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In the United States, investor-owned firms have come to dominate renal dialysis, nursing home care, inpatient psychiatric and rehabilitation facilities and health maintenance organizations (HMOs).

inroads among acute care hospitals (now owning about 13% of such facilities), as well as outpatient surgical centres, home care agencies and even hospices

The excess payments for care in private for-profit institutions were substantial: 19%.

elite wing on the new penthouse floor of NewYork-Presbyterian/Weill Cornell hospital. Pampering and décor to rival a grand hotel, if not a Downton Abbey, have long been the hallmark of such “amenities units,” often hidden behind closed doors at New York’s premier hospitals. But the phenomenon is escalating here and around the country, health care design specialists say, part of an international competition for wealthy patients willing to pay extra, even as the federal government cuts back hospital reimbursement in pursuit of a more universal and affordable American medical system.

$1,000 to $1,500 a day

Many American hospitals offer a V.I.P. amenities floor with a dedicated chef and lavish services,

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.

Changes to the NHS in England have created an "unholy mess", the editors of three leading journals have said.

suggests an independent commission be set up to oversee changes in the future

the major NHS unions have called for the bill underpinning the changes to be scrapped

the National Health Service, which for decades had management overhead costs of 5%

The additional costs of this market split in England have increased overheads to over 14% of NHS spending – an extra  £10 billion per year .

 In England Independent Sector Treatment Centres set up by Labour to create a new private sector provider network, charge an average 11.2% above the standard NHS cost. But they cherry-picked only the easiest cases  – leaving the rest to the NHS. And they were given generous 5-year contracts, which paid them for a fixed number of operations, regardless of how few patients chose to use the service.

Canada’s Best Kept Secret Revealed: Public health care gives Canada an economic advantage – despite the high dollar

This analysis neglects an important point: As the recent United Auto Workers-General Motors collective agreement reminds us, Canadian companies don’t have to deal with the health care headaches of our neighbours – or with the costs. Indeed, the fact that Canadian companies, large and small, don’t have to offer health benefits to compete for the most talented and productive workers explains in large part why we are still largely competitive in the NAFTA era – despite our skyrocketing dollar.

the Canada Health Act is incompatible with a number of policy options that have been successfully implemented in other countries

If the provinces are to proceed with meaningful reform, the act will have to be revised

cost-sharing, allowing private parallel health care, employing privately owned and operated surgical facilities and hospitals to deliver universally accessible care, and using independent insurers to operate the universal insurance scheme

By Andy Lines 15 Comments Controversial American health firm that donates to Tories handed huge NHS contract 3 Sep 2013 00:00 It is already at the centre of a massive row after being accused of overcharging the NHS by millions of pounds in a damning report // Vital skill; Brain surgeon at work Getty A contract to treat NHS patients with brain tumours has been awarded to a controversial American healthcare firm that is a donor to the Tory party.

Hospital Corporation of America

HCA has given the Tories at least £17,000 since they came to power.

By David Kilgour

Canadians have an enormous attachment, almost equivalent to national self-definition, in our universal health care system.

The cost savings of Canada’s single-insurer vs. the American multiple insurer competitive system are clear. A study reported by the International Journal of Health Services concluded that reducing American administrative and promotional costs to Canadian levels would save at least $209 billion a year, “enough to fund universal coverage.”

National News: Study Compares Insurance Coverage for New Medicines Between Canada's Public and Private Sector Drug Plans [ Edit ] Contributed by admin on Sep 20, 2013

A new study published by the Canadian Health Policy Institute (CHPI) compares insurance coverage for new medicines between Canada's provincial and federal public drug programs; and between public sector drug programs and the benchmarks currently set in a competitive market by private-sector drug insurance. Using data from Health Canada and IMS Brogan, the study specifically examined insurance coverage for new medicines in five (5) select therapeutic classes - allowing Canadians to see how they are uniquely impacted by differences in drug insurance benefits across plans, according to the treatment areas that affect them most directly.

The Timmins Daily Press Wed Dec 18 2013

STRIKE HITS CLOSE TO HOME It's a very sad day when those charged with looking after the elderly and the disabled in our communities can't count on decent wages and benefits. Now, I'm not blaming the Red Cross Care Partners (RCCP) because I believe they are doing the best they can given what the government has done to home care services in this province. Home care in Ontario was opened to "competitive bidding" over the last number of years with disastrous consequences. There are now more than 1,000 agencies delivering home care services in the province, and there are four levels of administration before any funds actually get into the hands of the front line Personal Support Worker (PSW).

A unionized Red Cross PSW receives maximum pay of $15.02/hr, but only after three years on the job while a non-union PSW gets paid between $12.25 and $13.50/ hr. PSWs working in a nursing home get paid an average of just over $20/hr yet they all must have the same level of education. To top that off, time spent driving to or between clients is not paid and the distances can be quite significant for RCCP caregivers in the north. Mileage is only paid if travelling between clients. If you live in Iroquois Falls and your only client that day happens to be in Ramore, you won't get paid any mileage at all! Health care benefits are quite poor and can be lost if the worker fails to work the minimum 1,352 hours in any given year. Red Cross PSWs do not have a pension plan and most only work part time. Many people have accepted the myth that we had been over taxed for way too long and the "tax relief" we now enjoy has made us all the more prosperous.

Released April 2014

Ontario’s performance in health care is uncompetitive among international peers The Institute finds that, overall, Ontario could get better value for money from its health care spending. Ontario is among the jurisdictions with the highest total per capita health care spending in the OECD, with spending 33 percent above the OECD average. Yet despite exceptional resources, Ontario falls short when comparing the province’s overall health care performance to that of international peers. Countries that spend less on health care have comparable or better health care outcomes, higher quality care, and more extensive public coverage than Ontario.

One of the hurdles to adopting ABF more widely is a lack of data about many dimensions of health care in Canada, including demographics and the specific costs of many aspects of delivering services, and the analytic capacity to develop an accurate funding formula based on those factors

Global budgets provide predictability, which is useful for planning purposes for providers as well as administrators,” she points out, “and it helps hospitals to live within their means, which is generally a good thing. But the downside is that this can affect access to care, because there are incentives to do less if the hospital faces going over budget.”

incentive to innovate or find efficiencies when funding levels are fixed by a global budget, rather than geared to delivery of services.

On Monday we’re going to court to launch our case for Canadian public health care, aiming to introduce some very important evidence about the devastating consequences of Brian Day’s attack on Medicare.  

Our group already has intervener status in the challenge, which means we’re participating directly in the case. On Monday we are applying to present evidence from our highly qualified experts, including: The consequences of opening the door to U.S. health conglomerates; The adverse impacts privatization will have on patients, but also on the health care provider who are committed to remaining in the public system; What happened in Quebec when it opened its door to private hospitals; What the loss of Medicare would mean to Canadian competitiveness; How NAFTA prevents the door to privatization ever being closed, once it is opened. Dr. Day’s true motives are clear. A provincial audit of Day’s Cambie Surgery Centre and the associated Specialist Referral Clinic found that patients were unlawfully extra-billed $491,654 in just 30 days. In one case, a Cambie patient was billed $7,215.00 for services that would only have cost $1,288.04 in BC’s public health care system.  Auditors also found over $66,000 in overlapping claims – evidence that suggests double dipping for the same services.[3]

National Post Sat Apr 18 2015

The fact is low-income Canadians should not have dental plans as well as drug plans. The issue with "universality" is it shares resources equally, rather than targeting those in need. Canadians who already have drug or dental coverage through their work, or those who can afford private plans, do not need state funding. The call for universality would lead to a replication of the existing flaws in Canadian medicare - namely rationing and restricted access. Who wants to go on a long wait list to see their pharmacist or dentist? A drug and dental plan for those in need should be operated by private insurers, with funding and oversight being government's responsibility. The last thing we need is an expansion of a Canadian system that already has 11 times as many public health bureaucrats as Germany where, incidentally, drug and dental coverage are included. In citing countries that already offer drug coverage, Steve Morgan and Danielle Martin conveniently ignore the fact they include private competition and choice in their systems. Dr. Brian Day Vancouver

Information about ingredients and food sources that other hospitals handed over readily, was refused by both Sodexo -- the $8 billion-a-year French corporation in charge of food service at Vancouver Coastal Health Authority (VCHA) facilities -- and the public health authority itself.

the Lower Mainland Business Initiatives and Support Services (BISS)

Formed in 2003, the BISS took purchase decision-making away from individual hospital administrators; even, to a degree, away from regional health authorities themselves.

The Province Tue May 26 2015

Canada's cities face a number of problems, including traffic congestion, housing costs, crime rates and shabby infrastructure. Now prescription drugs can be added to the list; it is a problem that is costing local governments as much as $500 million every year. Recognizing that access to necessary medicines is critical for health and well-being, many cities offer their employees private insurance coverage for prescription drug costs. For example, the cities of Toronto and Calgary spend about $43 million and $20 million, respectively, on private drug-insurance plans for their employees.

The coverage they offer is relatively comprehensive, resulting in costs per employee that are equal to private-sector averages. Vancouver and Halifax offer less comprehensive drug coverage for their employees, but still at considerable cost - about $3 million each. There are more than 600,000 local government employees across the country, according to Statistics Canada, and two-thirds of them receive private health insurance from the cities, towns and districts they work for. Based on the cost of such coverage for the four cities mentioned, it is a reasonable estimate that local governments are spending $500 million a year on private drug insurance for their employees. Cities have to spend this money - taken from local taxpayers - because Canada's medicare system is the only universal, public healthcare system among developed countries that does not include universal coverage of prescription drugs.