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Premiers acknowledged the Prime Minister’s commitment in the recent federal Speech from the Throne to continuing the 6% escalator on the Canada Health Transfer (CHT) while working collaboratively to renew the Health Accord and to enter into a separate agreement with the Government of Quebec regarding the implementation of the renewed Health Accord. Premiers agree that increases in CHT funding should not be financed by reducing other major transfers.

Premiers agreed to meet again early in the new year on an integrated approach to sustainable health. Premiers will work together on identifying key principles that should govern a new agreement on health care with the federal government.  Their discussions will also focus on innovations to modernize health care services that will bring savings to be reinvested in health care systems. Premiers directed their government departments to work together to support their discussion in early 2012.

14 different sponsors — each paying between $10,000 and $50,000 for preferential access to the premiers — are contributing a combined $225,000 to cover most of the social event costs at the three-day premiers conference

lobby groups from the insurance, oil and gas, electricity, pharmaceutical and biotechnology sectors

Labour groups, like in past years, are also expected to participate in the social gatherings

Ontario, for instance, is pumping money into providing more home care. Manitoba is looking toward preventive medicine. Saskatchewan is reviewing ways to improve long-term care. Nova Scotia has a system where paramedics treat some ailments in long-term care facilities to avoid tying up hospital beds.

Mr. Ghiz said they could use more help from Ottawa.“Hopefully, some day, the federal government will be at the table with dollars and with ideas – we're open

finding ways to keep seniors out of hospital. Ontario, for instance, is pumping money into providing more home care. Manitoba is looking toward preventive medicine. Saskatchewan is reviewing ways to improve long-term care. Nova Scotia has a system where paramedics treat some ailments in long-term care facilities to avoid tying up hospital beds.

Provinces and territories will start paying less for six widely used generic drugs after April 1, under a new agreement reached by the Council of the Federation's Health Care Innovation Working Group.

Provinces currently pay anywhere from 25 to 40 per cent of the brand-name price for the six medications, depending on what each jurisdiction negotiates with the generic-drug producer.

Using a more co-ordinated national approach, provinces will pay less — only 18 per cent — starting this April, saving provincial drug plans as much as $100 million.

a working group on health care innovation to examine three critical issues related to the health workforce. These issues include examining the scopes of practice of health care providers to better meet patient needs, better coordinated management of health human resources, and accelerated adoption of clinical practice guidelines (CPGs).

Typically, the public dialogue around the health workforce is narrowly focused on addressing shortages and other supply-related crises, real or imagined, so it is refreshing to see attention paid at this level to broader health workforce issues.

we are not so much suffering from a lack of health care professionals as from their inappropriate deployment

Tackling innovation solo, premiers hope to lure PM back to health table

As a start, Saskatchewan Premier Brad Wall and Prince Edward Island Premier Robert Ghiz will lead the work that aims to draft national standards to ensure innovations are shared between the country’s 13 separate health-care systems.

They’ll also look at ways to try to limit competition for health workers, and opened the door to a national fee structure for services.

This bold exercise in innovative thinking will focus on only three areas: the scope of practice of health professionals (important but hardly a task for premiers); human resources management (read: Hey guys can we stop stealing doctors and nurses from each other by co-ordinating what we offer them in collective agreements?) and encouraging the development of clinical practice guidelines (another triviality best left to professional associations.) That is work for bureaucrats, not premiers.

what we need to do reform medicare:

* Control spending by limiting medicare coverage to essential treatments that work; * Modernize primary care by moving away from solo physician practices to interdisciplinary teams; * Create some kind of universal prescription drug plan; * Shift money from institutional care to home care so we can look after people where they live, in the community and at home; * Instead of spending obscene amounts of money to marginally extend survival of the terminally ill, invest it in palliative care.

while premiers - to varying degrees - are miffed at Ottawa's cavalier "take it or leave it" attitude, their first agreement at the Victoria meeting of the Council of the Federation was to strike a health-care innovation working group.

The agreement will pool a variety of cost-saving ideas, including scope of practice (which means nurse practitioners), human resources management (stopping the interprovincial poaching) and clinical practice guidelines (doing things for less money).

They set up another working group to keep the argument going over the new funding arrangement

Ghiz and Saskatchewan Premier Brad Wall will cochair the working group on health care innovation. It is tasked with looking at how provinces are already innovating in medicare, and attempting to clone ideas for other provinces to save money and improve patient care.

Wall pointed to an example in Saskatchewan, which has reduced surgical wait times by as much as 83 per cent by booking procedures in private clinics, covered by the public health-care system. He acknowledged the controversy of private clinics, but said: "Given a choice between ideology and surgery, people in pain will pick surgery."

On innovation, Wall said his group will look at issues ranging from labour costs to the way patients are treated.Pointing to the success of adding private clinics into Saskatchewan's publicly delivered surgical system, Wall signalled that innovation is likely to mean a different approach to how services are delivered."Even though we're using private clinics, nobody has spontaneously combusted, no one burst into flames; we've actually delivered more surgeries more quickly in the public system," he said. "I think given a choice between ideology and surgery, people in pain will pick surgery."

The review - with a tight, six-month timeline - will examine fundamental issues surrounding medicare, such as how much to pay the health system's workers, who should treat patients, and what kinds of treatments should occur.

Prince Edward Island Premier Robert Ghiz and Saskatchewan Premier Brad Wall will co-chair the group, whose members will include health ministers from the provinces and territories.

The innovation group will work in consultation with health-care providers and will cover three key areas: scope of practice of health-care workers, human resources and clinical practice guidelines. It will provide its first report at a meeting of premiers and territorial leaders in July in Halifax.

The working group plans to work in close consultation with frontline health workers and the organizations that represent them.

95 per cent of all federal transfer funding arrangements expire in 2014, and that includes the health transfer.

Equalization funding and infrastructure and training funding agreements also expire in 2014

Wall, who came to Victoria extolling health innovation as a best practice and money-saver, said the newly-formed Health Care Innovation Working Group will focus on the provinces and territories finding and sharing new ways to meet health challenges, including the needs of seniors, patients with chronic diseases and northern populations.

Wall and Prince Edward Island Premier Robert Ghiz have been named co-chairs of a health care innovation working group that will report in July on possible improvements that can be made in the system. One of the areas of focus will be an examination of existing clinical guidelines.

"Every province in the country probably would have a very similar list of high volume procedures. Are they all needed? Are people getting procedures that are arguably not the best standard of care, clinical care, not purposefully but just as part of the system and what it's grown into be?" Wall said."The converse is true. Are there certain things the health care system is not delivering that would be a standard of care, that might be preventative, that might prolong good health?"

Wall said Saskatchewan also plans to move on several goals laid out by the provincial government in a news release issued last week

innovation in health care - including private delivery under public funding - is something worth pursuing

Wall and Prince Edward Island's Robert Ghiz would co-chair a Health Care Innovation Working Group that will work collaboratively on health-care delivery, with specific emphasis on "the needs of seniors, patients with chronic diseases and Northern populations."

Wall said Friday that ensuring health-care spending did not outpace economic growth was one of the many new goals that should be part of a health innovation agenda.

Such whip-sawing by health-care workers is an old story. As the reality of the new Canada Health Transfers sinks in – a redistribution announced by Ottawa last month that cuts the rate of growth over the coming decade – the provinces are suddenly keen to craft a strategy to curb the interprovincial competition for health-care workers.

Labour costs are the single biggest factor in health-care budgets. In B.C. they make up 62 per cent of the $12.6-billion annual budget. In Nova Scotia, they make up 70 per cent of the health budget.

This week, Saskatchewan Premier Brad Wall and Prince Edward Island Premier Robert Ghiz agreed to take a stab at the health human-resources challenge as part of their countrywide innovation working group.

At the recent Council of the Federation meeting, the provinces (except Quebec) announced that they would begin bulk purchasing generic drugs to reduce health-care costs. They also flagged the need to both expand and accelerate group pricing on brand-name pharmaceuticals.

This is a long time coming and a step in the right direction. Now, we need to see solid action and not good intentions or half-measures. Early attempts at similar programs were close to failure.

The U.S. Congressional Budget Office estimates that Medicare will spend an additional $112-billion in the next 10 years because of the inflated official pricing of pharmaceuticals. This amounts to a kind of corporate welfare for pharmaceutical companies