Category Archives: Health System

According to the Sudbury Star, North Bay families are scared, angry and frustrated about the transfer of 31 specialized mental health beds to Sudbury. The newspaper highlighted the story of Bob Kouris’ uncle, who is presently occupying one of the beds scheduled to transfer nearly 130 km west. This week patients will learn whether they stay or go. Kouris called North East Mental Health about his uncle. “I was also asked if I would consider having my relative move to Sudbury,” he told the newspaper. Kouris may not have a choice in the matter given shortages of alternate beds. The Concerned Citizens committee wrote to MPP Monique Smith asking a number of questions, including whether the Sudbury Kirkwood would be a permanent location for these patients. Smith instead deferred that question to the North East LHIN. Meanwhile a postcard campaign over the North Bay beds continues. … Quebec has backed down from a plan to charge $25 for a visit to the doctor. Facing widespread opposition to user fees, the Charest government admitted that “the culture here in Quebec is not ready for it.” … Toronto’s Women’s College Hospital surveyed 584 women about what they considered an ideal hospital. 96 per cent of women said they wanted dignity and respect from hospital staff – about a third said they don’t get it. 70 per cent said they feel rushed through the hospital system, while 65 per cent said they felt like a number instead of a person. The experience of the women may reflect the government’s push to move patients in and out of hospitals a lot faster.

Canada could save up to $10.7 billion a year in drug costs through a national pharmacare program according to a new report from the Canadian Centre for Policy Alternatives.

The Canadian Health Coalition is urging the Federal government to work with the provinces towards such a plan.

“Canada has an American-style system of paying for drugs, and it yields American results – inequity, waste and high cost,” says Health Economist Robert Evans. “Private insurers, Big Pharma, anti-tax ideologues and apathetic governments have kept this beyond our reach.”

“Canadians cannot afford not to have universal pharmacare,” says the study’s author, Marc-Andre Gagnon, an assistant profession in the School of Public Policy at Carleton University. Gagnon argues that Canada’s “jumbled assortment of public and private plans” are inefficient, costly and inequitable.

“A drug insurance plan is not only a way to compensate for or reimburse drug expenses, but also a way to control costs through efficient pharmaco-economic assessment of new drugs and by developing bargaining power when dealing with powerful transnational drug companies,” states the report.

The call for a national pharmacare plan is not new. In 1964 the Royal Commission on Health Services recommended such a plan, as did the National Health Forum in 1997. Even the 2002 Romanow Commission recommended catastrophic drug coverage as a first step towards a national pharmacare program.

Canada spent $25.1 billion on prescription drugs in 2008. It is one of the fastest growing health care costs – since 1985 drug costs have risen by 10 per cent per year.

Almost one in four Canadians has no drug coverage, and 8 per cent of Canadians say they did not fill a prescription in the last 12 months due to the cost of the drugs.

Savings would come from:

• 6 per cent savings on administrative costs, amounting to $560 million/year
• 10 per cent savings on tax subsidies on private plans totally $933 million/year
• Public plans are better able to negotiate better drug prices — Private plans pay 7 per cent more for generic drugs, and 10 per cent more for non-patented brand name drugs

At present Canada’s pays 30 per cent more for drugs than the OECD average. Australia, New Zealand, United Kingdom, France and Sweden have lower costs, and lower growth of drug costs. All have some form of universal public drug coverage.

The report is being released just as the provincial and federal health ministers meet in St. John’s, Newfoundland this week. The Ministers are working on a plan to use their collective buying power to reduce the price of drugs.

To download the complete report, go to:

https://s3.amazonaws.com/policyalternatives.ca/sites/default/files/uploads/publications/National%20Office/2010/09/Universal_Pharmacare.pdf

As the TD Bank encourages us to embrace privatization in Canada’s health system, consider this: Forbes Magazine released its first-ever survey of the U.S.’s most profitable hospitals.  The top 24 hospitals on the list make 25 cents or more for every $1 of patient revenue they bill for. Leading the list is 235-bed Flowers Medical Center in Dothan, Alabama, which takes in an astounding 53 cents in operating profit.  Second is the Del Sol Medical Center in El Paso, Texas, which rakes in 45 cents on the dollar.

The U.S. insurance industry is jumping all over the list, using it as evidence that hospitals are using local monopolies to overcharge patients. The insurance industry itself has been under fire with charges that health plan profits are driving rising costs.

Ten HCA hospitals make up Forbes’ Top 25 list, calculated based on operating income figures that hospitals must report to the U.S. Medicare program each year.

HCA paid a record $1.7 billion in fines last decade for Medicare and Medicaid fraud. According to www.thehill.com, the group’s CEO at the time the investigation began – but before the fines were handed down – was current Florida Republican gubernatorial candidate Rick Scott, a vocal opponent of healthcare reform who spearheaded Conservatives for Patients’ Rights.

For more, see http://thehill.com/blogs/healthwatch/corporate-news/116745-hospital-profits-raise-eyebrows-as-medical-costs-continue-to-soar

Last spring the media was filled with panic stories about the financial sustainability of public health care spending. The most extreme was TD Bank Financial, who issued a report suggesting that health care would take up to 80 per cent of Ontario’s budget by 2030 if corrective action wasn’t taken. Now that the barbeque season is winding down, the onslaught appears to be starting up again.

Global Public Affairs, a private “government affairs” company, has organized a September 22^nd Bay Street panel entitled “Ontario Health Spending: The Pacman of Provincial Budgets.” Aside from a title that doesn’t quite make sense, the breakfast forum is another chance for the TD Bank Financial Group to make its case that health care is unsustainable unless we increase private sector participation.

Last week Montreal Gazette columnist Janet Bagnall called efforts to brand health care as unsustainable a “masterful propaganda operation.” She also said that according to recent polls, Canadians were not buying the message.

Bagnall quotes internationally respected health economist Robert Evans (see https://opseudiablogue.wordpress.com/2010/06/17/evans-debunks-myths-about-health-care-unsustainability-at-ottawa-news-conference-today/) who says public Medicare spending is about the same as it was 20 years ago. Evans makes the point that the problem is “uncontrolled private health spending combined with a drop in provincial revenues created by large tax cuts over the years.”

From 1997 to 2004 tax cuts amounted to $170.8 billion taken from the public sector, representing about $35 billion per year at the provincial level. Private care – mostly drugs and dental care – account for 12.7 per cent of health spending by Canadians.

Bagnall makes the distinction between this panic mongering and our ability to run a more efficient ship.

She points to a 2003 study published in the Lancet medical journal in which 40 per cent of illness and 53 per cent of deaths in developed countries can be attributed to risk factors associated with smoking, excessive alcohol consumption, bad diet and obesity.

Bagnall writes that according to the Institute for Clinical Evaluative Services, the jurisdictions with the best health behaviours were British Columbia and Quebec. These two provinces spend far more money to encourage healthy behaviour than Ontario. BC spends $21 per capita on health prevention, Quebec spends $16.80. Ontario, which didn’t even have a Ministry of Health Promotion until 2005, only spends $7.40 per capita. Not surprisingly, BC has the highest life expectancy in Canada.

When Arnold Relman visited Ontario a few years ago, the former editor of the New England Journal of Medicine said that if privatization were the answer, the United States would have the most efficient health system in the world.

Despite the evidence, the TD Bank economists seem to think the private sector will bring innovations to solve our problems. If that were the case, then with an unfettered private system in the U.S., why are their health costs so high and their outcomes so low?

On top of that, the Ontario government continues to cut taxes. According to this spring’s Ontario budget, almost $5 billion in corporate tax cuts are expected within the next three years. That’s $5 billion less that can be spent on health, education, social services, infrastructure and the other key government functions.

Evans frequently says health care is as sustainable as we want it to be. As we march to the next provincial election we may need to ask ourselves, do we want more tax cuts, or do we want health care?

The only Pacman on the screen is the one labeled “corporate tax cuts” ingesting and digesting social spending through tax cuts to ever increase husky corporate profits.

The Erie St. Clair Local Health Integration Network (LHIN) has not had a stellar week. First they scrapped the $9,500 appearance of two Disney consultants who were scheduled to speak next month at the LHIN’s annual leadership conference in Windsor. Then CEO Gary Switzer lashed out at criticism from PC leader Tim Hudak, telling the Windsor Star “this guy is making this crap up and it’s false. I don’t think the public is stupid enough to believe him.” When the newspaper suggested the comments were “inappropriate” and “unprofessional,” Switzer offered up an apology to the community – not to Hudak – before departing on vacation. Finally, the LHIN Chair, Mina Grossman-Ianni, sparked outrage when she defended her 29 per cent increase in the part-time stipend she receives. The Chair said that $54,000 was not a lot of money. The provincial Tories pointed out that this money could have covered a year’s salary for a rookie nurse, 154 wheelchairs, 27 MRI exams or 1,350 pairs of crutches. Per diems for the rest of the LHIN board totaled $64,450 last year. The board also received $127,811 in expenses according to the Windsor Star.