Last week, Health Minister Kelvin Goertzen suggested he was "willing to look" at copying a Saskatchewan initiative that allows people to pay for MRI tests at private clinics to relieve pressure on the public system. In exchange for being able to charge directly for a scan, private MRI clinics have to provide one free scan to someone on the public waiting list.

In question period Friday, the NDP lashed out at Goertzen for his interest in a program the federal government has deemed illegal under the Canada Health Act. Two-tier health care remains a flashpoint between the right and left wings of the Canadian political spectrum, as was witnessed in the Manitoba legislature last week.

NDP critic Matt Wiebe put it bluntly. "This is the first step in (the Tory government’s) plan to create a two-tier health system, where the size of your wallet determines your care."

Family doctors in Saskatchewan are starting to ask their patients if they’ve ever had difficulty making ends meet at the end of the month.  The question is the first step in a poverty screening tool — a new resource launched by the College of Family Physicians of Canada, eight of its provincial chapters, and the territories, in collaboration with the Centre for Effective Practice.

Mahood noted it’s important to know a patient’s financial state to individualize appropriate care. “If I don’t know that a patient can’t afford their medications and I prescribe an expensive medication and they never fill it and never take it, then I’ve wasted their time, my time and the system’s time,” she said. Most people would be shocked to know the poor are at much greater risk for many diseases, she said.

“Good, healthy food is very expensive,” Mahood said. “It’s a very complex idea that poverty is the main risk factor for disease, but we know it is. It’s partly diet, but it’s also control over your life … If you’re deciding where you’re going to sleep tonight or if your kids don’t have enough food in their stomachs, you’re not so worried if it’s a healthy meal you’re putting in front of them.”

The Regina Qu’Appelle Health Region (RQHR) is missing surgical, emergency room and financial targets, according to its second quarter report released Wednesday evening at the Regina Qu’Appelle Regional Health Authority’s board meeting.

The emergency department length of stay continues to be on an upward trend with the average patient staying for 13 hours instead of the 2016-17 target of 7.75 hours

The region’s population has grown by 47,000 people over the past decade and the population is aging — both contributing to longer ER waits, said Keith Dewar, CEO of the RQHR. “The growth in demand has resulted in significant volume pressures that have not been directly funded,” he said. “About a third of that growth and demand — both by population increase and by demographic changes — is funded.”

The Westbank First Nation is going in a new direction after its longtime chief, who backed an effort to build Canada's first private for-profit hospital, was defeated in a hotly contested election. Roxanne Lindley beat incumbent Robert Louie by 34 votes in Wednesday night's election. The hospital project was one of the campaign's big issues

Under Louie's leadership, the WFN pursued a proposal to build a $120-million, 100 bed, for-profit health care facility on its reserve. Construction was supposed to begin by late 2012. The band spent over $8 million on the project, but it never materialized. That led opponents to say Louie wasted the band's money.

Manitoba Health Minister Kelvin Goertzen is considering allowing Manitoba to become the sixth province in Canada to let people buy MRI scans — and other diagnostic tests like CT scans — directly from private clinics.

Goertzen visited Saskatchewan last week on a fact finding mission to get a closer look at some of the health care reforms they've made in recent years. And one of the things that piqued the rookie health minister's interest was the move by the Saskatchewan government to allow private clinics to sell MRI scans to patients, while still providing services to the public sector.

"If there's evidence that's provided that says that that can work in Manitoba, I would be doing Manitobans a disservice not to look at it," said Goertzen. Critics opposed to private clinics say it's unfair for anyone to get quicker service for a medically necessary test just because they have the ability to pay. That's ideology. That's not evidence-based decision making.

A B.C. woman with spinal muscular atrophy is joining the British Columbia Civil Liberties Association to challenge the federal government's new assisted dying legislation.

The Liberal government's controversial assisted dying legislation was approved on June 17, after passing a vote in the Senate earlier that day. It was spurred by a 2015 Supreme Court of Canada ruling that stuck down the ban on physician-assisted dying on the grounds that it violated Canadians' Charter rights. But the legislation was criticized in part because it was limited to those facing a "reasonably foreseeable" death. Critics says that excludes those suffering from a non-terminal illness, including Kay Carter, who launched the original court challenge with the BCCLA before her death.

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Mr Peterson* has had advanced Parkinson’s Disease for several years and his wife has finally been pushed to her limits caring for him at home. Mrs Dhaliwal* has suffered from Alzheimer’s Dementia for years, and she is now struggling with major behavioural challenges, worsened by a urinary infection that has further clouded her thinking and ability to communicate. The consultant shakes her head and says, “That’s two beds that we won’t be able to clear for at least a few weeks”. A non-medical onlooker would probably find our exchange disturbing — we seem more focused on the beds these patients are occupying rather than on how we might help them. But to me, the situation is so familiar that for a brief moment I forget that I’m not in my usual digs in Canada but in the United Kingdom. Indeed, this defeatist attitude can be seen over and over across the spectrum of health care settings, all over the developed world, as we struggle with the wrongly-labelled “Silver Tsunami” of aging populations — even though we have known for decades that a baby boom would eventually lead us to where we are today.

Now, thanks to advances in medicine, we are living much longer lives, likely with a number of illnesses that have become rendered as chronic diseases. However, while our patients have changed, our health care systems haven’t — the focus needs to shift from just fixing issues to keeping these patients living independently in the community with increasing levels of homecare or nursing care.    Instead, our hospitals, designed to deal with discrete emergent issues, have become incubators for these patients as they await the right “social” environment for their discharge. Such patients take up about 15% of Canada’s acute care beds — representing 7,500 Canadians each day and at an annual cost of $2.3 billion annually, with dementia alone accounting for over 30% of such hospitalization days. This keeps us in a near-constant state of overcapacity. The situation is similar in other developed countries like the United Kingdom. It is high time to refocus and redevelop our health care systems to respond to the unique needs of our aging population, who collectively represent 60% of all hospital days in Canada.

Comment Print When it comes to the numbers, the take-up for the Saskatchewan Party government’s privatized diagnostic imaging tests has not yet been what you would call overwhelming. In the two months since two Regina facilities were licensed to provide private-pay MRIs, the numbers show 258 patients used them. This includes 77 patients who paid for their own scans plus several organizations — yes, including the Saskatchewan Roughriders — that forked over cash for preferential treatment. These numbers are too small to point to to the success of the program, but, in turn, they sure don’t solidify

the worst fears of medicare purists that the rich would be leaping at the opportunity for early diagnosis just so they could jump the queue for surgery.

Most significant are the problems of keeping up with the demand for diagnostics and the cost of paying for it all. This is reflected in numbers showing that in an 11-month period ending in February, the number of people on Saskatchewan’s CT wait list increased by 29 per cent, to 3,823 from 2,954. Wait times for non-urgent CTs averaged 119 days. Moreover, the Regina Qu’Appelle Health Region’s contract with the private CT providers ($183.85 per exam) is significantly less than the in-hospital cost of $230 to $240. “It really has added to the capacity within the system without costing the taxpayers any dollars,” Duncan told reporters last week. “We’re just getting a better price when we go to the market.”

More day surgeries will be done at private clinics in Regina and Saskatoon after the Saskatchewan Surgical Initiative got a cash infusion in Wednesday’s provincial budget. To shorten surgical wait times, $70.5 million was allocated to the Surgical Initiative — a $20-million increase. “Over the last year, in large part due to a higher demand for surgeries than we had forecasted at the beginning of the last fiscal year, we started to see our surgical wait times start to creep up again,” Health Minister Dustin Duncan told the Leader-Post on budget day.

In 2010, the provincial government introduced the Saskatchewan Surgical Initiative — a plan to shorten surgical wait times. At the time, the government promised no patient would wait longer than three months for elective surgery by 2014. Although the initiative concluded in March 2014, wait time information continues to be updated on the website monthly. According to the latest data on the Surgical Initiative’s website, 1,934 patients in the Regina Qu’Appelle Health Region (RQHR) and 2,835 in the Saskatoon Health Region (SHR) had waited more than three months at the end of March. There were 317 RQHR patients and 1,000 SHR patients who had already waited longer than six months for surgery on March 31.  The SHR saw a 7.5-per-cent growth in demand for surgeries from April 2015 to April 2016

The province’s privacy commission has ordered the health ministry to release the names of doctors along with their OHIP billings, in the interests of transparency and accountability.The decision comes two years after the Star began requesting physician-identified billings from the health ministry, and brings the province more in line with other jurisdictions that are opting to disclose public funds paid to doctors. In granting an appeal from the Toronto Star, John Higgins, an adjudicator with the Office of the Information and Privacy Commissioner of Ontario, said physician-identified billings are not “personal information” and are, therefore, not exempt from disclosure under the province’s Freedom of Information and Protection of Privacy Act.

Higgins has ordered the health ministry to release the information to the Star by July 8.“In my view, the concept of transparency, and in particular, the closely related goal of accountability, requires the identification of parties who receive substantial payments from the public purse, whether they are providing services to public bodies under contract or, as in this case, providing services to the public through their own business activities under an umbrella of public funding,” Higgins wrote.

Adjust Comment Print A Pointe-St-Charles community health clinic is seeking court authorization to launch a class action against the Quebec government and private medical centres to put a stop to what it claims are “abusive and illegal” fees charged to patients under medicare — fees ranging from $50 to access one’s file to $10 to have one’s blood sample transported. If a Quebec Superior Court judge grants the authorization, the plaintiffs would then be able to pursue a class-action lawsuit seeking up to $150 million in medical fees billed to patients in the past three years. “We will be asking the court for patients to be repaid what they spent on these illegal fees,” said Cory Verbauwhede, one of the lawyers involved in the case.

“We’re opposed to all of these fees because they create a two-tier system,” Defoy said. “What these fees do is undermine our public health system.” In February 2015, the Pointe-St-Charles clinic launched a registry for patients to list questionable fees that they have had to pay doctors. To date, more than 700 patients in the low-income district have submitted data to the registry. In May, a coalition of patient-advocacy groups across Quebec filed a petition in federal court to compel Ottawa to enforce the Canada Health Act, which prohibits both user fees and extra billing.

KELOWNA, BC – The Surrey Board of Trade is calling on the provincial government and the federal government economic benefits of universal pharmacare for businesses at the BC Chamber of Commerce Annual General Meeting and Conference, May 29 – 31 in Kelowna. This policy was approved at today’s BC Chamber policy session as a priority to the BC Government. “Drug coverage in Canada is provided through an incomplete patchwork of private and public programs that varies across provinces. This fragmented system reduces access to medicines, diminishes drug purchasing power, duplicates administrative costs, and isolates pharmaceutical management from the management of medical and hospital care. It is needlessly costing Canadian businesses billions of dollars every year,” said Anita Huberman, CEO Surrey Board of Trade.

There is a better option. A universal, comprehensive public drug plan that was consistent throughout BC and across Canada would be a wise investment for BC’s economic prosperity. Research has shown that such a plan would reduce employer-sponsored drug costs in Canada by up to $10.2 billion per year – a $570 million annual savings for businesses in British Columbia alone.4 This would boost Canada’s labour market competitiveness.

A universal pharmaceutical program would be economically viable not only by taking advantage of the power of a single purchaser, but through the following: Reduction of administration costs for businesses and unions Elimination of the need for tax subsidies to encourage employer funded benefit packages Decreased direct emergency and acute care medical costs due to inappropriate or underuse of drug 28therapies Reduction of other health service costs 28Because of these increased efficiencies, a universal pharmacare program would increase government costs by only $3.4 billion, $2.4 billion of which could be financed by the reduced cost of private drug benefits for public sector employees. The 2015 Angus Reid Institute poll found that most taxpayers would support such a program, even if it required modest increase in taxes.

We have cyclical resource revenues in Saskatchewan. Of this, there is no dispute. How cyclical they truly are will again be demonstrated when Finance Minister Kevin Doherty presents today’s 2016-17 budget. Hopefully, he will not repeat the mistakes of his predecessors who consistently inflated revenue projections at budget time and wound up overseeing a deficit budget that year.

Wall said on Monday that the 2016-17 Saskatchewan budget will have $1 billion less revenue than last year. This is obviously not comforting, because it translates into the Saskatchewan Party government’s third-straight deficit budget and sixth deficit in nine years. But by acknowledging this problem at budget time — instead of playing the game of high-balling resource revenues and presenting a deficit at year’s end — we at least are seeing early signs that the government gets that its deficits are no longer cyclical, but structural in nature.

Consider how its supposed big cost-saver in health — the John Black and Associates lean model — has produced no tangible evidence of actual savings, but plenty of evidence that it it has created a new bureaucracy within the already-bloated health bureaucracy. In Regina, there are now no fewer than 36 government/health region employees with the term “Kaizen” in their title — JBA’s lasting legacy of lean — including six Kaizen directors, 12 Kaizen specialists, lean specialists, workflow specialists, directors, Kaizen promotion office specialists, surgical Kaizen specialists, communication specialists, “Kanban” specialists, conference administrators, standard work and replication specialists, measurement specialists and certification and training specialists.

NEW YORK – In 2015, around 5.9 million children under the age of five, almost all in developing countries, died from easily preventable or treatable causes. And up to 200 million young children and adolescents do not attend primary or secondary school, owing to poverty, including 110 million through the lower-secondary level, according to a recent estimate. In both cases, massive suffering could be ended with a modest amount of global funding.

In fact, the world has made a half-hearted effort. Deaths of young children have fallen to slightly under half the 12.7 million recorded in 1990, thanks to additional global funding for disease control, channeled through new institutions such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

The reason that child deaths fell to 5.9 million, rather to near zero, is that the world gave only about half the funding necessary. While most countries can cover their health needs with their own budgets, the poorest countries cannot. They need about $50 billion per year of global help to close the financing gap. Current global aid for health runs at about $25 billion per year. While these numbers are only approximate, we need roughly an additional $25 billion per year to help prevent up to six million deaths per year. It’s hard to imagine a better bargain.

A new court ruling on assisted death is raising questions about whether the Liberal government’s proposed law is constitutional, as the House of Commons prepares to vote Tuesday on a historic bill to legalize the practice.

When the Supreme Court declared last year that severely ill Canadians have a right to an assisted death, it did not restrict that right to the terminally ill or very elderly, as the Liberal government is doing in its proposed legislation. The top court said the right belongs to mentally competent adults who are suffering intolerably from an irremediable illness.

An Ontario court, while not ruling directly on the bill, echoed a decision by the Alberta Court of Appeal earlier this month, when it said that the Supreme Court’s minimum standard for the right to an assisted death is the loss of quality of life, not whether natural death is “reasonably foreseeable,” as stated in the Liberal bill.The basis for an assisted death, under the Supreme Court’s ruling, “is the threat the medical condition poses to a person’s life and its interference with the quality of that person’s life,” Ontario Superior Court Justice Paul Perell said in a decision last week that has just come to light. “There is no requirement … that a medical condition be terminal or life-threatening.”

Adjust Comment Print “Overwhelming” support from 10,265 local people to stop hospital cuts shows people are suffering from the consequences of deteriorating care, organizers of a referendum said Monday. Results from the local referendum — taken Saturday by the Windsor and Essex County arms of the Ontario Health Coalition — are being added into the Ontario-wide referendum results that will be delivered Tuesday to the government at Queen’s Park. The statement, “Ontario’s government must stop the cuts to our community hospitals and restore services, funding and staff to meet our communities’ needs for care,” received 10,265 Yes votes, 39 No votes and two spoiled ballots, with yet-to-be-counted ballot boxes still arriving on Monday

Cleveland MaGee, 80, worked the front hall of his seniors apartment building, Ashgrove Manor on Bridge Avenue, and the response was unanimous. “I didn’t have a No vote,” the retiree said. “That means that our seniors are concerned, they’re concerned about their health care and the deterioration of the health care they’re getting.

The Ontario Health Coalition says Ontario is heading into the ninth consecutive year of cuts to hospital budgets. That impact has hit hard in Windsor, where earlier this year Windsor Regional Hospital announced a major staffing shakeup that involved the elimination of 169 registered nursing positions, to cope with a $20-million budget shortfall.

As Canada’s aging population grows, our assisted-dying dying legislation cannot stand in isolation – the federal government must do its part to ensure doctors, health-care providers and families receive adequate options and pathways for care at the end of life. So, what are some of the social policies that are needed to support the assisted-dying dying legislation? In its nationwide consultations, the Canadian Medical Association (CMA) identified the importance of advance-care planning (ACP), palliative care, long-term care, home care, a national seniors’ strategy, and research and investment in Alzheimer’s as parallel issues to assisted dying.

While the medical and legal frameworks for ACP are a provincial jurisdiction, the federal government should at a minimum support the forthcoming assisted-dying dying legislation by investing in ACP education and training for health-care professionals and launching public awareness campaigns. We have a lot to learn from other jurisdictions, including the United Kingdom’s Gold Standards Framework training institute and Australia’s National Framework for Advanced Care Directives.

While there are innovative models of delivering palliative care, actual access to high-quality palliative care varies by region and health provider. We need a Pan-Canadian palliative and end-of-life care strategy. In 2014, NDP MP Charlie Angus successfully moved such a strategy in Private Members’ Motion M-456. Dealing with issues of access, funding and standardization, Angus’s motion was nearly unanimous, but nonbinding. It calls for support for family caregivers and increased access to home-based and hospice-based palliative care. Canada’s assisted-dying legislation would only be strengthened with national direction on palliative care, which is long overdue.

The Copeman clinic, a private medical facility, has been billing Alberta Health for medical tests many of its own doctors believed were unnecessary. Allegations of over-testing have been raised before; but until now it was not clear that several layers of government were defraying the cost.

Copeman bills are also structured so that patients, and their employers, through health spending accounts, may apply the expense as a tax deduction

While Copeman's in-house lab took patients' blood and urine samples, it has almost no capacity for analysis, and the vast majority of analysis work was done, and paid for, by the province, sources told CBC News.

Dentists are not part of the primary health-care system and physicians are not trained to deal with mouth diseases, such as those that affect teeth and gums. Primary mouth care is not covered under OHIP, and hospitals are not equipped to deliver dental care. Ontario only has public dental programs for low income children under 18, and a patchwork of basic services for people receiving social assistance.

In 2014, there were almost 61,000 hospital emergency room visits for dental problems. The most common complaints were abscesses and dental pain. It is estimated that every nine minutes a person shows up in a hospital emergency room with a dental problem. The minimum cost of each hospital visit is $513. As a result, taxpayers spend approximately $31 million annually to have physicians acknowledge that patients have dental disease which they cannot treat.

The College of Dental Hygienists of Ontario estimates that two to three million Ontarians have not seen a dentist in the past year. The main reason is the cost.

Ontario has pledged to spend $222 million over three years to improve health care for First Nations, especially in the north where aboriginal leaders declared a state of emergency because of a growing number of suicides.The Liberal government also promised to contribute $104.5 million annually — after the initial three years — to the First Nations Health Action Plan, which will focus on primary care, public health, senior’s care, hospital services and crisis support.

The James Bay community of Attawapiskat declared a state of emergency

in April because of an increasing number of suicides and suicide attempts, especially by young people.“We have learned from the recent health emergency declarations that communities need support in times of crisis and need to know that they can count on the provincial government,” Health Minister Eric Hoskins said Wednesday.“So we will establish dedicated funding, expanding supports including trauma response teams, suicide prevention training, positive community programming for youth, and we will fund more mental health workers in schools.”