The story on PSWs and interview with Deb Mathews runs from minute 1:34 to minute 9:28. Mathews: I would say to the operators "they are taking a very big risk and they really should not be supporting a practice that isn't safe - they have to take that responsibility very seriously" I'm asking PSWs to "please stand up and report this". The scope of practice for PSWs is not as clear as it ought to be ... this is why we're establishing the PSW registry. It will allow us to see the training and experience of PSW - this information will be available to the public. My expertise is long-term care homes. Very high standards there. Retirement homes in Ontario are different - wide range of people. They do not fall under the Ministry of Health. Dr. Goldman: Why not regulate retirement homes? Mathews: Because they serve a very different function - e.g. for people who are very healthy but would like to have for example their meals prepared for them. They are not health care facilities the way long term care homes are. A retirement home is a home. We really do want to offer choice to people. The retirement homes determine when a person needs care they can't provide. Dr. Goldman: Regulation of PSWs?  Mathews: I don't see it any time soon. We are working with our training colleges and universities on a common curriculum. Until we have that standard training and established scope of practice, we can't take them the next step to make them a regulated health care professional.

The 2011 Commonwealth Fund International Health Policy survey involved about 19,000 randomly chosen adults from 11 countries, who were interviewed by telephone between March and June. The survey included 3,958 Canadians. Almost 60 per cent of those with ongoing health concerns have below-average household incomes, making it difficult to afford certain types of care and medications. Secondary costs such as paying for transportation to appointments, child care and lost wages from time away from work can also present obstacles to care, the Health Council said. The report recommends a number of ways to eliminate cost barriers, including increasing use of alternatives to face-to-face visits, such as telemedicine, email and phone consultations. To improve co-ordination of care, widespread use of electronic medical records in Canada would reduce costs and improve efficiency, the council said.

JUDITH STEIN Executive Director in NYT December 2011: Your editorial about changing Medicare into a voucher system wisely states many of the problems with public subsidies of private health insurance for Medicare beneficiaries. All such experiments have cost more and provided less value to those in need of coverage. I have been an advocate for Medicare beneficiaries for almost 35 years. I've seen numerous forays into privatizing Medicare. Clinton-era plans, Medicare Plus Choice, Medicare Advantage: none of them have provided better coverage more cost-effectively than the traditional Medicare program. I don't recommend a private plan to my mother. That should be a good test for anyone championing premium support. Additionally, ever-increasing private options have made Medicare too complex, especially given the very limited number of advocates available to help beneficiaries understand, choose and navigate the system. Call it what you will, "premium support" is the latest jingle for privatizing Medicare. It's not a new or creative idea, and it will only add more costs and confusion. What we need is an objective look at what's needed to encourage participation and cost efficiencies in traditional Medicare, not further adventures in privatization.