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Irene Jansen

Healthcare Policy, 7(1) 2011: 68-79 Population Aging and the Determinants of Healthcare Expenditures: The Case of Hospital, Medical and Pharmaceutical Care in British Columbia, 1996 to 2006 Steven Morgan and Colleen Cunningham Healthcare - 0 views

www.longwoods.com/...22525

demographics spending

shared by Irene Jansen on 23 Jan 12 - No Cached
    • Irene Jansen
      Irene Jansen on 23 Jan 12
       
      Rising hospital expenses, use of specialists threaten system; Aging population accounts for one third of increase, says UBC study Vancouver Sun Tue Aug 30 2011 Page: A4 Section: Westcoast News Byline: Matthew Robinson 
  • We found that population aging contributed less than 1% per year to spending on medical, hospital and pharmaceutical care. Moreover, changes in age-specific mortality rates actually reduced hospital expenditure by –0.3% per year. Based on forecasts through 2036, we found that the future effects of population aging on healthcare spending will continue to be small. We therefore conclude that population aging has exerted, and will continue to exert, only modest pressures on medical, hospital and pharmaceutical costs in Canada. As indicated by the specific non-demographic cost drivers computed in our study, the critical determinants of expenditure on healthcare stem from non-demographic factors over which practitioners, policy makers and patients have discretion.
  • research dating back 30 years illustrates that population aging exerts modest pressure on health system costs in Canada (Denton and Spencer 1983; Barer et al. 1987, 1995; Roos et al. 1987; Marzouk 1991; Evans et al. 2001; McGrail et al. 2001; Denton et al. 2009)
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  • To shed new empirical light on this old debate, we quantified the impacts of demographic and non-demographic determinants of healthcare expenditure using data for British Columbia (BC) over the period 1996 to 2006. Using linked administrative healthcare data, we quantified the trends in and the determinants of expenditures on hospital care, physician services and pharmaceuticals. To our knowledge, this is the first time that all three of these major components of healthcare costs have been analyzed in a single Canadian study.
  • our study cohort included 3,159,900 residents in 1996 and 3,662,148 residents in 2006
  • We found that population aging in British Columbia contributed less than 1% per year to total growth of expenditures on hospital, medical and pharmaceutical care from 1996 to 2006. We also found that changes in age-specific mortality rates reduced (albeit modestly) per capita healthcare costs over time, confirming what other researchers have suggested (Fries 1980; Breyer and Felder 2006). With rigorous analysis of recent healthcare data, we can therefore confirm what studies spanning earlier decades for British Columbia, elsewhere in Canada and other comparable health systems have found: the net impact of demographic factors on major components of the healthcare system is moderate (Denton and Spencer 1983; Fuchs 1984; Barer et al. 1987, 1995; Gerdtham 1993; Evans et al. 2001; McGrail et al. 2001). Moreover, when we forecasted the effects of expected demographic changes in British Columbia through 2036, we found that the future effects of population aging on healthcare spending will continue to be modest (1% or less per year).
  • Our findings also indicated that average payment per unit of hospital care increased over the period. The increase in hospital unit costs may have been an appropriate policy response to increases in age-adjusted clinical complexity per patient remaining in care following reductions in the average length of stay
  • After taking into account population aging, the average number of days of prescription drug therapy received by British Columbia residents grew more than 5% per year during the first half of our study period and plateaued in the latter half of the period (data not shown)
  • Despite popular claims about population aging and the sustainability of healthcare in Canada, demographic changes exert steady, predictable and modest forces on the cost of major components of our healthcare system. This is likely to remain true for the foreseeable future.
  • Irene Jansen on 23 Jan 12
     
    Despite popular claims about population aging and the sustainability of healthcare in Canada, demographic changes exert steady, predictable and modest forces on the cost of major components of our healthcare system. This is likely to remain true for the foreseeable future. Changes in the age-specific profile of healthcare costs, by contrast, can exert and have exerted significant pressures on health system costs. Clinicians, policy makers and patients have some discretion over the non-demographic sources of healthcare cost increases - unlike population aging. Though these results are largely confirmations of studies from past decades, it is nevertheless important to update the scientific basis for policy debates. Moreover, close attention to recent trends and cost drivers - such as the price of prescription drugs that drove pharmaceutical expenditures in the past decade - also helps to illuminate the non-demographic forces that seem most amenable to policy intervention. Ultimately, then, research of this nature is a reminder that the healthcare system is as sustainable as we want it to be.
Heather Farrow

Ontario's $4.8 billion hospital underfunding means 48 less nurses, 143 fewer hospital staff, $16 million a year funding gap for Cornwall - CUPE Ontario - 0 views

cupe.on.ca/lion-year-funding-gap-cornwall

cupe Ontario hospital cuts campaign

shared by Heather Farrow on 22 Aug 16 - No Cached
  • Cornwall, ON — When compared with the rest of Canada the Ontario government’s $4.8 billion underfunding for hospitals like Cornwall Community, means skeleton hospital staffing and much less care for Cornwall patients, a report released today has found. The report (Fewer Hands, Less Hospital Care) compares funding, staffing, nursing, and readmissions in Ontario and other provinces. Based on the latest figures from the Canadian Institute for Health Information (CIHI), Ontario government funding for hospitals is $1,395.73 per capita. The rest of Canada, excluding Ontario, spends $1,749.69 per capita. In other words, provincial and territorial governments outside of Ontario spend $353.96 more per person on hospitals than Ontario does. That is a whopping 25.3 per cent more than Ontario.
Heather Farrow

Provincial supervisor for Brockville hospital a distraction for real problem of government ... - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|nxbg|20160922|256705516

cupe Ontario hospital admin cuts

shared by Heather Farrow on 23 Sep 16 - No Cached
  • BioMedReports Thu Sep 22 2016,
  • TORONTO, ONTARIO--(Marketwired - Sept. 22, 2016) - The appointment of a provincial supervisor for Brockville General Hospital (BGH), a Mike Harris strong-arm tactic that the Ontario Liberals once railed against, is a "surface distraction from the real problem; provincial underfunding of our hospitals, including BGH, that is causing deficits," the Canadian Union of Public Employees (CUPE) charged today.
  • Reports suggest that the hospital borrowed $5 million in addition to a $4 million deficit. "Suggesting that mismanagement is at the root of the hospital's deficit deflects blame from the culprit, a provincial government intent on starving hospitals of the funding they need to provide adequate patient care. Putting the hospital under administration is an optics exercise to distract from the significant provincial funding shortfall," says Michael Hurley, president of CUPE's Ontario Council of Hospital Unions. CUPE represents several hundred BGH front line staff.
  • ...2 more annotations...
  • Ontario is among Canada's lowest provincial funders for hospital care. Based on the latest figures from the Canadian Institute for Health Information (CIHI), Ontario government funding for hospitals is $1,395.73 per capita. The rest of Canada, excluding Ontario, spends $1,749.69 per capita. In other words, provincial and territorial governments outside of Ontario spend $353.96 more per person on hospitals than Ontario does. That is a whopping 25.3 per cent more than Ontario. "BGH is not alone in racking up a deficit. Every hospital in Ontario is struggling because hospital funding is far too low," says Hurley. Research done by CUPE has found that average Ontario hospital funding for the population the size of Brockville in 2005/6 would have been about $1.04 million less than average funding for the same population outside of Ontario. But by 2015/16 the funding shortfall for a population the size of the City of Brockville would have exploded to $7.74 million.
  • "$7.74 million a year for the Brockville hospital would have them operating solidly in the black. This hospital is struggling valiantly to provide services through eight consecutive years of provincial funding cutbacks. The solution here isn't a supervisor and more cuts to care, staff and programs but to increase this hospital's funding," says Hurley.The views expressed in any and all content distributed by Newstex and its re-distributors (collectively, the "Newstex Authoritative Content") are solely those of the respective author(s) and not necessarily the views of Newstex or its re-distributors. Stories from such authors are provided "AS IS," with no warranties, and confer no rights. The material and information provided in Newstex Authoritative Content are for general information only and should not, in any respect, be relied on as professional
Irene Jansen

Alberta Views - Perspectives On A Province | A Painful Truth. Diana Gibson. 2011 - 0 views

www.albertaviews.ab.ca/...a-painful-truth

occupancy hospitals alberta

shared by Irene Jansen on 21 Feb 12 - No Cached
  • Hospital spending in Alberta has plummeted from 44.7 per cent of health spending in 1975 to 27.8 per cent in 2009.
  • “Most Canadian urban hospitals routinely operate at greater than 100 per cent bed occupancy.
  • Canada had only 1.8 acute care beds per 1,000 population in 2008, the lowest number of all OECD countries except Mexico (the OECD average is 3.6 beds per 1,000 people).
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  • One year after Dr. Parks’s letter was leaked, the government claims the ER wait times issue is under control.
  • Should we believe the hype?
  • In October 2010, local media published a leaked letter from the province’s chief emergency room doctor to Health & Wellness Minister Gene Zwozdesky and other government officials warning of “catastrophic collapse” if immediate action wasn’t taken. The letter was written by Dr. Paul Parks, president of the Alberta Medical Association Section of Emergency Medicine
  • Dr. Parks started to collect examples of substandard care and “adverse events” caused by overcrowding in the ER
  • When the letters and reports were eventually leaked to the media in 2010, they launched a firestorm.
  • It’s common to have five-plus EMS units and their medics tied up for hours while they wait for an ER stretcher to be freed up so that they can download their patient and get back on the streets
  • The situation has gotten so out of hand that we now have patients calling 9-1-1 from the ER
  • ER was overcrowded because hospitals were overcrowded
  • A study in the British Medical Journal found that patients whose ER wait times were six hours or longer were more likely to suffer an “adverse event,” such as the need for hospital admission, or even death.
  • Dr. Parks estimates that Alberta’s large-volume hospitals are still hovering at around 30 per cent of beds occupied by patients waiting to be admitted—meaning that those hospitals are still operating at well over capacity.
  • Dr. Parks, ER doctors were clear from the beginning of this crisis that the issue of overcrowding in emergency was due to downstream capacity problems, mostly a lack of long-term-care beds in nursing homes.
  • despite our vast wealth, Alberta has fewer hospital beds than the Canadian average.
  • The same situation exists for long-term care, where Alberta’s number of beds per capita falls below the national average. But don’t think the province makes up for this by supporting those folks in their homes. Alberta also sits close to the bottom of provinces for home-care spending.
  • the government opened 360 new hospital beds in Edmonton and Calgary in 2011. It announced plans to open 5,300 new long-term care beds by 2015 (1,174 of them were ready by April 2011), to make additional investments in home care (800 new clients in Edmonton and Calgary) and to improve patient discharge planning. It also announced a five-year plan that includes a primary-care focus
  • But there’s no plan to increase full long-term care, nursing homes and auxiliary hospitals. This is the category of care that is most needed to take pressure off our hospitals
  • He also says that even if beds are created, they may not match the needs of hospitalized patients, because of the lower levels of nursing support and the high personal cost for the patient and his family. “Indications are that the private, for-profit care model may actually create barriers to moving patients out of hospital beds,” he says.
Govind Rao

The great shrinkage: fiscal capacity under Prime Minister Harper - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150903|228460444

from heather accord funding taxes medicare

shared by Govind Rao on 03 Sep 15 - No Cached
  • The Globe and Mail Thu Sep 3 2015
  • When the Harper government took office, federal tax revenues (2006-07 fiscal year) were 13.5 per cent of GDP, a bit shy of the 14.5per-cent peak in 2000-01. In the most recent fiscal year (2014-15), they are projected in the most recent federal budget to be just 11.4 per cent of GDP, which is lower than in the mid-1960s before the creation of much of the modern welfare state. With total GDP now just under $2-trillion, a seemingly small decline in federal tax revenues of 2.1 percentage points of GDP translates into foregone annual revenues of $41.5-billion. To put that in perspective, in 2014-15, federal transfers to the provinces for health care and social programs combined came to almost as much, $44.7-billion. If federal capacity were at the same level as in 2006, Canada could afford eight national childcare programs on the scale proposed by NDP Leader Thomas Mulcair. Or we could more than triple the current level of federal funding of transit and municipal infrastructure.
  • To which the government responds that it has had to deal with many factors outside of its control, including a global recession and the recent collapse of commodity prices. But the government can be fairly judged by its own discretionary fiscal actions, including decisions whether to raise or lower spending and taxes, and whether to run deficits.
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  • Economic Insight Prime Minister Stephen Harper's economic record since taking office in 2006 is at the centre of debate in the current federal election campaign. Arguably his signature achievement is to have radically reduced the fiscal capacity of the federal government, and with it, the broader role of government in advancing the economic and social welfare of Canadians. As labour economists Jim Stanford and Jordan Brennan have shown, the Harper economic record is the worst of any postwar federal government when judged by 16 key macro-economic variables including per capita GDP growth, job creation, unemployment and under-employment, business investment, exports and productivity growth.
  • Tax cuts have clearly been a much greater priority for the Harper government than investments in programs or services, or balancing the federal budget. Revenues continued to fall after 2008-09 when the government first ran a deficit, mainly as a result of corporate tax cuts. Almost all taxes have been reduced. The general corporate income tax rate has been cut gradually but deeply from 22.1 per cent to 15 per cent, with each one percentage point reduction costing $1.85-billion in lost revenue per year according to the Parliamentary Budget Officer. The two percentage point cut to the GST introduced in the early days of the government now costs $12.8-billion per year in lost revenues.
  • With respect to the personal income tax, the government has brought in numerous "boutique" tax credits and deductions, a universal child tax credit, and family income splitting, which mainly benefits more affluent families with children at a cost of $2.2billion a year. While it still costs relatively little, the new system of Tax-Free Savings Accounts now allows for contributions of up to $10,000 a year with no cap on total accumulations. This will eventually all but eliminate taxation of investment income such as capital gains as the assets of the richest Canadians are gradually shifted to tax-free vehicles.
  • Opinions obviously differ as to the wisdom of specific tax cuts and their impact on economic growth and social justice. The government argues that lower taxes and smaller government underpin a strong economy, while the critics point to the unfair distribution of winners and losers from tax cuts, weak business investment despite corporate tax cuts and the costs of foregone public investments. One thing is clear. A progressive alternative to the Harper government and ambitious investment plans will be possible only if some part of the massively eroded fiscal capacity of the federal government is restored. Andrew Jackson is adjunct research professor in the Institute of Political Economy at Carleton University, and senior policy adviser to the Broadbent Institute.
Heather Farrow

NetNewsLedger - Thunder Bay News - Frailty a better gauge for health-care funding - 0 views

www.netnewsledger.com/...tter-gauge-health-care-funding

accord

shared by Heather Farrow on 26 Jul 16 - No Cached
  • Posted 25 July 2016
  • Canada’s per capita health funding formula fails to address the clear and growing need created by our frail population. When the previous Health Accord expired in 2014, the Conservative government unilaterally established a new funding model for federal health transfer payments to the provinces and territories on an equal per capita basis. It included a guarantee that no province would receive less than its 2013 transfer amount, with a further guaranteed minimum three per cent growth rate from 2017 onward. So what’s not to love? Plenty.
  • That makes sense. But the health minister should also craft a new federal funding arrangement based on the more precise and evidence-based concept of frailty.
Govind Rao

The cost of coverage - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|pgct|20150323|216970347

from heather pharmacare drugs bc

shared by Govind Rao on 23 Mar 15 - No Cached
  • Prince George Citizen Mon Mar 23 2015
  • The case for a national pharmacare program, covering prescription drug costs for all Canadians, is now noticeably stronger. A persuasive new study analyzing the cost of such coverage has found it would save a great deal of money, especially for the private sector, with relatively little expense to government. "In many of the scenarios that we modeled, universal pharmacare was cost-neutral for governments," said Dr. Danielle Martin, one of the study's authors and a vice-president at Women's College Hospital in Toronto. "This goes against current thinking that a universal program will cost more."
  • These findings, published on Monday in the Canadian Medical Association Journal, should be required reading for provincial and territorial politicians and especially in Ottawa, where federal determination to make pharmacare happen has been noticeably lacking. Universal public drug coverage could lower annual spending on prescription medicine in Canada by $7.3 billion, conclude the study's authors. Several scenarios were developed on what such a program might cost government, with the worst-case estimate pegging additional costs at $5.4 billion and the best-case scenario producing a net saving of $2.9 billion. Under a mid-range "base scenario," total cost to governments would be $958 million. But that would generate an $8.2-billion drop in private-sector spending on prescription drugs. It's an investment well worth making. Savings of this magnitude would put Canadian per capita prescription drug spending on par with levels in countries such as Switzerland, Austria and Spain, note the authors. (Nations such as the United Kingdom, New Zealand and Sweden spend even less.) Canadians currently shell out an average of 50 per cent more, per capita, than people in other developed countries.
Irene Jansen

On health-care funding, 2 + 2 probably does equal 4 - The Globe and Mail - 0 views

www.theglobeandmail.com/...article2270491

accord cht

shared by Irene Jansen on 23 Jan 12 - No Cached
  • In 1977 both sides agreed to an incredibly complex formula, the essence of which was that federal funding for health care would increase annually at the rate of the nominal increase in the gross domestic product averaged over the previous three years.
  • the rate of inflation, add the rate real of economic growth – which, combined, equals nominal GDP
  • John Wright is CEO of the Canadian Institute for Health Information
  • ...8 more annotations...
  • He believes the 1977 formula is “the most logical” basis for a new agreement.
  • Federal government revenues generally increase at same rate as nominal GDP.
  • we can already calculate the likely increase for 2017, the first year of the new agreement. The Bank of Canada is determined to limit inflation to 2 per cent annually. The spreading debt crisis that is imperiling the euro is suppressing growth projections for Canada going forward. Over the next three years, growth of 2 per cent annually is a reasonable guess. Two plus two equals four
  • the Canadian economy could prove the cynics wrong, but an average of 3 per cent is as enthusiastic as anyone not waving pom-poms would predict. In that case, health-care funding would increase by 5 per cent – still well below the provincial demand of 6 per cent, at least.
  • the United States and Canada could be dragged into a recession along with Europe. If so, inflation could turn into deflation
  • But the Conservatives promise that the final agreement will contain a funding floor
  • the Harper government is adamant that any future deal be negotiated on a strictly per capita basis
  • The Harper government is firm in the belief that regional equalization subsidies should be restricted to the equalization program itself.
Govind Rao

Canada's health-care system is financially unsustainable - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|kwrc|20150305|215760176

from heather privatization medicare

shared by Govind Rao on 05 Mar 15 - No Cached
  • Waterloo Region Record Thu Mar 5 2015
  • Here's a little thought quiz: Which of the following characteristics come to mind when you hear the term "monopoly service": efficient, customer-oriented, innovative, high quality, low cost? If you answered "none of the above," you probably recall the days when hooking up your telephone, sending a package or even travelling by air offered few or no choices. Today, we have a wide variety of competing providers that offer higher quality service at a lower cost.
  • But in health care, by far the most important and costly service, Canada is the only country that forbids competing with the public system. A 2014 Commonwealth Fund Report found the performance of Canada's monopoly health-care system ranked well behind Australia, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom. And a 2013 Organization for Economic Co-operation and Development (OECD) report found that, despite spending 36 per cent more per capita than the OECD average, Canada has the longest wait times for elective surgery.
  • ...7 more annotations...
  • The 2012 government of Ontario-commissioned Drummond report projected that the cost of the province's health-care system, which already devours almost half of provincial spending, will rise to 80 per cent over the next two decades. The report states, "We challenge the government to open the door more widely for private sector involvement, not only to improve efficiencies, but also to capitalize on the huge economic potential in building a vibrant health care sector in Ontario".
  • The role of government is mainly funding and regulatory. The lesson here is that, as in virtually all other sectors, governments that try to be the deliverer and the regulator fail to do either well. That systems featuring competing private sector providers would prove superior to a bureaucratic government monopoly should come as no surprise. But that monopoly is also financially unsustainable. Ontario is the poster boy for this stark reality.
  • Recent Fraser Institute reports on the German and Dutch health-care systems found that just five per cent suffered elective surgery wait times longer than four months, compared with 25 per cent in Canada. Those assessments also pinpoint the key reasons for this superior performance. Germany provides universal access to high quality, timely health care through statutory social health insurance, along with an option to buy supplemental insurance. Since Germany's government monopoly health-care system was replaced in 1991, the proportion of care delivered by private hospitals and clinics has risen to 70 per cent. The result has been higher quality care and shorter wait times at a lower cost. Private hospitals and clinics also play a dominant role in the Netherlands. The Dutch system offers universal coverage while allowing the public to select providers competing on the basis of quality and timelines of care.
  • So what is that "economic potential"? A 2013 report commissioned by the Royal College of Physicians and Surgeons found that one out of six new medical specialists can't find work, while many others accept roles far below their qualifications. Even long-established specialists are only working part time because of severe shortages of operating room access. Allowing these highly qualified professionals to fill those empty hours treating paying patients in private facilities would not only reduce public system waiting lists and costs, but also foster the establishment of Canada as a "go-to" country for fee-paying international patients. This represents a huge opportunity to enhance the sustainability of our public health-care system, while creating a thriving private health care industry.
  • One would think such a compelling picture would have funding-stressed governments eager for change. But with the exception of Quebec, provinces have tried to stamp out the fragile green shoots of private patient care. The fate of private health care will soon rest with the Justices on the Supreme Court of British Columbia.
  • After the British Columbia Medical Services Commission ordered him to stop collecting fees at his Vancouver private clinics, Dr. Brian Day launched a lawsuit on behalf of four of his patients claiming a constitutional right to access timely private care. These patients had faced long waiting times that would have proven permanently debilitating or even fatal.
  • It's astounding that Day and his patients should be forced to fight an expensive court case aimed at winning Canadians the same freedom of choice that exists in every other country. Governments across Canada had better hope he wins, or they will see their citizens trapped in a downward spiral of ever-longer waiting lists and ravaged social programs. Gwyn Morgan is a retired Canadian business leader who has been a director of five global corporations. (troymedia.com)
Heather Farrow

Supervisor at city hospital a 'distraction': Union - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|brrt|20160924|256862233

cupe Ontario hospital

shared by Heather Farrow on 26 Sep 16 - No Cached
  • The Brockville Recorder & Times Sat Sep 24 2016
  • Brockville General Hospital needs more provincial funding, not a provincial supervisor, an Ontario hospital workers' union argues. The Canadian Union of Public Employees (CUPE) said in a media statement the appointment of the supervisor at BGH is a "surface distraction from the real problem: Provincial underfunding of our hospitals, including BGH, that is causing deficits." "This is being characterized as a problem of management, but we would say, actually, this is a systemic problem of underfunding, chronic underfunding," Michael Hurley, president of CUPE's Ontario Council of Hospital Unions, added in a telephone interview Friday. Officials at the Ontario Ministry of Health and Long-Term Care on Friday reiterated that the appointment of a supervisor stems from a local recommendation.
  • BGH officials this week confirmed the Ontario government will appoint a supervisor who will have full control of the organization's affairs. The move, initiated by the hospital's board of governors, follows news the hospital has borrowed $5.3 million from the South East Local Health Integration Network (LHIN) to cover its bills. The hospital faces an additional $4.2-million deficit for 2016. BGH interim president and chief executive officer Wayne Blackwell this week said a provinciallyappointed supervisor will help develop the plan for putting BGH back on track.
  • ...4 more annotations...
  • The provincial government has only exercised the right to appoint a supervisor to Ontario hospitals 21 times since 1981. But CUPE, which represents more than 300 BGH front line staff, called the move "an optics exercise to distract from the significant provincial funding shortfall." The union said it relied on the latest figures from the Canadian Institute for Health Information (CIHI), to conclude the Ontario government's funding for hospitals is $1,395.73 per capita. The rest of Canada, excluding Ontario, spends $1,749.69 per capita, the union added. CUPE's own research shows that average Ontario hospital funding for a population the size of Brockville in 2005-06 would have been about $1.04 million less than average funding for the same population outside of Ontario. By 2015-16, the union adds, the funding difference would have reached $7.74 million.
  • That much more money every year would put an end to BGH's financial distress, added Hurley. "We're advocating for the hospital to receive an infusion of funding," he said. Leeds-Grenville MPP Steve Clark has also pointed to the provincial funding model as a "primary factor" behind BGH's fiscal woes. Staffat the Ministry of Health and Long-Term Care did not immediately respond on Friday to a question about CUPE's funding figures, but defended the appointment of a supervisor.
  • In an email to The Recorder and Times, spokesman David Jensen said the supervisor's appointment is based on a recommendation by the South East LHIN, which cited "ongoing concerns about the hospital's financial situation and organizational challenges." Jensen cited local media coverage "regarding the organization's financial challenges as well as other organizational issues facing BGH. "The appointment of a supervisor will help to move the hospital forward to achieve its goals and foster the development of more positive relationships," wrote Jensen. At this stage, added Jensen, the supervisor appointment is still a recommendation to be made by Health Minister Dr. Eric Hoskins.
  • "If appointed, a hospital supervisor would work with the hospital and government to support robust governance and management at the facility," wrote Jensen. The minister has notified BGH of his intention to recommend to the Lieutenant Governor in Council that a hospital supervisor be appointed, added Jensen. The Public Hospitals Act provides for a 14-day notice period, after which the supervisor can be appointed.
Heather Farrow

Alberta's sky-high health care costs make deficits hard to shake: report - Calgary - CBC News - 0 views

www.cbc.ca/...are-spending-deficit-1.3645646

Alberta privatization spending

shared by Heather Farrow on 22 Jun 16 - No Cached
  • Per-capita spending is 33% above national average, Conference Board of Canada says
  • Jun 21, 2016
  • Alberta spends more money on health care per capita than any other province and demand is only going to increase, making it difficult for the province to meet its modest deficit-reduction targets, according to the Conference Board of Canada.
Irene Jansen

APEC. February 2012. Pre-budget fiscal update for Atlantic Canada - 0 views

www.apec-econ.ca

cht nb ns nl pei

shared by Irene Jansen on 16 Feb 12 - Cached
  • Irene Jansen on 16 Feb 12
     
    a shift to per capita health funding would reduce the Canada Health Transfer by $55 million in Newfoundland and Labrador, $3 million in Prince Edward Island, $22 million in Nova Scotia and $17 million in New Brunswick.
Irene Jansen

Aging population makes feds' health care cuts hurt: Falcon - 0 views

www.vancouversun.com/...story.html

accord diktat bc

shared by Irene Jansen on 23 Jan 12 - No Cached
  • British Columbia will receive $256 million a year less when the new per capita system takes effect in 2014-15
  • Alberta, for example, will gain an additional $1 billion a year.
  • Tweaking the per-capita formula to reflect B.C.'s older population will help the province recover much of the $256 million, said Falcon.
  • ...3 more annotations...
  • Falcon said he supports the new plan because it gives ample lead time for provincial governments to begin to take more control of their own health care systems.
  • Adrian Dix who accused the B.C. Liberal finance minister of selling out taxpayers."Let's be clear, when Mr. Falcon signs off into the future on shortfalls that are at least $250 million, according to him, he is arguing for long-term cuts to senior's care and health care services
  • Under the new system there won't be a tax-point component, just a cash transfer.
Govind Rao

Spending on prescriptions is slowing - but it won't last for long - The Globe and Mail - 0 views

www.theglobeandmail.com/...article15945038

from heather drugs

shared by Govind Rao on 17 Dec 13 - No Cached
  • Steve Morgan and Kate Smolina Contributed to The Globe and Mail Published Friday, Dec. 13 2013,
  • Canadians spent almost $23-billion on prescription drugs at retail pharmacies in 2012/13 – or more than $650 per capita, according to the findings from the Canadian Rx Atlas published recently by the UBC Centre for Health Services and Policy Research. That is a lot of money. However, after adjusting for general inflation, spending per capita actually fell over the past five years – despite the fact that the population is getting older.
Govind Rao

South East LHIN's announcement of $21 million budget cuts to area hospitals will endanger quality of care and will not pass without strong resistance from staff- union | Ontario Council of Hospital Unions news and information | Canadian Union of Public Em - 0 views

www.ochu.on.ca/...lhins_cutback_announcement.php

from heather hospital cuts cupe Ontario campaign

shared by Govind Rao on 08 Sep 15 - No Cached
  • 04/September/2015
  • Toronto ON- “The announcement by the South East LHIN that it plans to cut hospital budgets in the region of the province that includes Brockville, Perth/Smith’s Falls, Kingston, Quinte, Picton, Trenton and Belleville by $16 to $21 million dollars is staggering and will ultimately endanger patient care” said Michael Hurley, President of the Ontario Council of Hospital Unions/CUPE. “This announcement comes on top of 4 years of budget cuts, which have reduced these hospitals budgets by 24% in real terms,” Hurley explained.
  • Hospital across the South East LHIN are cutting services in the face of a 5-year funding freeze imposed by the provincial Liberal government. An Ontario’s Auditor General report quotes studies which estimated that hospitals need a 5.8% increase in funding each year just to keep pace with the costs of drugs, medical technologies and doctors’ salaries which are rising faster than the general rate of inflation. The freeze has cut hospital budgets by 24% in real terms. Ontario hospitals were already the most efficient hospitals in the country with the fewest beds and staff and the shortest lengths of stay going into the budget freeze. Ontario spends $350 less per capita than any other province in Canada.
  • ...2 more annotations...
  • We can predict that beds and services will close as a result of funding cuts of this magnitude. Access problems will intensify and quality of care will deteriorate further. Women and the elderly will be hit hardest. The hospital staff that we represent will plan a stiff resistance, including demonstrations, rallies, lobbying, advertising and public engagement,” said Hurley.
  • Ontario’s Liberals dropped the corporate income tax rate to one of the lowest in North America, and economists estimate that the province has lost nearly $20 billion in revenue. This drop in tax revenue triggered austerity in provincial expenditures including a 5-year funding freeze for Ontario hospitals, already the worst funded per capita in Canada. “ Ontario’s hospitals are the least expensive and most efficient in the country and they are starved of operating revenue. It’s time for the provincial government to reverse the deep cuts it has made in hospital budgets in Ontario. The announcement of budget cuts of $20,000,000 to hospitals in the South East LHIN is surely an indicator of how bad the situation has become,“ said Hurley.
Govind Rao

Pharmacare article Aug 27 2014 - 0 views

www.fpinfomart.ca/...arrow_20140903_1416_ir7i_6.pdf

from heather pharmacare

shared by Govind Rao on 03 Sep 14 - No Cached
  • Govind Rao on 03 Sep 14
     
    Waterloo Region Record  Wed Aug 27 2014  Page: A7  Section: Editorial  Byline: Marc-André Gagnon  Canadians pay among the highest costs per capita among Organization for Economic Co-operation and Development countries for prescription drugs, with one Canadian out of 10 unable to fill their prescriptions because of financial reasons. According to the recently released study, A Roadmap to a Rational Pharmacare Policy in Canada, commissioned by the Canadian Federation of Nurses Unions, there are two main reasons why prescription drug costs are so expensive in Canada. First, we have a fragmented system with multiple public and private drug plans. In a fragmented system, attempts to reduce costs normally result in shifting the cost somewhere else in the system. Although provincial public plans have managed to significantly reduce drug costs since 2010 by reducing the price of generics and by negotiating confidential agreements with drug companies, there have been significant cost increases in private plans as drug companies and pharmacists seek compensation for their losses from public plans. Second, according to the study, Canadians pay artificially inflated prices for both brand-name drugs and generics in order to support the national pharmaceutical sector. But this strategy has not delivered what was promised, namely, investment and employment in Canada. Studies show that paying higher prices for drugs does not result in a thriving pharmaceutical sector in the country. Numbers alone tell the story; employment in the Canadian brand-name pharmaceutical sector went from 22,332 employees in 2003 to 14,990 in 2012. Instead of 
Govind Rao

Modernize, not privatize, medicare - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|wifp|20151214|235819030

from heather medicare accord privatization

shared by Govind Rao on 15 Dec 15 - No Cached
  • Winnipeg Free Press Mon Dec 14 2015
  • National Medicare Week has just passed, buoyed with optimism as a fresh-faced government takes the reins in Ottawa -- elected partly on a promise of renewed federal leadership on health care. Yet, these "sunny ways" are overcast by recent developments at the provincial level that entrench and legitimize two-tier care. Saskatchewan has just enacted a licensing regime for private magnetic resonance imaging (MRI) clinics, allowing those who can afford the fees -- which may range into the thousands of dollars -- to speed along diagnosis and return to the public system for treatment. Quebec has just passed legislation that will allow private clinics to extra-bill for "accessory fees" accompanying medically necessary care -- for things such as bandages and anesthetics.
  • Once upon a time, these moves would have been roundly condemned as violating the Canada Health Act's principles of universality and accessibility. These days, two-tier care and extra-billing are sold to the public as strategies for saving medicare. Under Saskatchewan's new legislation, private MRI clinics are required to provide a kind of two-for-one deal: for every MRI sold privately, a second must be provided to a patient on the public wait list, at no charge to the patient or the public insurer. Quebec's legislation is touted as reining in a practice of extra-billing that had already grown widespread.
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  • Underlying both reforms is a quiet resignation to the idea that two-tiered health care is inevitable. This sense of resignation is understandable, coming as it does on the heels of a decade-long void in federal leadership on health care. Throughout the Harper government's time in office, the Canada Health Act went substantially unenforced as private clinics popped up across the country. Even in its reduced role as a cheque-writer, the federal government took steps that undermined national unity on health care, switching the Canada Health Transfer to a strict per capita formula, which takes no account of a province's income level or health-care needs. If Canadians hope to reverse this trend, we cannot simply wage a rearguard battle for the enforcement of the Canada Health Act as it was enacted in 1984. Even if properly enforced, the act protects universal access only for medically necessary hospital and physician services. This is not the blueprint of a 21st-century public health-care system.
  • We desperately need universal coverage for a full array of health-care goods and services -- pharmaceuticals, mental-health services, home care and out-of-hospital diagnostics. Canada is unique among Organization for Economic Co-operation and Development countries in the paucity of what it covers on a universal basis despite falling in the top quartile of countries in levels of per capita health spending. Far from being our saviour, the Canada Health Act in its current incarnation is partly to blame -- not because of its restrictions on queue-jumping and private payment, but because it doesn't protect important modern needs, such as access to prescription drugs.
  • There are limits on what a public health system can provide, of course -- particularly as many provinces now spend nearly half of their budgets on health care. But fairness requires these limits be drawn on a reasoned basis, targeting public coverage at the most effective treatments. Under the current system, surgical removal of a bunion falls under universal coverage, while self-administered but life-saving insulin shots for diabetics do not. A modernized Canada Health Act would hold the provinces accountable for reasonable rationing decisions across the full spectrum of medically necessary care.
  • Instead of modernizing medicare, Saskatchewan and Quebec are looking to further privatize it. Experience to date suggests allowing two-tiered care will not alleviate wait times in the public system. Alberta has reversed course on its experiment with private-pay MRIs after the province's wait times surged to some of the longest in the country.
  • The current wisdom is long wait times are better addressed by reducing unnecessary tests. A 2013 study of two hospitals (one in Alberta, one in Ontario) found more than half of lower-back MRIs ordered were unnecessary. Skirmishes over privatization have to be fought, but they should not distract us from the bigger challenge of creating a modern and publicly accountable health system -- one that provides people the care they need, while avoiding unnecessary care.
  • Achieving that will make National Medicare Week a true cause for celebration. Bryan Thomas is a research associate and Colleen M. Flood is a professor at the University of Ottawa's Centre for Health Law, Policy and Ethics. Flood is also an adviser with EvidenceNetwork.ca.
Govind Rao

Provinces push for health-funding changes in Ottawa summit - The Globe and Mail - 0 views

www.theglobeandmail.com/...article27886224

from heather accord federal

shared by Govind Rao on 22 Dec 15 - No Cached
  • BILL CURRY and NICOLAS VAN PRAET OTTAWA and MONTREAL — The Globe and Mail Published Sunday, Dec. 20, 2015
  • Provinces are trying to push the federal government’s $36-billion health-transfer program onto the agenda of this week’s finance ministers’ meeting in Ottawa, with some calling for a new formula that shifts more cash to provinces with older populations.
  • The formula for federal health transfers changed last year so they are distributed on a per-capita basis, a change that led to a major increase for Alberta at the expense of other provinces.
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  • “The health-care transfers should not be simply on a per-capita basis but should include a formula, a ratio, indicating that [citizens] 65 years and over should get a different weight than those under 65,” he told The Globe and Mail. The minister said there is significant support for the idea.
Govind Rao

MIT Press Journals - American Journal of Health Economics - Early Access - Abstract - 0 views

www.mitpressjournals.org/...AJHE_a_00041

from heather costs research spending

shared by Govind Rao on 05 Apr 16 - No Cached
  • Posted Online March 31, 2016.
  • Bradley RossenDepartment of Economics, Laurentian University
  • Akhter Faroque
  • ...2 more annotations...
  • Department of Economics, Laurentian University
  • This paper uses a new (Hartwig-Colombier) method to decompose the growth rate of provincial per capita health-care spending in Canada over the period 1982–2011 into the contributions of the cost disease, traditional observable variables, and technological progress. Based on extensive robustness analysis across a variety of specifications, estimation methods, and two separate data sets, we find that the cost disease (rent extracting) is a relatively minor contributor, while technical progress in health care and growth in per capita incomes are by far the biggest contributors to the secular growth in health-care spending in Canada.
Heather Farrow

Make senior care a priority; New health accord - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20160827|254784412

accord seniors ltc

shared by Heather Farrow on 29 Aug 16 - No Cached
  • Toronto Star Sat Aug 27 2016
  • Canadian health care faces a rare opportunity - and a daunting challenge. Officials at the federal and provincial level are quietly working toward a new national accord with potential to reshape medicare in this country. If properly done, the process will produce a stronger, more efficient health-care system better serving the needs of both the sick and the healthy. Expect the opposite if turf wars prevail; if inadequate funding leaves vital parts of the system starved of cash and if established interests use this opportunity to give themselves a raise instead of investing in better patient care.
  • With negotiations expected to last for several more months, the outcome of this process remains far from clear. But provincial and territorial officials are, at least, talking with a Liberal government in Ottawa elected on a pledge to negotiate a new health pact. That, in itself, marks a welcome change from years of intransigence under former prime minister Stephen Harper. Under his misguided leadership, the federal level disavowed any responsibility for shaping the health-care system. When an earlier $41-billion health accord, negotiated by Paul Martin's Liberals, expired in 2014, Harper refused to do the hard work of negotiating a new deal.
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  • Instead, he simply continued existing transfers of money, with annual increases of 6 per cent, to be followed by a reduction, to about 3 per cent, as of 2017. That formula was issued unilaterally, without consulting the provinces. And transfers came with no strings attached, meaning the federal government effectively abandoned leadership in the realm of Canadian health care. It's vital for Ottawa to oversee the evolution of medicare. That's the best way to set shared national priorities and establish universal standards suited to Canadians' 21st-century needs.
  • One worthwhile change, forcefully advocated by the Canadian Medical Association earlier his week, would be for Ottawa to deliver additional health-care funding through a special "top-up" based on each province's population of seniors. Health transfers are currently issued on a per-capita basis, failing to take into account far heavier costs associated with caring for the aged. This gives provinces with a younger population, such as Alberta, a break while failing to adequately compensate those with more old people, including British Columbia and Ontario.
  • Health Minister Jane Philpott explained that promised changes to home care are part of ongoing talks toward a health accord. Fair enough. But it's essential for the federal contribution, in any new deal, to go beyond just this. Ottawa's health-care transfers to the provinces and territories totalled $34 billion last year, about 22 per cent of public spending in this area. At one time it was a 50-50 split. And Canada's provincial premiers, as recently as July, have urged the federal government to cover at least 25 per cent. That seems reasonable to expect from a new accord, especially given growing pressure on Canada's health-care system from an expanding, and rapidly aging, population.
  • Prime Minister Justin Trudeau appears to understand this, with his party campaigning on a pledge to "provide the collaborative federal leadership that has been missing during the Harper decade." Key to this is negotiating a new health accord, including a long-term agreement on funding. Now comes the hard part: actually hammering out a deal. The only immediate commitment made by the Liberals was an investment of $3 billion, over four years, "to deliver more and better home care services for all Canadians." But there was no mention of that in the federal budget this spring, a document notable for its lack of attention to expanding Canada's health-care system.
  • The Conference Board of Canada made a compelling case for a demographic top-up in a report last fall, calculating that it would cost Ottawa about $8.6 billion over five years. Currently, "there are large discrepancies across the country when it comes to the health-care services available to seniors, particularly in pharmacare, home care, long-term care and palliative care," warn authors of the report. "As Canada's population continues to age, this situation is likely to worsen."
  • One goal of a national accord is to eliminate, or at least ease, such discrepancies. To that end, it would make a great deal of sense to introduce some form of demographic top-up. This represents just one opportunity inherent in negotiating a new health accord. It remains to be seen if it will actually be delivered. © 2016 Torstar Corporation
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