Skip to main content

Home/ CUPE Health Care/ Group items tagged inequality

Rss Feed Group items tagged

Cheryl Stadnichuk

Canada's sluggish track record on health inequality must be addressed, say experts &#82... - 0 views

  •  
    Health inequality in Canada is growing. And nowhere is that more evident than in the health gap between indigenous and non-indigenous Canadians. In a report released last November the Canadian Institute for Health Information concluded that Canada wasn't likely to see any major improvements in health inequality without addressing the social determinants of health. "A big part of that isn't our health care system, it's that we don't have the kind of equal society, we don't have the social safety net that many European countries for example do. And that reflects in statistics," said Dr. Ryan Meili, a family doctor from Saskatoon and a former provincial NDP leadership candidate.
  •  
    Health inequality in Canada is growing. And nowhere is that more evident than in the health gap between indigenous and non-indigenous Canadians. In a report released last November the Canadian Institute for Health Information concluded that Canada wasn't likely to see any major improvements in health inequality without addressing the social determinants of health. "A big part of that isn't our health care system, it's that we don't have the kind of equal society, we don't have the social safety net that many European countries for example do. And that reflects in statistics," said Dr. Ryan Meili, a family doctor from Saskatoon and a former provincial NDP leadership candidate.
Govind Rao

Economic inequality is bad for our health - Infomart - 0 views

  • Toronto Star Sun Apr 26 2015
  • The powerful relationship between poverty and health has been documented for nearly two centuries. We have long known that a person's economic position is the strongest predictor of their health status. Being poor means dying sooner and dying sicker. A Toronto Public Health report released earlier this week concludes that poverty is literally imprinting itself on the lives of Torontonians. The findings presented in the report are grim. Over the past decade, health inequalities between the rich and the poor have persisted. In some cases, they have grown wider. Opportunities to be healthy in Toronto remain as unequally distributed as ever. The report rightfully attributes these inequalities to the social determinants of health - a diverse range of factors including income, education, employment and housing.
  • We live in a divided city and the deepening of economic cleavages has become a defining feature of our civic landscape. Income inequality is on the rise. Housing is becoming less affordable. Neighbourhoods are becoming more polarized. And the cost of living has far outpaced individual earnings. In Toronto, as elsewhere, the social determinants of health have suffered significant decline. As the report makes clear, the poorest among our city's residents have borne the greatest part of this burden. These trends have affected the health of the poor in countless ways. They have constrained access to quality health care. They have increased susceptibility to harmful behaviours, such as smoking. They have compromised the adequacy and stability of housing conditions. They have restricted access to nutritious foods. They have heightened exposures to daily stress and adversity that get under our skin and harm not only our minds but our bodies as well. In fact, research has shown that economic conditions underlie almost every pathway leading to almost every health outcome.
  • ...3 more annotations...
  • So it shouldn't come as a surprise that, despite a decade of public programs intended to promote health equity, the health status of the poorest Torontonians hasn't improved. In fact, this was entirely predictable. At the heart of the issue are two important insights provided by our best available science. First, public health programs that are designed to encourage people to alter their lifestyles and behaviours simply do not address the myriad other associations between economic position and health status. Attempts to address any one problem do little to fundamentally interrupt the overall correlation. Second, because public health programs do not address the "causes of the causes," they are incapable of stemming the tide of new individuals that develop poor health-related behaviours. No sooner has one cohort been exposed to a health-promotion program than another is ready and waiting.
  • oronto has made little progress in the fight against poverty over the last decade and thus it's to be expected that health inequality remains stark. We find little fault in the actions of Toronto Public Health. Rather, as the science makes clear, the true guardians of our health are the policy-makers that determine whether all Torontonians - and all Canadians, more generally - are able to keep up with the costs of everyday life. What can we do? We can create widespread recognition that when our governments fail to redress inequalities, they undermine the health of our society. We can engage in civic and political action to help pass public policies that reduce the economic distance between the rich and the poor. We can also support organizations that advocate on behalf of these policies, including Toronto Public Health and the labour unions that protect the conditions of low-wage workers.
  • Health inequalities are one of the most formidable public health problems of our time. The science strongly supports Toronto Public Health's insights that public health programs are wholly insufficient to alleviate their burden. The solution lies in tackling the unequal distribution of resources that has become a defining feature of our city and our society at large. Arjumand Siddiqi is assistant professor and Faraz Vahid Shahidi is a doctoral student at the Dalla Lana School of Public Health, University of Toronto. Correspondence should be sent to Ms. Siddiqi at: aa.siddiqi@utoronto.ca
Govind Rao

Canada needs to end regional health inequalities - Infomart - 0 views

  • The Globe and Mail Mon Oct 19 2015
  • cweeks@globeandmail.com Canadians, on average, are fairly healthy. Life expectancy continues to rise, fewer of us smoke and more of us are becoming physically active. That's the problem with averages. They are misleading. In Ontario, for instance, average life expectancy is 81.5 years - a pretty decent number. It's only when you look beyond the big picture that you see the cracks.
  • The life expectancy of a baby born in Brampton is 84. A child born the same day in Sault Ste. Marie, less than 700 kilometres away, is 79. Another telling metric is potentially avoidable deaths - how many people likely died unnecessarily because they didn't receive proper care after a heart attack, weren't vaccinated against a disease or suffered another preventable or treatable ailment. According to the Ontario average, 163 in 100,000 people die from a potentially avoidable death a year. But in reality, the numbers vary wildly across the province, from a low of 114 per 100,000 in cities such as Richmond Hill and Vaughan, to a high of 258 in Thunder Bay, Marathon, Dryden and the surrounding area.
  • ...5 more annotations...
  • These numbers are from a report released last week by Health Quality Ontario, a provincial agency mandated to improve the province's health care system. But this isn't just an Ontario problem
  • Across the country, the situation is much the same: startling, persistent regional health inequalities that, quite literally, are sickening and killing countless Canadians before their time. Often, stark inequalities exist between urban and rural or remote communities, which is why northern parts of the country are so often struck by much higher rates of disease and premature death.
  • There are many reasons behind these differences, such as the fact that in northern communities, people tend to smoke more, be less physically active, have a much more difficult time accessing specialized medical care, have higher aboriginal populations and have lower education and income levels compared with large urban centres. Of course, many of these same problems can be found within cities, where pockets of vulnerable individuals can live just a few blocks from affluence. But none of this explains why we as Canadians have allowed these problems to persist for so long. Why we consider it acceptable that, depending on where you live, how much you earn or what education level you have achieved, you are much more likely to die from a chronic illness or have to wait weeks longer for a loved one to get a spot in a long-term care home. The answer, quite possibly, is that many of us have never really stopped to consider that these differences exist. That, in 2015, aboriginals in Canada are being infected with and dying of tuberculosis. Or that many patients with chronic diseases living outside of urban centres often have few resources to help them manage their conditions. Or that many communities throughout Canada face crippling doctor shortages that close emergency rooms and delay treatment.
  • Joshua Tepper, president and CEO of Health Quality Ontario, says that many people simply don't "understand how dramatically different health outcomes are across the province." After all, most politicians and policy-makers live in and around the urban areas where health outcomes tend to be the best. It's all too easy to forget about the people living in remote cities or rural areas. Some will argue that it's up to people to take charge of their own health. That's true. But when the realities of daily life set them up for failure, it's a sign that change is needed from a higher level. An excellent example of this is cited by Connie Clement, scientific director of the National Collaborating Centre for Determinants of Health.
  • She notes that the Liquor Control Board of Ontario is able to tightly regulate the price of alcohol throughout the province. Yet nothing is done about the fact that milk or fresh produce can be priced so high that few families in remote communities can afford them. It's heartening to hear experts such as Tepper and Clement put these serious health inequality issues on the table. Now, it's up to the politicians and policy-makers to listen up and pledge to do something about it.
Govind Rao

8 steps toward addressing Indigenous health inequities - Healthy Debate - 0 views

  • by Wendy Glauser, Joshua Tepper & Jill Konkin (Show all posts by Wendy Glauser, Joshua Tepper & Jill Konkin) January 7, 2016
  • The health inequities between Indigenous and non-Indigenous Canadians have long been shamefully apparent – the various studies finding infant mortality rates in Indigenous populations to be 1.7 to four times that of non-Indigenous populations; the diabetes prevalence that’s nearly twice that of non-Indigenous people; the fact that Indigenous people are six times more likely to suffer alcohol-related deaths; and many more.
  • Better support for health workers in Indigenous communities
  • ...7 more annotations...
  • Address prejudice among health workers
  • Provide benefits for Indigenous people not recognized by the Indian Act
  • Put less addictive pharmaceutical options on the formulary
  • Collaborate more across service providers
  • Make trauma-informed care the standard of care
  • Address smoking rates in Indigenous communities
  • Implement basic standards for supplies in nursing stations in remote, Indigenous communities
Govind Rao

Changes in Social Inequalities Sask April 2016 - 0 views

  •  
    A University of Saskatchewan study showed large and increasing social and health inequalities in the province between 2001 and 2013. Among the biggest gaps: people living in the most deprived areas were nearly twice as likely to have chronic obstructive pulmonary disease compared to those in the least deprived areas.
  •  
    A University of Saskatchewan study showed large and increasing social and health inequalities in the province between 2001 and 2013. Among the biggest gaps: people living in the most deprived areas were nearly twice as likely to have chronic obstructive pulmonary disease compared to those in the least deprived areas.
Govind Rao

High Inequality Results in More US Deaths than Tobacco, Car Crashes and Guns Combined -... - 0 views

  • Tue Apr 22 2014
  • High Inequality Results in More US Deaths than Tobacco, Car Crashes and Guns Combined( (s.tt») ) (via Moyers & Company( (s.tt») )) In 2009, the British Medical Journal (BMJ) published a study that revealed what seems to be a shocking truth: those who live in societies with a higher level of income inequality are at a greater risk for premature death. Here in the United States,...
Govind Rao

Income gap in Toronto: 10 things to know about health inequalities | CTV Toronto News - 0 views

  • Toronto's low income groups are more likely to suffer from diabetes and cardiovascular disease, while those who earn more are more likely to have unhealthy alcohol use.
  • April 20, 2015
  • Toronto's low income groups are more likely to suffer from diabetes and cardiovascular disease, while those who earn more are more likely to have unhealthy alcohol use. The report, titled "The Unequal City 2015: Income and Health Inequities in Toronto," was written by Toronto Public Health officials and released Monday.
  • ...1 more annotation...
  • The 36-page report (www.toronto.ca/legdocs/mmis/2015/hl/bgrd/backgroundfile-79096.pdf) found that those in the city's lowest income groups tended to be the least healthy. Low-income groups had worse health in 20 of 34 indicators examined.
Govind Rao

The non-Hillary hope of U.S. progressives; Bernie Sanders, a democratic socialist, hasn... - 0 views

  • Toronto Star Tue Feb 10 2015
  • Angry speech complete, Vermont Sen. Bernie Sanders, who is giving "serious thought" to running for president, sat down to take questions from the Brookings Institution audience. "No one would accuse you of being 'Morning in America' with your presentation today," pundit Mark Shields began, referring to the sunny Ronald Reagan campaign ad.
  • "My wife often tells me that after I speak we have to pass out the tranquilizers and the anti-suicide kits," Sanders said. "I've been trying to be more cheerful!" White hair askew, suit jacket creased, Sanders, a 73-year-old whose Brooklyn accent occasionally turns Obama into "Obamer," looks and sounds the part of doomsday prophet. On Monday, he said that America is either on the road to "oligarchy" or already there, that the conservative Koch brothers might have successfully purchased the country with campaign donations, and that resistance to "the billionaire class" from a grassroots candidate like him might be futile.
  • ...6 more annotations...
  • Sanders is not even a registered Democrat: Though he caucuses with the party, he has sat as an independent since he was elected to Congress in 1990. He self-identifies as a democratic socialist. In an Iowa church basement in December, he called for "a political revolution in this country." Not the stuff of major-party nominees. But no one else with sterling progressive credentials appears to possess the martyrdom instinct to stand in front of the Hillary Clinton express.
  • If you had two million people, a phenomenal response, putting in $100 bucks, that's $200 million. That is 20 per cent of what the Koch brothers themselves are prepared to spend. Can we take that on? I don't know the answer," he said. "Maybe the game is over. Maybe they have bought the United States government. Maybe there is no turning back. Maybe we've gone over the edge. I don't know. I surely hope not." This man could be progressive Democrats' last great 2016 hope.
  • A small but vocal effort to draft Massachusetts Sen. Elizabeth Warren, the most formidable left-leaning Democrat, has shown no sign of accomplishing anything. Warren would be a long-shot. Sanders may be a no-shot. But his presence in the debate could at least drag Clinton to the left on economic policy. And some activists believe his candour on the gap between rich and poor, which he described Monday as "grotesque and growing," would keep him afloat.
  • "Any candidate who speaks up as aggressively and as forthrightly as Sen. Sanders has on the growing income inequality in this country is a viable candidate. Income inequality will be the defining issue of the 2016 election," said Neil Sroka, communications director for Democracy for America, a political action committee founded by former candidate Howard Dean. Democracy for America is trying to convince Warren to enter the race. She keeps saying no. Sroka said the group is supportive of a Sanders candidacy even if Warren gets to yes.
  • "I think having more candidates in the 2016 Democratic primary talking about income inequality issues ensures that every single candidate has to talk about those issues," he said. Much of the recession-era country has come around to Sanders's anti-elite fury. He said Monday that "the business model of Wall Street is fraud and deception," demonstrating a populist frankness resonant with the segment of the Democratic base uneasy with Clinton's coziness with big donors.
  • Sanders offered a 12-point prescription for change. He called for a doubling of the federal minimum wage to "at least" $15 per hour, $1 trillion in infrastructure spending, repealing NAFTA, Europe-like free university tuition, and a Canada-like single-payer health-care system that insures everyone. Obamacare, he said, has been only a "modest success." He said he has seen "a lot of sentiment that enough is enough, that we need fundamental changes." Lest anyone get too excited, he added a caveat. "On the other hand, I also understand political realities," he said. "And that is: When you take on the billionaire class, it ain't easy."
Irene Jansen

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

  • 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
  •  
    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
Govind Rao

Address huge public health coverage gaps - Infomart - 0 views

  • Guelph Mercury Thu Oct 15 2015
  • It's time to tackle root causes of health inequities As Canadians, we are justifiably proud of our publicly funded health-care system. It is, arguably, the single-most powerful expression of our collective will as a nation to support each other. It recognizes that meeting shared needs and aspirations is the foundation on which prosperity and human development rests. We can all agree that failing to treat a broken leg can result in serious health problems and threats to a person's ability to function. Yet, we accept huge inequities in access to dental care and prescription drugs based on insurance coverage and income. Although the impacts can be just as significant, dental care isn't accessible like other types of health care, and many Canadians don't receive regular or even emergency dental care. Many others have no insurance coverage for urgently needed prescription medications and may delay or dilute required doses due to financial hardship.
  • Demand for dental care among adults and seniors will only increase as the population continues to grow in Ontario. From 2013 to 2036, Ontario's population aged 65 and over is projected to increase to more than four million people from 2.1 million. It is time all Canadians had access to dental care. This necessitates federal and provincial leadership in putting a framework together to make this possible. Dental health problems are largely preventable and require a comprehensive approach for all ages that includes treatment, prevention, and oral health promotion.
  • ...8 more annotations...
  • Low-income adults who do not have employer-sponsored dental coverage through a publicly funded program - and most don't - must pay for their own dental care. Because the cost is often prohibitive, too many adults avoid seeking treatment at dental offices. Instead, they turn to family doctors and emergency departments for antibiotics and painkillers, which cannot address the true cause of the problem. In 2012, in Ontario alone, there were almost 58,000 visits to Ontario hospital emergency rooms due to oral health problems. Why is access to dental care essential now?
  • A person's oral health will affect their overall health. Dental disease can cause pain and infection. Gum disease has been linked to respiratory infections, cardiovascular disease, diabetes, poor nutrition, and low birth weight babies. Poor oral health can also impact learning abilities, employability, school and work attendance and performance, self-esteem, and social relationships. It is estimated that 4.15 million working days are lost annually in Canada due to dental visits or dental sick days. Persons with visible dental problems may be less likely to find employment in jobs that require face-to-face contact with the public.
  • Why is there such a difference in coverage? In short, dental care and pharmacare were not included within the original scope of Canada's national system of health insurance (medicare), and despite repeated evidence of the need to correct this oversight, is still not covered today. Instead, we are left with a patchwork of private employer-based benefits coverage, limited publicly funded programs, and significant out-of-pocket payments for many. Publicly funded dental programs for children and youth do exist for low-income families, including the dependents of those on social assistance. Most provinces and territories have some access to drug coverage, mostly for seniors and social assistance recipients, and there is some support for situations where drug costs are extremely high.
  • Pharmaceutical coverage in Canada remains an unco-ordinated and incomplete patchwork of private and public plans - one that leaves many Canadians with no prescription drug coverage at all. This has many negative consequences including: Three million Canadians cannot afford to take their prescriptions as written. This leads to worse health outcomes and increased costs elsewhere in the health-care system.
  • One in six hospitalizations in Canada could be prevented through improved regulation and better guidelines. Medicines are commonly underused, overused, and misused in Canada. Two million Canadians incur more than $1,000 a year in out-of-pocket expenses for prescription drugs. The uncontrolled cost of medicines is also a growing burden on businesses and unions that finance private drug plans for approximately 60 per cent of Canadian workers. Canada pays more than any comparable health-care system for prescription drugs. We spend an estimated $1 billion on duplicate administration of multiple private drug plans. Depending on estimates, we also spend between $4 billion and $10 billion more on prescription drugs than comparable countries with national prescription drug coverage plans.
  • Affordable access to safe and appropriate prescription medicines is so critical to health that the World Health Organization has declared governments should be obligated to ensure such access for all. Unfortunately, Canada is the only developed country with a universal health care system that does not include universal coverage of prescription drugs. From its very outset, Canada's universal, public health insurance system - medicare - was supposed to include universal public coverage of prescription drugs. The reasoning was simple. It is essential to deliver on the core principles of "access," "appropriateness," "equity" and "efficiency." Building universal prescription drug coverage into Canada's universal health-care system, based on the above principles, is both achievable and financially sustainable.
  • A public body - with federal, provincial and territorial representation - would establish the national formulary for medicines to be covered. This body would negotiate drug pricing and supply contracts for brand-name and generic drugs. Importantly, it would use the combined purchasing power of the program to ensure all Canadians receive the best possible drug prices and thereby coverage of the widest possible range of treatments. To patients, the program would be a natural extension of medicare: when a provider prescribes a covered drug, the patient would have access without financial barriers.
  • To society, universal access to safe and appropriately prescribed drugs and access to dental care will improve population health and reduce demands elsewhere in the health system. The single-payer system will also result in substantially lower medicine costs for Canada. In short, Canada can no longer afford not to have a national pharmacare program and a national dental care program. Disclaimer: The Guelph and Wellington Task Force for Poverty Elimination is a non-partisan organization. However, the poverty task force does have ties with two Guelph federal party candidates. Andrew Seagram, the NDP candidate, is a current member of the task force and Lloyd Longfield, the Liberal candidate, is a past member.
Irene Jansen

Healthcare Policy Vol. 7 No. 1 2011 Do Private Clinics or Expedited Fees Redu... - 0 views

  • Discussion: An overall difference of approximately three work weeks in disability duration may have meaningful clinical and quality-of-life implications for injured workers. However, minimal differences in expedited surgical wait times by private clinics versus public hospitals, and small differences in return-to-work outcomes favouring the public hospital group, suggest that a future economic evaluation of workers' compensation policies related to surgical setting is warranted.
  • In 2004, for example, WorkSafeBC (the workers' compensation system in British Columbia) paid almost 375% more ($3,222) for an expedited knee surgery performed in a private clinic than for a non-expedited knee procedure in a public hospital ($859) (both fees represent the aggregation of facility, surgical and anaesthetists' fees)
    • Irene Jansen
       
      ownership and quality (for-profit = worse quality)
  • ...6 more annotations...
  • As a policy under the workers' compensation insurance system, expedited fees were effective in reducing wait time to surgery. While a difference of only two weeks may not improve longer-term clinical outcomes post-surgery, it represents a reduction in the total disability duration (i.e., pain, suffering, quality of life) for the injured worker and increases the worker's likelihood of successfully returning to work; the reduced disability duration also represents a cost saving to the workers' compensation system for time-loss benefits and to employers who pay compensation premiums based on the frequency and duration of their claims experience.
    • Irene Jansen
       
      See two paragraphs down, which suggests that expedited patients did not in fact return to work faster.
  • the provision of surgeries "after hours" or within private clinics may result in a redistribution of finite resources (e.g., surgeons, surgeon time, surgical staff) from one insurance provider to another, favouring those associated with higher fees, thus creating inequities. An evaluation of the effect of workers' compensation policies on inequity in the provincial healthcare system was not part of this study and warrants future investigation.
  • Despite surgery wait time differences, injured workers in the public hospital group tended to do slightly better in terms of time to return to work after surgery compared to workers in the private clinic group
  • . In this case, the improved outcomes were a shorter disability duration and earlier return to work for injured workers. Some might argue that the approximate one-week difference was not statistically significant and, as such, the provision of surgeries with private clinics "does no harm" within the context of the workers' compensation environment. Yet, as with expedited fees, it remains unclear whether the reliance on for-profit clinics increases capacity for surgeries with costs borne appropriately by employers and industries for work-related injuries, or whether they redistribute finite resources away from the provision of surgeries within the public healthcare system. Further, minimal differences in disability duration for patients treated by private clinics relative to those treated in public hospitals, given the added cost associated with surgeries performed in for-profit clinics, suggest that a future economic evaluation of this workers' compensation policy is warranted.
  • the time leading up to surgery may be confounded by co-morbidities and that individuals with complications may be directed to the public system
  • A difference of approximately two weeks in surgery wait time associated with the expedited fee policy may have meaningful clinical and quality-of-life implications for injured workers, in addition to being cost-effective policy for workers' compensation insurance systems, but did not affect the return-to-work time post-surgery as part of total disability duration. Minimal (and not statistically significant) differences in disability duration were observed for surgeries performed in private clinics versus public hospitals.
  •  
    An overall difference of approximately three work weeks in disability duration may have meaningful clinical and quality-of-life implications for injured workers. However, minimal differences in expedited surgical wait times by private clinics versus public hospitals, and small differences in return-to-work outcomes favouring the public hospital group, suggest that a future economic evaluation of workers' compensation policies related to surgical setting is warranted.
Irene Jansen

Chefs, Butlers and Marble Baths - Not Your Average Hospital Room - NYTimes.com - 0 views

  • 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,
  • ...9 more annotations...
  • The rise of medical tourism to glittering hospitals in places like Singapore and Thailand has turned coddling and elegance into marketing necessities
  • The spotlight on luxury accommodations comes at an awkward time for many urban hospitals, now lobbying against cuts in Washington and highlighting their role as nonprofit teaching institutions that serve the poor.
  • In space-starved New York, many regular hospital rooms are still double-occupancy
  • “We pride ourselves on getting anything the patient wants. If they have a craving for lobster tails and we don’t have them on the menu, we’ll go out and get them.”
  • 30 percent of its clientele comes from abroad
  • “I’m perfectly at home here — totally private, totally catered,” she added. “I have a primary-care physician who also acts as ringmaster for all my other doctors. And I see no people in training — only the best of the best.”
  • Increasingly, hospitals serving the merely well-off are joining the amenities race.
  • The conflicts echo those of a century ago, in another era of growing income inequality and financial crisis, said David Rosner, a professor of public health and history at Columbia University. Hospitals, founded as free, charitable institutions to rehabilitate the poor, began seeking paying patients for the first time in the 1890s, he said, restyling themselves in part as “hotels for rich invalids.”
  • “Every generation of hospitals reflects our attitude about health and disease and wealth and poverty,” Professor Rosner said. “Today, they pride themselves on attracting private patients, and on the other hand ask for our tax dollars based upon their older charitable mission. There’s a conflict there at times.”
Govind Rao

Inequality in Canada: Driving Forces, Outcomes and Policy » Institute for Res... - 0 views

  • IRPP-CLSRN Conference (SOLD OUT) February 24, 2014 – February 25, 2014 Delta Ottawa City Centre101 Lyon StreetOttawa
Govind Rao

Improving the health of older Indigenous Canadians : The Lancet - 0 views

  • The Lancet, Volume 382, Issue 9908, Page 1857, 7 December 2013 <Previous Article|Next Article>doi:10.1016/S0140-6736(13)62610-0
  • Refreshingly, 2013 has been a year in which the health inequalities between Indigenous and non-Indigenous peoples have gained greater attention. An early example of this attention was the announcement, in July, by the Australian Government of their 10 year plan to address these inequalities. And, on Nov 28, the Health Council of Canada added to this progress with the publication of Canada'sMost Vulnerable: Improving Health Care for First Nations, Inuit, and Métis Seniors. The authors of the Canadian report set out to explore the health challenges faced by older Indigenous Canadians.
Govind Rao

Pharmaceutical firms contribute to wealth inequity | Physicians for a National Health P... - 0 views

  • April 27, 2015
  • Pharmaceutical Companies Buy Rivals’ Drugs, Then Jack Up the Prices
  • By Jonathan D. Rockoff and Ed SilvermanThe Wall Street Journal, April 26, 2015
  • ...1 more annotation...
  • On Feb. 10, Valeant Pharmaceuticals International Inc. bought the rights to a pair of life-saving heart drugs. The same day, their list prices rose by 525% and 212%. Neither of the drugs, Nitropress or Isuprel, was improved as a result of costly investment in lab work and human testing, Valeant said. Nor was manufacture of the medicines shifted to an expensive new plant. The big change: the drugs’ ownership.
Govind Rao

Support for Sanders presidency gathers steam; Candidate with battle cry for 'political ... - 0 views

  • Toronto Star Mon Oct 5 2015
  • In the early 1970s, a young left-wing radical from New York, Bernie Sanders, would run into a young political science professor, Garrison Nelson, in a library at the University of Vermont. Sanders would tell Nelson about his plans to challenge the influence of the billionaire Rockefeller family. "I would just laugh. I'd say, 'The man is delusional,'" Nelson recalled. "I'd smile and send him on his way to go to the movies and figure out how he was going to 'undo the Rockefellers.'"
  • The young radical is now an old radical. Saying the same contemptuous things about billionaires in the same Brooklyn bark, he has become a legitimate contender for the Democratic presidential nomination. "I'm stunned. Stunned. It's beyond belief," said Nelson, who remains a Sanders acquaintance. "When I see these crowds, in California, in Texas, I say, 'My God, this is just unreal.'"
  • ...8 more annotations...
  • Twenty-seven thousand in Los Angeles. More than 25,000 in progressive Portland. Eight thousand in conservative Dallas. Sanders, a 74-year-old "democratic socialist" with little regard for traditional campaign requirements such as smiling, has drawn the biggest crowds of any candidate from either party. Calling for a "political revolution," Sanders has overtaken favourite Hillary Clinton in the first two voting states, Iowa and New Hampshire. Last week, he announced the feat that finally got America's money-talks political class to take him seriously: he raised $26 million (U.S.) over the past three months, just shy of Clinton's $28 million and better than Barack Obama over the comparable period in 2007.
  • He collected that cash while refusing to hold swanky fundraisers - or many fundraisers at all - and while railing against the corporate titans whom candidates usually ask to write cheques. The haul came largely from grassroots donors who contributed online. The average donation, his campaign said, was $30. Brad Cooley, a 19-year-old computer science student at Arizona State University, had never heard of Sanders until he came across his name this spring on Reddit, where Sanders has amassed a zealous following. Cooley now gives Sanders $5 every month. When he has some spare cash, he chips in another $10 or $15.
  • "He's the only politician that's ever made me excited for politics or for being part of the political activity in this country," Cooley said. Every Democratic primary produces a liberal alternative to the establishment choice. None - not Bill Bradley, not Howard Dean - has offered a platform nearly so ambitious. Sanders, a two-term Vermont senator elected both times as an Independent, is pushing the kind of unabashed big-government agenda that Canada's NDP might deliver if it set up shop in the United States and evicted all its centrists. And he is doing it with unrestrained anger. Though he is a career politician, he radiates an anti-establishment rage that resonates in the era of stagnant middle-class wages, growing income inequality and billionaire-backed Super PACs.
  • His crusty sincerity is especially appealing to voters who believe the cautious Clinton is inauthentic in her professed concern for "everyday Americans." In substance and in style, he is exposing Clinton's weaknesses. "Bernie is talking to the middle-and-below guy that is just screwed, and nobody else is really addressing what's happening to them," said Peter von Sneidern, 70, a retired motorcycle shop owner and the former party chair in the New Hampshire town of Temple. Sanders calls income inequality "the great moral issue of our time." He says he would pursue a Scandinavia-style universal health care system, make public universities free, double the federal minimum wage to $15, spend $1 trillion over five years to repair infrastructure, break up big banks and change the Constitution to curb the campaign clout of "the billionaire class."
  • Like conservative critics of Donald Trump, Clinton supporters say Sanders would get eaten alive by opposition operatives in a general election. "I know that the (Republican) Karl Rove team has one goal in mind, and that's to get Bernie the nomination. Because he's their dream candidate to run against," said Bert Weiss, the Democratic chair in the New Hampshire town of Chatham. The drama-hungry media can make Sanders' chances sound better than they are. Among the non-white voters particularly important in the South, Clinton leads 76 per cent to 16 per cent, according to a recent NBC poll. And Clinton's overall lead, while shrinking, is still large: Clinton is ahead of Sanders 65 to 35 per cent, a recent YouGov poll found.
  • Dan Payne, a Boston-based Democratic analyst, said the upcoming debates are a "big, big hurdle" for a candidate he describes as "rude."Nelson believes Sanders is unlikely to do much better than his current 30-odd per cent of the national vote. "But he's already had an impact. He'll have a major speaking role at the convention, and he's already pushed the agenda." Sanders's fervent fans - the Reddit soldiers and the New Hampshire retirees alike - are convinced he can win. Cooley cites Obama, who trailed Clinton by a similar margin at this time in 2007. Von Sneidern cites Jesus Christ.
  • "Somewhere," von Sneidern said, "I saw something that said, 'Somebody thought that a socialist Jew couldn't get anywhere? Well, you celebrate his birthday every December.'"
  • Bernie Sanders, who considers himself a "democratic socialist," has passed Hillary Clinton in the first two voting states, Iowa and New Hampshire.
  •  
    He says he would pursue a Scandinavia-style universal health care system,
Govind Rao

Richest 1% Percent To Have More Than Rest of Humanity Combined | Common Dreams | Breaki... - 0 views

  • January 19, 2015
  • New Oxfam report shows the scale of global inequality is 'simply staggering'byJon Queally, staff writer
  • In less than two years, if current trends continued unchecked, the richest 1% percent of people on the planet will own at least half of the world's wealth. That's the conclusion of a new report from Oxfam International, released Monday, which states that the rate of global inequality is not only morally obscene, but an existential threat to the economies of the world and the very survival of the planet. Alongside climate change, Oxfam says that spiraling disparity between the super-rich and everyone else, is brewing disaster for humanity as a whole.
Govind Rao

Why this man is fighting for national home-care standards | Toronto Star - 1 views

  • Health policy professor Terry Sullivan, outgoing chair of Public Health Ontario, seeks to reduce inequities in publicly funded home and community care across Canada.
  • University of Toronto professor Terry Sullivan's vision is for a "common, federally supported guarantee" for home care and community care services.
  • By: Theresa Boyle Health, Published on Mon Jun 30 2014
  • ...2 more annotations...
  • In Etobicoke, it’s possible for an ailing senior living south of Eglinton Ave. to get two baths a week from a personal support worker while an equally sick senior on the north side gets only one. In Manitoba, the frail elderly generally get more hours of home care than those in Ontario. And in British Columbia, home-care patients make income-tested co-payments while those in Ontario don’t. If health policy professor Terry Sullivan had his way, there would be fewer inequities with publicly funded home and community care across Canada. And there would be more funding available to address the shortage of services. “Canada has no common standard of coverage for home and community services,” says Sullivan, who teaches at the University of Toronto, where he is also a senior fellow at the Institute of Health Policy, Management and Evaluation. “This turns out to be kind of a problem with an aging population as many of us are finding out with aging parents.
  • The result is a significant variation in how much is effectively covered by provinces, says Sullivan, outgoing chair of Public Health Ontario and former president of Cancer Care Ontario. He is calling for a national strategy that would see a “common, federally supported guarantee for a specified basket of home and community services.” This would help reduce disparities that see some Canadians getting more publicly funded care than others, that result in some family caregivers facing greater pressure than others, and that force some Canadians dip into their pocketbooks more than others to supplement what is publicly covered.
Govind Rao

Civil servants need fair wages - Infomart - 0 views

  • National Post Thu Feb 19 2015
  • Re: "Fat public sector paycheques," Charles Lammam and Niels Veldhuis, Feb. 18 Funded by right-wing corporate interests, the Fraser Institute's latest in a series of distorted studies on public sector compensation only aims to spur animosity between Canadian workers. This is a troubling distraction from the real issues of income inequality.
  • CUPE's own study, B attle of the Wages, shows a small overall premium for public sector workers - less than two percent - when comparing workers in similar occupations. But this is entirely due to a smaller pay gap for women in the public sector than in the private sector. The Canadian Centre for Policy Alternative's own analysis, Narrowing the Gap, shows that higher public sector wages are attributed to higher wages for workers most discriminated against in the private sector. This analysis shows women, radicalized and Aboriginal workers are the ones seeing higher, and much fairer, wages in the public sector.
  • ...2 more annotations...
  • Driving down the compensation of public sector workers won't address the growing income inequality gap between working people and the richest Canadians. We need real action that will help all Canadian workers - public and private sector alike. Affordable and accessible child care, strengthened public health care, an expanded Canada Pension Plan that will give millions of Canadians a secure retirement income, and building an economy that is based on good jobs with fair wages for all.
  • Paul Moist, National President, Canadian Union of Public Employees
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.
  • ...3 more annotations...
  • 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.
1 - 20 of 96 Next › Last »
Showing 20 items per page