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Govind Rao

PROVINCE TO KILL ANTI-STRIKE BILL ; Controversial legislation proposed stiff fines for ... - 0 views

  • The Edmonton Sun Fri Mar 20 2015
  • The Alberta government will repeal controversial anti-union strike legislation as Premier Jim Prentice looks to "reset the table" with public sector unions ahead of an expected spring election Following a meeting with the heads of the Alberta Union of Provincial Employees (AUPE), United Nurses of Alberta (UNA), the Health Sciences Association of Alberta (HSAA) and the Canadian Union of Public Employees (CUPE) Alberta branch on Thursday, Prentice said the government will move to repeal Bill 45, The Public Sector Services Continuation Act. Passed in December 2013 but never proclaimed, Bill 45 proposed stiffer penalties for unions involved in illegal strikes to the tune of $1 million per day of strike action. The bill was introduced after a costly wildcat strike at the Edmonton Remand Centre in April 2013. Prentice said he personally didn't think the legislation should have ever been passed.
  • "I didn't go into this meeting offering to repeal Bill 45 as a negotiating chip. That was not the point ... the purpose of the discussion today was to reset the table," said Prentice in a news conference at Government House following the meeting. "I don't agree with (Bill 45). I don't agree with the content of the legislation and we will move forward and define essential service legislation that is as respectful of the rights of our employees as it is respectful of taxpayers." Prentice said the government wants to collaboratively work with unions to define essential service legislation as well as a new contract negotiation process that's similar to British Columbia's, where all public sector labour negotiations go through the Public Sector Employers' Council Secretariat under a fixed fiscal mandate.
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  • "This is not about rolling back contracts. This is about working together to find solutions as we go forward that reflect the fiscal circumstances that we're in," he said, noting the government is "staring down" a $7 billion revenue hole. AUPE President Guy Smith said the repeal of Bill 45 means "one of the most odious remnants of the (Alison) Redford era" will be gone. Smith said he made it clear to Prentice that front-line workers "are not the problem" and discussions on the negotiations framework and essential service legislation "have to happen in consort with each other."
  • HSAA President El i sabeth Ballermann said she was encouraged by the "sign of good faith" as the "punitive, mean-spirited legislation to repress labour unrest" was killed. She said HSAA is prepared to proceed in good faith. Prentice confirmed the government will repeal Bill 45 "immediately" during this spring session. It is expected that Prentice will call an early spring election shortly after the government presents its budget on March 26.
Govind Rao

Premier's office polling says protect health care, don't privatize - Regional - The Sou... - 0 views

  • March 24, 2015
  • Focus group report points to widening urban-rural divide If Premier Paul Davis is looking to make cuts in the upcoming budget, he’d do well to avoid slashing spending on health care, according to polling information provided to the premier’s office.
Govind Rao

Health care system has been under attack - Infomart - 0 views

  • Campbell River Courier-Islander Wed Mar 25 2015
  • It's time for Canadians to take back the public health care agenda. For far too long, forces have been chipping away at our most cherished social program. To get a glimpse of the future facing public health care today, just follow the money. This March 31 marks the first anniversary of a decade-long $36 billion cut to health care transfers to the provinces by Ottawa. B.C.'s share of that historic 10-year long reduction totals $5 billion.
  • I think we can all agree that less money for health care is not what is needed for our province. In fact, a Conference Board of Canada report released last August determined Victoria must invest $1.8 billion more than budgeted for health care between 2014 and 2017 just to maintain current service levels. With an aging population requiring more complex care, this deliberate underfunding of services by both federal and provincial governments is playing out in very ugly ways - and the signs are everywhere. Take the growth in private health care. For a third-year in a row, B.C. was fined for allowing illegal extra-billing of patients for services that are supposed to be without cost to all Canadians under the Canada Health Act. Later this June, a B.C.-based private hospital owner will push for the reintroduction of two-tier medicine into Canada at the province's Supreme Court. Then there's the impact on seniors' care. According to a poll conducted last September, many of B.C.'s frail elderly do not receive the attention they require.
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  • Approximately three-quarters of B.C. care aides surveyed said they are forced to rush through basic care for the elderly and disabled because of high workloads and reduced staffing. And let's not forget the workers who bear the brunt of health care cuts. Between January 21 and February 26, nearly 1,500 health care workers were laid-off at care homes and hospitals across B.C. because of contracting out or contract flips. Any former workers rehired at these facilities can expect to start at the bottom of the employment ladder. Some will lose their pension, others will receive lower probationary wages and most will have zero-earned vacation time. It's plain to see public health care is going down a bad road.
  • As we head towards a federal election, Canadians have an opportunity to think about how they can best vote for health care in 2015. The next government in Ottawa can take immediate steps to put our nation's signature social program back on the right track. That means your vote - and the vote of your family and friends - can make a difference in electing MPs that will fight for health care. They say voters get the government they deserve. And we certainly are due for leadership in Ottawa that puts the future of a strong public health care system front and centre in their election promises. To learn more about what can be done to save public health care, please visit saveourhealthcarebc.ca online. Bonnie Pearson, HEU Secretary-Business Manager
Govind Rao

Ambulance fees unfair, dangerous obstacle to care - Infomart - 0 views

  • Toronto Star Fri Mar 27 2015
  • Imagine you're a physician seeing a 6-month-old child in clinic. She has a fever and cough, she's working hard to breathe and her oxygen levels are falling. You know she needs assessment in the emergency room and requires transportation in an ambulance in case her condition worsens en route. Her family understands the urgency of the situation, but asks, "Could we take her there in our car?" Experiencing a medical emergency is an incredibly stressful experience for patients and their families. This stress should not be compounded by worries about getting an ambulance bill they can't afford. As physicians, we know the importance of the first few minutes of an emergency situation, and the crucial role of Emergency Medical Services (EMS) in saving lives. And yet ambulance fees remain a significant barrier to people receiving necessary care across Canada.
  • One young mother recently spoke to the Saskatchewan press about receiving a bill of $7,000 after several ambulance trips were required for her severely ill daughter. Connie Newman of the Manitoba Association of Seniors Centres recently described to reporters the plight of an elderly woman who walked to the hospital in -40 C because she could not afford an ambulance. How often are people forced to choose the unsafe option of driving themselves or their loved ones to hospital simply because they cannot afford to pay? A recent CBC Marketplace survey revealed that 19 per cent of Canadians did not call an ambulance due to cost. Clearly, this is an issue that our provincial and territorial health ministers need to address. A look across our provinces and territories reveals a patchwork system for financing ambulance services. New Brunswick has recently removed ambulance fees for anyone who does not have private insurance coverage. All other provinces and territories in Canada - with the exception of the Yukon - charge ambulance fees. The burden of cost to patients is highest in the prairies: Manitoba charges up to $530 per trip, and Saskatchewan tacks on fees for interhospital transfers on top of the $245-$325 fee for an ambulance pickup from home.
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  • In Ontario, the cost is typically much lower at $45 per trip, but increases to $240 if the receiving physician deems it unnecessary. The reality on the ground violates the spirit, if not the letter, of the Canada Health Act: Equal access to physician and hospital services means little if safe passage to them is anything but. There are a variety of options to reduce this inequity in access. One option is to follow New Brunswick's lead and offer full coverage. An alternative would be to only charge users if the ambulance ride is deemed medically unnecessary. However, differentiating "appropriate" from "inappropriate" ambulance use isn't straightforward, and can vary between providers. What's more, evidence suggests that institutions - schools, long-term care facilities, hospitals and police services - more often initiate potentially unnecessary ambulance services than do individuals, as a result of compliance with internal policy or protocol.
  • As with other areas of health care, user fees are a blunt tool: they reduce both necessary and unnecessary use of services. The risk of footing the bill could deter people, especially those living in poverty, from calling for help. This would deny them not only safe transport to hospital, but also the initial emergency interventions by paramedics that can mean the difference between life and death. Public education and enhanced availability of primary care are more effective ways to decrease unnecessary ambulance use. Ideally, ambulance services should be fully covered for everyone. This would, however, require provincial governments to take on more of the costs. In Nova Scotia, that cost is an estimated $9.7 million, according to the Nova Scotia Citizen's Health Care Network. This is a drop in the bucket of the $6.2-billion Nova Scotia health-care budget; a small investment to ensure everyone, regardless of income, has access to vital emergency care. The variety and inequity of ambulance charges in Canada is a policy mess. Canada's health ministers should work together to establish a consistent and compassionate approach that balances cost with the need to remove barriers to care. Ryan Meili is an expert adviser
  • with EvidenceNetwork.ca, a family physician in Saskatoon and founder of Upstream: Institute for a Healthy Society. @ryanmeili Carolyn Nowry is a family physician in Calgary. They are both board members with Canadian Doctors for Medicare.
Govind Rao

March 27 rally to protest nursing cuts at Almonte General Hospital | Ontario Council of... - 0 views

  • 26/March/2015
  • Staff at Almonte General Hospital represented by CUPE will rally at noon on March 27 at the office of local MPP Jack MacLaren (240 Michael Cowpland Drive, Unit 100, Kanata) as part of a campaign to protest the cuts to registered practical nursing staff at the hospital.10 registered practical nurse positions are being eliminated at the hospital to be replaced with personal support workers.Registered practical nurses complete a 2-year community college program. They are fully trained nurses and, among many other skills, can do physical assessment, wound care, manage IV's and dispense medications.Almonte Hospital is in the 4th year of a 5-year funding freeze, imposed by the provincial Liberal government. Ontario's Auditor General has estimated that hospitals need a 5.8% funding increase each year to meet their costs, which are rising faster than inflation due to the costs of drugs, medical technologies and doctors' salaries. The 4-year funding freeze has cut Almonte's budget by 24%. Ontario hospitals were already the most efficient hospitals in the country with the fewest beds and staff and the shortest lengths of stay going into the freeze."We are building an escalating campaign aimed to push the provincial government to fund hospitals like Almonte General properly. A community meeting in Almonte is planned for May", says Linda Melbrew, president of CUPE local 3022, which represents staff at the hospital.SOURCE Ontario Council of Hospital Unions (CUPE)For further information:Linda Melbrew, President, CUPE Local 3022, 613-314-5283; Michael Hurley, President, Ontario Council of Hospital Unions/CUPE (OCHU), 416-884-0770
Govind Rao

Hospital defends cuts ; LAYOFFS: Operations chief maintains patient care won't be impac... - 0 views

  • The Sudbury Star Thu Mar 26 2015
  • After months of talk about pending cuts to nursing and other staff positions at Health Sciences North, hospital administrators have released a document saying how they believe the hospital can cut $5.1 million from its budget without affecting patient care. The Ontario Nurses' Association has warned as many as 42 nursing positions -- equivalent to about 85,000 hours of nursing care--will be eliminated so HSN can balance its books. Until Wednesday, hospital officials would only say they didn't expect a single nurse to lose his or her job because the positions could be trimmed by attrition. Seven layoff notices have been issued to ONA members, but the hospital's official position is not one nurse will "be out the door." ONA Local 014 president Kelly Latimer spoke Tuesday night to more than 300 people at the Steelworkers Hall at a forum organized by the Ontario Health Coalition, which has a Sudbury chapter.
Govind Rao

Right-wingers singing same song - Infomart - 0 views

  • Cape Breton Post Fri Mar 27 2015
  • Every spring, we seem to get the same old song from the usual right-wing groups, such as the Canadian Federation of Independent Business, the Canadian Taxpayers Federation, and the Fraser Institute. They always look to play the blame game, pitting the public sector and its unions and the private sector against one another just in time for the spring budgets. The spin seems to be that people making a decent living with benefits in the public sector is a bad thing, and that those workers' wages should be brought down and their benefits and pensions slashed.
  • They completely ignore the real reason that wages are higher in the public sector - namely, that historical wage and benefit inequities for women and other equality seeking groups have been addressed much more thoroughly in the public sector. That's the real news story here: Equality seeking groups - including 51 per cent of the population (women) - continue to be dramatically underpaid and undervalued in the private sector. The other important questions they never seem to address are: What actually happens to the people who don't have those benefits, who don't have a pension? What happens when they retire, when they get sick, when they need dental work, have vision problems or other major health issues that are not covered by public health care? What happens to the folks who don't have a drug plan and can't afford their medication? Shouldn't we be having a conversation about how to ensure all workers make a decent wage, have a job with benefits and a pension they can retire on with some dignity ... in both the private and public sector?
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  • Let's be honest: The real purpose of these right-wing groups is to try to keep wages and benefits low for businesses small and large. Danny Cavanagh, president CUPE Nova Scotia
Govind Rao

Province "picking the pockets" of public workers: CUPE Alberta | Canadian Union of Publ... - 0 views

  • Today’s provincial budget chips away at the incomes of hard-working public employees and their families while failing to increase revenues through progressive taxation, CUPE Alberta Treasurer Glynnis Lieb said. “The Premier is picking the pockets of public workers,” Lieb said. “Demanding wage concessions while eliminating health care tax cost-sharing means less money for our kids’ after-school activities and less money for groceries and rent.”
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    March 27 2015
Govind Rao

Union drama in Nova Scotia: Real showdown coming in Act 2 | rankandfile.ca - 1 views

  • March 31, 2015
  • By Larry and Judy Haiven The Nova Scotia government and its four acute health care unions have finally resolved their dispute over which unions represent which workers in collective bargaining. The British Columbia model of “bargaining associations,” floated by the unions last summer, and rejected by the government then, will now be the order of the day. Was this the big victory for the workers that some commentators claim?
  • Will the groups of skilled workers with clout submit meekly, or will their anger and militancy redouble as the government attempts to balance the provincial budget on their backs?
Govind Rao

Liberal government has turned its back to patient hardship and suffering in northern On... - 0 views

  • Jan 20, 2016
  • Sault Ste. Marie, Ontario — Ontario’s Standing Committee on Finance and Economic Affairs is in Sault Ste. Marie tomorrow for one of six pre-budget consultations across the province. Michael Hurley the president of Ontario Council of Hospital Unions (OCHU) presenting to the committee at 1:45 p.m. at the Delta Waterfront, has a direct message for the provincial government; “invest in hospital care before more patients in northern Ontario suffer.”
Govind Rao

Moving Canada toward a true health care accord - Infomart - 0 views

  • Trail Daily Times Thu Jan 21 2016
  • This week Canada's Minister of Health, Dr. Jane Philpott, will meet with her provincial and territorial counterparts in Vancouver. This is no ordinary get-together. In his mandate letter to the Minister, Prime Minister Trudeau tasked Philpott with "engaging provinces and territories in the development of a new, multi-year Health Accord with long-term funding agreement." This is a distinct change in tone from the previous federal government, which refused to meet with provinces to negotiate a new agreement after the accord ran out in 2014.
  • The top-down approach by the Harper government was greeted with two distinct reactions. There were those that saw the cancellation of the Health Accord as a step backward that would further reduce the federal portion of funding for health care, offloading costs to the provinces. Others criticized the past accord, billed as "a fix for a generation," because it didn't buy the intended change. While progress was made on wait times for certain services, other innovations in home care, primary care, prevention and health promotion, and the development of a national pharmaceutical strategy were not achieved in any meaningful way, with most of the increased funding getting absorbed into regular health budgets. Both of these perspectives hold merit.
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  • There is a strong case to be made for a return to the original 50/50 funding arrangement, which is one of the key reasons the provinces signed on to Medicare in the first place but which has steadily been eroded in the decades since. There is also a fair criticism that increased funding - from $124 billion in 2003 to $207 billion in 2012 - should have been used more deliberately to attempt to achieve the intended change in system performance or health outcomes for Canadians. So as the health ministers meet in Vancouver, how can they bend the curve toward a less costly and more effective health care system? How can they ensure the funds invested this time around will buy real improvements in health?
  • Some of the directions for this can be found in the Prime Minister's mandate letter to the Minister of Health, which included an exhortation to "support the delivery of more and better home care services." Investment in quality home care has been shown to improve patient experience while easing pressure on acute and long-term facilities.
  • The letter also encouraged Minister Philpott to "encourage the adoption of new digital health technology." If done right, electronic medical and health records can greatly expand our ability to effectively treat individuals and the population. A third major element described in the mandate letter was a call to "improve access to necessary prescription medications" by "joining with provincial and territorial governments to buy drugs in bulk," and "exploring the need for a national formulary." This falls short of a national pharmacare program, but does not close the door to the possibility.
  • Canada is the only nation with a universal health care system that doesn't include drug coverage; one in five Canadians reports being unable to afford to take necessary medications as prescribed. A national pharmacare program would eliminate that problem while saving Canadians approximately $6 billion per year in excess costs. Half measures in this area will not achieve the desired savings or accessibility. The directives from Trudeau to Philpott are helpful, but there are two key ingredients missing. The first is that the flow of health care funds needs to be connected to clearly articulated goals. Indiscriminately increasing fund transfers with no accountability for how they will be used is a recipe for continually increasing costs without improving the quality and accessibility of care. The second is that all levels of government need to move toward a Health in All Policies approach that understands all areas of government - policies affecting income, education, housing, food security, for example - impact health outcomes. Health care is the greatest cost driver in provincial governments, but it isn't the area in which spending has the greatest impact on health - and it's not where those costs can best be controlled.
  • The decisions emerging from this upcoming summit could change the landscape of health care policy in Canada. Ryan Meili is a family physician in Saskatoon, vicechair of Canadian Doctors for Medicare, an expert with EvidenceNetwork.ca and founder of Upstream: Institute for A Healthy Society.
Govind Rao

Health care hampered by red tape; Bloated bureaucracy: That means there is less money a... - 1 views

  • Vancouver Sun Wed Jan 20 2016
  • Byline: Brian Day Source: Vancouver Sun
  • Over 60,000 B.C. residents have signed a petition against rising Medical Services Plan premiums. Organizers report that the wealthy pay the same fees as those earning $30,000. Their point is valid. But their anger would probably be tempered if the funds garnished from wage earners were being used efficiently. Few are probably aware of the Medical Services Commission (MSC), an unelected body responsible for spending the $4 billion-plus in MSP premiums and other taxes. Their mandate is "to facilitate reasonable access throughout B.C. to quality medical care, health care and diagnostic facility services for B.C. residents under MSP."
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  • Hundreds of thousands of patients on B.C. waiting lists know that role is not being fulfilled. The health minister and premier recently admitted that patients were waiting inappropriately long times, and a health region spokesperson reported some "life-saving" procedures were being delayed. Provincial health commissions were the brainchild of Tommy Douglas, who believed they should be chaired by doctors and never subject to political influence. But the MSC is always chaired by a politicallyappointed civil servant. Douglas supported premiums and felt they made the public cost-conscious, creating a sense of individual responsibility. He would never have condoned the practices of raising premiums to compensate for fiscal failures, nor reporting low-income earners, delinquent with their payments, to collection agencies. The commission is wasting health care funds as it displays contempt, in terms of its fiscal and social accountability, toward taxpayers.. In one example of carelessness and incompetence, I received cheques from them totalling hundreds of thousands of dollars, for services on patients that I had never seen. I also received confidential personal information on hundreds of patients unrelated to me or our clinic. When informed of their error, they responded: "Just mail them back." They were not inclined to investigate.
  • In Canada, health providers are compelled by law to share confidential patient files with government employees armed with the right to inspect and copy patients' files. Your health record is considered public property; you cannot block government access. Consent is not needed, and you are not notified when Big Brother is looking. Privacy rights have been legislated away. I witnessed a defeated provincial cabinet minister's medical file being reviewed by a newly elected government. In the 1989 tainted blood inquiry, Justice Horace Krever was "shocked by the inadequate laws, the abuses of confidentiality, and the fact that so many people - except the patient - had access to medical records." Little has changed.
  • The MSC is also charged with defining what services are "medically necessary" - and therefore publicly insured. They have never created a definition, but have arbitrarily designated clearly essential services such as ambulance, drugs, physiotherapy, artificial limbs, and dentistry as unnecessary, creating a true two-tier structure of care. The government's last action in delaying our constitutional challenge on patient rights resulted from a "last minute" discovery of 300,000 documents they were legally bound to provide. After a delay of more than seven years, the plaintiffs in the coming June trial will confirm that the Supreme Court of Canada's 2005 finding - that patients are suffering and dying on waiting lists - applies in B.C. Supporters of a system that limits timely access are complicit in such outcomes.
  • Our public sector health system (MSC included), is grossly overstaffed with non-clinical workers. A 2011 study revealed that Canada has 11 times as many public health bureaucrats per capita as Germany, where there are no waiting lists. Canada has 14 ministries of health, each with bloated bureaucracies and commissions scavenging dollars that should go to patient care. The mentality that cost inefficiencies can be balanced by increased taxes or "premiums" is responsible for our escalating charges. Independent health groups in Europe rated Canada as last in value for money compared to hybrid public-private systems that have accessible public systems. The Commonwealth Fund, a non-profit foundation focused on issues affecting lowincome groups, ranked Canada 10th of 11 health systems in developed nations.
  • What specific changes would I incorporate if I were minister of health? Apart from incorporating the best practices of other hybrid systems (including private-sector competition), I would dismantle the ministry and its committees and commissions. Then I would resign. The finance ministry could fund patients directly (thus empowering them), and also assign budgets to the newly emancipated, self-regulated health organizations, allowing them to cater directly to patient needs. Maybe our June constitutional court challenge will point us in that direction. Dr. Brian Day is an orthopedic surgeon, medical director of the Cambie Surgery Centre, and a former president of the Canadian Medical Association.
  • Dr. Brian Day says bureaucrats at the Medical Services Commission sent him cheques totalling hundreds of thousands of dollars for services on patients he had never seen.
Govind Rao

Ministers begin talks on prescription drugs - Infomart - 0 views

  • The Globe and Mail Thu Jan 21 2016
  • Provincial and territorial health ministers have agreed to begin talks on improving access to prescription drugs, and are asking the new federal government to join the discussions. The move, which gained the support of health ministers during a meeting in Vancouver on Wednesday, is the first step toward the possible inclusion of a national pharmacare plan in a new health accord, said Ontario Health Minister Eric Hoskins, who introduced the proposal. Mr. Hoskins, who has long pushed for more equitable access to pharmaceuticals, said the current negotiations on a new health deal provide a unique opportunity for governments to consider what a Canadian pharmacare plan might look like.
  • Such a plan might be a combination of public and private insurance, he suggested, that could start with an agreement among governments about what prescription drugs to cover. "I like to believe we have a generational opportunity to really create a visionary document," Mr. Hoskins said in an interview on Wednesday. While there is no guarantee that Canadian governments can agree on a national drug plan, he said, they need to try. "It would be unfortunate if we didn't take advantage of the opportunity and at least do the hard work to look at the possibilities and to have the courage to dream and to think of the bigger vision." A working group set up by the provinces will look at improving "equitable and appropriate access to pharmaceuticals based on evidence," according to a release issued after the closeddoor meeting.
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  • Provincial and territorial health ministers began two days of talks on Wednesday, and federal Health Minister Jane Philpott will join them on Thursday. The meetings are the beginning of what is expected to be a year of intense talks aimed at negotiating a new deal on health that will set national standards and deliver the stable funding the Liberals promised during the election campaign. The federal Health Minister has indicated she wants to steer the talks away from dollars at this stage of the negotiations, but B.C. Health Minister Terry Lake said on Wednesday that is not likely.
  • "You can't talk about health care without talking about dollars," he said. "It consumes 43 per cent of many of our provincial budgets." The first day of the talks covered a range of topics, from physician-assisted dying to access to drugs for rare diseases to newborn screening, according to a summary released afterward. While the topic of supervised injection sites was not specifically discussed, Quebec Health Minister Gaetan Barrette said in response to a journalist's question that his province will soon follow B.C.'s lead. Insite, a supervised injection facility, has operated on Vancouver's Downtown Eastside since 2003, and a second site has just received federal approval to operate in the city's west end. "We've watched the Insite project with great interest, and it works. We're in favour of this type of initiative," Mr. Barrette said.
Govind Rao

Write to the Prime Minister - Canadian Medical Association - 0 views

  • Make your voice heard by writing a letter to the Prime Minister and your Member of Parliament (MP)!
Govind Rao

Liberals get it right with focus on home care - Infomart - 1 views

  • The Globe and Mail Thu Jan 28 2016
  • The Liberal government has made so many ambitious promises that a mixture of relief and surprise greets the discovery of promises it could have made, but did not. Take health care, an important area of social policy where the Liberals, being Liberals, made a host of smallish promises. However, several big promises the party did not make are as interesting and important as the ones it did.
  • For example, the Liberals did not promise a national pharmacare program, as did the New Democrats, and as advocated by Ontario's Liberal government. The Liberals did not promise, as do the NDP and health-care unions, to restore annual 6-percent increases in federal transfer payments to the provinces for health care. The Liberals did not mention by how much the transfers would rise, but it will be something less than 6 per cent. The final number will emerge from tug-of-war negotiations with the provinces.
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  • Those negotiations have not yet begun. At last week's meeting of provincial health ministers, to which federal Health Minister Jane Philpott was invited, she shooed away any mention of money, which, at this stage of the game, is the correct approach. Meanwhile, the provincial health ministers said they would work on what a national prescription-drug plan would look like and cost - the cost having squelched the idea of national pharmacare in the past. Several academics, often quoted in the press, believe that national pharmacare would save money. Almost nobody else does, which is why the idea has never got off the ground. Quebec has discovered that its public plan, more elaborate than any other, costs a lot more than anyone had anticipated. Prime Minister Justin Trudeau's instructions in Dr. Philpott's mandate letter are much more limited. Since Ottawa spends in the order of $1-billion on drugs for aboriginal people and the military, let Ottawa join the provinces in more bulk drug purchases to lower costs. She is also to "explore" the idea of a national formulary - an excellent idea since no logical reason exists for every province to have one. Again, though, this is far from national pharmacare.
  • What the Liberals do want is directed spending on home care. Here, the federal-provincial negotiations will be fascinating, and perhaps consequential for patients. The federal Liberals are always tempted to put strings around the health-care dollars Ottawa sends to the provinces. Ottawa doesn't deliver health care to Canadians (except the military and aboriginal people) and it's paying a smaller share of overall health-care spending than years ago.
  • Yet the Liberal itch to influence, if not direct, how federal transfers should be spent never dies. The trouble is that every time previous Liberal governments pulled out string to wrap around the transfers, at least some of the provinces said: Just give us the cash and stuff the strings away. We do health care; you write cheques. We set priorities; you help pay. This time, though, the provinces are aware of their burgeoning number of older citizens, an increasing share of whom need or prefer to be cared for at home rather than in institutions. Provinces need to save money, too, and care at home costs less than care in a hospital bed. Home care also keeps some patients from emergency rooms and reduces calls to paramedics.
  • The strategic health-care plans of almost every province underscore the importance of home care. So do provincial health-care budgets, which are giving new money to home care and little or none to hospitals. Now, along comes a federal government willing to hand over money - how much remains to be seen - in what the minister's mandate letter describes as a "long-term funding agreement" that would "support the delivery of more and better home-care services."
  • Beefing up home care is what Ottawa wants. It seems to be what the provinces want. But will the provinces sign an agreement that binds them to spend at least some of the federal money for this purpose only? Or will the provinces offer vague assurances that cannot be monitored? Perhaps some (hello, Quebec) will say: Give us the money to spend as we wish, health care being provincial jurisdiction. Maybe home care; maybe not. We'll decide. Home care is the correct priority in a health-care world with endless priorities and incessant demands. Can the often-disputatious Canadian governments pull together around this common objective?
Govind Rao

Write to the Prime Minister - Canadian Medical Association - 0 views

  • Make your voice heard by writing a letter to the Prime Minister and your Member of Parliament (MP)! During the election campaign, DemandAPlan supporters sent more than 40,000 letters to candidates across the country. As a result, our call for a national seniors strategy was heard and you should be very proud of the role you played. Thank you! Now that we have a new government in Ottawa, DemandAPlan supporters, alongside the Alliance for a National Seniors Strategy, have an opportunity to once again work with all parties to bring about the change we need in health and health care. Your elected representatives need to be reminded that too many Canadian seniors are not getting anywhere near the care they deserve.
Govind Rao

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

  • 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

What's holding up home-care reform? - Infomart - 0 views

  • Toronto Star Sun Dec 6 2015
  • After months of planning and false starts, Ontario Health Minister Eric Hoskins finally has all the proof he needs to push ahead at full speed with sweeping changes to the province's troubled home-care system. So what's holding him up? For weeks, Hoskins has been signalling he will release a "discussion document" outlining radical reforms, including scrapping the beleaguered 14 Community Care Access Centres (CCACs) that co-ordinate home-care delivery across the province.
  • He received even more evidence this past week that it's time to transform the system with the release of auditor general Bonnie Lysyk's annual report. Lysyk listed a wide range of mismanagement, poor oversight and horror cases in which patients failed to get services such as nursing, physiotherapy and personal support on time or in enough quantity to make a lasting difference in their health. In many instances patients had to wait almost a year just for an initial assessment. In recent days, Hoskins has been telling key health-sector players he will release his discussion paper "before the holidays."
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  • The document is expected to propose shifting much of the CCACs' home-care planning and oversight roles to the 14 Local Health Integration Networks (LHINs) that now are responsible for overall regional planning, funding and health-care integration. The job of co-ordinating face-to-face services, which now falls to CCAC staffers, may be moved to primary care agencies, such as hospitals or community health clinics led by doctors or nurse practitioners. The goal is to save more than $200 million by eliminating the bureaucracy-heavy CCACs, with their high-paid executives, and directing the savings to front-line services.
  • More than 700,000 Ontario residents receive care annually at home or in community settings. The province spends $2.5 billion a year on home and community care, about 4 per cent of its total health budget. Despite overwhelming evidence that the system is in dire need of reform, Hoskins seems reluctant to move ahead with any speed. Two months ago his office cancelled a private lock-up for home-care stakeholders at which they were to discuss a "white paper" on reforms. Hoskins also scrapped plans for a special home-care task force on the grounds it would be viewed as just another stalling tactic. Still, Hoskins is indeed moving, albeit slowly.
  • On Nov. 20, he spoke privately with the board chairs and chief executive officers of the 14 CCACs about the coming changes. On Nov. 30, Bob Bell, the deputy health minister, met with the same CCAC bosses and while he didn't share any "concrete plans," he did suggest health ministry officials will consult with CCACs and other agencies about the proposed changes "in the new year." And on Dec. 1, Hoskins wrote to the CCAC bosses to explain that his ministry has every intention of "working together with CCACs to build a health care system that truly responds to the needs of patients and their families." Again, no specifics were mentioned. Clearly, Hoskins is dealing with a health-care establishment that is reluctant to change. That includes the CCACs, LHINs, doctors and his own bureaucrats.
  • LHIN officials, for example, don't want to be in charge of direct delivery of care. They have few staffers who actually know how to run a big health system on a day-to-day basis. At the same time, the LHINs have their own troubles, as Lysyk noted in her report. She said their "marching orders are not clear enough" and performance gaps are widening, especially on wait times. In the weeks ahead, Hoskins must address whether the LHINs are ready to assume greater duties, whether they should be in the health-care delivery sector at all and how to achieve better integration of hospitals, public health, primary care and home-care agencies. Also, he should look at whether all - not just some - home-care delivery should be left to private and non-profit service providers. Hoskins and his bureaucrats may be delaying the reform push until they develop "the perfect plan."
  • But Hoskins, who has shown true vision in this initiative, should view the document as the starting point - not the end point - for wholesale reforms that cut out an entire layer of costly bureaucracy and that improve the delivery of services that patients need and deserve. Everyone in the health-care sector is primed and ready to act, although not eagerly in all cases. Just as important is the fact that more delays and more wasted tax dollars won't fix the broken system. So it's time for Hoskins to end the needless holdups and move swiftly and boldly on behalf of the people who really matter - Ontario patients. Bob Hepburn's column appears Sunday. bhepburn@thestar.ca
  • Ontario Health Minister Eric Hoskins may be delaying action until his team develops "the perfect plan" for home-care delivery, Bob Hepburn writes. • Chris Young/THE CANADIAN PRESS file photo
Govind Rao

Union expects more cuts to healthcare - CHCH - Your Superstation - 0 views

  • December 5, 2015
  • The union representing 17-hundred staff at St. Joseph’s Healthcare in Hamilton says a lack of provincial funding will result in more job losses. Domenic DiPasquale, the President of the Canadian Union of Public Employees local 786 — says the looming closure of a seven-bed mental health treatment unit at St. Joseph’s Healthcare is the beginning of a series of coming cuts to hospital services. DiPasquale fears a $26-million shortfall in St. Joseph’s budget could translate into staff reductions: “It’s a lack of funding from the government that is affecting the hospitals which creates this funding shortfall and the hospitals are advocating not due to the government’s lack of funding by closing programs which we do not accept as acceptable because it’s affecting our communities, it’s affecting the care that the patients that need these services”.
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