Group items tagged

Retired hospital CEO Murray Martin has suggested that Ontario's health care system is unsustainable in the absence of dramatic cost-saving changes, such as further hospital mergers. However as with many other health care policies, there is a serious disconnect between the problem — sustaining free, universal health care — and his solution.

The report found that although the appeal of hospital mergers is powerful, the evidence supporting mergers is weak. It concludes that "the urge to merge is an astounding, runaway phenomenon given the weak research base to support it, and those who champion mergers should be called upon to prove their case."

We are getting older/living longer because at each age level, average health is better than it was 10, 20 and 30 years ago. Health care needs per person are falling at each age, which is healthy aging. But the methods governments use to plan health care services, the number and type of health care providers and expenditure on health care are not based on the health care needs of the population. Instead they are based on the assumption each age group will need the level of care it received in the past. We simply increase expenditures to allow for the increased numbers in each group, never realizing the savings from healthy aging.

Mar 18, 2014

Lack of commitment to funding by Ontario Ministry of Health led to decision by TSH board Scarborough Mirror

Two hospital boards made different decisions, but with only one result: after 10 months of careful work, a merger between The Scarborough Hospital and Rouge Valley Health System is “abandoned effective immediately.”

Emergency rooms will be closed, group says at press conference

Scarborough Mirror

By Andrew Palamarchuk

Scarborough's two hospitals have agreed to start studying a full merger.

The Central East Local Health Integration Network, a regional overseer expected to approve the study on Monday, ordered the hospitals in March to create an "integration plan" between TSH General and Birchmount campuses and RVHS Centenary.

"Right away it was like silos fell down between the two hospitals," said Lyn McDonell, a TSH board member on the committee.

Friends of The Scarborough Hospital have arranged a town hall meeting for Monday, March 31, to examine the merger with Rouge Valley Health System, which was suspended by a last-minute vote of the TSH board.

The TSH board on March 15 voted to abandon the merger indefinitely but said it "shall be reconsidered" when conditions - including financial support to cover merger costs - are satisfied.

Despite the merger's defeat, TSH and RVHS are expected to work together on a study of planning needs for hospitals in Scarborough and West Durham, as well as a review of maternal and children's care in the area.

BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h5090 (Published 24 September 2015) Cite this as: BMJ 2015;351:h5090

Gareth Iacobucci

The NHS in England has spent £2bn (€2.74bn; $3.06bn) on 12 hospital mergers over the past five years that have largely failed to resolve the problems they were intended to deal with, a report from the King’s Fund has found.The report from the healthcare think tank1 found that most of the £2bn committed by the Department of Health to initiate the mergers had been spent on tackling historical debts and covering deficits and capital investment rather than on delivering the service changes required to make the merged organisations sustainable.

November 16, 2015

The cost of merging the province’s district health authorities was $3 million more than the previously discussed total. The Nova Scotia Government & General Employees Union recently released the results of a freedom of information request about the amalgamation cost and that document showed an additional $3.37 million the Health Department hasn’t discussed.

Two of the region’s corporate giants — one focused on government health insurance, the other specializing in communities for seniors — were acquired by larger industry players last week, as consolidation heats up in health-related sectors.

Insurance giant Aetna announced it will buy Bethesda-based Coventry Health Care, which provides Medicare and Medicaid services, for $5.7 billion. Two days later, Ohio-based Health Care REIT announced an $845 million deal to acquire McLean’s Sunrise Senior Living, which manages 300 senior living facilities in the United States, Canada and the United Kingdom, including 25 in the Washington region.

the health care industry is increasingly turning to consolidation as a way to cope with smaller profit margins and higher compliance costs that many anticipate when the federal government’s health care reforms under the Affordable Care Act take effect.

CUPE Nova Scotia urges caution on health care mergers Nov 1, 2013 01:14

(Truro) – The president of CUPE Nova Scotia, Danny Cavanagh, says he believes the McNeil government should move very cautiously with any kind of health care amalgamations. “The downsizing of administration that was already taking place with the previous government was working. That was a good thing. It saved money and should continue,” says Cavanagh. “Any moves to merge District Health Authorities, eliminate front line services or privatize services will be detrimental to the system.  We respectfully ask the health minister to sit down with the unions representing workers in the system before heading down the risky path of amalgamation,” he says.

More than a year after health authority merger, two sides will meet for the first time in October

Aug 12, 2016

The last of the major unions in the province waiting to begin negotiations will sit down with their employer in October. Several dates have been set for the council of unions representing health-care workers to meet with representatives of the Nova Scotia Health Authority. It's been more than a year since the province's district health authorities merged and the 50 collective agreements for unions expired.

National Post Sat Jul 4 2015

Aetna Inc.'s US$37-billion deal to buy smaller health insurer Humana Inc. will face rigorous scrutiny from U.S. regulators, which antitrust experts said could also make other large-scale mergers in the sector more difficult. The Aetna-Humana tie-up would be the largest such deal among health insurers. Friday's announcement starts the clock on an examination by regulators of whether consumers will be hurt by diminished competition. The deal follows weeks of intense discussions about potential combinations among the five biggest U.S. health insurers: Aetna, Humana, Cigna Corp., Anthem Inc. and UnitedHealth Group.

Insurers want more leverage in a health-care system that has seen major consolidation among hospitals and doctor practices, as well as mergers between medical device makers and other suppliers. The cost of new drugs has soared, and President Barack Obama's health-care law has made it harder for insurers to pass on higher costs to customers. Last month, Anthem offered to buy Cigna for US$47 billion. Cigna, which had also considered purchasing Humana, has so far rejected the buyout approach. Some industry watchers expect a potential buyout of Cigna to be revived.

CMAJ December 9, 2014 vol. 186 no. 18 First published November 3, 2014, doi: 10.1503/cmaj.109-4928

Nova Scotia is cutting the number of district health authorities in the province from 10 to 2, with the aim of reducing administration and saving $5 million annually in senior management salaries. The new Health Authorities Act passed through the legislature in just five days.

Nova Scotia, a relatively small province with a population of 940 000, has “10 health authorities and 10 different ways of doing things,” says Dr. Lynne Harrigan, vice president of medicine at Annapolis Valley Health and co-lead of the transition team responsible for recommending how physicians will operate in the new system. But the focus of the merger will be on the patient. “We will streamline processes to improve care.”

January 26th, 2015

by Julie Brill

In this post, I want to focus on the key role economic analysis plays in the Federal Trade Commission (FTC)’s health care enforcement program. I use this lens to look first at how the FTC has become more successful in challenging hospital mergers, and then to rebut the notion that the Affordable Care Act is somehow a “free pass” for health care industry consolidation. After the federal antitrust agencies successfully challenged a number of hospital mergers in the 1980s and early 1990s,[1] we suffered a string of court losses in the mid- and late-1990s, even in cases involving highly concentrated hospital markets.[2] In 2002, the FTC decided to take a step back and examine the reasons for our losses, and whether our analysis of hospital markets was correct.

The Globe and Mail Tue Nov 24 2015

The Ontario government is preparing to overhaul health care in the province, including scrapping its troubled system for delivering home care and reforming primary care with the aim of improving patient access. The proposed changes, mapped out in a paper to be made public in the coming weeks, will be the focus of consultations in the new year and are expected to touch on all aspects of the health system.

A centrepiece of the proposals will be the expansion of the role played by the province's Local Health Integration Networks. At the same time, the province would eliminate Ontario's 14 Community Care Access Centres (CCACs), the public agencies responsible for overseeing the delivery of services such as nursing, physiotherapy and help with personal care for the sick and the elderly in their homes. The agencies have long been a lightning rod for criticism, and were the focus of a Globe and Mail investigation this year that found inconsistent standards of care and a lack of transparency that left patients and their families struggling to access services.

A provincial panel's proposal to slash the number of health units through amalgamations isn't likely to be implemented, a local official says. Dr. Ian Gemmill, the acting medical officer of health for Hastings and Prince Edward Counties, said Wednesday the concept is too "revolutionary" and difficult to be managed before next year's provincial election.

Gemmill said it's basically "a huge trial balloon" but, implemented, would be a major change in the province's public health system.

But he stressed it is merely one option and, given the next provincial election is scheduled for June 7, 2018, the idea isn't likely to come to fruition.

Scarborough-Rouge River MPP Bas Balkissoon

The issue isn't management, it's a lack of funding, and it's getting worse, said Dr. Robert Ting, president of the medical staff association at The Scarborough Hospital.

He also said he disagrees with ongoing funding cuts to hospitals like Scarborough's, that have already worked to find efficiencies in recent years.

Robert Biron stepped into the CEO job at The Scarborough Hospital last week as the hospital prepared to plunge into work that will determine its future in a short length of time. The hospital's senior administrators were surprised on March 27 when the Central East LHIN, the region's health care overseer, froze their controversial plans to divide all surgical services between the Birchmount and General campuses and to merge their separate birthing centres into one centre at the Birchmount.

It also ordered other teams to do a six-month study - starting with a "directional report" in 60 days - on possible service mergers between the hospital and the Rouge Valley Health System, plus a 90-day review of how maternal and pediatric care could be shared within Scarborough.

During a hospital board meeting last Tuesday, he said one community member from each hospital's catchment area will be appointed by the LHIN to the panel studying integrations between the hospitals.

The hospital in Iroquois Falls has rescinded a contentious decision to amalgamate with the hospitals in Cochrane and Black River-Matheson.

The amalgamation was going to be voted on by those residents who are paid-up members of the hospital at an annual general meeting that was initially scheduled June 11. That meeting has now been moved to July 2.

Jim Brown, a former Iroquois Falls mayor who has been an outspoken critic of the hospital administration and the proposed amalgamation, noted the rescinding could simply be a temporary measure by the hospital board.

May 27, 2016

by Martha Rosenberg – Ronnie Cummins

If Monsanto, perhaps the most hated GMO company in the world, joins hands with Bayer, one of the most hated Big Pharma corporations on Earth (whose evil deeds date back to World War I and the Nazi era), the newly formed seed-pesticide-drug behemoth would have combined annual sales of $67 billion.

Corporate chains tend to buy and sell lower-quality nursing homes, and quality remained low following transactions

May 2, 2016

Harvard Medical School