Group items tagged

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.

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.

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.

the federal government ramped up its share of the nation’s total health care spending while private businesses reduced their share

Out-of-pocket spending by consumers rose in 2010 compared with 2009, as many workers paid higher premiums, deductibles and co-payments or lost their insurance coverage. But out-of-pocket spending still grew more slowly than the annual average between 2000 and 2008

Although the report outlines 10 categories of benefits that insurers must cover, such as costs of hospitalisation, preventive care, and ambulance transport, it does not prohibit insurers from shifting costs to patients through premiums, copayments, deductibles, and cost sharing.

would give patients the illusion that they have “real insurance.”

Although the report panel recommends establishing an independent “national health benefits council” to review scientific evidence regarding new technologies, the plan does not task the council with assessing current testing and treatment strategies that might be unnecessary or dangerous.

Dr Brody called the act a “sop to the insurance industry”

“They work hard and play by the rules,” President Obama said

“Today’s action will ensure that these men and women get paid fairly for a service that a growing number of older Americans couldn’t live without.”

These workers, according to industry figures, generally earn $8.50 to $12 an hour, compared with the federal minimum wage of $7.25 an hour. The White House said 92 percent of these workers were women, nearly 30 percent were African-American and 12 percent Hispanic. Nearly 40 percent rely on public benefits like Medicaid and food stamps.

many do not receive a time-and-a-half premium when they work more than 40 hours a week. Twenty-two states do not include home health care workers under their wage and hour laws.

PHI PolicyWorks, a nonprofit group that seeks to improve conditions for home care workers

six million of the 40 million Americans older than 65 now need some form of daily assistance to live outside a nursing home. That number, government officials say, is expected to double to 12 million by 2030

the proposed rules, which might be modified after a 60-day public comment period

some companions employed by individuals for activities like helping them take walks or engage in hobbies would still be exempt from minimum wage and overtime coverage

estimated that Medicare or Medicaid, which cover 75 percent of the nation’s home care costs, would pay $31.1 million to $169.5 million more each year toward home care aides, which she said would represent 0.06 percent to 0.29 percent of federal and state outlays for home care

In 1974, the Labor Department exempted “companionship” workers from coverage under the Fair Labor Standards Act, a move that focused on baby sitters at a time when the home care industry was in its infancy.

In 2007, the Supreme Court issued a decision involving a New York home care aide, Evelyn Coke, who often worked 70 hours a week, ruling that she was not entitled to overtime pay under existing regulations. The court said it was up to Congress or the Labor Department to change the rules.

nearly 90 percent of the nation’s home care aides work for agencies

The new law lists 10 categories of “essential health benefits” that must be provided by insurance offered in the individual and small-group markets, starting in January 2014. These include preventive care, emergency services, maternity care, hospital and doctors’ services, and prescription drugs.

The announcement by the administration follows its decision this year to jettison a program created in the law to provide long-term care insurance

This criticism has inspired legal challenges to the new law — with the Supreme Court set to decide next year whether the government can require Americans to buy health insurance — and helps explain why public opinion of the law remains deeply divided.

Under this approach, each state would designate an existing health insurance plan as a benchmark. The benefits provided by that plan would be deemed essential, and all insurers would have to provide benefits of the same or greater value.

Each state would choose one of the following health insurance plans as a benchmark: ¶ One of the three largest small-group plans in the state. ¶ One of the three largest health plans for state employees. ¶ One of the three largest national health insurance options for federal employees. ¶ The largest health maintenance organization operating in the state’s commercial insurance market.

the administration’s approach “builds off the experience of today’s marketplace and will minimize disruption to it.”

Several states have received temporary waivers from tough new federal standards that require insurers to spend more of each premium dollar for the benefit of consumers. Federal officials have also provided temporary exemptions from some provisions of the law for some employers and labor unions offering bare-bones coverage.

The law also says that the definition of essential benefits must not “discriminate against individuals because of their age, disability or expected length of life.” Sara Rosenbaum, a professor of health law and policy at George Washington University, said the new bulletin “does not offer any guidance on this crucial part of the law.”

Accountable care organizations will increase coordination of patient’s care and shift the focus of medicine away from treating sickness and toward keeping people healthy.

Sousa reckons that Ontario is coming out of the economic slump. Progress is slow and uneven. But the government estimates, with some justification, that matters are beginning to look up, that more people are being employed and that government tax receipts will therefore rise. The reasons are well-known. The oil price slump may be bad news for Alberta. But it's good news for the consumers and manufacturers of this province. More important, the U.S. economy is on the rebound - which helps Ontario exporters. And finally the dollar has slipped. That's tough for those buying, say, Florida oranges. But again it's good news for Ontario manufacturers, who now have a built-in price advantage in the U.S. market. Interestingly, Sousa's budget shows that the growth-driven gains in tax revenues will contribute far more to the elimination of the province's deficit than either spending cuts or asset sales. Which suggests two things: First, budgets do often balance themselves - when the business cycle picks up. Sousa calculates that Ontario will reap

$10 billion in new revenue over the next two years, more than enough to eliminate the current $8.5-billion deficit. Second, many of the other things the Wynne government has done to balance the books may not have been necessary. Which is the confusing part of this budget. Why is Wynne's government going out of its way to cause itself to political grief? Exhibit A: the proposal to sell to private investors 60 per cent of Hydro One, the publicly owned electricity transmission utility. After paying off Hydro One's debts, the province expects to net $4 billion from the sale. The government says it wants to use the proceeds to build transit infrastructure over the next 10 years. But by selling a chunk of the electricity monopoly, Queen's Park is also giving up close to $5 billion in guaranteed revenue over the next 10 years. It would be cheaper to hold onto

100 per cent of Hydro One and use the utility's profits to fund infrastructure. In a press conference Thursday, a jovial Sousa was asked about Hydro One. In effect, he answered that selling most the utility was a good deal for the government. He didn't really explain why. Other matters mentioned in, but not seriously addressed by, the budget include Wynne's decision to fight climate change through a so-called cap-and-trade system, her proposed Ontario Retirement Pension Plan and the Liberal promise to cut auto insurance premiums by 15 per cent. On cap-and-trade, the budget confirmed that crucial details have not yet been decided. On pensions, it revealed that the government has talked to a lot of people and heard a lot of different things. Auto insurance? Two years ago, the insurers grudgingly agreed to cut rates, but only if they were allowed to provide accident victims with fewer benefits. The government was fine with this. According to the budget, it still is.

August 21, 2015

But Japan took a few key initiatives in 2000 that are widely admired among long-term care policy experts.

A 1994 survey said one in two family caregivers in Japan had abusively treated their frail older relatives; one in three reported feelings of “hatred.” Elders were shunted into hospitals (called “social hospitalization”) since Japan offered free hospital care to frail elderly — an expensive government policy.

Public pressure propelled reform and Japan came up with a public, mandatory long-term care insurance system in 2000.

The universal elder program is funded half by general tax revenues and half by a combination of payroll taxes and additional insurance premiums paid by everyone 40+.

The clothes retailer Uniqlo has begun experimenting with a four-day, 10-hours-per-day workweek in Japan, for instance.

“Every major developed country in the world has adopted some measure of long-term care social insurance,” says Howard Gleckman, senior fellow at the Urban Institute in Washington, D.C. “Except the U.S., and maybe Britain.” (Britain has passed, but not implemented, a public universal catastrophic long-term care policy.)

Beneath the political radar, experts at places like the Urban Institute, the Bipartisan Policy Center and the Long-Term Care Financing Collaborative have been working on some ideas. They’re drawn from the ranks of health care providers, the insurance industry, the government and elder care organizations. And they’re well aware of what has worked in Japan and other countries.

It is hard to estimate the economic cost - lost productivity, costly treatments if illnesses are allowed to get worse, or even premature death - of such a high level of non-compliance. But studies show the highest compliance rates are for drugs for erectile dysfunction, contraception, and pain relief that have nothing do with saving lives. But if these drag down the average non-compliance rate, then prescriptions for other ailments, including serious ones, must be dragging it back up. A third reason to consider universal Pharmacare is a more easier-to-measure economic loss. Green leader Elizabeth May's plan sounded too good to be true as she outlined it - annual cost of $300 million a year for the feds to set up a national Pharmacare agency in return for savings to the health-care system of up to $11 billion a year.

But these estimated savings aren't something dreamed up in the party's backrooms - they are drawn from a recent scholarly analysis by UBC health economist Steven Morgan, a leading researcher in the field. The issue, Morgan told me in an interview, is that the whole system is fundamentally flawed and inefficient. Despite recent agreements by the provinces to co-operate on drug purchases - an approach Morgan thinks is worthwhile, but not nearly enough - neither the governments nor the dozens of private insurers have enough clout with drug companies to negotiate best prices. Not to mention the millions of uninsured who have no negotiating power at all.

As well, governments spend $3 billion a year on employees' health insurance premiums, Morgan said, and businesses pay several times that - money that would be saved if we had universal Pharmacare. May didn't pitch her plan simply as something a Green government would implement if her party is elected - a long-shot by any measure. Rather, she called on other parties to work together on this. This isn't likely to happen in the toxic partisan environment of federal politics, especially during an election. But given the Angus Reid poll's finding that 39 per cent of Canadians strongly support and 48 per cent moderately support adding prescription drugs to the universal medicare program (B.C.'s numbers are 44 per cent and 47 per cent), it's an issue other parties ignore at their peril.

The Supreme Court’s recent blessing of Obamacare has precipitated a rush among the nation’s biggest health insurers to consolidate into two or three behemoths. The result will be good for their shareholders and executives, but bad for the rest of us—who will pay through the nose for the health insurance we need. We have another choice, but before I get to it let me give you some background.

Executives say these combinations will make their companies more efficient, allowing them to gain economies of scale and squeeze waste out of the system. This is what big companies always say when they acquire rivals.

Their real purpose is to give the giant health insurers more bargaining leverage over employees, consumers, state regulators and health care providers (which have also been consolidating).

That’s not what they’re telling federal and state regulators, of course. They say rate increases are necessary because people enrolling in Obamacare are sicker than they expected, and they’re losing money.

Which is why, ultimately, Americans will have to make a choice. If we continue in the direction we’re headed, we’ll soon have a health insurance system dominated by two or three mammoth for-profit corporations capable of squeezing employees and consumers for all they’re worth—and handing over the profits to their shareholders and executives. The alternative is a government-run single payer system—such as is in place in almost every other advanced economy—dedicated to lower premiums and better care. Which do you prefer?

Yet a glance at the actual data shows that the unemployment rate has been steady at 6.8 per cent for several months - an enviably low rate that most countries around the world would kill for. Another bogus Unifor claim is that the federal government has cut health care transfers to the provinces by $36 billion. In fact, the feds have merely reduced the rate of growth of health care transfers from an unsustainable 6 per cent per year to a more realistic 3 per cent per year, still well in excess of inflation. Facts show that the federal government will transfer $34 billion to the provinces this year for health care, which represents 23 per cent of provincial health budgets, up from 15 per cent in the late 1990s. Over the past decade federal health transfers have increased 70 per cent - hardly a pittance. These fabrications are only two of the many whoppers in the Unifor ads.

In addition to reiterating the false claims of Unifor concerning health care spending and other issues, the unionbacked group Engage Canada, which interestingly is an alliance of Liberal and New Democratic Party interests, has made other inaccurate claims in its advertising. For instance, they say tax measures introduced by the federal government will merely benefit the rich. To choose one of these tax measures, the enhanced contribution limits for Tax Free Savings Accounts (TFSAs), the facts show quite the contrary. Currently about half of Canadians have TFSAs, and 60 per cent of those who have maxed out their TFSAs earn less than $60,000 annually - hardly the rich. Also, TFSAs are a great tool for older Canadians for whom RRSPs are no longer useful.

Another falsehood promoted by the left is that Canada has a pension crisis with a majority of Canadians not saving enough for their retirement. As noted by knowledgeable professionals such as tax expert Jack Mintz of the University of Calgary and Morneau and Shepell actuary Fred Vettese , no such crisis exists.

Facts indicate that most Canadians are well prepared for retirement and do not need another forced savings plan such as higher CPP premiums or the very flawed Ontario Retirement Pension Plan promoted by the Ontario government. The motivation behind the unions' and other left groups' advocacy for more forced savings is that it will mean more taxpayer funds in government hands to spend on even higher pay and benefits for government workers and more funds for pet government programs.

All political parties are campaigning for the middle class vote in this election, as is always the case since that is where most votes are. Recent results from a study conducted by the New York Times, as well as information from other sources, show that the Canadian middle class is currently the most prosperous in the world. In the last couple of months, an annual analysis from the international Reputation Institute concluded that in 2015 Canada is the most respected nation in the world, with the best reputation. Not too shabb

So why all of the fabrication and dishonesty from our brethren on the left? One reason is that the left always thrives on misery and, despite facts to the contrary, must constantly tell people they are doing badly, should be doing better, are ill-treated, etc. This is true no matter which political party is in government. Look no further than our very wellpaid and entitled teachers in the public school system, who constantly whine about how "disrespected" and poorly treated they are while earning very generous salaries, having lots of time off, retiring early and having one of the best pension plans around.

Another key reason is that the money behind all of these leftist groups is largely coming from unions, and most Canadian union members these days are government workers. It is hardly surprising that the ads of the Public Service Alliance of Canada are claiming that services are suffering because of cuts in the number of federal workers. Yet once again, a quick look at the facts show that there are still more federal government workers today than there were in 2006 when the current government was initially elected. It is completely understandable that government unions want more government employees and therefore more union dues in their coffers, but the 80 per cent of Canadians who do not work for government should realize that they are hurt when government unions prevail.

Interestingly enough, whenever I get into a debate with union folks about all of the horrendous things the current federal government has supposedly inflicted on the Canadian people, I always ask them one question, which is "Where in the world would you rather live?" Tellingly, I have not ever gotten an answer to that question. And perhaps that is answer enough.

Catherine Swift is Spokesperson for Working Canadians. www.workingcanadians. ca, @WorkingCdns

The federal government is providing funding, but they're restricting it to P3 builds." With P3s, the private-sector partner assumes the lion's share of risk in terms of financing and construction. Giroux compares the P3 model to buying a house on your credit card instead of going to the bank for a lower interest rate. He said the North Bay Regional Health Centre is a prime example.

In July, Michael Hurley, president of the Ontario Council of Hospital Unions, suggested North Bay has been hard hit by hospital cuts partly because of the province's $1-billion deal with the private sector to build, finance and maintain the North Bay Regional Health Centre. As a P3 facility, Hurley said, the North Bay hospital shoulders higher operating costs than those owned outright by the province. The hospital cuts in North Bay have probably been among the deepest in the province," he said.

Giroux raised concern about Canadore's proposal in January after the college issued a request for expressions of interest seeking a private-sector company to build, finance and operate a multi-purpose sports facility at its Commerce Court Campus. A wise person studies history to avoid repeating costly mistakes," Giroux said at that time, pointing to a report by Auditor- General Bonnie Lysyk.

Lysyk's report found that public- private partnerships have cost Ontario taxpayers nearly $8 billion more on infrastructure over the past nine years than if the government had successfully built the projects itself. The report indicated companies pay about 14 times what the government does for financing, and that they receive a premium from taxpayers in exchange for taking on the projects. Giroux suggested North Bay was learning about the costs of P3sfirsthand via cuts at the North Bay Regional Health Centre. He said the hospital was closing beds and slashing services, in no small part because of long-term P3 agreements for mortgage payments and maintenance fees."

Dr. Brendon Carr (president and CEO of Island Health) when asked at the Island Health Board meeting here in June stated that there will be a premium in cost for the surgeries at the private clinic. We know private, for profit, health care is more expensive. He said they have the information and would provide it, but when I wrote and asked what the difference in cost for the taxpayers between surgeries in public or private, for profit, operating rooms, Mr. Peters declined to answer the question.

It is extremely concerning that our provincial government is contracting up to 55,000 surgeries to a private surgery clinic Re: Deal with private contractor could reduce surgery wait times - J.R. Rardon. The above noted article was in the Aug. 26, Campbell River Mirror. Reading the headline I have to ask "but at what cost?"

I pointed out to Dr. Carr that we have a shortage of doctors in Canada and he agreed. He said it would be the same doctors doing the surgeries in the private, for profit, surgery clinics. I asked how they can usurp our doctors into the private system without straining our public system more. He just said they will be watching it. That doesn't bode well for our public operating rooms. I fear that our provincial government is seriously undermining our position in defending the Dr. Brian Day court case on behalf of all British Columbians. At the very least it looks like a huge conflict of interest when they are seeking to contract an enormous number of surgeries to private clinics.

Our provincial and federal governments seem determined to starve the public health care system in favour of private, for profit, health care. They have let the surgery wait lists increase substantially. Our federal government refused to renegotiate the Canada Health Accord and brought in a new funding formula. They are telling us they are "increasing"  funding of the transfer payments to the provinces by three per cent, tied to the cost of living. Currently they are paying six per cent annually so this actually is a massive cut to the provinces for public health care in the amount of $36 billion over the next 10 years. With the federal government's cuts to health care funding, the share of federal CHT cash payments in provincial-territorial health spending will decrease substantially from 20.4 per cent in 2010-11 to less than 12 per cent over the next 25 years. This, according to the Parliamentary Budget Office, will bring the level of federal cash support for health care to historical lows. National Medicare was implemented across Canada by provinces and territories on the understanding that the federal government would contribute roughly 50 percent of the spending on Medicare.

Canadians are vehemently opposed to private health care whether it is using our public tax dollars or not. Canadians should not have to suffer and wait a long time for surgery. Funds would be far better invested in the public health care system which is being starved by our governments. It is very difficult for Canadians to see our medicare in serious jeopardy. The Canadian Medical Assoc., Canadian Doctors for Medicare, Canadian Health Coalition, Council of Canadians, B.C. Health Coalition, HEU, CUPE, Citizens for Quality Health Care and many others are united to protect, strengthen and expand our public health care. Please check out their websites and get more information. Please vote in the next two elections and vote for health care for the benefit of all Canadians. Lois Jarvis Citizens for Quality Health Care Campbell River

The health care system was in crisis. It took nearly 15 years of incremental increases to bring the federal portion of health funding back to the level is was at before Paul Martin took his axe to it. Going through an exercise like that again would be devastating for the health services that Canadians depend on each and every day.

Adding fuel to the speculation that the Liberals are planning massive cuts to health funding is Trudeau’s September 2nd letter to the Council of the Federation that makes no firm commitments to health care or federal transfers. The only firm commitment was to improve the federal-provincial relationship. That’s pretty thin gruel considering the state of that relationship after 10 years of Stephen Harper!

All Canadians who are concerned with the future of health care in this country need to scratch below Trudeau’s soothing words and take a look at his hard numbers. When you break down their plan, 77 per cent of the value of their “new investments” are tax shifts and benefits (including others not listed under that category), 12 per cent is the catch-all of ‘infrastructure’ spending (though most Canadians don’t think of early learning and cultural facilities as ‘infrastructure’), and five per cent is EI (paid for through EI premiums).

That leaves only six per cent, or a little over two billion a year for everything else. How much of that available funding will go to public home care and long-term care? How much will go to the provinces for new hospital beds after years of cuts? On reading the Liberal plan, we have to conclude: not a penny.

Their plan also targets $6.5 billion in spending reductions from an expenditure review. Will health care be on the table for cuts, if they can’t meet that ambitious target? John McCallum said on Saturday that in the effort to balance their books before the next election, ‘everything was on the table.’ Contrast this with Tom Mulcair’s plan for health care under a federal NDP government, and the stark choice is brought in to focus. 

Mulcair has committed to reversing Harper’s $36 billion in health care transfer cuts to the provinces.  He has committed to investing $5.4 billion into new public health care programs, including a prescription drugs, a plan for 41,000 home care and 5,000 long-term care spots. Over five million more Canadians will have access to primary health care through his plan to build 200 Community Health Clinics. And there are practical policy initiatives on mental health for youth, Alzheimer’s and dementia care.

Canadians cherish their universal Medicare system as one of the things that makes Canada great. They want a federal government that will commit the necessary funding and leadership to build the public health care system of our collective futures, to meet the challenges of an aging population and increasing drug costs. The next party to lead the federal government should be judged by the real dollars and focused policy it has committed to meet Canadians’ health care needs.

On that measure, the Liberal plan is dead on arrival. Paul Moist is national president of the Canadian Union of Public Employees. Representing over 633,000 members, including over 153,000 working in the health care sector, it is Canada’s largest union.