Monthly Archives: May 2013

Obesity rates rise – will Ontario implement the recommendations of its own panel?

Obsesity is on the rise in Canada. From the Health Council of Canada Progress Report 2013.

Obsesity is on the rise in Canada. From the Health Council of Canada Progress Report 2013.

Health prevention is one of those hands down winners. You ask people about health care reform, and almost everyone believes that moving health issues upstream has the potential to reduce costs for the health system.

In the Health Council of Canada’s progress report for 2013, they note that when it comes to public health, we have too few objectives and measures to evaluate our successes or failures. No kidding.

Health promotion was supposed to be a key narrative in the health accord signed between the provinces and federal government in 2004. That accord is about to expire in October of next year.

One measure they do have is the prevalence of obesity.

Clearly obesity is a major factor for public health, yet the results between 2003 and 2011 are disastrous. Almost every province and territory has seen a rise in obesity. Only the Yukon saw a decline.

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More “transformation” — 53 jobs cut at Peterborough Regional

Peterborough’s regional hospital  is losing more staff positions.

The good news is the hospital administration isn’t at least pretending these new cuts are about “transformation” of the health system as the Health Minister and Premier have repeatedly claimed elsewhere.

The government’s ongoing funding freeze to base hospital budgets means 53 more positions are being eliminated in Peterborough, many of these already vacant positions. In 2010 Peterborough eliminated close to 300 full-time equivalent positions to deal with a mounting deficit and meet its accountability obligations to the Local Health Integration Network.

The Peterborough Regional Health Centre’s board chair told the Peterborough Examiner “when you are getting 0% increases and you have to absorb inflation and other cost increases plus pay off our debt, it’s getting tougher every year.”

In his pre-election report in 2011, the Auditor General of Ontario described the government’s decision to limit health care funding increases to 3.6 per cent as “aggressive,” suggesting it would lead to a choice between hospital deficits and cuts to services. A 3.6 per cent increase now seems like the Halcyon days in this province, overall health care budget increases now limited to 2 per cent. None of that 2 per cent is applied to hospital base budgets, the government instead maintaining the fiction that it is being instead reallocated in the community as part of that “transformation.”

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Losing four psychiatrists at Grand River may very well be carelessness

Oscar Wilde’s character Lady Bracknell says in The Importance of Being Earnest: “to lose one parent may be regarded as a misfortune … to lose both seems like carelessness.” Does the same apply to psychiatrists?

Kitchener-area residents in need of outpatient psychiatric support for their children may very well be quoting Wilde these days.

The Grand River Hospital has lost not one, not two, but four psychiatrists recently, requiring the hospital to restrict outpatient psychiatric care for children and adolescents to the most acute cases. It has also lost two clinical managers according to an on-line source in the community.

Usually when an exodus like this takes place, you need not look much further than management of the facility for the reasons why, but Grand River claims the docs are leaving for personal reasons.

A spokesperson for the hospital said one is leaving to be closer to family, another for professional opportunities, and a third is expanding a community practice. In all, Grand River has 16 psychiatrists on staff (not all full-time), some of which are being required to “switch over” to the children’s unit.

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Linda McQuaig for Mayor?

Linda McQuaig speaking at the Older Canadians Network forum Wednesday at Toronto City Hall.

Linda McQuaig speaking at the Older Canadians Network forum Wednesday at Toronto City Hall.

Linda McQuaig couldn’t resist. Standing at the Mayor’s podium at the Toronto City Hall council chambers, she told the Older Canadians Network: “I have never smoked crack cocaine.”

Linda McQuaig for Mayor?

The author (The Trouble with Billionaires w/Neil Brooks) and journalist compared the recent Senate scandal to the U.S. Watergate scandal that led to the impeachment of President Nixon. While in Canada we may not have had a burglary, we did have the involvement of the highest office in the land in “an attempt to stop an investigation that was an embarrassment to government,” she said.

On hand for the presentation of the Alexander Gorlick Humanitarian Award to former Parliamentary Watchdog Kevin Page, McQuaig criticized the Harper government for shuffling off the Senate scandal investigation to ethics commissioner Mary Dawson, who is now going to conduct her investigation in secret.

McQuaig said she particularly liked Page because he publicly raised questions of accountability around austerity programs, which had an enormous impact on Canadians.

“He exemplifies the best of the public service and the best of Canadians,” she said of the now unemployed budget officer.

McQuaig says the best way to understand that a better more equitable society is possible is by simply looking to the past.

She asked who in the room had been borne since 1980?

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“My office will start to unravel” – former federal budget watchdog Kevin Page

Former budgetary watchdog Kevin Page speaks about the bumpy ride he had during an open forum hosted by the Older Canadians Network.

During an open forum hosted by the Older Canadians Network, former federal budgetary watchdog Kevin Page speaks about the bumpy ride he had in office.

Federal Conservatives sure liked to talk about accountability while in opposition. In power? Not so much.

Kevin Page, Canada’s first parliamentary budget officer, said no governments want more accountability. It’s not even a partisan issue.

That puts a budget watchdog in a very difficult situation.

While appointing Page to the job to fulfill his own election promise, Stephen Harper made the appointment at the “pleasure” of the Prime Minister’s office, not that of Parliament.

Appearing in Toronto Wednesday to accept a humanitarian award from the Older Canadians Network, Page said the appointment by the PM’s office meant he could be removed from office at any time by the Prime Minister’s office – a major flaw in the design.

The legislation creating the parliamentary budget watchdog never protected for what Page calls “analytical dissonance.”

When he was first appointed five years ago, opposition members on committees just assumed he was the “PM’s guy.”

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Ombudsman would be ideal party to resolve London’s toilet cleaning claims

Oh come on now. Attending question period at Queen’s Park can be an exercise in frustration as the opposition’s questions and the government’s answers seldom align.

You can ask anything you want, but it doesn’t necessarily mean the government will provide you with an answer that remotely addresses it.

Yesterday NDP Leader Andrea Horwath asked the Premier about an 80-year old patient at the London Health Sciences Centre who says he was told to clean his toilet.

Joseph Cummins was not just any patient – he is a retired professor of genetics at Western University and knows about hospital-acquired infections.

According to today’s Toronto Star, Cummins wandered out into the ward looking for someone to clean the bathroom he shares, at first finding no professional staff on the ward. Cummins admits to having had a mishap after being given a strong laxative and wanted to ensure it was cleaned up.

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Even the wealthy can be impacted by the negative health effects of austerity

At first it was a mystery. How was it that during an excessively dry and hot 2007 summer that cases of West Nile disease had jumped in Bakersfield California by 276 per cent?

Dry weather is not normally associated with an abundance of mosquitos, which are transmitters of the disease from birds to humans.

Laboratories confirmed 140 cases in Bakersfield, a city of more than 800,000 in Southern California.

According to researchers at the University of California, aerial photography of the city showed something unusual – a high number of algae blooms in private swimming pools, hot tubs and ornamental ponds. One photograph showed 17 per cent of visible pools and hot tubs appearing green and likely producing mosquitos.

It turns out that Bakersfield was also at the epicenter of mortgage foreclosures, the downturn in the housing market leading to a 300 per cent rise in mortgage delinquencies.

Dr. William K. Reisen, a research entomologist with the Center for Vectorborne Diseases, had his team knock on the doors of these homes and found no one living there. The pools, hot tubs and water features were essentially abandoned and had become breeding grounds for the mosquitos.

The story, featured in a new book, The Body Economic: Why Austerity Kills by David Stuckler and Sanjay Basu, reminds us that we are ultimately all in this together.

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Canada could have universal drug coverage without raising taxes – Morgan

The UK's John Abraham on a panel with Carelton University's Marc Andre Gagnon.

The UK’s John Abraham on a panel with Carleton University’s Marc Andre Gagnon.

10 things we learned from last week’s Ottawa conference on drug coverage hosted by the Canadian Health Coalition and Carleton University:

1. The University of British Columbia’s Steven Morgan noted that if Canada were to adopt the UK’s public drug plan without any changes, it would “be enough to pay for universal Pharmacare in Canada at current rates. We would not have to increase taxes.” Carleton University’s Marc Andre Gagnon says Canada could save $10.7 billion on pharmaceutical costs with a universal drug plan. The question is not can we afford universal drug coverage, but can we afford not to?

2. We’ve reported in several posts on how Canada and the U.S. are outliers when it comes to a universal drug plan for our citizens. This has been the case for a very long time. The international panel noted many countries adopted universal access to prescriptions shortly after World War II. France adopted its social insurance system in 1945 while Britain was a few years behind in starting the National Health System in 1948, quickly adding prescriptions to it in 1952. More recent Scotland, Wales and Northern Ireland abolished all prescription charges, whereas England charges about 5 per cent co-pay on the cost of drugs in its Pharmacare program.

3. New Zealand has among the lowest drug costs in the world. They do this by placing a cap on total drug spending and making pharmaceutical companies bid on a share of that pie. The drawback is it does tend to slow the speed in which expensive new drugs become available, but does succeed in providing universal access to needed medications. There is a small co-pay of about $5 per prescription. There is no co-pay after 20 prescriptions are filled annually. There is practically no private coverage for pharmaceuticals in New Zealand. According to Matthew Brougham, former CEO of PHARMAC, New Zealand has been able to limit the increase in drug pricing over the last decade to 3 per cent per year compared to 9-10 per cent increases worldwide. While Canadian politicians claim they cannot afford to introduce Pharmacare, New Zealand adopted such a system precisely because the country was in dire economic circumstances.

4. The lack of universal drug coverage in Canada has not been for want of evidence or trying. Dr. Joel Lexchin of York University noted in his opening remarks that the Hall Commission recommended it in 1964, the National Health Forum did so in 1997, and it is now policy for both the federal Liberals and NDP. Lexchin says Canada’s Pharmaceutical policy resembles the U.S. health care system – some private coverage, some public, and a lot of people who have nothing. “This is not a pie in the sky scheme,” he said, noting Saskatchewan formerly had universal drug coverage.

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Drug benefits vulnerable for even those receiving the best plans — White

Julie White (CURC) says private drug plans are insecure, inconsistent, and unfair. They also make cost control difficult from a public policy perspective.

Julie White (CURC) says private drug plans are insecure, inconsistent, and unfair. They also make cost control difficult from a public policy perspective.

OTTAWA – Julie White has a grown son who lives in Toronto and suffers from a condition that produces debilitating migraines one to three times per week.

Representing the Congress of Union Retirees of Canada (CURC), White told a Ottawa Pharmacare conference Saturday that by trial and error her son’s doctors found a set of drugs that would give him “an approximation of a normal life.”

The bad news is the drugs cost $5,000-$6,000 per year and are not covered by the Ontario government. When White lived in Vancouver, her son was able to get assistance on the costs from the BC government.

Now she pays for them personally out of her retirement pension income.

White is among the 20 per cent of pensioners who were able to carry their benefits into retirement, but these retiree benefits only cover her personally, not her parents, kids, nieces, nephews, neighbours or friends.

Despite what she calls her “Cadillac” plan, she is aware that as a retiree she herself is vulnerable to negotiations every two years over the contents and rules of that plan. During the present ideological attack on the wages and benefits of working people, retirees are feeling unease over the ability of unions to maintain these plans, particularly for retirees.

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Federal health minister missing in action (again) during major conference on drug coverage

Jeff Connell (Canadian Generic Pharmaceutical Association) says Ontario spend $24 million more than they needed to by delaying adoption of the generic version of just one drug -- Crestor -- into the provincial formulary.

Jeff Connell (Canadian Generic Pharmaceutical Association) says Ontario spend $24 million more than they needed to by delaying adoption of the generic version of just one drug — Crestor — into the provincial formulary.

OTTAWA – Experts came from as far away as France, the United Kingdom and even New Zealand. Politicians from both the NDP and Liberals were there, as well as academics and policy-makers from across Canada. But Leona Aglukkaq, Canada’s Federal Minister of Health, couldn’t travel the few blocks from Parliament Hill to Ottawa’s National Hotel to participate in a national forum on pharmaceutical policy.

She might have been excused had her schedule not allowed her to come, but her letter to organizer Michael McBane stated “the subject matter of this conference has to do with health care delivery, which is a provincial and territorial responsibility.”

The question is, why is Aglukkaq so blatantly misrepresenting the Federal government’s responsibilities around both health care and pharmaceutical policy?

As we pointed out yesterday, the Federal government is the fifth largest direct provider of health care in Canada. They have a constitutional responsibility for health care to both First Nations and Inuit communities. They also have a responsibility to provide health care to specific groups within society, including veterans, refugees claimants, federal inmates, the Canadian Forces and the RCMP.

Forgetting even all of this, the Federal government also has a very specific role around pharmaceuticals, including approval and labeling of new prescription drugs as well as patent rights. They also regulate prices.

There is a sign here on Wellington Street that tells visitors the distance to both war and civilization, a reference to the two major museums. War is closer. Had the conference been about the war on drugs, rather than how to make civilization with a national Pharmacare program, the Feds might have actually been here. While the Federal Minister shows no interest in the savings that could be reaped from a national drug plan, the Federal government has been active in sending support to Mexico to fight the war on drugs.

This is not the first major conference on Pharmacare Aglukkaq has absented herself from. Representatives from industry, patient groups, labour, and even the Conservative-friendly National Citizen’s Coalition were in Vancouver earlier this year to discuss how we could better coordinate a national strategy to provide universal coverage to Canadians for prescription drugs.

Guess she had something else to do that week too.

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