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Govind Rao

International | CIHI - 0 views

www.cihi.ca/...cihi014192

from heather provinces statistics quality international comparisons

shared by Govind Rao on 07 Feb 14 - No Cached
  • Canada’s Health System: International Comparisons Comparing countries’ health systems can help Canadians understand how well their health system is working. Although health information is collected and used differently in every country, policy-makers, practitioners and the public can use international comparisons to establish priorities for improvement, set goals and motivate stakeholders to act. The Organisation for Economic Co-operation and Development (OECD) provides comprehensive, reliable international data that measures the economic and social well-being of people around the world. The OECD coordinates activities between countries and develops indicators that, among other things, can be used to compare health systems.
Govind Rao

BMJ Group blogs: BMJ » Blog Archive » Sarah Gregory: What can we learn from h... - 0 views

blogs.bmj.com/...es-fund-health-and-social-care

from heather funding international

shared by Govind Rao on 08 Apr 14 - No Cached
  • by BMJ
  • 31 Mar, 14
  • England is not alone in facing the implications of an ageing population with changing patterns of illness. To inform the work of the independent commission on the future of health and social care in England, I have spent the past few months looking at how other countries are responding to these challenges. By comparison with other OECD countries, two features of the English system stand out. First, we have an unusually defined split between our health and social care systems. By comparison, many countries have developed a funding system for social care that complements their funding for health. For example, Germany, France, Korea, and Japan have all introduced insurance for social care to complement their systems of health insurance. Second, we are at the lower end of the range for public spending on social care, although it is difficult to establish direct comparisons as we do not report on social care funding to the OECD. The UK spent 1.2 per cent of GDP on long term care in 2012/13, while the highest figure reported to the OECD was 3.7 per cent (in the Netherlands).
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  • Sarah Gregory is a researcher in health policy at The King’s Fund.
Govind Rao

Feeling underpaid? There are health consequences to that - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150320|216785183

from heather health and safety wages

shared by Govind Rao on 20 Mar 15 - No Cached
  • The Globe and Mail Fri Mar 20 2015
  • When you think about the pay you get for your work, do you feel you are paid about right, underpaid or overpaid? Over the past month we've posed that question to Canadian workers from a diverse cross-section of occupations and sectors. Here's what our Canadian Work, Stress, and Health study (CANWSH) has discovered so far: 46 per cent feel "paid about right;" 33 per cent feel "underpaid a little;" 14 per cent feel "underpaid a lot."
  • By comparison, the 2014 General Social Survey (GSS) asked American workers a slightly different question: "How fair is what you earn on your job in comparison to others doing the same type of work you do?" The patterns are remarkably similar to our results: 51 per cent report they earn "about as much as I deserve;" 27 per cent report earning "somewhat less than I deserve;" 12 per cent report earning "much less than I deserve." Surely no one feels overpaid, right? Not so: 7 per cent of Canadians and 10 per cent of Americans feel overpaid and, among those folks, a handful say severely so. You might be wondering: "Who are these people?" You might also wish to extend a helping hand to relieve their burden. As Guillermina Jasso, a sociologist who studies justice evaluations, puts it: "We live in a world that rarely realizes congruence between actual earnings and just earnings." The International Social Survey asked more than 48,000 people from 40 countries if their pay is "just," given their skills and effort. More than half of respondents said "unjust."
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  • Figuring out precisely what people perceive as "just pay" is complicated, but there are social standards and patterns. People who feel paid appropriately experience a balance of investments and rewards. Investments such as education, skill, effort and seniority are on one end of the scale - that is, how much have you put in? Rewards are on the other. When the scale tips toward investments, you feel underpaid; when it tips toward rewards, you feel overpaid. We all have internal standards, but we also rely on social comparisons: "Why does so-and-so earn more than me? I have better credentials, work harder and have more seniority!" Getting less than you deserve It hurts to feel under-rewarded - to get less than what (you think) is just - on a cognitive, emotional and even physical level. Perceived underpayment and job dissatisfaction go hand in hand. A recent Accenture study of 3,600 entry- to managementlevel business professionals across 30 countries found that feeling underpaid is the top reason for worker dissatisfaction.
  • Likewise, in the CANWSH and GSS studies, roughly one-quarter of those who feel severely underpaid are "very dissatisfied" with their job, while about 6 per cent of those who feel appropriately paid are "very dissatisfied." Feeling underpaid doubles the probability that a worker will report experiencing "stress, depression and problems with emotions" on a majority of days in any given month. Physiological reactions are common, too. Perceived underpayment raises the risks of rating oneself as having poor health, headaches, and stomach, back and chest pain. All this affects sleep quality: Those who feel severely underpaid have more difficulty falling or staying asleep. Perceived underpayment also hurts because it amplifies other stresses, such as interpersonal conflict, work interfering with non-work life, and having too much work and not enough time. That's a lot of suffering - and it isn't equally distributed in the population. In collaboration with Atsushi Narisada and Sarah Reid, our research shows that the pain of feeling under-rewarded hurts more among those who earn less, mostly because of the link with greater financial insecurity.
  • Everyone has a stake in understanding the social causes and consequences of perceived underpayment. We need to talk about it and address it collectively as departments, organizations and institutions. The conditions that surround unjust earnings are ripe with chronic stress. Ultimately, that makes this a public health concern. If monkeys aren't cool with getting less than they deserve, why should we be? Health Advisor contributors share their knowledge in fields ranging from fitness to psychology, pediatrics to aging. Dr. Scott Schieman is a Canada Research Chair (Social Contexts of Health) and professor of sociology at the University of Toronto. His research focuses on the causes and health consequences of social stress. You can follow him on Twitter @ScottSchiemanUT.
Irene Jansen

Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Inc... - 1 views

www.plosmedicine.org/...10.1371%2Fjournal.pmed.1001244

privatization quality costs excellent

shared by Irene Jansen on 31 Mar 13 - No Cached
  • Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector
  • Irene Jansen on 31 Mar 13
     
    Summary by Anna Marriott, Oxfam Access and responsiveness * Studies that measured utilization by income levels tended to find the private sector predominately serves the more affluent. In Colombo, Sri Lanka, where a universal public health service exists, the private sector provided 72% of childhood immunisations for the wealthiest, but only 3% for the poorest. * Waiting times are consistently reported to be shorter in private facilities and a number of studies found better hospitality, cleanliness and courtesy and availability of staff in the private sector. Quality * Available studies find diagnostic accuracy, adherence to medical management standards and prescription practices are worse in the private sector. * Prescribing subtherapeutic doses, failure to provide oral rehydration salts, and prescribing of unnecessary antibiotics were more likely in the private sector, although there were exceptions. * Higher rates of potentially unnecessary procedures, particularly C-sections, were reported at private facilities. In South Africa for example, 62% of women delivering in the private sector had C-sections, compared with 18% in the public sector. * Two country studies found a lack of drug availability and service provision at public facilities, while surveys of patients' perceptions on care quality in the public and private sector provided mixed results. Patient outcomes * Public sector provision was associated with higher rates of treatment success for tuberculosis and HIV as well as vaccination. In South Korea for example, TB treatment success rates were 52% in private and 80% in public clinics. Similar figures were found for HIV treatment in Botswana. Accountability, transparency and regulation * While national statistics collected from public sector clinics vary considerably in quality, private healthcare systems tended to lack published data on outcomes altogether. Public-private partnerships also lacked data. * Several reports ob
Irene Jansen

Critiques of World Health Report 2000 (comparison of health systems). - 0 views

www.who.int/...overallframework_docs.htm

international international comparisons

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Irene Jansen on 23 Jan 12
     
    The anti medicare folks often refer to a 2000 WHO report which ranked every health care system in the world according to a number of indicators which saw France come out at #1. This report was subsequently panned by health policy experts all over the world because of data problems (quality, different comparators, comparing apples & oranges). Notwithstanding the problems with the study it still gets a lot of reference. This site is a collection of the critique of the study.
Irene Jansen

International comparisons shed light on Canada's health system Nov 23 2011 CIHI - 0 views

www.cihi.ca/...RELEASE_23NOV11

international comparisons determinants

shared by Irene Jansen on 23 Jan 12 - No Cached
  • examines Canadians’ health status, non-medical determinants of health, quality of care and access to care. It is based on international results that appear in the OECD’s Health at a Glance 2011, also being released today, which provides the latest statistics and indicators for comparing health systems across 34 member countries.
  • While Canada has lower smoking rates than most OECD countries, rates of obesity and overweight are among the highest.
  • CIHI’s analysis shows that Canada performs relatively well in screening and survival rates for cancer
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  • Canada is in or close to the top 25% of OECD countries on many measures of quality of care.
Irene Jansen

Doctors still paid farless in Canada than U.S.: Study. - 0 views

www.financialpost.com/...story.html

doctors wages international comparisons

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Canadian doctors still lag dramatically far behind their American counterparts in income
  • Orthopedic surgeons in Canada make less than half the $440,000 average net income of colleagues in the States while doing more procedures
  • comparison of six industrialized countries
  • ...4 more annotations...
  • published in the journal Health Affairs
  • stark differences in payment between nations, and between private and public payors in those places that have two-tier systems
  • Provincial medicare agencies pay an average fee of $652 to surgeons in Canada for a hip replacement. Government programs like Medicaid in the States reimburse almost triple that, while U.S. private insurers offer an average of just under $4,000 per hip operation
  • Primary-care physicians include family doctors, pediatricians, internal-medicine specialists and obstetriciangynecologists. Those in the U.S. earned an average after expenses in 2008 of $186,582, versus $125,000 in Canada, $159,000 in Britain and just $92,000 in Australia
Govind Rao

Quality of care: How the provinces fare internationally | CIHI - 0 views

www.cihi.ca/...RELEASE_23JAN14

from heather international comparisons quality

shared by Govind Rao on 29 Jan 14 - No Cached
  • January 23, 2014—For the first time, provincial and international health care systems can be compared in terms of quality of care. The Canadian Institute for Health Information (CIHI) found that the results of these comparisons are mixed, with no province being consistently the best or worst performer across the Organisation for Economic Co-operation and Development (OECD) quality of care indicators.
Govind Rao

Land - Home | CIHI - 0 views

www.cihi.ca/land

from heather international comparisons quality

shared by Govind Rao on 10 Dec 13 - No Cached
  • International Comparisons: A focus on quality of care (January)
  • Govind Rao on 10 Dec 13
     
    Jan 2014 report coming
Govind Rao

More spent on taxes than food, shelter and clothing - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|wifp|20150828|228050643

from heather taxes privatization medicare

shared by Govind Rao on 28 Aug 15 - No Cached
  • Winnipeg Free Press Fri Aug 28 2015
  • CANADIANS spend more on taxes than on food, clothing and shelter combined, according to a study released Thursday. The study by the Fraser Institute shows the average Canadian family spent 42.1 per cent of its income on taxes while 36.6 per cent went to the combined basic necessities of food, clothing and shelter. In its study, the non-partisan, public policy think-tank looked at an average family in Canada earning $79,010 in 2014. While 42.1 per cent of that income went to taxes, just 21 per cent was spent on shelter, 11 per cent on food and five per cent on clothing.
  • That translated to $33,272 in total taxes compared to $28,887 on food, clothing and shelter combined. "With growth in the total tax bill outpacing the cost of basic necessities, taxes now eat up more family income, so families have less money available to spend, save or pay down household debt," Charles Lammam, director of fiscal studies at the Fraser Institute and co-author of the study, said in a statement. However, a community advocate cautions people should remember taxes cover programs such as health care that would have to be paid by families as necessities if those programs didn't exist. "There's no question we're paying far more in taxes, but what tends to be really misleading is to state that we are paying more in taxes than we are paying in necessities in life when you take into account medicare because that's part of the reasons taxes went up after 1961," said Harold Dyck, a community social-assistance advocate with Winnipeg Harvest, referring to Canada establishing its universal health-care program. A key focus of the study was a comparison of taxes paid in 2014 by families with taxes paid by families in 1961. It found an average family's tax bill has risen 1,886 per cent in the past 53 years while average income increased by 1,480 per cent, a slower rate than taxes.
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  • In 1961, the scales tipped the other way as the average family spent 33.5 per cent on taxes and 56.5 per cent on food, clothing and shelter. "Over the past five decades, the tax bill for the average Canadian family has ballooned, and now the amount of money going to taxes is greater than what's spent on life's basic necessities," Lammam said in a statement. The study noted the total tax bill considered reflected "both visible and hidden taxes families pay to the federal, provincial and local governments, including income taxes, payroll taxes, sales taxes, property taxes, health taxes, fuel taxes, alcohol taxes and more." Dyck said it is necessary to consider the 1961 date as the baseline for the comparison to get a clearer picture.
  • "From 1961 back, we did not have a national medicare program. Since then we have, and that is definitely part of our tax dollars. We now have free access to this necessity of life, medical care," he said. "A portion of that tax burden needs clarification so people aren't left with the impression that this (tax dollars) goes into some netherworld where we never see anything coming back to us," Dyck said. "It (the study) is a subtle way to get people's ire up that we want taxes cut, cut, cut without asking what does that mean and how would that impact Canadians in the end? What services are we going to lose? There are many other things you can consider necessities. Taxes pay for our highways and roads, hospitals, education system, all these things that should also be considered necessities."
  • The study showed average families in 1961 earned an average of $5,000 and paid taxes worth $1,675. In the past 53 years, the average family's tax bill increase of 1,886 per cent outpaced price increases to food (561 per cent), clothing (819 per cent) and shelter (1,366 per cent). Dyck said the focus should be on where the waste takes place in use of tax dollars and ways to reduce that waste. The study also found the percentage of income used to pay taxes has risen steadily since 2008 when 40.9 per cent of income was spent on taxes. ashley.prest@freepress.mb.ca
Irene Jansen

York U research program to shed light on gender influences in senior care work | York M... - 1 views

news.yorku.ca/...influences-in-senior-care-work

ltc ally

shared by Irene Jansen on 04 Mar 13 - No Cached
  • will be supported by eight partner organizations
    • Irene Jansen
      Irene Jansen on 04 Mar 13
       
      CUPE is one of the partner organizations.
  • “LTC work is increasingly precarious, fast-paced and low paid and that leads to health implications.
  • Comparative studies exploring LTC working conditions among various provinces, as well as Canadian conditions in comparison with those in Germany, Sweden, Norway, the United Kingdom and the United States, are proposed as part of the five-year plan.
  • ...4 more annotations...
  • York University Professor Tamara Daly will lead a research program studying the gendered health impacts of performing paid and unpaid care work for seniors in long-term care (LTC) settings.
  • The professor has been awarded one of nine Canadian Institutes of Health Research (CIHR) research chairs in Gender Work and Health. The program, Working well: understanding how gender influences working conditions and health in long term care settings across Canada and internationally, will receive $800,000 in CIHR funding over five years
  • “Health care work is unhealthy and at times dangerous work, with the most challenging conditions prevailing in LTC settings. We don’t often talk about gender in LTC settings even though care work is primarily performed by women,” says Daly, a professor at the School of Health Policy and Management in York U’s Faculty of Health.
  • (Watch the video)
Irene Jansen

Calgary Herald Editorial: Quebec has the right RX on health care (Fraser Institute report) - 0 views

www.calgaryherald.com/...story.html

neoliberal think tank privatization alberta quebec vfm

shared by Irene Jansen on 21 Jan 13 - No Cached
  • According to a new study from the Fraser Institute, and using 2010 data that looked at 46 indicators, the institute concluded that Quebec's healthcare system, followed by Ontario's, provided the best "value for money." Alberta scored a dismal seventh, Saskatchewan was eighth, and Newfoundland was dead last.
  • Quebec uses far more private delivery of publicly funded health care in comparison with the rest of the country.
  • maybe Alberta's government should take a close look at the private options being served up in Quebec
Govind Rao

Light years ahead: Digital hospital opens doors; Humber River set to open, with robots ... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|tost|20151016|231507893

from heather hospital Ontario it technology

shared by Govind Rao on 16 Oct 15 - No Cached
  • Toronto Star Fri Oct 16 2015
  • It's hard to be envious of anyone stuck in a hospital bed, but the new Humber River Hospital draws more comparisons to a swanky hotel than a gloomy facility reeking of antiseptic and teeming with nerves. Step through the doors of the state-of-the-art hospital and you'll find robots that mix drugs and transport goods, bedside touchscreens that allow patients to video-chat with doctors, and machines that process blood samples in minutes, automatically entering results into electronic records. All of that catapults the facility, set to open Saturday at Keele St. and Hwy. 401, light years ahead of its former digs, which were desperate for an upgrade.
  • "Patients could hold hands in the beds, it was so tiny ... It was time to replace the old buildings," said chief operating officer Barb Collins as she wandered the halls of the cutting-edge facility, being heralded as North America's first fully digital hospital. That title hasn't been fully researched, but no one has called yet to disprove the claim. So Collins is content to keep trumpeting the hospital's innovative features, which include robotic equipment that can position and scan patients at any angle, digital patient records accessible from patient rooms and, for people who are under walking restrictions, wristbands that alert staff when they start to wander.
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  • The measures make age-old tasks more efficient. They might also dredge up worries about a patient's every move being tracked and whether it's entirely safe to have machines mix and process toxic drugs. To the skeptics, Collins responds: "It's safer to have an alarm telling me if (a patient) got out of bed and fell, than not knowing," and "Robots are robots, but they still need monitoring."
  • That's why employees will be on hand to double-check robot-filled prescriptions and to ensure equipment is working correctly, while still delivering a human touch. If you're fretting about how many employees were cut loose to make way for technology, the hospital has an answer for that, too. Rather than using technological efficiencies to axe jobs, the hospital has hired 700 more employees to staff the hospital's 656 rooms - 80 per cent of which are single-patient spaces.
  • Unlike the old Humber River Hospital, the private rooms allow the hospital to nix restricted visiting hours and to place chairs that convert into beds in every room for use by family members - who "are encouraged to stay over." For out-of-town family or those who face extenuating circumstances, there is even an "amenity" suite on each floor, with a bed and bathroom for overnight stays.
  • Implementing the policy and building the hospital into a futuristic facility "hasn't been all smooth," says Collins. There were tussles about getting electronic features to "speak to each other" and naysayers to prove wrong, including a former deputy health minister, whom Collins refused to name, who insisted renovations could be made to the old hospital instead of building a new one. That deputy minister has since had a change of heart, claims Collins, but it's hardly a surprise to her. After 15 years planning the new facility, she says without hesitation: "This could well be a model."
  • Bedside terminals act as a computer, phone, record display, menu and radio. Built-in cameras let patients communicate with family members or nurses.
Heather Farrow

Health Statistics | - 0 views

www.hilltimes.com/...52631

statistics

shared by Heather Farrow on 11 May 16 - No Cached
  • Monday, March 7, 2016
  • A Check-Up on Canada’s Health:
  • Total Fertility rate (average number of children per woman)    1.61 Infant mortality rate (per 1,000 live births)         4.8 Current smokers       18.1%
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  • Has a doctor   85.1% Heavy drinkers          17.9% High blood pressure 17.7% Overweight or obese adults 54.0% Overweight or obese youth (12-17)          23.1% Physically active (leisure time)       53.7%
  • In 2014, roughly 3.4 million Canadians aged 12 and older (11.2 per cent) reported that they did not receive health care when they felt they needed it. Overall, females (12.4 per cent) were more likely than males (10 per cent) to have reported an unmet health-care need. Among age groups, unmet health-care needs were lowest for those aged 12 to 19 and those aged 65 or older, and were highest for those aged 20 to 54. Source: Health Canada
  • Top 10 Causes of Death in Canada (2012) Ischaemic heart disease       13.8% Alzheimer’s and other dementias   9.5% Trachea, bronchus, lung cancers     8.1% Stroke             5.4% Chronic obstructive pulmonary disease     4.5% Colon and rectum cancers   3.7% Diabetes mellitus      2.7% Lower respiratory infections           2.3%
  • Breast cancer             2.2% Falls    1.9% Source: World Health Organization International Comparison of Health Spending  Canada           OECD Average           Canada’s OECD Ranking Total Health expenditure as a percentage of GDP            10.2    8.9       10/34 Total Health expenditure per capita           $4,351            $3,453            10/34
  • Public expenditure on health per capita   $3,074            $2,535            13/34 Public share of total health expenditure   70.60%          72.70%          22/34 Hospital expenditure per capita     $1,338            $1,316            15/29 Physician expenditure per capita   $720   $421   27-Apr Drug Expenditure per capita          $761   $517   2/31 Source: OECD Health Statistics 2015           
Cheryl Stadnichuk

Health Canada hasn't fined Quebec in past decade for medicare violations | Montreal Gaz... - 0 views

montrealgazette.com/...decade-for-medicare-violations

CHA user fees Quebec

shared by Cheryl Stadnichuk on 11 May 16 - No Cached
  • Despite raising concerns about the prevalence of user fees in Quebec, among other violations of the Canada Health Act, Health Canada hasn’t penalized the province for more than a decade while other provinces have been fined repeatedly. A Montreal Gazette review of Health Canada’s annual reports since 2002-2003 has found that the federal agency has warned Quebec more often than not about a wide range of contraventions against medicare — most recently, last year about user charges — but has not deducted penalties from funding transfers to the province. By comparison, Health Canada has penalized British Columbia, Alberta, Manitoba, Nova Scotia, as well as Newfoundland and Labrador for a total of $10.1 million in that time period. In its latest available report last year, Health Canada noted that it “wrote to the Quebec Ministry of Health concerning patient charges by physicians, when they provide certain publicly insured health services in their offices or private clinics. Health Canada’s consultation with Quebec on this issue is ongoing.”
  • The Montreal Gazette’s review has found that, unlike most other provinces, Quebec routinely declines to provide Health Canada with relevant statistical information about its private for-profit clinics. The issue of enforcing the Canada Health Act (CHA) arose last week after patient-rights groups across Quebec filed a lawsuit against the federal government to compel Health Canada to put an end to illegal extra billing and user charges in the province. Dr. Isabelle Leblanc, president of the pro-medicare group Médecins québécois pour le régime public, said she was taken aback over the fact that Quebec hasn’t been fined in more than a decade despite the proliferation of two-tier medicine in the province and the growth of so-called accessory fees, such as $200 eye drops. “The principles of the Canada Health Act should be the same throughout Canada,” Leblanc added. “If the federal government acts on non-compliance in one province, they should do it for all other provinces.” The CHA, adopted in 1984, gives the federal government the power to assign financial penalties over medicare violations. The penalties are deducted from federal funding transfers to the provinces.
  • British Columbia and Alberta have been fined the most of all provinces since 2002-2003, but Leblanc argued that queue-jumping, extra billing and user charges — all violations under the CHA — are just as widespread in Quebec, perhaps more so in recent years. Leblanc suggested that Health Canada might be more reluctant to crack down on medicare violations in Quebec for political reasons. “It’s probably different for the federal government to do something in Quebec than the other provinces,” she said. “Quebec has a different perception of what is a provincial duty and what is a federal duty.”
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  • Health Canada’s annual reports show that Quebec has sometimes complied with its concerns. But in its 2003-2004 report, the agency observed that the Quebec government was “not at liberty to reveal the status of the province’s investigation” into user charges imposed by a private surgical clinic. A year earlier, Health Canada expressed concern “about private surgical clinics that allow individuals to privately pay for medically insured services and thus jump the queue. … Health Canada asked Quebec to confirm that the matter had been resolved.” A long-standing complaint of Quebec by Health Canada is that it allows patients to be charged for MRIs and CT scans if they are done in private clinics. In its 2004-2005 report, Health Canada held discussions with British Columbia, Alberta and Nova Scotia about charging for medical imaging in private clinics, but Quebec refused to participate. 
  • Health Canada officials did not respond to requests for an interview since last Thursday. Reacting to the Quebec lawsuit last week, federal Health Minister Jane Philpott said she’s a strong supporter of the CHA, and did not rule out reducing transfer payments to provinces that flout the law.
Govind Rao

Fixing foreign surgery costs millions; Taxpayers footing the bill for botched stomach-s... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|saob|20160314|242461399

from heather private clinics international quality privatization

shared by Govind Rao on 14 Mar 16 - No Cached
  • Sarnia Observer Mon Mar 14 2016
  • Complications can be a nightmare to manage and repair "because we don't really know what they've had done," Karmali says. "There's no real operative report; we don't know exactly what happened elsewhere. It's hard for us to figure out what was done, and how to fix it." One woman in her 20s who underwent surgery in Mexico had to have her "essentially her entire stomach," as well as part of her esophagus, removed, he says. She will need to be fed through a feeding tube for the rest of her life. Despite increased funding in Ontario and other jurisdictions, wait lists average five years across Canada. Only one per cent of eligible patients are offered access to surgery. "Consequently,
  • When things go wrong, Canadian doctors and surgeons are left to treat them. And their care is entirely funded by the public purse. Medical travel companies and websites are luring obese Canadians with offers of discount prices, private drivers for preop "shopping and sightseeing" and post-op recovery in four-star resorts. Clinics in Tijuana are offering surgeries such as Roux-en-Y gastric bypass, where the stomach is stapled down to a small pouch about the size of a golf ball, for as little as $5,900 US. In Canada, the same surgery at a private clinic can cost $19,500.
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  • But many medical tourists are returning home with potentially catastrophic complications, including anastomotic leakages, where intestinal contents leak through surgical staples into the abdominal cavity, increasing the risk of life-threatening sepsis. "It's almost like your stomach ruptures," says Dr. Shahzeer Karmali, an associate professor of surgery at the University of Alberta and one of the authors of the newly published paper.
  • Millions of taxpayer dollars are being spent in Canada repairing botched stomach-shrinking surgeries performed outside the country, suggests new research into the growing phenomenon of "bariatric medical tourists." Researchers who surveyed Alberta surgeons estimate that province alone is spending a minimum $560,000 annually treating complications in people who have travelled to Mexico and other destinations for cut-rate bariatric surgery. Doctors say abysmally long wait lists in Canada for virtually the only obesity treatment proven to provide long-term weight loss is driving people out of the country for surgery. Yet most don't receive co-ordinated, long-term post-surgery care.
  • many patients turn to medical tourism despite potentially severe complications," the Alberta researchers write in the Canadian Journal of Surgery. Earlier work by the same group estimated a complication rate of 42 to 56 per cent for out-of-country weight loss surgery. In Canada, unplanned readmission to hospital within 30 days of bariatric surgery was 6.3 per cent in 2012-2013, according to the Canadian Institute for Health Information. Karmali says Canadians living with obesity are being shortchanged because of lingering stigma and bias. "The stigma is that these people just eat too much and don't exercise enough and they can fix themselves," he said.
  • "The reality is, it's a significant problem and when people become severely obese it is very hard to 'fix.'" Surgery not only improves weight and overall life expectancy, it helps reduce the drain on the health-care system and economy. A Senate committee report released this month pegged the cost of obesity at upwards of $7.1 billion a year in health care and lost productivity. The committee made 21 recommendations to combat obesity, from overhauling Canada's food guide to banning food advertising to children. But it was silent on reducing wait times for bariatric surgery. Karmali and colleagues surveyed Alberta general surgeons to estimate the cost of revision surgery, ICU stays and other interventions to treat complications in "BMTs" - bariatric medical tourists.
  • In all, 25 doctors responded to the survey. Together they treated 59 out-of-country surgery patients in 2012-13. Complications included slipped bands, leaking, abscesses and blood clots. The estimated average cost per medical tourist was just under $10,000 - an "extremely conservative estimate" that doesn't include total hospital stay, blood work, nursing care and other costs. By comparison, the average cost of bariatric surgery performed in Alberta public hospitals was just under $14,000. "Alberta does not seem to save much money by limiting the annual volume of bariatric surgeries," the authors write. Studies suggest bariatric surgery accounts for a growing proportion of Canadian medical tourism, with Mexico one of the most popular destinations. According to Statistics Canada, one in four adults in Canada - more than six million people - are obese. skirkey@postmedia.com
Irene Jansen

Canadian Health Coalition. Harper's Cuts to Refugee Health Care: A violation of medical... - 0 views

healthcoalition.ca/...stnl_iframe.php

chc immigration federal budget cuts

shared by Irene Jansen on 07 May 12 - No Cached
  • As of June 30th refugees in Canada will be cut off access to treatment for chronic diseases including hypertension, angina, diabetes, high cholesterol, and lung disease.
  • “The changes are being justified using three flawed arguments. First, we are told that refugees are abusing our health care system. The reality is the exact opposite. Our challenge as physicians is to engage vulnerable people with the health care system, especially prevention and primary care, not turn them away. I have never met a refugee who came to Canada because they wanted better health care. In comparison to starvation, torture, and rape, getting vision care is never the motivation. Second, they say they are doing this for public safety. Actually, they are endangering public safety by denying basic health care services. People only pose a risk to the public if they are not properly engaged in health care. For example, if a person with tuberculosis is only offered care after they are spitting blood, they will have already infected others. Third, the Minister claims this is about saving taxpayers money. When you stop providing preventive care you wind up with repeated emergency room visits and preventable hospitalizations that cost a lot more money,” said Dr. Mark Tyndall, Head of Infectious Diseases at the Ottawa Hospital and Professor of Medicine at the University of Ottawa.
  • The Canadian Heath Coalition sees the cuts to refugee health care services as part of a broader pattern emerging from the recent federal budget. Other cuts that affect the health of vulnerable Canadians include: mental health services for soldiers at Petawawa; systematic spending cuts to aboriginal health programs; the elimination of Health Canada’s Bureau of Food Safety Assessment and food safety inspection at the CFIA.
Irene Jansen

What premiers could do for health care - 0 views

www2.canada.com/...story.html

accord allies international comparisons

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Canada's health system is 70 per cent publicly financed; the European norm is 75 per cent to 85 per cent. Where they have user fees, they also have less income inequality so that people can pay them without hardship. They cover a wider range of services.
  • A fragmented patchwork of provincial systems is a drag on the economy
Irene Jansen

Walkom: Canada's never-ending medicare fight - thestar.com - 0 views

www.thestar.com/...-s-never-ending-medicare-fight

manning insurance medicare user fees comparisons social programs sustainability

shared by Irene Jansen on 23 Jan 12 - No Cached
  • The most depressing element of Canada’s on-again, off-again medicare debate is its repetitiveness. The country is forced to fight the same battle again and again. It’s as if our political elites learn nothing. I was reminded of that this weekend when Reform Party founder Preston Manning showed up on CTV’s Question Period to — again — make his pitch for two-tier health care.
  • Manning has been pushing two-tier medicine since 2005. That’s when he and former Ontario premier Mike Harris wrote that Canada’s medicare system should be replaced by a narrowly defined scheme focused on catastrophic illness and financed, in part, by user fees. All other health care would be paid for privately.
  • Any number of studies have demonstrated that so-called single payer public insurance systems like Canadian medicare are more efficient than two-tier schemes
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  • And user fees? Even a Senate committee that had been warm to the idea of charging patients each time they saw a doctor changed its mind when faced with the evidence.
  • But the real problem with two-tier medicine, as former Saskatchewan premier Roy Romanow noted on the same CTV show, is that it simply shifts costs.
  • Manning made much of the fact that Quebec’s government devotes proportionally less of it provincial budget to health —30 per cent of program spending as opposed to about 40 per cent in Ontario. He appeared to attribute this to the fact that Quebec, unlike Ontario, allows physicians to opt out of medicare and bill patients privately. But the real reason why the Quebec government spends less in proportional terms on health care is that it spends more in absolute terms on everything else. Provincial government program spending per capita in Quebec is $11,457. In Ontario, the figure is $9,223.
  • total health spending in Ontario represents 11.9 per cent of the province’s gross domestic product. In Quebec, the comparable figure is 12.4 per cent
  • The Germans, Dutch and French, all of whom are praised by two-tier fans, spend more of their gross domestic product on health care than we do.
  • Surely it’s more productive to build on what we have — a successful, publicly funded, universal health insurance system that covers doctors and hospitals. It could be improved or even expanded. But it works. That’s why Canadians keep fighting for it. Over and over and over again.
Irene Jansen

Seniors in hospital beds costly for health system. CIHI report - CBC News - 0 views

www.cbc.ca/...hospital-beds-health-care.html

seniors home care ltc

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Canadian seniors account for 85 per cent of patients in hospital beds who could be receiving care elsewhere
  • Thursday's report by the Canadian Institute for Health Information called Health Care in Canada, 2011: A Focus on Seniors and Aging, examines how seniors use the health system and where there’s room for improvement.
  • 47 per cent of seniors have completed their hospital treatment but remain in an acute-care hospital because they're waiting to be moved to a long-term care facility such as a nursing home or to rehab or home with support (so-called "alternate level of care" patients.)
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  • seniors represent 14 per cent of the population, but they use 40 per cent of hospital services and account for about 45 per cent of health spending of provincial and territorial government
  • an acute-care bed costs about $1,100 a day. In comparison, Turnbull estimated it costs a quarter of that to care for the same senior in the community.
  • services include traditional health-care services such as nursing and physiotherapy as well as transportation or help with household chores
  • 93 per cent of seniors who live at home
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