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Contents contributed and discussions participated by Irene Jansen

Irene Jansen

By attaching no strings, Flaherty binds irate provinces to health plan - The Globe and ... - 0 views

  • Sources within the government report that Mr. Harper won’t interfere with any province that experiments with or expands private delivery of publicly funded care. But user fees, fully private care or other major violations of the Canada Health Act will result in clawbacks.
  • Federal funding currently accounts for about 20 per cent of provincial health budgets. If costs increase annually above nominal GDP, which they might as the population gets older and sicker, then the federal contribution could become proportionately so meager that one or more provinces may decide it’s cheaper to impose copayments or let the rich purchase private care, and forgo the federal cash.
  • But British Columbia Finance Minister Kevin Falcon praised Mr. Flaherty, saying it was up to provincial governments to bring health costs under control. Criticism from Alberta and Saskatchewan was also noticeable by its absence.
Irene Jansen

Provinces angry as feds impose health plan that reduces payments after 5 years - Winnip... - 0 views

  • unprecedented, one-sided meetings
  • the majority of provincial and territorial leaders said the deal amounted to a take-it-or-leave-it offer that was slapped on the table without any chance of discussion
  • "We were expecting to discuss how we were going to discuss federal transfers,"
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  • Duncan and Bachand were joined at a post-meeting news conference by the finance ministers from Manitoba, Prince Edward Island, Newfoundland and Labrador and Nova Scotia, who all blasted the new transfer arrangement.
  • He said tying health transfers to the nominal rate of economic growth starting in 2017-2018 effectively removes $21 billion from health care funding across Canada.
  • B.C. Finance Minister Kevin Falcon said he's happy with the five-year plan.
  • "The process that we saw today where the federal government comes and says this is our non-negotiable position simply is not the way to build a nation," he said.
Irene Jansen

More money won't fix Canadian health care, poll finds - The Globe and Mail - 0 views

  • The more Canadians use the health care system, the less they seem to like it, according to a new poll
  • Environics
  • when you use the system on an ongoing basis, you are more apt to see where the cracks in the system are.”
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  • 53 per cent of those who took prescription medication for a chronic condition – and therefore would have recently used the services of a health-care professional such as a physician or pharmacist – feel the system is either in or heading to a state of crisis.
  • those users of the health-care system are less likely than others to believe that our system does a good job of caring for the health of the more vulnerable in society (55 per cent compared to 65 per cent of other Canadians) and less confident services will always be there when they need them (62 per cent compared to 69 per cent of other Canadians.)
  • Overall, Canadians still prefer their government-funded system, with 77 per cent of them saying so.
  • Of the G8 nations that took part in the survey, Canada was the only country where a majority (52 per cent) held a positive view of their health system.
  • for those Canadians who use the health system more frequently and have chronic medical conditions, solutions are more likely to rest with better management (63 per cent) rather than increased spending (31 per cent).
Irene Jansen

Critics call spaces a move towards privatization | Edmonton | News | Edmonton Sun - 0 views

  • Critics are calling a new round of more than 500 private-public senior care spaces a move towards privatization.
  • “It’s almost a $100,000 subsidy per space, a lot of them going to private businesses,” said David Eggen with Friends of Medicare.
  • the province has committed $48.2 million to help build 511 new affordable supportive living and 30 long-term care spaces in Calgary, Okotoks, Strathmore, Edmonton, Villeneuve and Olds.
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  • That contract with Alberta Health will grow as the needs grow for the senior.”
  • Eight private and public organizations beat out more than 60 applicants to share the funds, which will build nine projects across the province.
  • under the Affordable Supportive Living Initiative (ASLI).
  • 1,815 seniors were waiting for continuing care placement.
Irene Jansen

CBC On the Money December 19, 2011 - Armine Yalnizyan on Flaherty's announcement of CHT... - 0 views

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    At 5 min, Armine says that we overuse hospitals and "we can integrate more fully into the communities". Does she mean substitution of community care for acute care? Armine also says in this interview that the six percent increases in CHT every year translates to 0.9% - 1.4% of provincial revenue.
Irene Jansen

timestranscript.com - Home support workers want respect | BY ALLISON TOOGOOD - Breaking... - 0 views

  • rallying outside the constituency office of Social Development Minister Sue Stultz
  • 45 home support workers and their supporters
  • The members of CUPE Local 4598 say they are tired of being ignored by their employer and the government and are undervalued for the services they provide. They say most of the unionized workers, almost all of whom are women, are receiving a minimum wage salary and are sitting on the poverty line.
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  • union president Thérèse Duguay
  • Stultz eventually sat down with Duguay and a few other union representatives
  • the union and the Canadian Red Cross are currently in contract negotiations
  • The workers say that their contract, signed with the Canadian Red Cross and the department, is not being respected. Duguay says that there's a discrepancy within the transportation allowance. She says that they are only receiving 12 cents an hour for mileage and are asking the department to conduct an audit of the books of the Red Cross on such an allowance.
  • the Red Cross has not met a requirement of contracts with the Department of Social Development to give workers 75 per cent of transportation allowance money received from the department - the other 25 per cent covers program administration
  • base rate of $0.12 per hour but also $0.27 per kilometre
  • the reason for the split travel allowance is because it's not necessarily mileage travelled in a car and part of the care workers' job is to accompany the client to and from medical appointments and related events
  • the union has been in negotiations with its employer for better wages for almost 30 months
  • "When you compare this with people doing the same work in other provinces, the difference in wages is huge," she said. "For example, in 2008, in Nova Scotia, they received $15.62 an hour and in P.E.I., $19.19."
  • the NB Coalition for Pay Equity was supporting Duguay and the workers
Irene Jansen

CTV News Channel: Are cuts on the horizon? - 0 views

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    Mike McBane: laying the ground for serious cuts, backing away from election promise of six percent for the duration of the accord, could translate to rural hospitals closing, we have a growing and aging population, we can't afford to cut without destabilizing services, need to stop tax cuts, Canada is not Europe re finances, need health care more than ever in times of economic insecurity (unemployment = poor health), if federal government cannot afford health care, who can?
Irene Jansen

Tim Harper: Time for painful provincial health-care decisions - thestar.com - 0 views

  • This is how the Conservatives negotiate, whether it is with the federal opposition parties or the provinces. They don’t. They dictate.
  • extend the six per cent increases in health transfers through 2016-17 (by which time Conservatives may not even be in power) before tying increases through 2024 to economic growth, with a floor of three per cent.
  • If health-care spending must be pared during another future economic downturn, it is bound to create hardship because the health-care system is under much more stress during economic downturns.
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  • Some provinces will be able to spend more on health care, others will bear a bigger burden of the aging population, others now have an opportunity to experiment with more private delivery.
  • there will now be an opportunity, as Canadian Medical Association president John Haggie puts it, “to identify how resources will be used to improve patient care across the country.”
Irene Jansen

Provinces get more autonomy to drive health-care reform - The Globe and Mail - 0 views

  • Canada's provinces are being granted more autonomy to reshape health care as Ottawa moves to end 50 years of using its funding power to coerce provinces to adopt national standards.
  • Aglukkaq sent a letter on Tuesday to her provincial and territorial counterparts urging them to focus on how to reduce escalating health costs and to “put the divisive issue of funding behind us.”
  • the most important change in half a century to how Ottawa and the provinces run Canada
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  • Harper is inviting provinces, with some federal guidance, to do as they see fit in their own jurisdictions while inviting them to co-operate in establishing national benchmarks for delivering health services.
  • The West welcomes the certainty of the new model. It sees as a key victory the fact that Ottawa will allocate funds on a per capital basis rather than disproportionately favouring poorer provinces. The East calls the offer insufficient and an abuse of the federal-provincial process.
  • By offering money with no strings attached, Mr. Romanow said, richer provinces can experiment with new services – via public or private routes – that other provinces can’t afford.
  • The Conservatives decided on a unilateral approach several months ago, government sources said.
  • Officials identified three potential windows for releasing the new numbers. The first was Mr. Flaherty’s November fiscal update. But cabinet had not approved the new deal then. The second opportunity was Monday’s meeting of federal and provincial finance ministers. The Conservatives also contemplated holding off until January, when the premiers meet to discuss health care
  • Finance Canada documents said that the slower growth is because “governments are working to move health care funding to a balanced and sustainable path,” but a CIHI official said the institute can’t explain the one year drop, or whether it is a statistical blip.
Irene Jansen

New Brunswick criticizes Flaherty's health proposal - New Brunswick - CBC News - 0 views

  • the proposed move is unacceptable to the New Brunswick government
  • "We understand that the federal government is trying to rein in health care spending. Our government is faced with similar challenges, and we are addressing them through the government renewal process,” Higgs said. “But by tying health care dollars to GDP, the federal government is making the burden even heavier for smaller provinces with declining and aging populations."
  • The New Brunswick government has already asked the Department of Health to limit its new revenue demands to three per cent.
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  • Higgs also dismissed a report in a national newspaper that New Brunswick didn’t speak out against the federal government on Monday because the provincial government feared "retribution." Higgs said that's not true. He said the other provincial finance ministers organized a media scrum with reporters after he'd already left for the airport.
  • Nominal GDP is the monetary value of all goods and services produced within the country annually, including inflation. If nominal GDP rises four per cent and inflation is two per cent, the economy's real GDP growth is two per cent.
Irene Jansen

Can community care take pressure off hospitals? - The Globe and Mail - 0 views

  • some worry that retaining the existing funding formula of 6-per-cent annual increases for the next five years could drain some of the energy from the reform process that is under way and even breed complacency
  • An enhanced role for community care is considered essential to take the pressure off hospitals, where one in six acute-care beds in Canada is occupied by an elderly patient waiting
  • Bob Bell, chief executive officer of the University Health Network
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  • Howard Waldner, president and CEO of the Vancouver Island Health Authority
  • Hospitals are experimenting with “virtual” wards that provide follow-up care at home for patients with chronic medical conditions to lessen their chances of being re-admitted
Irene Jansen

Tories have 'cut and run' on health-care funding, NDP says - 0 views

  • if premiers are counting on Harper to call a first ministers summit early next year to discuss medicare, they should think again. He's not so inclined to call a meeting for the sake of it, and is more likely to work individually with the premiers to foster health-care reform.
  • Harper is not ready to elevate this to a first ministers summit until progress is being made.
  • "It's the federal government's job to ensure Canadian families have access to universal, quality health-care services - no matter where they live," said interim leader Nycole Turmel. "Instead of working with the provinces to improve front-line services, the Conservatives have simply cut and run.
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  • How will it ensure federal funding leads to more doctors and nurses, better home care and more affordable prescription drugs?"
  • During the recent federal election campaign, in their 66-page platform the Conservatives devoted nine paragraphs - about three-quarters of a page - to renewing the Health Accord.
Irene Jansen

Ottawa backs off on health - thestar.com - 0 views

  • Rather than engage in the difficult process of negotiating a new health accord with the provinces, his government decided to skip right over that part and dump a final deal on Canadians this week.
  • without any strings attached. And that, in the end, may matter far more to Canadians.
  • That the Harper government has not bothered to tie billions of federal dollars to any particular outcome at all is a clear signal that Ottawa intends to get out of the health care business.
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  • since what she has to say isn’t tied to the money, there is little incentive for provincial counterparts to take her seriously
  • The funding in the last 10-year federal-provincial health accord was used, to some success, to reduce surgical wait times.
Irene Jansen

Ottawa's surprise health-care offer is a good one - The Globe and Mail - 0 views

  • The Conservative government’s surprise health-care offer to the provinces is fair, reasonable and appropriate. It does not bill itself as a plan to save Medicare. It does not hold the provinces’ feet to the fire. But Canada had its supposed fix for a generation, and it didn’t take.
  • The government is throwing the ball of innovation into the provinces’ court, where it belongs. The plan is generous (six per cent in each of the first three years, at least three per cent thereafter, and possibly more, depending on economic conditions), but not so generous that the provinces can sit back and attempt to do business as usual. The deal is to last 10 years, so the provinces can plan.
  • They should accept federal Health Minister Leona Aglukkaq’s offer to work together toward common goals, though they might not be able to extract more cash for doing what they promised to do the first time.
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  • Six per cent a year is unsustainable. The provinces’ budgets would eventually be swallowed by Medicare. All that cash was the wrong kind of “fix” – it induced reliance, not change.
Irene Jansen

New health funding formula a victory for Alberta - 0 views

  • For years, the Alberta government has been pushing the federal Tories to boost cash health transfers here. Former premier Ed Stelmach called it discriminatory that Albertans receive $240 less per person in health transfers than the rest of Canada - a disparity he said was worth about $900 million annually.
  • The difference going forward is that Alberta will receive actual money from Ottawa as opposed to a combination of cash and tax points.
  • an agreement made in 2004 by premier Ralph Klein because of the province's strong tax base.
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  • Menzies acknowledged this has resulted in "some complaints from Alberta all along, but they had signed the deal."
  • some net improvement in what that transfer looks like
Irene Jansen

Ottawa shirks health funding: Oswald - Winnipeg Free Press - 0 views

  • THE Selinger government is worried it will shoulder a greater share of health care-funding in the future -- and angry Ottawa is imposing this on Manitoba and other provinces unilaterally.
  • looking for a 10-year funding commitment from Ottawa with six per cent annual increases as a negotiating starting point. It has also argued health transfers should not be discussed in isolation from equalization and other social transfers. The worry is that one sector will benefit at another's expense, which has occurred in the past.
  • Oswald said health ministers wanted to discuss funding at their meeting last month but Aglukkaq refused.
Irene Jansen

Diagnosing changes to health-care funding - thestar.com - 0 views

  • Patrick Fafard, a health policy expert at the University of Ottawa, says the clawback will have an minimal effect as it’s spread over many years. He says there are other things, such as the rate of economic growth, that will have a bigger effect on health care than federal transfers.
  • Gordon Guyatt, a professor in the department of clinical epidemiology at McMaster University, calls the clawback “unequivocally bad.”
  • Canadians may well be willing to pay more for health care if they gain increasing benefits
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  • Over the next decade, we anticipate major technological advances that will improve the quality of care
  • with restricted funding, those who could get those benefits will be those who can pay out of pocket. The result will be two-tiered health care.
Irene Jansen

Unilateral pronouncements won't help us all get along - The Globe and Mail - 0 views

  • Given that most of the players, including provincial governments, think that health costs are growing too quickly and have to be contained, this seems like a reasonable approach.
  • we don’t know what the impact on other provinces will be. It may not do much for interprovincial harmony
  • It has also been announced that the equalization program will grow with the economy. But there is a suggestion that the program will be capped. Given that Ontario is eligible for larger and larger amounts, what will be the impact on other receiving provinces?
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  • Process matters in federal-provincial relations. A federation is about rules and process. In this case, why does it matter? Because federal involvement in health care is necessary and can be achieved only with co-operation. Even if one rejects the use of the federal spending power to influence health-care delivery, the federal government holds many levers that affect health-care costs directly.
  • It also exercises many responsibilities that affect health outcomes. Here are important examples. The federal government regulates the marketing of drugs. What could it do to contribute to cost control in that area? Are there ways the federal government could use its considerable health research dollars to support health-care reforms? As the Canadian population ages, the use of health technology will cost more. Here again, the federal government has some jurisdiction. What about health costs and health outcomes for first nations?
  • Co-operation in these areas might be more fruitful than in areas where the federal comparative advantage is not strong.
  • André Juneau, director of the Institute of Intergovernmental Relations at Queen’s University, is a former federal deputy minister
Irene Jansen

Public's appetite for efficient health care only goes so far - The Globe and Mail - 0 views

  • By the account of a new Environics poll, a majority of Canadians now believe inefficiency, rather than underfunding, is the biggest threat to health care. Perhaps all those dire warnings from politicians and think-tanks and media outlets about costs growing unsustainably are starting to penetrate.
  • Among the most inescapably necessary reforms is hospital restructuring. In Ontario, governments dating back to Bob Rae’s New Democrats have recognized that it’s no longer practical for hospitals, particularly in rural areas, to function as one-stop shops. Much more cost-efficient, and often better for patient outcomes, is to centralize difficult and expensive procedures in fewer places.
  • for policy-makers, a certain cold-bloodedness is required
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  • The hard truth about health policy, acknowledged by anyone who works in the field, is that it’s largely about rationing care.
  • To spend on a rare procedure that could save a single life, for instance, might mean quietly not spending on something else that could spare a dozen.
Irene Jansen

Health funding plan contains 'positives' - 0 views

  • Premier Brad Wall says the release of the federal government's new health-care funding plan is frustrating and the results aren't what he'd hoped for.
  • "There's a frustration with the process and a concern about post-2017, there's no question," Wall told reporters Monday. "But we asked for extension of the six per cent (past 2014). It's there - not as long, but it's there. We'd asked for a longer-term view. It's there - not the way we wanted it, but there's room for changes, especially when we're six years out."
  • "We're not talking about a cut," Wall said. "We're talking about a reduction in an increase."
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  • other types of federal financial support for health care, particularly innovative initiatives, might be possible.
  • there are opportunities for Saskatchewan to negotiate some additional funding for innovation ... That's what we'll be working toward."
  • The Saskatchewan government is preparing its own proposal around extra funding for innovation in health care, he noted, pointing out "we've seen flexibility from the federal government on other files." That's partly why he isn't joining other premiers in sounding the alarm, he said.
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