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Irene Jansen

The Mowat Centre for Policy Innovation. A TRANSFORMATIVE BLUEPRINT FOR REDUCED COSTS, I... - 0 views

www.mowatcentre.ca/press-releases.php

abf private clinics competitive bidding it

shared by Irene Jansen on 23 Jan 12 - No Cached
  • the Mowat Centre at the University of Toronto has released a blueprint for transformative changes to the healthcare system
  • The report recommends five significant changes: • Modernize the organization of hospitals, with academic centres focused on diagnostic work-ups, specialty clinics providing routine procedures efficiently and accessibly, and networks of care that monitor patient well-being • Embrace the ‘‘virtualization’ of many existing services that are currently only delivered in person • Widely deploy digitization by reforming agencies so that they can respond to technological change more quickly and by providing more IT funding directly to providers • Encourage organic governance evolution without undertaking wholesale restructuring, and • Reform the way health services are purchased.
  • The report is part of the Shifting Gears Series on the transformation of public services and was supported financially by KPMG.
  • ...1 more annotation...
  • To read the full report, please click here
  • Irene Jansen on 23 Jan 12
     
    National Post coverage: Innovations seen as lowering health costs. National Post. Nov 1 2011 Tom Blackwell  Provinces must find ways to profit from efficiencies - like the steadily falling cost of cataract surgery. While favouring marketstyle competition, the academics draw the line at allowing a private tier of medicine or even expanding the role of privatehealth operators in the public system. Set up more stand-alone clinics, like those that do cataract surgeries. Move away from block funding of hospitals (an institution is paid a lump sum every year to cover most services) toward payments tied to treatment of individual patients. Cap increases in physicians' fees, link fees more closely to changes in technology and hold auctions in the public system, to get the best deal for providing some procedures. Experience suggests doctors may not welcome some of their proposals. In 2002, a $4-million study funded by the Ontario government - and initially supported by the Ontario Medical Association - recommended an overhaul of the fee schedule to better reflect the up-to-date value of each doctor service. It would have meant income drops for some specialists - such as the opthalmologists who do cataracts - while others would earn more. See also: Health Care reform? Despite frightful predictions of ever-rising costs, governments can reap savings by managing change Toronto Star Nov 1 2011  Opinion  Will Falk
Irene Jansen

Will Falk (Mowate Centre). October 31 2011. How to reform health care - thestar.com - 0 views

www.thestar.com/...107--how-to-reform-health-care

accord shared services specialty clinics abf

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Modernize the organization of hospitals
  • specialty clinics providing routine procedures efficiently and accessibly
  • with public funding and in partnership with traditional hospitals
  • ...4 more annotations...
  • Policy-makers should strengthen regional bodies, specialty care networks, and support mergers and acquisitions that build scale.
  • Reform the way health services are purchased. The health-care pricing system is fundamentally broken. Global budgeting for hospitals and inflation in fee-for-service payments for doctors need to be urgently reformed in most provinces.
  • These reforms do not rely on new revenues or any form of privatization to create a fiscally sustainable system. They could all take place within the Canada Health Act and are consistent with its principles.
  • Will Falk is executive fellow in residence at the Mowat Centre at the University of Toronto. He is lead author of a new report, Fiscal Sustainability and the Transformation of Canada's Healthcare System.
Heather Farrow

https://mowatcentre.ca/wp-content/uploads/publications/125_partnership_renewed.pdf - 1 views

mowatcentre.ca/...125_partnership_renewed.pdf

accord

shared by Heather Farrow on 27 Sep 16 - No Cached
  • Heather Farrow on 27 Sep 16
     
    sept 2016 Mowat centre health care funding report
Irene Jansen

We need a Grand Bargain to save our public services - The Globe and Mail - 0 views

www.theglobeandmail.com/...article1664718

accord think tank

shared by Irene Jansen on 23 Jan 12 - No Cached
  • But Canada doesn’t simply need “protection” of current transfers. It needs a Grand Bargain, where greater, more transparent and more reliable federal funding is combined with a realignment of the way the provinces deliver those services, and of the whole fiscal relationship between the provinces and the federal government.
  • Without more federal support – now stuck at 20 per cent of total provincial spending – current reforms could stall. New ones will not get off the ground.
  • The provinces and the federal government should take a hard look at options such as European-style social insurance, in which health and welfare spending are funded by payroll deductions that are split off from the regular income tax stream.
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  • Tax swaps, whereby the federal government takes over corporate income tax and the provinces take in all sales tax revenue, are another alternative worthy of consideration.
  • Australia does all-in transfers, bundling federal health and social payments into a single funding package, that are then equalized according to each state’s need.
  • An opinion poll commissioned by the Mowat Centre for Policy Innovation shows that, in every province except Quebec (where sentiment is almost evenly split), people feel they’re not getting fair treatment when it comes to federal transfers.
  • Mowat Centre for Policy Innovation
Irene Jansen

Mowat Centre. November 2010. A Report Card on Canada's Fiscal Arrangements - 0 views

www.mowatcentre.ca/research-topic-mowat.php

equalization federal cht

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Every year, the federal government transfers approximately $50 billion in its major transfers–the Canada Health Transfer, the Canada Social Transfer and Equalization.
  • There is broad recognition that our fiscal transfer system does not serve Canadians as well as it could.
  • This Report Card identifies areas of strength and for improvement against commonly agreed upon and international best benchmarks.
Irene Jansen

Fiscal Sustainability and the Transformation of Canada's Healthcare System: A Shifting ... - 0 views

www.mowatcentre.ca/research-topic-mowat.php

privatization sustainability canada

shared by Irene Jansen on 23 Jan 12 - No Cached
  • October 31, 2011
  • This report from the Mowat Centre and the School of Public Policy and Governance at the University of Toronto, supported by KPMG, is intended to help facilitate informed, strategic, long-term decision-making in healthcare in Canada. This report is part of the Shifting Gears series.
Irene Jansen

Federal health role is about more than money - thestar.com - 0 views

www.thestar.com/...-role-is-about-more-than-money

accord reforms think tank mowat

shared by Irene Jansen on 23 Jan 12 - No Cached
  • There are at least seven areas that require national policy leadership and federal attention:
  • Transparent reporting on health quality and access.
  • Delocalization and virtualization of health-care delivery.
  • ...6 more annotations...
  • Health human resources: credentialing and immigration.
  • Aboriginal health system improvement.
  • New technology approver and regulator.
  • Health promotion and disease prevention.
  • Epidemic preparation.
  • Will Falk, executive fellow in residence at the Mowat Centre for Policy Innovation
Irene Jansen

Expenditure Need: Equalization's Other Half - 0 views

www.mowatcentre.ca/research-topic-mowat.php

equalization cht

shared by Irene Jansen on 07 Feb 12 - No Cached
  • Expenditure Need: Equalization’s Other Half is the first paper in a Mowat Centre series exploring options for reforming the Canadian transfer system.
  • It argues that the current approach to Equalization turns a blind eye to the differences in expenditures that provinces must make to provide comparable levels of public services.
  • The paper shows that incorporating these differences can make Equalization fairer and less costly. It also highlights Ontario’s unique position—the province has both higher than average expenditure needs and lower than average revenue raising capacity. The paper demonstrates that adopting an expenditure need based approach to equalization would come closer to fulfilling the federal government’s Constitutional obligation to ensure that provinces have the fiscal capacity to provide their residents with comparable levels of services at comparable levels of taxation.
Irene Jansen

Lorne Gunter: Equalization is a flawed formula | Full Comment | National Post - 0 views

fullcomment.nationalpost.com/...ualization-is-a-flawed-formula

equalization neoliberalism

shared by Irene Jansen on 08 Feb 12 - No Cached
  • According to a new study released this month by the Mowat Centre for Policy Innovation at the University of Toronto, no consideration is given to how much it costs to provide services in different provinces. It’s cheaper to hire a nurse in the Maritimes than in Alberta, yet that is never taken into account. A greater percentage of the population in Atlantic Canada is older and lives in remote communities than in Ontario, but the cost of providing public services is much higher in Ontario because of the cost of living.
  • Our equalization system is good at calculating how much a province should receive relative to its “fiscal capacity” — its ability to raise revenues from income, sales and corporate taxes — but fails to take into account at all each province’s “expenditure needs.” No consideration is given to how much it actually costs to provide basic public services.
  • The Mowat Centre study uncovers — albeit in polite academic-speak — the main fraud in equalization: Most of the provinces that receive it don’t truly need it. “Most of the provinces that qualify for payments under the existing equalization system due to their low fiscal capacity, pay less than average for the goods and services they must buy (P.E.I., Nova Scotia, New Brunswick, Quebec, and Manitoba) … This lower need may offset, in whole or in part, the below average fiscal capacity that currently qualifies those same provinces for equalization.”
Irene Jansen

Health vow may leave Tories ill - 0 views

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

accord equalization

shared by Irene Jansen on 23 Jan 12 - No Cached
  • In the mid-election fog of March, Jim Flaherty appeared on CBC's The House and made a commitment he may yet live to regret.
  • "We need to negotiate with the provinces and say, 'How long an agreement do you want? A five-year agreement? A 10-year agreement? A two-year agreement?' ... We will keep it at 6% for whatever the duration of the agreement is," he said.
  • At first blush, it looks like the feds have given away the farm before they have even sat down with the provinces. But what Ottawa gives with one hand, it may take away with the other
  • ...6 more annotations...
  • The bulk of transfers from Ottawa are for health but Ottawa also sends the provinces $11.5billion for social policy (mainly education) and $14.6-billion in equalization payments. Social transfers have been rising at a rate of 3% a year, while equalization increases have been linked to GDP growth. Both of those deals are up for re-negotiation at the same time as the health accord and the feds have made no similar commitments to increase spending. The government could say it intends to put its emphasis on the growing seniors demographic and healthcare, rather than on the education, leaving the provinces little room to complain, since their transfers would be rising overall.
  • Josh Hjartarson, policy director at the Mowat Centre, said he would not be surprised if Ottawa is considering ways of clawing back some of the money it is set to send to the provinces for health care.
  • The Premiers are set to meet in January to come up with a common front to take into the meetings with the feds. Ottawa's advantage is that the provinces are easy to divide and conquer, particularly when it comes to equalization.
  • The McGuinty government has previously called on the federal government to transfer tax points - for example, Ottawa would hand over sales tax revenue and in return it would receive all corporate income tax revenues.
  • People familiar with the government position say redesignating tax powers are not on the government's radar screen right now.
  • "The entire suite of fiscal federalism is up for negotiation," said Mr. Hjartarson.
Irene Jansen

Queen's Park seeks fee cuts for certain surgeries - The Globe and Mail - 0 views

www.theglobeandmail.com/...article2233049

doctors fee for service ontario

shared by Irene Jansen on 23 Jan 12 - No Cached
  • The Ontario government is seeking fee reductions for several medical procedures in an effort to rein in spending on doctors, the fastest-growing expense in the province’s health-care system.
  • fees have not fallen in lockstep with improvements in technology that allow doctors to perform many procedures more quickly
  • A new report published by the Mowat Centre, a Toronto think tank, concludes that the fee system for Canada’s doctors is “fundamentally broken.”
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  • An economic adviser to Premier Dalton McGuinty says the government won’t meet its commitment to erase the province’s deficit by fiscal 2018 unless it caps annual spending growth at 1 per cent for the next six years. The deficit is projected to hit $16-billion in the current fiscal year.
  • the government wants doctors to accept a fee reduction for cataract surgery – which the province has already cut twice – as well as other unidentified procedures
Irene Jansen

Specialist fee cuts could save $5B, study says - 0 views

www.ottawacitizen.com/...story.html

wages doctors ontario spending

shared by Irene Jansen on 23 Jan 12 - No Cached
  • A cut in provincial fees paid to certain medical specialists would save deficit-plagued Ontario $5 billion over four years
  • The report by the Mowat Centre for Policy Innovation points to the potential savings as one reason the Ontario government should overhaul its payment system for the province's 26,000 doctors, who represent the fastest-growing expense of the $47.6 billion being spent on health care this year.
  • Report co-author Will Falk singled out the lucrative fees paid to cataract surgeons, radiologists, endoscopists and orthopedic surgeons, which have not fallen over the past decade.
  • ...4 more annotations...
  • even though improvements in technology have allowed these specialists to treat a greater number of patients more swiftly
  • According to the Canadian Institute for Health Information, total billings by Ontario doctors have risen by an average of nine per cent over the past five years
  • In medical specialties, such as cataract surgery and diagnostic imaging, where the volume of procedures has increased and new technologies have boosted productivity significantly, annual raises have amounted to as much as 12 per cent.
  • paid in the $650,000 to $700,000 range
Irene Jansen

Equalization system unfair to some provinces: study - 0 views

www.canada.com/...story.html

equalization cht

shared by Irene Jansen on 07 Feb 12 - No Cached
  • The equalization program is redistributing $15.4 billion in federal tax dollars this year to every province but British Columbia, Alberta, Saskatchewan and Newfoundland.
  • The formula is based on the Trudeau-era constitutional amendment requiring that Canadians get ``reasonably comparable levels of public services'' funded by ``reasonably comparable levels'' of provincial taxation.
  • But the report from Peter Gusen, former director of federal-provincial relations at the federal Department of Finance, said the current system is flawed because it considers only a province's ``fiscal capacity'' to raise revenues.That means factors that have a huge influence on funding services - like wage costs or the relative age of a population - aren't considered.
  • ...5 more annotations...
  • ``If equalization continues to ignore differences in expenditure need, it will not be treating provinces fairly and it will not be fulfilling its constitutional mandate,'' Gusen wrote.
  • Josh Hjartarson, policy director for the Mowat Centre for Policy Innovation, the think-tank that published Gusen's paper Monday, said the current program is particularly insensitive to health-care costs.
  • Quebec, with both a low fiscal capacity to raise revenue and low expenditures, is a ``notable'' example of a province that would be treated much differently under a fairer formula.
  • ``A fair equalization system, which reflected both the expenditure and revenue sides of the coin, would pay Quebec less.''
  • Quebec, rather than getting the $7.6 billion that year, would get $4.5 billion, based on Gusen's proposed formula. Ontario's share would rise to $4.5 billion from $3.7 billion.B.C., Alberta and Saskatchewan would continue to get no equalization transfers, though Newfoundland would receive $310 million rather than nothing.Hjartarson said under Gusen's plan, B.C. and Saskatchewan would be better placed to receive equalization funds than under the current arrangement if their economies turned sour.
Govind Rao

Our world has changed - our social programs haven't - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|tost|20150520|220838169

from heather federal election ally

shared by Govind Rao on 20 May 15 - No Cached
  • Toronto Star Wed May 20 2015
  • Unless you're rich enough to buy your way out of life's problems, you're at risk of falling through the holes in medicare, employment insurance, job training, elder care or social assistance. Perhaps you already have. Consider the following all-too-common scenarios:
  • For the past year, a team of researchers from the Caledon Institute, the Mowat Centre, the Institute for Competitiveness and Prosperity and the Institute for Research on Public Policy has been drafting a comprehensive plan to replace Canada's fraying, outdated safety nets with fresh, effective ones. The framework is now complete and three of the pillars - support for caregivers, access to affordable housing and employment skills training - are in place. The project was unveiled last week. Eight more components will be released by the end of June.
Govind Rao

What will the "sharing economy" mean for health care? - Healthy Debate - 0 views

healthydebate.ca/...sharing-economy-health-care

from heather home care staffing contracting out privatization

shared by Govind Rao on 29 Jun 15 - No Cached
  • by Will Falk (Show all posts by Will Falk) May 27, 2015
  • This is the “sharing economy”.
  • An under-appreciated feature of the return of sharing, however, is the impact on government— not only as regulator, but also as a deliverer of public services. Though a strict definition of the sharing economy does not translate perfectly into publicly provided programming, its key principles— creating trust through feedback, community collaboration, scheduling efficiency, asset optimization, and payment settlement— are well-suited to entrepreneurialism in public sector delivery models, including in healthcare.
  • ...10 more annotations...
  • One early indicator is the resurrection of the house call.
  • Now, there is a mass of mobile app developers swarming to revitalize this home-based care model. Pager, for example, is the brainchild of sharing economy pioneer and Uber co-founder Oscar Salazar. It markets itself as allowing users to see a doctor within two hours in the patient’s home, office, or hotel room. Companies like @mendathome, @HealApp, @medicast, and firstlineapp.com deliver similar services and are creating access and price competition.
  • In 2014, Uber delivered free nurse-administered flu shots to customers in Boston, New York, and Washington. Another company is seeking to enable hospitals to easily rent-out their bulky and unused medical equipment or, conversely, temporality access specialized equipment quickly and without the sizeable expense of purchasing.
  • allows for the home to become the site of much more care.
  • Sharing economy models of diagnostics are emerging both for clinicians and for their patients.  Figure1 is a Toronto mobile health start-up and peer to peer network that has created an “Instagram for doctors”, allowing medical professionals to seek input on complex cases by posting relevant images and information. And well established websites like CureTogether.com and PatientsLikeMe.com have fostered a peer coaching culture that lets patients share stories of treatment regimes and generate real-time research networks.
  • More recently, @Crowdmed has launched a crowd-sourced diagnostic service that uses “medical detectives” to better characterize rare and complex conditions.
  • How long will it take before hospitals start leveraging their idle operating room and facility hours to generate revenues and improve the timeliness and quality of procedures (AirOR)? We can already request a personal support worker or registered nurse through start-up services like eAdvocate and myPSW. We should expect established providers to emulate these start-ups, just as the traditional taxicab companies have started to emulate Uber. CCACs, for example, may use sharing economy-like services to match patient needs with clinicians and patient support workers.
  • As decentralization takes hold and more care moves from institutions and medical offices into the home, how will we deal with our overbuilt capacity? 
  • Can we trust clinical professionals to self-organize within their scopes of practice?
  • Will Falk is the Managing Partner – Health Industries at PwC Canada, an Executive Fellow at the Mowat Centre and an Adjunct Professor at the Rotman School of Management at the University of Toronto. Follow Will on Twitter @willfalk
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