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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.
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  • 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)
CPAS RECHERCHE

TThe 'Make or Buy' Decision in Long-term Care: Lessons for Policy - 0 views

www.euro.centre.org/...1402907971_54043.pdf

privatization soins de longue durée ltc europe

shared by CPAS RECHERCHE on 27 Oct 14 - No Cached
  • CPAS RECHERCHE on 27 Oct 14
     
    Executive Summary This report was commissioned by the Swedish Ministr y of Health and Social Affairs with the aim of analysing the decision to make or to buy long-term care services, i.e. whether to deliver long-term care services through public providers or contract them out to public and non-public providers. This report reviews existing literature on the theoretic al underpinnings of the make or buy decision and how it applies to the specificities of long-term ca re. It analyses the implementation of quasi-markets in four European countries that represent different long-term care systems: England, Denmark, Germany and the Netherlands. It also critically rev iews six quality assessment and quality management systems in Europe and the issues surroun ding the definition and assessment of quality in long-term care.
healthcare88

BC refutes Charter challenge of medicare - 0 views

www.cmaj.ca/...E369

day privatization bc

shared by healthcare88 on 18 Oct 16 - No Cached
  • CMAJ October 18, 2016 vol. 188 no. 15 First published September 19, 2016, doi: 10.1503/cmaj.109-5327
  • Steve Mertl
  • It was the British Columbia government’s turn Sept. 12 to rebut a Charter challenge barring doctors from operating both inside and outside the public health care system. However, anyone who came to the BC Supreme Court expecting an impassioned defence of medicare was disappointed. Instead, lawyer Jonathan Penner attacked the legal underpinnings of the case filed by Cambie Surgeries Corp., which operates a Vancouver private clinic, and its co-plaintiffs.
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  • Penner’s argument addressed core questions in the closely watched case: Does the law infringe doctors’ freedom to provide and patients’ right to receive timely medical care and, if it does, are those restrictions reasonable under the Canadian Charter of Rights and Freedoms?
  • The strains on the public system, such as waiting lists to see specialists and for surgeries, are “indisputable facts,” Penner told Justice John Steeves. But the remedy proposed by the plaintiffs — a hybrid system where doctors can deliver private and medicare services and patients can buy insurance for services already covered by medicare — will not solve the problem. In fact, said Penner, it could make things worse by disrupting the public system and diverting resources from it.
  • Penner warned that if the Cambie plaintiffs win their challenge, the implications will extend outside British Columbia. Other provinces have similar restrictions on physician practice and private insurance that, like BC, are tied to federal transfer payments under the Canada Health Act. The trial opened Sept. 6 when Peter Gall, acting for Cambie, an affiliated clinic and several patients, argued BC’s Medicare Protection Act handcuffed both doctors and those seeking timely care.
  • The law prevents physicians from operating both inside and outside of the provincial Medical Services Plan. The restriction on so-called dual or blended practices violates Section 7 of the Charter of Rights and Freedoms guaranteeing “right to life, liberty and security of the person,” Gall said.
  • Orthopedic surgeon Dr. Brian Day of Cambie Surgery Centre says provincial laws limiting private care have resulted in rationing and long waiting lists.
  • The law also keeps residents from using private insurance to pay for treatment for things covered by the public system, despite the fact that some groups, such as those covered under WorkSafe BC injury claims, get expedited private care. That violates the Charter’s equality provisions under Section 15, argued Gall. The arguments echoed long-held positions of orthopedic surgeon Dr. Brian Day, Cambie’s co-founder and the visible face of the case. He contends provincial laws limiting private care have resulted in rationing and long waiting lists.
  • The alleged Charter violations are far from clear cut, said Penner, as he reviewed previous Charter decisions. A key test, for instance, is whether legislation violates the principles of fundamental justice under Section 7. Past rulings have specifically warned against applying it to social policies, he pointed out. Gall noted that the Supreme Court of Canada’s 2005 decision in the Dr. Jacques Chaoulli challenge affirmed Quebecers’ right to use private medical insurance to pay for publicly insured services when the public system was inadequate.
  • But Penner said the wording of the Canadian and Quebec charters differ on fundamental freedoms and only three of nine Supreme Court justices found the Quebec law violated the Canadian Charter in Chaoulli. The evidence in the Cambie case is not the same, he added. “It will tell a very different story.” Even if evidence points to Charter violations, he said, such violations are legal under Section 1 of the Charter, which allows “reasonable limits prescribed by law as can be demonstrably justified in a free and democratic society.”
  • The justification here is government’s ability to ensure universal access based on need, not ability to pay, said Penner, adding courts have deferred to legislatures on social policies such as those covering housing. Granting the plaintiffs’ application would reverse that by putting patients with money or insurance ahead of those without, said Penner.
  • Penner was expected to take two days to present the government’s defence, with intervenors on both sides of the case presenting separate arguments later in the week. The trial is scheduled to last six months and hear from dozens of witnesses, including experts, historians and patients. Steeves’ decision is expected to end up being reviewed by the Supreme Court.
Govind Rao

Would you stand by while a senior was being abused? - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20150515|220533236

from heather seniors abuse violence ltc

shared by Govind Rao on 15 May 15 - No Cached
  • Toronto Star Fri May 15 2015
  • You've probably seen the telltale signs. But you weren't sure. You didn't want to embarrass or incriminate anyone. It wasn't really your business. That, says Margaret MacPherson of Western University, is why elder abuse remains a hidden epidemic. Friends, neighbours, relatives and caregivers sense that something is wrong. But they don't speak out or step in.
  • For the past three years, MacPherson has been spearheading the development of a campaign called It's Not Right! Changing Social Norms for Bystanders of Abuse of Older Adults. The objective is to turn bystanders into first responders. She and her colleagues from the university's Centre for Research and Education on Violence Against Women and Children introduced it to 130 federal and provincial officials, health-care professionals, social workers, police officers and non-profit leaders at a recent conference in Toronto.
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  • If their approach takes root, elder abuse will spread from the criminal justice system into the realm of social responsibility. Getting involved will become the norm. Challenging ageism - from the use of demeaning language about older people to the impatient shoves and insulting put-downs they endure - will be accepted, indeed expected.
  • MacPherson's partner and community link in this endeavour is Alison Leaney, co-ordinator for vulnerable adults at the office of the Public Guardian and Trustee in British Columbia. She has worked in the field for more than 20 years. Her role is to train citizens from coast to coast to overcome their uncertainty. A core group is already trained and reaching out to others in their region. Most of the members were at last week's conference.
  • There are no reliable statistics on elder abuse. Front-line workers estimate that somewhere between 4 and 10 per cent of seniors are abused physically, mentally, sexually or financially every year. But those are just the reported cases. The vast majority are not reported.
  • Contrary to common belief, most elder abuse does not occur in nursing or retirement residences. It happens in people's homes. The majority of perpetrators are family members. Seniors say nothing because of fear, shame or a desire to protect the loved one who is hurting them. It happens at every socio-economic level in every part of the country.
  • Changing public attitudes is a three-part process. First, people need to be taught to recognize the warning signals. Second, they need to get beyond their misgivings. Finally, they need the tools to intervene properly. Step one is relatively easy. Most people know what to look for: unexplained injuries (bruises, lacerations, fractures); behavioural changes (withdrawal, fearfulness, depression); unusual financial transactions (large cash withdrawals, sale of property, liquidations of assets). Step two becomes easy when you realize what's holding you back is often misinformation. Alan Berkowitz, an American psychologist specializing in bystander behaviour pointed to three common beliefs - all wrong - that immobilize people.
  • Most bystanders mistakenly think everybody else knows more than they do. Most abusers mistakenly assume everyone else treats older adults the way they do. Most people who want to help mistakenly believe they are outliers. "If you don't think other people are likely to do anything, you're less likely to act," Berkowitz said. "The perception becomes the reality." Step three is largely common sense. It doesn't take a psychology degree to figure out what to do - and what not do - when you suspect elder abuse.
  • 1. Listen carefully. Don't judge or jump to conclusions. 2. Encourage the individual to be his or her own advocate. People are more likely to act if they make the plan. 3. Don't take charge of the situation without the permission of the person you're trying to support. If he or she doesn't want help, respect that. 4. Don't be frustrated if an older adult insists nothing is amiss. Victims sometimes protect their abuser because it's a person they love unconditionally and don't want to be separated from. 5. Don't confront the suspected perpetrator. That can lead to retaliation against the victim. 6. Ask if there's someone the person would like to speak to - a doctor, a priest or minister, a social worker, a financial adviser, the head of the nursing or retirement home.
  • 7. Offer to find out what local services are available. MacPherson boils it down to a simple message: "You don't have to solve the problem," she stressed. "You just have to ask the older person: Are you OK? Do you want to talk about it? What can I do to help? "If we can teach everybody to take these steps, we can change attitudes." The goal is ambitious. The gain would be immeasurable. Carol Goar's column appears Monday, Wednesday and Friday.
Govind Rao

Advancing Social Rights in Canada | Irwin Law - 0 views

www.irwinlaw.com/...advancing-social-rights-canada

from heather book social services canada

shared by Govind Rao on 06 Jan 15 - No Cached
  • Edited by Martha Jackman and Bruce Porter
  • Canada is at a crossroads. The gap between our national self-image as a country that respects human rights and the reality of socio-economic inequality and exclusion demands a re-engagement with the international human rights project and a recommitment to the values of social justice and equality affirmed in the early years of the Canadian Charter of Rights and Freedoms.
  • Irwin Law Inc. August, 2014
Govind Rao

Saving costs, hurting families - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246200|ntnp|20150313|216302039

from heather Quebec cuts

shared by Govind Rao on 13 Mar 15 - No Cached
  • National Post Fri Mar 13 2015
  • Gaetan Barrette, Quebec's Minister of Health, recently announced proposed legislation that would change how the province funds in vitro fertilization (IVF) for women unable to conceive without medical assistance. Women would have to sign a declaration stating that they had been sexually active for a sustained period, and were still unable to become pregnant. Women over the age of 42 would not be eligible for IVF at all. Minister Barrette, I would like to introduce you to Mikey, my little boy. I had him when I was 43 and I am not alone. The trend toward later motherhood is significant in most Western countries today. The proportion of Canadian women giving birth in their early forties has doubled since 1988, and in the U.S., it has quadrupled. The decision when to have a child is very personal. It is also widely acknowledged that women today are under tremendous social pressures to "be responsible," complete their education and establish financial and relationship stability prior to starting a family. Having a child later in life is not always a mere preference; often it is the result of how our current social structure limits the choices open to women. But by the time it is "socially responsible" to have a child, it may become biologically challenging. Our fertility declines and we are racing against our biological clocks. This is precisely when some need the assistance of IVF to conceive.
  • I am not certain why you chose 42 as a threshold (perhaps you are relying on policy advice from Douglas Adams' Hitch Hiker's Guide to the Galaxy, that suggested "42" is the answer to the meaning life). But this age threshold discriminates between women who are lucky enough to conceive spontaneously in their forties, and those who need assistance. It also discriminates between me and my husband, for whom there is no age limit in your Bill. Is it medically riskier to have a baby after 40? Yes, it is. Does the risk justify not having a baby? In most cases, it does not. And in almost all cases, this is a decision that a woman should have the liberty to make for herself. Women are making much riskier decisions without government intrusion, such as undergoing plastic surgery. They are making them for more trivial reasons than the desire to bring a child into the world.
  • ...4 more annotations...
  • Your proposed Bill 20 is meant to improve health-care access and cut costs in Quebec. But by banning access to IVF for women over 42, it is overstepping its objectives and violating the rights of citizens. Choosing to limit public funding for a service, when trying to save money, is one thing; but banning it completely, even when people choose to pay out of their own pockets, is an entirely different matter. When you were recently challenged on this point, you said that this is not a matter of cost but rather of "protecting mothers and children." My son and I are doing very well, thank you for your concern. And like other mothers who conceived in their 40s, I would appreciate some respect for my autonomy. This justification of 42 as an age limit for IVF is good old-fashioned paternalism that has no place in today's society. Under the guise of protection, this Bill represents an attack on Quebec women and mothers.
  • To make things worse, Bill 20 is threatening physicians with heavy fines if they direct me to another province or jurisdiction where I can privately access IVF after 42. This is an alarming violation of the professional autonomy of a doctor to refer patients, not to mention a violation of a woman's freedom to have access to health information she needs. In 2010, the Quebec government introduced a program that funded every aspect of IVF for everyone, an unprecedented level of coverage in North America. The program was in such high demand that it cost much more than expected, $261 million to date. Looking back, there is wide agreement in Quebec that the hasty introduction of the program in the absence of reflection and public consultation led to very problematic consequences. You, Minister Barrette, famously criticized this program for being an "open bar" and allowing access to IVF without appropriate restrictions.
  • But the fix for bad policy is not another bad policy. Proposing ethically and socially appropriate conditions of eligibility for publicly funded IVF is a laudable objective. The thoughtful and well-argued report published in June 2014 by the Quebec Commissioner for Health and Well-being, based on an extensive public consultation, proposes many such conditions that would allow cutting costs while respecting considerations of justice and equity. Conditions on access to public funding may be justified.
  • But there is no way to justify draconian measures that have nothing to do with cost control, but are rather an affront to women's rights. Rather than protecting us from IVF, you should protect us from unwarranted government intrusion. Vardit Ravitsky is an associate professor in the Bioethics Program at the School of Public Health, University of Montreal.
Irene Jansen

Home care or homes? John Chilibeck - telegraphjournal.com - coverage of CURC paper - 0 views

telegraphjournal.canadaeast.com/...1447074

home care nb

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Provinces should start offering better home-care services rather than keep building costly nursing homes, a new national study suggests.
  • "Seniors want to live at home as long as they can and they deserve to have quality care," Cassista said on Tuesday, the eve of a big convention held by the Congress of Union Retirees of Canada, which sponsored her study.
  • The report calls upon Ottawa to introduce a national home-care program with standards comparable from province to province.
  • ...7 more annotations...
  • the Manitoba model, which offers the highest-end version of home care in the country: Unionized employees work shifts, allowing patients to receive service up to 24 hours a day, seven days a week.
  • in Manitoba, where a universal home-care program was created in 1974
  • There's a high turnover because they aren't paid good wages or benefits
  • There's no training and little regulation, so that doesn't help either
  • a spokeswoman for the Department of Social Development said offering home care all the time would also be too expensive
  • "The implementation of a 24/7 subsidized home support service would definitely be challenging in light of the current fiscal situation of the province," Judy Cole wrote in an email. "We would also have to examine our ability to recruit and train home-support workers to provide round-the-clock service. Home-support agencies would be called upon to revamp their operations to 24/7."
  • Cole said the province provides up to a maximum of 336 hours a month of home support or about 11.2 hours a day. The cost of the program in New Brunswick is about $120 million a year to serve 8,000 clients. Manitoba, on the other hand, served a monthly average of about 23,000 clients in 2009-2010, the latest figure available. Even taking Manitoba's bigger population into account, it still offers many more seniors home-care services than New Brunswick does on a per capita basis.
Irene Jansen

Union asks N.B. government to audit Red Cross Home Support Service Agreement < Bargaining, New Brunswick | CUPE - 0 views

cupe.ca/...overnment-audit-red-cross-home

home care wages nb

shared by Irene Jansen on 23 Jan 12 - No Cached
  • In August, the Minister of Social Development, Sue Stultz, announced an additional $4.4 million to increase funding to home support agencies to $16 per hour with a requirement for agencies like the Red Cross to pay its workers a minimum wage of $11, as of October 1.&nbsp;&nbsp;
  • “At the present time, this increase has not been paid to the workers. Most of the Home Support workers are women, who live below the poverty line. They don’t have full employment and the highest paid worker at Red Cross receives $9.65 an hour after ten years of services.&nbsp; Even with an increase to $11 an hour, we would be the lowest paid in the Maritimes province. When you compare this with people doing the same work in other provinces, the difference in wages is huge.&nbsp; For example, in 2008, in Nova Scotia, they received $15.62 an hour and in PEI, $19.19.”
  • In New Brunswick, there are 57 home support agencies which employ 3,300 workers. This afternoon, a petition signed by 2,469 New Brunswickers will be presented at the Legislative Assembly by the MLA for Nepisiguit, Ryan Riordon. The petition is asking the Provincial Government to adequately subsidize the services of home support workers so that the workers receive wages and benefits worthy of the value of their work. The petition is also asking that this service becomes an accessible public service and an equal quality for the entire province.
Govind Rao

Call to save BGH laundry rejected - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|brrt|20150422|218937352

from heather Ontario laundry cuts privatization

shared by Govind Rao on 22 Apr 15 - No Cached
  • Brockville Recorder and Times Wed Apr 22 2015
  • It's not city council's place to tell Brockville General Hospital where to save money, a majority of finance committee members believe. The committee rejected a motion by councillor Leigh Bursey that urged BGH to reconsider its decision late last year to close its internal laundry service and outsource it to private providers.
  • Bursey's motion stated the closure "would eliminate 12 local jobs and move the work to Kingston," a charge BGH's top administrator rejected. "I think that this is a nominal savings and in the process it is removing jobs from the overall economy," Bursey told the committee. "I've never believed that starting at the bottom is where you're going to find the savings that you're looking for." Mayor David Henderson opposed the motion, arguing the city should not tell BGH how to achieve efficiencies. He did, however, acknowledge the hospital should seek input from the community on vital services.
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  • "What I'm really concerned about is that they make sure that they have a maternity ward," said Henderson. In February, fears began to surface on social media that BGH's maternity ward was under threat of closure, a suggestion hospital management denies. The hospital's board of governors recently approved its 2015-16 budget, which still requires another $1.9 million to balance the books Councillors Tom Blanchard, who is the finance committee chairman, and Phil Deery also opposed Bursey's motion.
  • In a prepared statement earlier Tuesday in response to the motion, BGH president and chief executive officer Tony Weeks said the hospital is one of the last in Ontario to operate an internal laundry service. "The decision to close was necessary to offset risks with old equipment, and significant capital investment requirements," he added. "We also know there's an opportunity to run the service at a better cost. We'll do this by leveraging a new partnership with the Kingston Regional Laundry Service, a model already adopted by other hospitals in the South East LHIN."
  • The South East Local Health Integration Network (LHIN) oversees hospital funding in the region. Weeks added the laundry decision will save BGH about $200,000 a year. The hospital's laundry team consists of 10 full-time, two part-t ime and casual staff, noted Weeks. "Open and honest discussions with staff and CUPE on transition plans continue in accordance with collective agreements,' he added, referring to the Canadian Union of Public Employees.
  • The talks could lead to voluntary early retirement offers and reassignment to vacant positions "with equivalent employment terms," wrote Weeks. "No full-time or part-time laundry employee will involuntarily experience a loss of employment or income as a result of the laundry closure," the statement continues.
Govind Rao

Who best spends your money?; Collectivists think they should make investments for all of us, ignoring the share captured by the public service - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246200|ntnp|20150423|219012118

from heather privatization medicare accord

shared by Govind Rao on 23 Apr 15 - No Cached
  • National Post Thu Apr 23 2015
  • Collectivists not only are dismissive of mass consumption, but pretend government spending is hyperefficient, finely tuned and able to address every social problem and disadvantaged group. They ignore the large and growing share of government spending that is captured by the public service for its own benefit, both through ever higher levels of compensation per employee and ever more employees needed to administer government programs (what public administration expert Donald Savoie calls the "thickening" of civil service operations due to constant growth in oversight by central agencies and endless investment and training of its own employees, the results of which you undoubtedly appreciate every time you have contact with government services). This is why, for example, 80 per cent of the increased health-care spending in response to the 2002 Romanow Report on the Future of Health Care ended up going to health-care workers and not better services to Canadians.
Govind Rao

Ten health stories that mattered this week: Feb. 2-6 - 0 views

www.cmaj.ca/...E148

from heather cma

shared by Govind Rao on 16 Mar 15 - No Cached
  • CMAJ March 17, 2015 vol. 187 no. 5 First published February 9, 2015, doi: 10.1503/cmaj.109-4992
  • Lauren Vogel
  • The Supreme Court of Canada unanimously struck down the ban on physician-assisted death to mentally competent patients who are suffering and deemed impossible to remedy or cure. The court ruled that the ban infringes on provisions for life, liberty and security of person in Section 7 of the Charter of Rights and Freedoms. Parliament has 12 months to draft new legislation. Physicians will not be compelled to assist
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  • Four measles cases in Toronto and a possible outbreak in Quebec prompted health officials across Canada to urge parents to vaccinate their children. “We know that vaccines are safe,” Health Minister Rona Ambrose told CBC News. “I believe this debate is almost bordering on the ridiculous at this point … you’re putting children who are more vulnerable than your own at risk of getting sick and potentially dying.”
  • British Columbia announced a new clinical intake process at 72 child and youth mental health offices that will allow young people in distress to see a clinician immediately, rather than go on a months-long waiting list. The province also launched an interactive online map of some 350 service providers and mental health intake offices to help young people find help near them.
  • BC Member of the Legislative Assembly Adrian Dix asked the province to release the full, unredacted December 2014 report by an independent reviewer on the firing of seven health researchers in 2012. Of the seven workers fired, several have returned to their positions, two are pursuing wrongful dismissal suits and one researcher, Roderick MacIsaac, committed suicide in January 2013.
  • Alberta New Democrats called the province’s mental health care system among the worst in the country, citing an Alberta Health Services briefing note that outlines problems at hospitals across Edmonton. The document lists unsafe facilities, major capacity issues and safety risks to patients and front-line workers.
  • The Wellesley Institute issued a scathing report on racism against indigenous people in the health care system, including pervasive and unconscious “pro-white bias” among health care workers that continues to harm Aboriginal health. Among possible solutions, the report recommends the creation of indigenous-directed health services, increased cultural sensitivity training and the use of indigenous patient navigators to serve as a bridge between patients and the system.
  • The Ottawa Hospital and Winnipeg’s Health Sciences Centre will conduct the Canadian arm of a large clinical trial studying the use of stem cells to treat multiple sclerosis. The trial is being conducted in nine countries with the aim of developing safe protocols for therapy involving mesenchymal stem cells, which have been shown to suppress inflammation and repair nerve tissue.
  • Ontario Health Minister Dr. Eric Hoskins said hospitals in the province will adopt a “bundled” approach to care. This means patients will be paired with a care coordinator — usually a registered nurse — throughout their medical treatment. Pilot testing of the system found it improved patient outcomes and enabled patients to receive more care at home.
  • Quebec’s Liberal government confirmed it will invoke closure in order to force through controversial health care reforms. Bill 10 would see the administration of more than 100 health and social services centres merged into regional boards. Critics say the restructuring will slash hundreds of jobs and put English services at risk.
  • Health union hearings got underway to reassign some 24 000 Nova Scotia health workers into new bargaining units. Arbitrator Jim Dorsey gave the province the green light to slash the number of unions representing health workers from 50 to 4.
Irene Jansen

In defence of the NHS: why writing to the House of Lords was necessary -- McKee et al. 343 -- bmj.com - 0 views

www.bmj.com/...bmj.d6535.full

reforms nhs

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Last week more than 400 public health doctors, specialists, and academics from across the country wrote an open letter to the House of Lords stating that the Health and Social Care Bill will do “irreparable harm to the NHS, to individual patients, and to society as a whole,” that it will “erode the NHS’s ethical and cooperative foundations,” and that it will “not deliver efficiency, quality, fairness, or choice.”1
  • our concerns are based on a wealth of evidence, much published in peer reviewed journals
  • There are many problems with the bill. For one, it abolishes direct accountability of the secretary of state for health to secure comprehensive care for the whole population and the mechanisms and structures for securing that duty.6 The health secretary has also stated that equitable resource allocation will no longer be his direct responsibility and that national resource allocation formulas will change from area based populations to GP registrations, a move that portends a shift towards a model of competing insurance pools or funds, for which the evidence from other countries is adverse.7 8
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  • The bill will usher in a new era of commercialisation but still does not make clear the public duties of the economic regulator, Monitor.
  • And while the proposed duties of clinical commissioning groups remain weak, they will be given the freedom to compete for or select their registered populations, as well as “flexibilities” in defining which services to provide. Allowing clinical commissioning groups to also enter into joint ventures with private companies will create inequalities in entitlement to care and introduce commercial conflicts of interest.
  • New commercial actors will be driven to compete and maximise income, overshadowing the need to cooperate and collaborate in ways that place the patient and population at the heart of the health system. The absence of clear responsibilities for geographically defined populations will make it difficult, if not impossible, to link clinical NHS commissioning with social care services or with plans and interventions to act on the social determinants of health.
  • the bill hands over greater control over public budgets to the dictates of the market
Govind Rao

Numbers not sole consideration in hospital cuts - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|wetr|20150305|215766692

from heather hospital cuts Ontario

shared by Govind Rao on 05 Mar 15 - No Cached
  • The Welland Tribune Thu Mar 5 2015
  • In 1994, there were 605 babies born at Brockville General Hospital. By 2014 that number had shrunk to 375. Like other hospitals in Ontario -- in particular those in smaller cities -- Brockville's hospital faces huge financial challenges. It continues to run deficits, despite layoffs a year ago, although it is not permitted to be in the red by the region's local health integration network. So from the point of view of a hospital administrator, the numbers make the case for closing the maternity ward: fewer babies being born, and an annual cost overrun of $600,000.
  • n the past week, however, these administrators were quickly reminded that the numbers do not make up the whole case. Last week, concerned locals claiming inside knowledge took to social media to warn that administrators had presented staff with a dire warning: find ways to cut $600,000 from the maternity ward's costs or it would be closed. What followed was yet another lesson on social media's role in civic discourse.
  • ...2 more annotations...
  • Facebook and Twitter were accelerants. If indeed management presented staff with a fiscal ultimatum on Wednesday, hoping to scare some people into accepting deep cuts a few weeks down the line, it found itself with a very different result on Thursday, with a "Save Brockville General Hospital Maternity Unit" Facebook page, (it had 879 likes as of this writing) and a letter from Leeds-Grenville MPP Steve Clark. It's important to note here the head of the hospital's board, Charlotte Patterson, denied such a fiscal ultimatum was issued. "It's my understanding that was not what was said," she told us. "If that's what was perceived, that's unfortunate." Time will tell whether the tale was amplified in the posting, but social media clearly helped traditional media (yours truly included) turn something meant to be an internal matter into a very external matter.
  • And that matter should be external, because it is of vital importance not only to Brockville, but any other community facing similar challenges. A full service hospital is a key part of what allows smaller cities like Brockville to conceive themselves as cities. The maternity ward in particular is a vital organ of a credible city. Without it, how can such communities credibly try to attract young families? How can they bring in new employers if their future employees will have to travel out of town to have babies? How can you be a city when the most elementary form of population growth is unavailable to you? And as MPP Clark pointed out, if you close maternity, you lose obstetricians and gynecologists, dealing a dangerous blow to women's health services.
Irene Jansen

We need a Grand Bargain to save our public services - The Globe and Mail - 0 views

www.theglobeandmail.com/...article1664718

accord think tank

shared by Irene Jansen on 23 Jan 12 - No Cached
  • But Canada doesn’t simply need “protection” of current transfers. It needs a Grand Bargain, where greater, more transparent and more reliable federal funding is combined with a realignment of the way the provinces deliver those services, and of the whole fiscal relationship between the provinces and the federal government.
  • Without more federal support – now stuck at 20 per cent of total provincial spending – current reforms could stall. New ones will not get off the ground.
  • The provinces and the federal government should take a hard look at options such as European-style social insurance, in which health and welfare spending are funded by payroll deductions that are split off from the regular income tax stream.
  • ...4 more annotations...
  • Tax swaps, whereby the federal government takes over corporate income tax and the provinces take in all sales tax revenue, are another alternative worthy of consideration.
  • Australia does all-in transfers, bundling federal health and social payments into a single funding package, that are then equalized according to each state’s need.
  • An opinion poll commissioned by the Mowat Centre for Policy Innovation shows that, in every province except Quebec (where sentiment is almost evenly split), people feel they’re not getting fair treatment when it comes to federal transfers.
  • Mowat Centre for Policy Innovation
Irene Jansen

The Progressive Economics Forum » The OECD Attack on Medicare - 0 views

www.progressive-economics.ca/...the-oecd-attack-on-medicare

economics international user fees

shared by Irene Jansen on 23 Jan 12 - No Cached
  • OECD Economic Survey of Canada
  • only a summary is available
  • call to impose user fees or deductibles on services covered by Medicare
  • ...7 more annotations...
  • OECD country surveys are mainly put together by the OECD Economics Department with major input from the Canadian Department of Finance and the Bank of Canada. There is relatively little input from the social policy directorate at the OECD (DELSA) or social departments here
  • OECD messages tend to hue very closely to the neo liberal economic mainstream, and are tweaked by Finance to build support for desired policy shifts.
  • explicitly calls for cuts in health care (or at least very constrained growth of spending.)
  • The OECD report itself notes (p.137) that the Canadian system is the best in the OECD in terms of providing equitable access to physician and hospital services.
  • The report also notes (Fig. 3.6) that Medicare costs have not grown as a share of GDP since the early 1990s and are well in line with the costs of other national public health care systems.&nbsp; It shows that it is in the private not the publicly insured part of our system that cost pressures have been greatest.
  • The OECD report similarly endorses more private delivery of hospital services
  • To its credit, the OECD report calls for the inclusion of pharmaceutical drugs and home care into the public part of the health care system
Irene Jansen

Research Synthesis on Health Financing Models: The Potential for Social Insurance in Canada 2011 - 0 views

www.chsrf.ca/...09-419d-9aad-9d89d6cff0d0.aspx

funding privatization canada us medicare

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Charles D. Mallory, Alexandra Constant, Anna Piercy, Jennifer Major 04/10/2011
  • Most provincial and territorial medicare programs fully or partly fund health services beyond the requirements of the CHA
  • Healthcare has changed dramatically since the CHA was passed in 1984. With technological innovation, medically necessary care is no longer provided solely in hospitals
  • ...3 more annotations...
  • There is a need to identify financing options that do not impose burdens on government budgets.
  • The social insurance (SI) model, common in Europe and used in Canada to finance public pensions and employment insurance, has been suggested as a way to raise revenue to improve access to non-CHA services.
  • This paper examines the implications of using the SI model to expand coverage to services such as pharmaceuticals and long-term care.
Irene Jansen

Home care is a right, not a privilege. Rejean Hebert. Troy Media - 0 views

www.troymedia.com/...are-is-a-right-not-a-privilege

home care accord federal

shared by Irene Jansen on 23 Jan 12 - No Cached
  • less than 15 per cent of our public funds spent on long-term care are dedicated to home care services
  • Other OECD countries invest significantly more resources: the Netherlands, France and Denmark, for example, invest, respectively, 32 per cent, 43 per cent and 73 per cent of their public long-term care funding on home care.
  • According to OECD data, Canada dedicates 1.2 per cent of its gross domestic product (GDP) to long-term care.
  • ...8 more annotations...
  • If nothing is done to transform the health care system, with the aging of the population this proportion will rise to 3.2 per cent by the year 2050.
  • This growth could be significantly reduced to 2.3 per cent if a sizable investment (e.g. 0.4 per cent of GDP or $5 billion) is made in home care now.
  • In the short term, a substantial return on investment (ROI) would be generated by keeping women in the work force and creating home care jobs in the public, private and social economy sectors. In the medium term, a further ROI would likely result from decreasing the use of hospital beds by patients waiting for nursing home beds and reducing the need for nursing homes.
  • home care should become a right and not a privilege as it is now
  • To achieve this, a public long-term care insurance plan should be created
  • to cover the necessary services from public (“in kind”), private, social economy or voluntary organizations
  • We should not opt for “cash-for-care” allowances as in some European countries since this type of benefit has undesirable effects: the creation of a “gray market” with untrained and underpaid workers, risk of financial abuse, poor quality services, and keeping women in traditional roles.
  • To finance this universal publicly funded insurance plan, a specific fund should be created to which the current budget for long-term care would be transferred to ensure a clear separation of this budget from the rest of the health care budget.
Govind Rao

Health and Home: An Overview of Senior Care in Canada - 0 views

www.conferenceboard.ca/...abstract.aspx

from heather seniors continuing care ltc conference

shared by Govind Rao on 06 May 15 - No Cached
  • The Conference Board of Canada, May 26, 2015 at 11:00 AM EDT Live Webinar by Philip Astles
  • As Canada’s population ages, services for seniors are becoming more important to provide, and more challenging to deliver. Compared with the overall Canadian population, seniors are more frequent users of provincial and territorial health care systems and related social services, which puts additional strain on funding. However, by taking heed current trends as well as the strengths and weaknesses of our present arrangements in seniors care, Canada can adapt to meet the needs of our oldest citizens.
  • Webinar Highlights In addition to outlining the state of care for seniors, this research will look at five key challenges: lack of timely and equitable access, the growing dementia challenge, limited funding to support growing seniors' health needs, limited senior-friendly mechanisms for redress, and limited federal role in key health and social services for seniors.
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