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Govind Rao

Leave the patchwork for the quilts: The case for national pharmacare | Canadian Centre ... - 1 views

www.policyalternatives.ca/...uilts-case-national-pharmacare

from heather coalition pharmacare

shared by Govind Rao on 03 Feb 15 - No Cached
  • Author(s):  Adrienne Silnicki Joel Lexchin Julie White Keith Newman
  • February 2, 2015 The Canadian Health Coalition (CHC) was founded in 1979 as a public advocacy organization dedicated to the preservation and improvement of medicare. It brings together organizations representing nurses, health care workers, seniors, churches, trade unions, anti-poverty groups and women, as well as affiliated coalitions in nine provinces and two territories. The CHC has supported a universal public pharmacare plan since its inception, because prescription drugs are an essential part of health care and should be provided, like doctors and hospitals, to all Canadians as part of our public health care system.
  • The problems Currently, prescription drugs are provided in a partial and unfair manner, to the detriment of our health and at enormous cost. With prescription drugs left out of our national medicare plan, we have a patchwork of provincial and territorial plans that cover less than half the population. Sometimes these plans cover only seniors, those on social assistance, and certain illnesses. In a few cases, people pay for drugs based on an income assessment. More than half the population is outside any public arrangement and must rely on private insurance, usually through a wide variety of workplace plans. Commonly workers contribute to the cost of these private plans, by paying towards the insurance premiums and by paying co-pays at the pharmacy counter. Since these plans are attached to the workplace, they are unreliable; if you change jobs, get laid off or retire, your drug plan usually disappears. The federal government pays a mere 2% of total drug costs, covering only specific groups such as the military, veterans and First Nations.
Govind Rao

Advocate: Poorest seniors not getting help - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|vitc|20150305|215752232

from heather bc user fees seniors poverty

shared by Govind Rao on 05 Mar 15 - No Cached
  • Times Colonist (Victoria) Thu Mar 5 2015
  • B.C.'s seniors advocate says the first survey conducted by her office has revealed that many of the people who are in most need of help don't know how to get it. Isobel Mackenzie said the next step is to find out how to get the message to seniors and to make it easier to apply for subsidies, some of which must be renewed each year. The survey conducted in the fall of 2014 involved interviewing 506 seniors throughout B.C. by telephone. Here are some of its key findings.
  • Medicare premiums "Something that really jumped out was MSP [Medical Services Plan] premium assistance," Mackenzie said. "It's a sliding scale, so you get full premium assistance at $22,000 or less. "And absolutely everybody with a household income of $30,000 or less would benefit in some way." It adds up to a savings of $864 per year for the lowest income group. Sixty per cent of respondents living on less than $30,000 a year said they didn't know they could get help with MSP premiums. Rent and property taxes
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  • About 17,500 people - one in five seniors - use the Shelter Aid for Elderly Renters which can provide $180 per month to people with incomes below $22,000. The money is available only to those who rent their homes, which is an estimated 20 per cent of B.C. seniors, according to Mackenzie's office. Seniors in Metro Vancouver were more likely to know about the grant, but it's used most within the boundaries of the Interior Health Authority, where half of the seniors surveyed received it. Those who are homeowners can defer property taxes until their home is sold (or until death) via the province's Property Tax Deferment Program. Yet only 40 per cent of senior homeowners with household incomes below $30,000 were aware of the program, compared with 75 per cent of homeowners with incomes greater than $60,000.
  • Seniors make up 17 per cent of the population, a figure that's expected to double during the next two decades. The B.C. Seniors survey, conducted in conjunction with the B.C. Vital Statistics Office and HealthLink B.C., says its margin of error is plus or minus 4.38 per cent. Susan Moore, director of an information and referral centre run by the West End Senior's Network in Vancouver, said she sees people scrimp on food and medications because they have never asked the government for anything and they don't know there is help available. The full report is available at seniorsadvocatebc.ca.
Govind Rao

Mulcair unveils NDP's urban agenda; Infrastructure spending in cities generates wealth,... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|tost|20150316|216493804

from heather ndp p3

shared by Govind Rao on 16 Mar 15 - No Cached
  • Toronto Star Mon Mar 16 2015
  • Despite pleas of poverty, Mulcair argues government should learn to make better use of public/private partnerships (P3s). Results in Canada have been mixed. Some (Bridgepoint Health in Toronto and Vancouver's Canada Line) have worked brilliantly; others (Brampton Civic Hospital) have not. "I'm not dogmatic," he says about P3s. "The point is to get things built."
Govind Rao

Feds' austerity focus damaging economy, Alternative Federal Budget has better options |... - 0 views

cupe.ca/eral-budget-has-better-options

from heather afb

shared by Govind Rao on 20 Mar 15 - No Cached
  • The federal government’s continued obsession with austerity and balancing the budget comes at the cost of higher household debt, fewer services, and weakened job growth. Canadians have better options that could lift many out of poverty and reduce inequality. That’s the message in the 2015 Alternative Federal Budget (AFB), released today by the Canadian Centre for Policy Alternatives (CCPA).
  • Govind Rao on 20 Mar 15
     
    March 19 2015
Govind Rao

The Health Profile Of Every County In America, Mapped | Co.Exist | ideas + impact - 0 views

www.fastcoexist.com/...every-county-in-america-mapped

from heather US equity children poverty

shared by Govind Rao on 25 Mar 15 - No Cached
  • This snapshot shines a light on how where we live matters when it comes to our well-being.
  • The idea of the County Health Rankings is to shine a light on the local, and show how where we live matters.
  • About 60% of counties are getting healthier, measured by their rates of premature death (i.e. how many years people die before life expectancy). For example, the District of Columbia saw a 31% improvement in 2010-12 compared to 2004-6. But 40% of counties are going backwards, as you can see from one of the charts. Many of the counties with higher premature deaths seem to be in the third quarter of the country, running south from the Great Plains.
Govind Rao

Ambulance fees unfair, dangerous obstacle to care - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|tost|20150327|217276859

from heather ems user fees Ontario ally

shared by Govind Rao on 27 Mar 15 - No Cached
  • 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.
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  • 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.
Govind Rao

Nunavut suicide inquest: the tragedy of an 11-year-old's death - 0 views

www.cmaj.ca/...1118

from heather aboriginal mental health inquiry

shared by Govind Rao on 22 Oct 15 - No Cached
  • CMAJ October 20, 2015 vol. 187 no. 15 First published September 21, 2015, doi: 10.1503/cmaj.109-5161
  • Laura Eggertson
  • At the age of 11, Rex Uttak had already experienced an unbearable amount of trauma and loss when he took his life in the remote Arctic Circle community of Naujaat (formerly Repulse Bay), Nunavut, in August 2013. Eight and a half months earlier, Rex’s older sister, Tracy Uttak, was murdered in Igloolik, Nun. Rex had already lost his older brother, Bernie, to suicide. For Rex, suicide was a solution to pain that had been modelled all too well in his family and his community.
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  • It was also a trauma his family would face again, a coroner’s inquest into the 45 suicides in Nunavut in 2013 was told when the inquest began Sept. 14. Three months after Rex’s death, yet another brother — 15-year-old Peter — killed himself. Rex was living with as many as 23 family members in his grandmother’s four-bedroom house in Naujaat, a community of about 1000 people. The family shared eight beds and one bathroom while they waited for subsidized housing.
  • The evening before he died, Rex played with his cousins and stayed overnight at their home. His aunt and uncle found him and tried to revive him. His family reported not knowing the immediate triggers for Rex’s decision to hang himself. “I don’t know what was wrong with him,” Martha Uttak, Rex’s mother, testified. “He was my baby and he hugged me all the time.”
  • Five years ago, four partner organizations came together and released a suicide prevention strategy that was visionary and evidence-based in its design. The Government of Nunavut, the Embrace Life Council, the Royal Canadian Mounted Police and Nunavut Tunngavik Inc.’s goal was to reduce the territory’s suicide rate to one commensurate with, or lower than, the rest of the country.
  • Nunavut coroner Padma Suramala, a registered nurse who presides over death investigations in Canada’s newest territory, called the inquest to examine the rate of suicide that has seemingly left no one here untouched. “Nunavummiut are soaked in unresolved grief,” testified Jack Hicks, an expert witness at the inquiry and Nunavut’s former suicide prevention advisor. Hicks helped with a landmark follow-back study interviewing the families and friends of 120 people who committed suicide in Nunavut from 2003–2006 and 120 control subjects.
  • The widespread unresolved grief surfaced again when testimony from Shuvinai Mike, a senior government official who was called to talk about her department’s involvement in cultural activities, devolved into a description of the impact of her own daughter’s suicide. When someone kills oneself, the news spreads rapidly, often via social media, throughout this vast territory of only 36 000 people. Parents live with the constant fear that one of their children will be next
  • The inquest, which ran Sept. 14 to 25 and included testimony from about 30 witnesses, touched on many underlying issues: poverty, high rates of child sexual and physical abuse, housing shortages, unemployment, educational deficiencies, food insecurity and historical trauma that are the reality for too many Inuit families. It is also exposed the deep divisions among the territorial government and organizations coping with the population-wide damage that suicide inflicts.
  • But as the inquest heard, Rex was living with many of the risk factors for suicide that researchers have identified, including repeated exposure to the suicide of others. From 1999 until 2014, Nunavummiut took their lives at a rate of 111.4/100 000 population — nearly 10 times the rate of other Canadians, which stands at 11.4/100 000 according to the most recent Statistics Canada data (2000–2011).
  • A year later, in 2011, the territory released and began to implement an action plan with specific goals, assigned responsibilities and time frames in eight different areas. Those areas, including early childhood education and school curriculum programs, gatekeeper prevention training, and mental health and addiction supports, are intended to address the root causes or risk factors that trigger suicide. The need for a strategy is undeniable. Between 1999 and 2014, 436 Inuit completed suicide. Like Rex, 22 of them were children between the ages of 10 and 14.
  • Before the implementation plan was tabled in the legislature, however, the territorial government stripped out the column stipulating the financial resources required to implement each item, Hicks testified at the inquiry. None of the other partners was consulted. Not only did the Government of Nunavut never allocate a specific pocket of resources, it never asked the federal government for money to tackle this critical public health issue. As a result, “we’ve had to cobble together funding from various sources,” Natan Obed, Nunavut Tunngavik’s director of social and cultural development, testified.
  • Nunavut has made progress on implementing pieces of the strategy, according to an independent evaluation. The government’s lack of capacity, poor communication with the other partners and inadequate resources have retarded success, the evaluation states. Nunavut has not yet achieved its overall vision for decreasing suicide rates, denormalizing suicide and keeping children — like Rex — safe.
Govind Rao

CIHR spurns Aboriginal researchers' call for reconciliation - 0 views

www.cmaj.ca/E75

from heather aboriginal research

shared by Govind Rao on 15 Mar 16 - No Cached
  • CMAJ March 15, 2016 vol. 188 no. 5 First published February 8, 2016, doi: 10.1503/cmaj.109-5232
  • Laura Eggertson
  • Aboriginal health projects received less than 1% of the funding awarded by the Canadian Institutes of Health Research (CIHR) in its first major competition since restructuring — an outcome Aboriginal researchers say illustrates the need to reconcile the new system with the vast inequities in Indigenous health.
  • ...21 more annotations...
  • CIHR’s decision-making style, which resulted in it going ahead with changes to funding despite objections from Indigenous and non-Indigenous researchers, “is not consistent with the recommendations of the Truth and Reconciliation Commission,” says Rod McCormick, a Mohawk researcher and co-chair of the Aboriginal Health Research Steering Committee.
  • There is no recognition or provision for the fact that systemic policies, when applied across the board, can have damaging impacts for groups that are different,” McCormick told an emotionally charged meeting at the Wabano Centre for Aboriginal Health in Ottawa on Jan. 25.
  • In 2014/15, funding for Aboriginal health research was $31 million, down from $34 million at its annual peak 2004–2008, the Aboriginal Health Research Steering Committee reported.
  • McCormick and co-chair Frederic Wien, the principal investigator for the Atlantic Aboriginal Health Research Program, urged CIHR to revisit its changes and rebuild what Wien called “a respectful relationship with First Nations, Métis and Inuit people.” Given the crisis in the health and well-being of many of these communities, the researchers want CIHR to prioritize Aboriginal health research.
  • We have gone through major changes at CIHR. I do not deny that,” Beaudet said. “But I would deny ... that these changes are affecting particularly the Aboriginal community.”
  • Marlene Brant Castellano, co-director of research for the Royal Commission on Aboriginal Peoples, believes CIHR is out of step with the Truth and Reconciliation Commission’s recommendations.
  • Beaudet made the remarks just three days after the shootings at La Loche, Saskatchewan. The murder of two teenagers, a teacher and a teacher’s aide in the largely Dene community underscored for some attendees the crises in suicide, lack of mental health support and poverty that affect many Aboriginal youth and families.
  • Beaudet said Aboriginal health research is “extremely important” for CIHR, and its strategic investments will reflect that. CIHR has been working with the Aboriginal Health Research Steering Committee for 14 months and, according to the institute’s media specialist David Coulombe, is committed to “co-building research initiatives” that “will improve the health of Canada’s First Nations, Inuit and Métis peoples.”
  • While Beaudet acknowledged both the magnitude of the recent changes and the fact that the Aboriginal health research budget has “flatlined,” he said it has done so parallel to CIHR’s overall budget. CIHR’s billion-dollar annual federal budget has not increased since 2009, meaning that its spending power has declined by roughly 25% since then.
  • CIHR’s president denied any need for the federal agency to engage in reconciliation. “I would like to bring my personal views, not only those of CIHR, about the stormy weather we have been experiencing lately,” Dr. Alain Beaudet told attendees at the January meeting. “But not in the spirit of reconciliation, because I don’t think anything has been broken.”
  • The Aboriginal Health Research Steering Committee contends that CIHR disadvantages researchers working in Aboriginal health through recent changes such as scrapping an Aboriginal-specific peer review process, requiring matching funds for several granting programs, and reallocating almost half the open competition funding for stellar emerging and establishing scholars.
  • But Beaudet said the changes promote more “out-of-the-box” research that will enable Canada to achieve more international success. He also suggested that those critical of the new system are afraid of change, and advised researchers that “looking back doesn’t work.” Learning from the past is a critical Indigenous value. CIHR is starting to analyze the
  • results of its initial investments, but it will take seven years for the new system to take full effect and before “meaningful” figures result, Beaudet said. “We’ll work as quickly as we can, but we need the data. I’m saying ‘Yes, trust us,’ because if you look at CIHR’s record, we’ve done a lot, and we’ve done it in good faith.”
  • Most of the researchers and representatives of Aboriginal political organizations at the meeting did not seem inclined to trust Beaudet’s reassurances.
  • You’re really saying to this group, ‘Trust us.’ And I just want to remind you that there’s very little basis for trust,” said Scott Serson, a former deputy minister of Indian Affairs and Northern Development, now with Canadians for a New Partnership, a group working for a new relationship between Indigenous and other Canadians.
  • The Aboriginal Health Research Steering Committee asked CIHR to set aside half a day at the June meeting of its governing council to address these issues. In an online statement, Beaudet acknowledged the request for an in-depth discussion at “a future meeting” of the governing council. He also urged Indigenous health researchers and community members to apply as members of the new Institutes Advisory Board on Indigenous People’s Health and a new College of Reviewers.
  • Marlene Brant Castellano, co-director of research for the Royal Commission on Aboriginal Peoples and the Mohawk elder who closed the meeting, described Beaudet and CIHR’s response to the committee’s requests as “disconnected” from the prevailing political environment.
  • Castellano, who is revered as the first Aboriginal full professor at a Canadian university, brought many in the audience to tears. Instead of recognizing the need for a new relationship between Canada and its Indigenous peoples, Beaudet’s remarks echoed a too-familiar demand that Aboriginal researchers “get with” CIHR’s program because, eventually, they would discover it was good for them, Castellano said.
  • “We have 400 years as Indigenous people trying to make things work in other people’s agendas, and that is where we’ve gotten to the place now, where we still are, of watching our children dying,” she said, tears streaming down her cheeks.
  • Beaudet had already left the meeting before Castellano went to the podium, and the two CIHR vice-presidents who had stayed for most of the discussion left as she began to speak, citing prior commitments. Only Malcolm King, scientific director of CIHR’s Institute of Aboriginal Peoples’ Health and a member of the Mississaugas of the New Credit First Nation, remained for the duration of the meeting.
  • According to Coulombe, Beaudet had a phone conversation with Castellano on Jan. 29, and “agreed to continue working collaboratively with community representatives and leaders in the future.”
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