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Govind Rao

Private MRIs wrong prescription - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|relp|20151026|232213388

from heather diagnostics private clinics privatization Saskatchewan

shared by Govind Rao on 26 Oct 15 - No Cached
  • 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.
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  • In Alberta, where private MRI facilities advertise and operate, the median wait time for an MRI is much longer (80 days) than in Saskatchewan (28 days). Furthermore, the wait has lengthened in the public system in Alberta since privatized facilities came on the scene. The explanations are complex, but siphoning human capacity (doctors and technologists), as well as other resources, from the public system into the private and more lucrative stream plays a big role. So does the market generation of increased demand by deceptive advertising and promotion of privatized services.
  • Medical tests should be ordered in accordance with evidence-based guidelines about their usefulness and indications. Patient access to MRI is currently prioritized in Saskatchewan health-care facilities on the basis of medical need, from Level I (a life-threatening diagnosis or treatment requiring MRI within 24 hours) to a Level IV (stable patients needing long range diagnosis or management allowing for delay of 30-90 days).
  • This system works and prioritizes appropriately. While patients sometimes feel that an urgent MRI will make a difference to their outcome, this is rarely the case. When it is the case, patients are prioritized and get urgent access. Allowing private MRI's based on ability to pay and jump the queue will trample this well-developed, equitable system. It will allow the wealthy or anxious to bypass this system and result in two-tiered care.
  • We live in a society obsessed with health. Selling fear of sickness is profitable. But access to MRIs is not our most urgent health-care need. To suggest otherwise is to obscure the social and economic determinants that define who is healthy and who is not, and to further shift resources away from the sick towards the worried well.
  • The Wall government and the private MRI operators that will profit from this legislation have proposed a two-for-one deal, suggesting that one public MRI scan will be done for every private MRI performed. Don't be fooled. This will not get around the problem of prolonging public wait lists since it will siphon resources from the public system. If we really need more MRIs, why not increase capacity in the public system instead?
  • While MRI can be a useful tool, when inappropriately used it can lead to overdiagnosis or "false positives." This then triggers a costly cascade of subsequent investigations or interventions to reassure either physician or patient MRI technology has important limitations, and frequently finds unrelated non-significant abnormalities that frighten patients. For example, 90 per cent of healthy individuals over 60 years of age with no symptoms of back pain show degenerative abnormalities on MRI. Similarly, the vast majority of adults over 50 show knee damage on MRI and only clinical assessment by a doctor identifies whether or not these findings are significant. Early MRI has not been shown to improve outcomes in low back pain and may actually make for worse outcomes. A doctor examining for red flag symptoms can identify the very small number of patients for whom an MRI is useful.
  • Many MRI scans are therefore unnecessary. Allowing patients to purchase an investigation they don't need wastes resources, bypasses the role of an informed health-care provider, and may in the end actually harm patients with needless investigations and interventions. Physicians are engaged in initiatives to "choose wisely" in testing. Throwing the door open to investigations based on ability to pay, rather than medical need, flies in the face of sensible approaches to health resources.
  • And the queue-jumping is not just limited to getting an MRI. It will extend to preferential and quicker access to treatment options, such as specialist care and surgery based on the MRI results if positive.
  • Let's promote greater equity, not less, and preserve health care based on need, not two-tiered care based on ability to pay. Let's trust health-care providers to counsel patients about the right test at the right time and to prioritize patients appropriately. The marketplace has no role in these decisions.
  • Dr. Sally Mahood is a Regina family doctor and an associate professor, Family Medicine, University of Saskatchewan.
Govind Rao

A look at the MRI plan - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|relp|20151019|231698836

from heather diagnostics Saskatchewan private clinics privatization

shared by Govind Rao on 19 Oct 15 - No Cached
  • The Leader-Post (Regina) Mon Oct 19 2015
  • The government announced changes to Saskatchewan's MRI process in the spring, and Premier Brad Wall has made it a priority to push the legislation through the house. The new system will allow people to pay a private clinic for an MRI, effectively skipping to the front of the queue. In return, the clinic will have to provide a second, free, MRI to the public system. Health Minister Dustin Duncan says it will chip away at ballooning wait times and provide more options to patients, but critics say the plan will create a two-tier health system and won't lessen waits at all. Here's a look at the government's plan.
  • The business case One of the biggest questions around the legislation is this: Will any private clinics bite? As Bryan Salte from the College of Physicians and Surgeons of Saskatchewan points out, between the investment in people and equipment, setting up a private clinic is "an expensive proposition," and he's "not sure it's a guaranteed way to make money." Duncan says government is "not going to force anybody to do this." At the end of the day, Duncan says, private clinics are "going to have to determine for themselves whether ... from their point of view, it's a sound business idea."
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  • Wait times Currently, MRI wait time trends are hard to figure out. Because there has been no consistent record-keeping, requests for data are met with several caveats. Looking at raw numbers, waits in 2014 were anywhere from within 24 hours for a Level 1 priority patient, to 287 days for a Level 4 patient. Current wait times also differ markedly between health regions - bad news if you're in Saskatoon, where for the past few years, average waits for all but Level 1 patients have been longer than in Regina. In 2014, for example, patients waited 10 days for a Level 2 scan in the Regina Qu'Appelle Health Region, compared with 19 days in the Saskatoon Health Region. Level 3 waits were 58 days in Regina and 86 in Saskatoon, and Level 4 waits were 96 and 120 days respectively. Duncan admits part of that might come down to overuse of diagnostic imaging - something the Saskatchewan Medical Association and government are working on.
  • That's backed up by the fact that in the past eight years, the number of publicly funded scans in Saskatchewan has more than doubled and there are more MRI machines, but it hasn't made a dent in wait times. Health policy analyst Steven Lewis can't see the new approach reducing waits, because the only way you do so "is if demand stays constant while you're increasing capacity - and that never happens." Duncan is convinced the new approach "will help toward wait times," but Dr. Ryan Meili, a family physician in Saskatoon and vicechair of Canadian Doctors for Medicare, disagrees. As evidence, Meili points to Alberta. It has private MRIs, he says, yet it "has the longest wait times for MRIs in the country." Erosion of public health?
  • You would expect Meili to be ideologically opposed to the privatization of MRIs - after all, he ran for NDP leadership and is a vocal opponent of privatizing any aspect of health care - but he also has "evidence-based" objections. "It starts to just further reinforce this idea that we need to privatize care, piece by piece, and it erodes confidence in the system," he says. Duncan argues that paying out of pocket for MRIs already "happens in Saskatchewan today" when people head to Alberta or the U.S. for a scan. The provincial health system doesn't stop them, he says, but "we don't get any benefit from people doing that." Duncan says at least this way, "the public system will get a scan for each one paid for out of pocket."
  • Because MRIs are generally a diagnostic tool, Lewis says the biggest risk in the change is that people who need a scan and pay out of pocket will end up getting treatment sooner than those who don't pony up the cash. "It's troublesome on so many levels," he says. egraney@leaderpost.com Twitter/LP_EmmaGraney
Govind Rao

New legislation restricts access to services; The change in the federal government will... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|sasp|20151123|234280853

from heather Saskatchewan diagnostics private clinics privatization

shared by Govind Rao on 24 Nov 15 - No Cached
  • The StarPhoenix (Saskatoon) Mon Nov 23 2015
  • There is nothing novel about providing some medical services in a private practice setting in Saskatchewan. Imaging services, such as X-rays and ultrasound, are already provided that way. What is novel is to legislate that these services will be privately paid for.
  • The Canada Health Act requires that medicare finance all "medically necessary" physician services. The intent of the act is that services be distributed on the basis of medical necessity rather than ability to pay. There is no doubt that the new Saskatchewan legislation will restrict access to services if private MRIs are not covered by medicare. Of course, enforcement of the federal Health Act is subject to ministerial discretion. The Saskatchewan government, when it drafted its legislation, was probably confident that the former federal minister would be discreet. It is highly doubtful that the new federal Liberal government will take the same view
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  • But Saskatchewan's Health Minister Dustin Duncan seems to believe that a novel feature in their "model" will make it palatable: MRI providers will be required to provide a "public" MRI for each private MRI sold. There is great fog around this stipulation. MRI clinics in Alberta and British Columbia provide a menu of services, just like an auto repair shop. Of course, it is difficult to identify prices for Canadian MRIs because their websites, while advertising "competitive" prices, ask you to contact them. The United States is more "competitive." For example, Ohio law requires hospitals to publish their prices. The website for medcentral.org lists more than 40 items in its MRI price list.
  • Here is my question: If a Saskatchewan MRI provider does a foot scan for a private patient, does it then have to do a foot scan for a public patient? How will this be monitored? Also, when does the public patient get her foot scan? If a paying patient is standing in the door, does the MRI provider say, "Sorry, you have to wait till we provide the public foot scan that we owe?" How is this monitored? Does the government pay for the patient from the public list? If so, at what price?
  • Is this simply a revenue guarantee in disguise? Undoubtedly Bill 179 provides for wide ministerial discretion. Can we bank on the minister being discreet? This model is bizarre. If the provincial government is seeking ways to provide more MRIs without having to incur the upfront capital costs and to remove the operating costs from its budget, then just negotiate MRI fees in the physician fee schedule, as currently occurs with other imaging services.
  • However, it might quickly become obvious that the private modality cannot compete with cost effective public provision. Glen Beck is emeritus professor of health economics at the University of Saskatchewan.
Govind Rao

BC man's stroke illustrates dangers of for-profit MRI scans, funding cuts to public hea... - 0 views

canadians.org/...unding-cuts-public-health-care

from heather coc private clinics privatization

shared by Govind Rao on 19 May 15 - No Cached
  • May 18, 2015 - 9:45am The Council of Canadians opposes the use of for-profit, user-pay Magnetic resonance imaging (MRI) scans to diagnose medical conditions. Earlier this month, we spoke out against the Saskatchewan government's new legislation that would allow more user-pay MRI scans in that province. Today, the CBC reports on a British Columbia resident, Peter Peczek, who suffered a near fatal stroke after a private MRI clinic failed to detect his illness.
  • CBC reports, "Peczek said the emergency room physician told him he couldn't have an MRI done right away in the public hospital. ...[The attending doctor] referred Peczek for a scan at the private local MRI clinic instead. ...Peczek paid $1,300 at Image One in Kelowna. Radiologist Casey McMillan interpreted the scan on behalf of the clinic and concluded there were 'no significant findings'. ...The radiologist who read Peczek's MRI for the private clinic also works in a public hospital. ...Go Public discovered that several doctors who work in or manage public hospital systems also own or work for private MRI clinics in B.C." The article comments, "Peczek's suffering has ... raised broader concerns over mixing public and private-for-pay health care — including possible conflicts of interest and errors by physicians who spread themselves too thin."
Govind Rao

CUPE calls on health ministry to review MRI legislation; Health care must be based on n... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|relp|20151222|236365545

from heather Saskatchewan privatization private clinics legislation

shared by Govind Rao on 22 Dec 15 - No Cached
  • The Leader-Post (Regina) Tue Dec 22 2015
  • The Canadian Union of Public Employees Saskatchewan is asking the federal health minister to review the Wall government's Bill 179, which permits private userpay MRI facilities in the province. The bill was passed by the government on Nov. 4 with the goal that it would be proclaimed in February before voters head to the polls in April.
  • Under the bill, when a patient elects to pay for an MRI out-ofpocket, the private clinic that does that MRI must provide a free scan for someone on the public wait-list.
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  • Last week, CUPE Saskatchewan sent a letter to Health Minister Jane Philpott requesting her to review the provincial legislation to determine if it violates the Canada Health Act and, if it does, that she instruct the Saskatchewan government to comply with the act.
  • Philpott was not available for an interview Monday, but emailed the Regina Leader-Post the following statement: "Our Government will work in close collaboration with our provincial and territorial partners to build constructive relationships. Our priority is to ensure all Canadians have access to health care."
  • CUPE Saskatchewan president Tom Graham says the union consulted with lawyer Steven Shrybman and it is his opinion that Bill 179 violates the Canada Health Act. "Health care needs to be provided on need, not the ability to pay," Graham said. "We think there are solutions that can be done within the system that don't require people to dig into their pockets to get an MRI."
  • CUPE sent the letter to Philpott days after the Saskatchewan Medical Association (SMA) raised concerns that the provincial government's decision to allow people to pay privately for MRIs was "a hasty policy." In a letter to physicians, SMA president Dr. Mark Brown said the organization opposed the move and told Health Minister Dustin Duncan that at the end of October. Brown said the legislation allowing people to pay privately for MRIs runs contrary to the fundamental principle of medicare.
  • (Bill 179) is privatizing our health-care system as far as we're concerned ... It's a slippery slope," Graham said Monday. "We already pay for health care in this province and in this country and now we're being asked to pay twice if you want it faster." Private MRIs in Alberta have not reduced wait times, he said.
  • "Their wait times are worse than ours and in Quebec, it's the same thing, " Graham said. "We're really quite concerned about it and we'd like the federal government to basically direct the government here to follow the Canada Health Act." In past interviews, Duncan has said people leave the province for MRIs now. The legislation is a way to level the playing field and provide some benefits for the public system.
  • I think they need to put the resources in where they are needed," Graham said. "It's a matter of getting MRI machines and technicians and scheduling it - it's as simple as that. I don't know why we have to get into these elaborate, complex schemes ... We should be enhancing our system, not taking it apart."
Heather Farrow

Kenney, Hoffman spar over private health care option; PC leadership hopeful calls for m... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|cahr|20160816|253937793

conservatives privatization private clinics

shared by Heather Farrow on 16 Aug 16 - No Cached
  • Calgary Herald Tue Aug 16 2016
  • Oh, no. We're into it again - back to the endless, arid Alberta debate on public versus private health care. Jason Kenney, the early bird unofficial Progressive Conservative leadership candidate, said Monday he thinks Albertans deserve more health options, on the models of Quebec and British Columbia. Kenney was answering questions about the Herald story that revealed MRI wait times in Calgary are up 20 per cent. Too many people are on the list who don't belong there, and the machines are idle too much of the time. "I think there needs to be more flexibility in the way the system is administered," Kenney told the CBC's David Gray.
  • "It means allowing people more options like the model in Quebec, which is universal and complies with the Canada Health Act." The interviewer asked if that means more private care. "As long as it's competition within the public system and everybody gets access to quality health care, I don't see any reason why Albertans should have less
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  • choices than British Columbians or Quebecers do," answered Kenney. Health Minister Sarah Hoffman has an answer: if Kenney wants a policy brawl over the injection of more private options, he's welcome to it. "I'm not surprised that he's trying to find ways to expand privatization in the health-care system," she said in an interview. "Certainly, that's unfortunate." As you'd expect from a federal Conservative, Kenney blames centralized decision-making. "I just believe that local management of resources is a lot more sensible than hyper-centralized control," he told the Herald. "You know, when hospitals are given a limited budget for a limited number of hours they can service people, that gets out of alignment with the actual local demand."
  • But Hoffman figures Albertans don't want another major shift in how health care is run, after watching a pack of failed experiments in the PCs' waning years. She has doctors and officials working on two related problems - how to get more use out of the city's publicly owned MRI machines, and how to make sure everyone on the list really needs the test. I asked if she eventually plans to fold the province's vast array of private clinics, including imaging centres, under the government wing through public ownership.
  • We're not planning on doing a full overhaul," she said. "In general, Albertans are proud of what we've got. I don't have any drastic plans for changing the way those programs are administered." As often happens, when you sift through the rhetoric the opponents are quite close together. Most New Democrats would agree with another Kenney statement (as long as they're weren't aware who said it): "We need to ensure our health care has adequate funding, that it's publicly administered, that it's universally available, that it complies with the Canada Health Act." The key point is not who owns the assets, but who pays the bill. If health care pays, it hardly matters whether you get the test in a public hospital or a private clinic.
  • The MRI dispute is a good example of how the public-private debate has become so futile and misleading. Nine MRI machines in Calgary are publicly owned. They perform the tests for people on the waiting list. But there are also three MRIs in privately owned clinics.
  • The province doesn't fund MRI tests in those private clinics. The PCs wouldn't, and now the NDP won't either. And yet, health care funds virtually every other imaging test, including X-rays, ultrasounds and mammograms. Those exams are done every day in the very same clinics that own the private MRIs. The cost of a private test is $750, which probably explains why those machines are underused despite the long public wait.
  • Simple answer, right? The province should just start funding tests on the private MRIs. Asked why she doesn't do that, Hoffman says, "Why would you pay to rent something when you already own it and you're only using it half the time?" OK then, why not use what you've got? Why does that have to be so ridiculously difficult? Health care in Alberta is extraordinarily complex, and because of that, far beyond the reach of simplistic rhetoric about private and public delivery. That debate is just a distraction from the real issue - making the system work. Do that, please. Don Braid's column appears regularly in the Herald dbraid@postmedia.com
Cheryl Stadnichuk

Evidence shows private MRI tests won't cut the wait - Winnipeg Free Press - 0 views

www.winnipegfreepress.com/...nt-cut-the-wait-404701236.html

MRI privatization Manitoba two-tier

shared by Cheryl Stadnichuk on 05 Dec 16 - No Cached
  • Last week, Health Minister Kelvin Goertzen suggested he was "willing to look" at copying a Saskatchewan initiative that allows people to pay for MRI tests at private clinics to relieve pressure on the public system. In exchange for being able to charge directly for a scan, private MRI clinics have to provide one free scan to someone on the public waiting list.
  • In question period Friday, the NDP lashed out at Goertzen for his interest in a program the federal government has deemed illegal under the Canada Health Act. Two-tier health care remains a flashpoint between the right and left wings of the Canadian political spectrum, as was witnessed in the Manitoba legislature last week.
  • NDP critic Matt Wiebe put it bluntly. "This is the first step in (the Tory government’s) plan to create a two-tier health system, where the size of your wallet determines your care."
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  • Many within the system believe allowing private, for-profit options is a potential solution. Government has always relied on private facilities such as walk-in clinics, X-ray clinics and laboratories to provide insured services within the public system. Perhaps it’s time to allow Canadians to purchase medical services on the open market.
  • Although a province may have an oversupply of surgeons, it has a shortage of the other disciplines. The hours nurses and anesthesiologists work in the private system would come at the expense of the hours they can devote to the public system.This is a key caveat on the argument in favour of allowing more private, for-profit health care options: it is difficult to create a private tier that does not ultimately weaken the public tier. In fact, it is tough to find examples where increased private options relieve pressure on the public system and reduce wait times.
  • There is some evidence of this in Saskatchewan, where the government has been allowing private, for-profit MRIs for about 10 months. To date, Saskatchewan claims it has taken 2,200 patients off public wait lists for MRIs. And yet, its wait times in the public system have not gone down.
  • In fact, during the first six months Saskatchewan allowed residents to purchase their own MRI tests, the government’s own website shows wait times went up.
Govind Rao

Option to pay for MRIs coming - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|yoen|20150520|220827808

from heather private clinics privatization diagnostics Saskatchewan

shared by Govind Rao on 20 May 15 - No Cached
  • Yorkton This Week Wed May 20 2015
  • New legislation introduced will give patients the ability to choose to pay privately for a Magnetic Resonance Imaging (MRI) scan in Saskatchewan. "Reducing wait times and giving patients more choice over their own care decisions is a high priority for the people of Saskatchewan," Health Minister Dustin Duncan said. "Wait times for many services are still too long. Our government is committed to moving forward with new and innovative solutions to barriers that prevent the very best in patient access and satisfaction."
  • The new legislation will allow for the creation of regulations that will require private clinics to provide a second scan to a patient on the public wait list at no charge every time a scan is provided to someone who chooses to pay for their own MRI. A physician referral will still be required to obtain an MRI scan. This arrangement is similar to agreements that are in place that allow for the Saskatchewan Roughriders and the Worker's Compensation Board (WCB) to purchase MRI scans. In both agreements, the Roughriders and the WCB pay for an additional scan for a patient on the public wait list. "The requirement for a private clinic to cover a second scan on the public wait list will increase fairness and access," Duncan said. "We are once again leading the way with an innovative, made-in-Saskatchewan approach to reducing wait times." Following passage of the Act and the establishment of regulations, private-pay MRI services could be offered in existing private MRI facilities as early as the spring of 2016. This model will be evaluated after one year in order to ensure it is meeting the goals of improving access to safe, high quality care.
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  • As of March 31, 2015, there are an estimated 4,000 - 5,000 patients waiting for MRI services in Saskatchewan.
Irene Jansen

Private 3T MRI clinic spurs concerns: New Brunswick Telegraph-Journal - 0 views

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nb private clinics diagnostics

shared by Irene Jansen on 18 Oct 12 - No Cached
  • There are concerns among New Brunswick physicians that a soon-to-be-operational private MRI clinic is opening the door to queue-jumpers with deep pockets.
  • roughly $900 fee
  • "There are certainly some concerns," Anthony Knight, CEO of the New Brunswick Medical Society
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  • Opposition Liberal health critic Bill Fraser said there are many questions about the private clinic, including what kind of oversight and safety practices the province will be enforcing.
  • "This is a major piece of equipment, and it is not without health concerns both in sighting, installation and use of the magnet," said Whelan, chief of diagnostic imaging at the Saint John Regional Hospital.
  • Knight said he's not sure there is much need in New Brunswick for the private service. The New Brunswick government has recently invested in the purchase of five smaller 1.5 MRI machines for hospitals across the province. As well, it is looking at buying 3T MRIs for the Saint John Regional and the Moncton Hospital.
  • Who OK'd the use of this in the province? Did the private operators have to jump through the same kind of hoops we have to go through in the hospital?"
  • "We have 70 per cent of patients who can get diagnostic imaging access within one month, according to data from the New Brunswick Health Council. We also know that patients who are the sickest get care immediately, including MRI scans. So it's the less urgent cases who will be pursuing this private service."
  • The clinic's clients must have a referral for a scan from a doctor.
  • will employ four full-time technicians and one nurse
  • It is a client's doctor who makes the final diagnosis and determines with the patient where to go from there.
  • A private MRI clinic has been operating in Nova Scotia for almost 10 years. Across Canada, there are at least 40 for-profit magnetic resonance imaging (MRI) and computed tomography (CT) clinics.
Govind Rao

Paying for quicker care good option - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|sasp|20150525|221197157

from heather privatization Saskatchewan private clinics

shared by Govind Rao on 26 May 15 - No Cached
  • The StarPhoenix (Saskatoon) Mon May 25 2015
  • Jordon Cooper
  • When the Saskatchewan government announced that it would allow private MRI clinics to provide scans paid out of pocket by patients, my first thought was that this is the start of two-tier health care in Canada. The wealthy will get better treatment than the rest of us. This is a privilege that until now was restricted to professional athletes. As a society, we decided long ago that they deserve better treatment than the rest of us as they pursued whatever championship they strive for. Most of the rest of us (except those on workers' compensation or SGI injury claims), were confined to work within the system and accept whatever treatment that we get in a manner that may or may not be in time. Why? It was a sacrifice for the greater principle of universal access. You could jump the queue, but you had to go to Alberta or the United States to do that.
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  • With the government's proposal, those with disposable income now can stay at home and do that by paying for two MRI scans: one for someone on the provincial waiting list and the other for themselves. The goal is shorter waiting lists, but in the end it will be a savings to the province. Historically, this has been seen as counter to the Canada Health Act. Battles between the federal government and Alberta in the 1990s were fought over issues such as private MRI clinics and operating rooms, which were seen as contrary to the concept of universal access. Since then, the political landscape in Canada has changed as we realized that despite massive cash transfers for health care the problems remained. I have had friends who became ill overseas. Before returning home, they scheduled and paid for tests that could take months in Saskatchewan. You never know if this saved a life, but it did make immediate treatment and faster recovery possible.
  • Others have left the country for diagnosis and treatment because they felt the timeline in Canada could be fatal. Last week, the CBC carried a story about Gerd Trubenbach, who flew to South Korea for treatment on an aggressive tumour. He felt that the wait time for treatment in British Columbia would have killed him. Fortunately for him, he had the resources and contacts to get treated overseas. Defenders of universal access call for more funding for medicare. The idea is that if we can improve medicare enough, these measures would not be needed. It is pointed out there are cities in the United States that have 10 MRI scanners, while Saskatoon only has two. What they forget is those MRI scanners are largely funded and run by private investment.
  • As for funding it, health care in Saskatchewan takes up to 42 per cent of the provincial budget. How much more do we have to spend to fix the problems? As baby boomers age and live longer, they will require more treatment and that percentage will increase. I have been thinking about this a lot, mostly in medical waiting rooms. I became sick in November and haven't been able to beat it. My ailment isn't life threatening, but does involve a lot of trips to doctors and hospital treatments. It isn't fun.
  • I ponder this issue often: would I pay to speed up this process? After months of fighting this issue, the answer is a resounding yes. This isn't a new thought. I am allowed to upgrade a cast or a hospital room, so why can't I pay to speed up my treatment or healing? Or as with an MRI, I can get what I need while also paying for someone else?
  • In a perfect world this wouldn't be done, but as I walk into hospitals that are struggling to keep up with basic maintenance, I know we don't have a perfect system. And I am not sure why people have to suffer until it is fixed. Allowing private MRIs won't fix the problem of increasing healthcare costs in Saskatchewan, but it puts more decision-making ability in the hands that need it. Our personal health shouldn't be subject to the greater good because the system in inefficient.
  • Some will always argue that any change to the health system is a slippery slope. It isn't. Governments have long balanced private and public services. Even the backbone of our health system consists of thousands of doctors acting as private contractors who run offices and bill the province. Figuring out a way to extend those services while giving suffering patients flexibility and more control of their own treatment should be the goal of every government.
Govind Rao

MRIs should stay public, says CUPE | Canadian Union of Public Employees - 0 views

cupe.ca/s-should-stay-public-says-cupe

from heather private clinics Saskatchewan cupe

shared by Govind Rao on 21 Oct 14 - No Cached
  • REGINA: CUPE is concerned that Brad Wall is floating the idea of private MRIs. The cost of private MRI scans fluctuates between $600 and $1,000 across the country. There have been concerns that private options for MRIs mean that only people who can pay can receive medically necessary procedures in a timely manner. “What we are talking about is a two tier system, where the people who are able to pay get access to the services quicker – regardless of need,” said Tom Graham, President of CUPE Saskatchewan. “While the rich get MRIs, the rest of us still have to wait.” CUPE has further concerns about what private MRIs might mean for the existing staffing complement. “Private clinics will make staff shortages we are already facing worse,” stated Gordon Campbell, President of CUPE Health Care Council. “This doesn’t add new staffing capacity – it poaches from the public system.”
  • Govind Rao on 21 Oct 14
     
    Oct 17 2014
Govind Rao

User-pay MRI legislation will reduce access and only increase wait lists | CUPE Saskatc... - 0 views

sk.cupe.ca/...s-and-only-increase-wait-lists

from heather cupe Saskatchewan diagnostics privatization private clinics

shared by Govind Rao on 11 May 15 - No Cached
  • Posted on May 6, 2015
  • The introduction of user-pay MRI scan legislation by the Government of Saskatchewan is the beginning of two-tier health care, says CUPE. “Allowing those able to pay for private MRI scans to get access to health care more quickly – regardless of need – is the introduction of two-tier health care,” said Tom Graham, President of CUPE Saskatchewan. “While those with large wallets can get MRIs quickly, the rest of us will have to wait.”
Govind Rao

Profit reality - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|relp|20150516|220596265

from heather privatization private clinics Saskatchewan diagnostics

shared by Govind Rao on 19 May 15 - No Cached
  • The Leader-Post (Regina) Sat May 16 2015
  • Thank you to Steven Lewis for his perfectly lucid May 12 analysis of the proposed two-for-one MRI legislation. My view had been that the provision of MRI services in Saskatchewan should be no different than the current model for radiology services, owned by individuals (or medical corporations), provided to patients as required and paid for by the public system. To those who so vehemently oppose "for-profit" medical services, be advised we have had this since the advent of medicare. In fact, virtually every physician in private practice of any kind in the province operates on a for-profit basis. Lewis' addition of the concept need for a determination of the appropriateness of MRI scans makes perfect sense. How many MRI scans are truly necessary and provide additional information significant enough to alter a diagnosis? In a large number of cases, the MRI is the use of technology because it is there to be used. Do we all really need a smart phone if all we use the device for is to make a telephone call?
  • First, let us determine the need and then allow the market to provide the service capacity. On this basis, demand will provide the number of MRI machines required in the province. Whatever the model, there should be no ability to jump the queue for surgery as proposed by the draft legislation. Chris Richter Regina
Govind Rao

Allowing Private MRI Clinics Does Not Shorten Wait Times in Public Healthcare... - 1 views

www.huffingtonpost.ca/...vate-healthcare_b_6056848.html

from heather waits privatization private clinics

shared by Govind Rao on 13 Nov 14 - No Cached
  • 10/28/2014
  • Last week, Saskatchewan Premier Brad Wall took to Twitter to ask the question "Is it time to allow people to pay for their own private MRIs in Saskatchewan like they can do in Alberta?" This came after a radio show in which he'd received a call from a patient who's been waiting three months for an MRI -- one of many Saskatchewan patients who are, understandably, frustrated by long waits for essential imaging services. It's a real problem. For that reason we should be very wary of false solutions, and look first to evidence before rhetoric takes over.
  • The best place to look for evidence is the province Wall references as a model: Alberta. Many Saskatchewan residents have sought out care in Alberta's private MRI clinics, giving the impression that the experiment there has been a success. It turns out, when we take a closer look, that things are not so wildly rosy in the land of private MRIs after all. Perhaps the most surprising fact is that the wait list for an MRI in Alberta, rather than having been shortened by the presence of private imaging clinics, is actually the longest in the country.
Govind Rao

Base MRI clinic policy on Alberta's experience - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|sasp|20141024|206863855

from heather Saskatchewan privatization private clinics Alberta

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  • The StarPhoenix (Saskatoon) Fri Oct 24 2014
  • Meili is a family physician in Saskatoon and vice-chair of Canadian Doctors for Medicare. Premier Brad Wall took to Twitter last week to ask: "Is it time to allow people to pay for their own private MRIs in Saskatchewan like they can do in Alberta?" This came after a radio talk show during which he'd received a call from a patient who's been waiting three months for an MRI scan. This is one of many Saskatchewan patients who are, understandably, frustrated by long waits for essential imaging services. It is a real problem. For that reason we should be very wary of false solutions and look first to evidence before rhetoric takes over. The best place to look for that evidence is the province Wall references as a model. Many Saskatchewan residents have sought out care in Alberta's private MRI clinics, giving the impression that the experiment there has been a success. When we take a closer look, it turns out things are not so wildly rosy in the land of private MRIs. Perhaps the most surprising fact is that the wait list for MRI scans in Alberta, rather than having been shortened by the presence of private imaging clinics, is actually the longest in Canada. According to the Canadian Institute for Health Information, patients in Alberta can wait from 87 days to 247 days for a scan, compared with 28 to 88 in Saskatchewan.
Govind Rao

Get back in line, Mr. Premier - 0 views

behindthenumbers.ca/...get-back-in-line-mr-premier

from heather ally Saskatchewan privatization private clinics

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  • October 17th, 2014 Simon Enoch
  • Saskatchewan Premier Brad Wall once again stirred the privatization pot yesterday when he took to social media to ask: “Is it time to allow people to pay for their own private MRI’s in Saskatchewan like they can do in Alberta?” The Premier’s twitter trial balloon suggests the government will argue that allowing private, for-profit MRIs will help reduce wait times in the public system. The Premier himself added: “It does make sense that the wait list is going to shrink because those who want to pay will come off that public wait list and they’ll get their MRIs and thereby shortening the wait list for all, whether they want to pay or not.”
Govind Rao

Wait times for medical scans surge in Quebec: report; Radiologists can earn more chargi... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|mtgz|20151209|235447975

from heather waits private clinics quebec privatization

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  • Montreal Gazette Wed Dec 9 2015 Page: A2
  • Quebec reported the steepest increase this year of any province in wait times for medical imaging scans in Canada - a finding which suggests that the public system is being stretched to the limit, a national survey reveals. The 25th annual survey by the Fraser Institute found that the median wait time in hospital for a magnetic resonance imaging (MRI) scan in Quebec jumped to 12 weeks this year from eight in 2014. By comparison, the median wait time for an MRI is five weeks in Ontario, unchanged from last year.
  • Wait times increased slightly for other medical imaging in Quebec, going up from four to five weeks for both ultrasounds and CT (computerized tomography) scans. (Although Prince Edward Island reported a considerably longer wait for ultrasounds, its survey sample size was much smaller than Quebec's and so its results are probably skewed, a Fraser Institute spokesperson said. In any case, P.E.I.'s wait times for MRIs decreased to 12 weeks from 16.) Unlike all other provinces, Quebec allows radiologists to work in both the public and private systems. Doctors are permitted by law to bill medicare for scans performed in hospital, and to bill patients for those same scans if conducted in a private clinic. This has proved to be a sore point for Health Canada, which has argued repeatedly that Quebec is flouting the accessibility principle of the Canada Health Act.
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  • Dr. Isabelle Leblanc, president of the pro-medicare group Médecins québécois pour le régime public, said the survey results show that radiologists in Quebec are increasingly choosing to work in the private sector to the detriment of the public system. "For us, this is the best example of how mixing the public and private systems can lead to decreased accessibility for most patients and increased accessibility for those who have the money to pay," Leblanc said. "Radiologists have no incentive to increase access in the public system, and in fact, they're draining resources from the public system." Leblanc explained that radiologists can earn more money charging patients for scans in private clinics than they would if they worked exclusively in hospital and billed the Régie de l'assurance maladie du Québec. Leblanc's group warned in a report three years ago that wait times for MRIs in hospital would increase.
  • "We're the province that has the highest number of MRI and CT scan machines per capita in the country - with a third of the machines in the private sector - and yet our public wait times are going up," Leblanc added. Health Minister Gaétan Barrette, a radiologist by profession who had worked in a private clinic before entering politics, was unavailable for comment. Officials with the Association des radiologistes du Québec could not be reached for comment, either. The Fraser Institute report observed little progress in cutting wait times for medically necessary surgery or treatments. The median wait time in Canada for treatment inched up to 18.3 weeks from 18.2 weeks last year. In Quebec, the median wait time for treatment by a specialist rose to 16.4 weeks from 7.3 weeks in 1993, when the Fraser Institute first started compiling such data. The median wait time denotes the midpoint for those waiting, as opposed to an average. In Quebec, the median wait time to see a medical specialist following referral from a general practitioner rose to 7.3 weeks from 7.1 weeks last year. The survey found that the longest median waits in Canada were for orthopedic surgery at 35.7 weeks, or almost nine months.
  • "These protracted wait times are not the result of insufficient spending but because of poor policy," Bacchus Barua, the author of the Fraser survey, said in a statement. "In fact, it's possible to reduce wait times without higher spending or abandoning universality. The key is to better understand the health policy experiences of other more successful universal healthcare systems around the developed world." aderfel@montrealgazette.com Twitter.com/Aaron_Derfel
  • The median wait time in hospital for a magnetic resonance imaging (MRI) scan in Quebec jumped to 12 weeks this year from eight in 2014, a survey has revealed. Wait times also increased slightly for other medical imaging. ALLEN McINNIS-MONTREAL GAZETTE FILES • MONTREAL GAZETTE / Source: Fraser Institute
Govind Rao

47 RQHR patients may need additional MRIs after error - Regina | Globalnews.ca - 0 views

globalnews.ca/...ed-additional-mris-after-error

from heather Saskatchewan diagnostics private clinics privatization quality

shared by Govind Rao on 05 Oct 15 - No Cached
  • October 2, 2015
  • By Shawn Knox
  • REGINA – The Regina Qu’Appelle Health Region (RQHR) says 47 patients need to have another MRI after a lengthy series of errors.Forty-seven RQHR radiology patients are being notified by letter that they may require another MRI due to ‘insufficiently detailed testing’.Patients received spine and head MRI scans between October 2014 and July 2015. These patients should have received a scan which included a contrast study, but instead got a non-contrast study.
  • Govind Rao on 05 Oct 15
     
    thanks to cheryl s
Govind Rao

Modernize, not privatize, medicare - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|wifp|20151214|235819030

from heather medicare accord privatization

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  • Winnipeg Free Press Mon Dec 14 2015
  • National Medicare Week has just passed, buoyed with optimism as a fresh-faced government takes the reins in Ottawa -- elected partly on a promise of renewed federal leadership on health care. Yet, these "sunny ways" are overcast by recent developments at the provincial level that entrench and legitimize two-tier care. Saskatchewan has just enacted a licensing regime for private magnetic resonance imaging (MRI) clinics, allowing those who can afford the fees -- which may range into the thousands of dollars -- to speed along diagnosis and return to the public system for treatment. Quebec has just passed legislation that will allow private clinics to extra-bill for "accessory fees" accompanying medically necessary care -- for things such as bandages and anesthetics.
  • Once upon a time, these moves would have been roundly condemned as violating the Canada Health Act's principles of universality and accessibility. These days, two-tier care and extra-billing are sold to the public as strategies for saving medicare. Under Saskatchewan's new legislation, private MRI clinics are required to provide a kind of two-for-one deal: for every MRI sold privately, a second must be provided to a patient on the public wait list, at no charge to the patient or the public insurer. Quebec's legislation is touted as reining in a practice of extra-billing that had already grown widespread.
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  • Underlying both reforms is a quiet resignation to the idea that two-tiered health care is inevitable. This sense of resignation is understandable, coming as it does on the heels of a decade-long void in federal leadership on health care. Throughout the Harper government's time in office, the Canada Health Act went substantially unenforced as private clinics popped up across the country. Even in its reduced role as a cheque-writer, the federal government took steps that undermined national unity on health care, switching the Canada Health Transfer to a strict per capita formula, which takes no account of a province's income level or health-care needs. If Canadians hope to reverse this trend, we cannot simply wage a rearguard battle for the enforcement of the Canada Health Act as it was enacted in 1984. Even if properly enforced, the act protects universal access only for medically necessary hospital and physician services. This is not the blueprint of a 21st-century public health-care system.
  • We desperately need universal coverage for a full array of health-care goods and services -- pharmaceuticals, mental-health services, home care and out-of-hospital diagnostics. Canada is unique among Organization for Economic Co-operation and Development countries in the paucity of what it covers on a universal basis despite falling in the top quartile of countries in levels of per capita health spending. Far from being our saviour, the Canada Health Act in its current incarnation is partly to blame -- not because of its restrictions on queue-jumping and private payment, but because it doesn't protect important modern needs, such as access to prescription drugs.
  • There are limits on what a public health system can provide, of course -- particularly as many provinces now spend nearly half of their budgets on health care. But fairness requires these limits be drawn on a reasoned basis, targeting public coverage at the most effective treatments. Under the current system, surgical removal of a bunion falls under universal coverage, while self-administered but life-saving insulin shots for diabetics do not. A modernized Canada Health Act would hold the provinces accountable for reasonable rationing decisions across the full spectrum of medically necessary care.
  • Instead of modernizing medicare, Saskatchewan and Quebec are looking to further privatize it. Experience to date suggests allowing two-tiered care will not alleviate wait times in the public system. Alberta has reversed course on its experiment with private-pay MRIs after the province's wait times surged to some of the longest in the country.
  • The current wisdom is long wait times are better addressed by reducing unnecessary tests. A 2013 study of two hospitals (one in Alberta, one in Ontario) found more than half of lower-back MRIs ordered were unnecessary. Skirmishes over privatization have to be fought, but they should not distract us from the bigger challenge of creating a modern and publicly accountable health system -- one that provides people the care they need, while avoiding unnecessary care.
  • Achieving that will make National Medicare Week a true cause for celebration. Bryan Thomas is a research associate and Colleen M. Flood is a professor at the University of Ottawa's Centre for Health Law, Policy and Ethics. Flood is also an adviser with EvidenceNetwork.ca.
Irene Jansen

Medecins Québécois pour un Regime Public. Two-Tier Radiology: Quebec's Creep... - 2 views

www.mqrp.qc.ca

doctors quebec coalition ally private clinics

shared by Irene Jansen on 19 Nov 12 - No Cached
  • Irene Jansen on 19 Nov 12
     
    Our 2012 annual report is now available in English The report shows: "While it has more material and human resources, Quebec is less effective than Canada as a whole in providing accessible medical imaging services. The exclusion from public coverage of CAT scan, MRI and ultrasound tests performed outside a hospital leads to joint public-private practice that has the effect of draining resources from the public to the private sector. This damaging distortion leads to problems of access to medical imaging for most patients…"  The report documents the inequitable, inefficient, costly and potentially unsafe utilization of medical imaging technology in Quebec's unique and highly privatized system.  One aspect, the relatively effective use of technology in hospitals compared to private clinics (which would be better yet if the system were entirely public), is clearly not limited to Quebec: "According to a 2008 study by Bercovici and Bell of public hospitals and private clinics offering MRIs in several provinces, including Quebec, the rate of use of machines is about 50% higher in hospitals than in private clinics: an average of 14.7 hours of operation per day during the week and 11.8 hours per day on weekends for hospital machines, compared to 9.7 hours per day during the week and 8.2 hours per day on weekends for machines in clinics." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645224/ The recommendations are also valuable information. 
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