the funding model of Switzerland; and the care for the aged of Japan.

In the book, Mr. Britnell elaborates on each of these examples of excellence and, in addition, provides a great precis of the strengths and weaknesses of health systems in 25 countries. The chapter on Canada is appropriately damning, noting that this country's outmoded health system has long been ripe for revolution, but the "revolution has not happened."

Why? Because this country has a penchant for doing high-level, in-depth reviews of the health system's problems, but puts all its effort into producing recommendations and none into implementing them. Ouch. "Canada stands at a crossroads," Mr. Britnell writes, "and needs to find the political will and managerial and clinical skills to establish a progressive coalition of the willing."

The book's strength is that it does not offer up simplistic solutions. Rather, it stresses that there is no single best approach because all health systems are the products of their societies, norms and cultures. One of the best parts of the book - and quite relevant to Canada - is the analysis of funding models. "The debate about universal health care is frequently confused with the ability to pay," Mr. Britnell writes. He notes that the high co-payments in the highly praised health systems of Asia would simply not be tolerated in the West.

But ultimately what matters is finding an approach that works, not a perfect one: "This is the fundamental point. There is no such thing as free health care; it is only a matter of who pays for it. Politics is the imperfect art of deciding 'who gets what, how and when.' " The book stresses that the challenges are the same everywhere: providing high-quality care to all at an affordable price, finding the work force to deliver that care and empowering patients. To do so effectively, you need vision and you need systems. Above all, you need the political will to learn from others and put in place a system that works.