Category Archives: Health System

Economist Dale Orr says policy makers need to look further before making decisions regarding health care.

Orr professes astonishment that there is no explanation for the wide variety in per capita health spending in Canada, of which Ontario finishes second last.

Orr says that Federal transfers play a big part in determining health spending, giving some provinces more of a cushion than others in making policy choices.

He also suggests that contracting out costs more – a lesson Ontario should closely examine given it has among the highest percentage of private delivery of public health care service.

Columnist Carol Goar looks at Orr’s analysis in today’s Toronto Star. To read the full story, go to:

http://www.thestar.com/opinion/article/796798–goar-an-economist-analyses-health-costs

The fastest growing jobs in the economic recovery are term or contract, not permanent, with health care among the sectors that are leading this change in employment status.

Armine Yalnizyan writes in “The Temporary Recovery” that “the current shift towards increasingly temporary and impermanent employment injects a new uncertainty into the macro-environment.” She warns that such instability may affect economic recovery: “Without lasting jobs at decent incomes, it won’t take much to topple the whole house of cards once more.”

To view her full article on the Canadian Centre for Policy Alternatives website, go to:

 http://www.policyalternatives.ca/publications/commentary/temporary-recovery

The London and District Labour Council unanimously decided to encourage its 30,000 members to boycott Shoppers Drug Mart and Rexall Pharmacies. The decision stems from an aggressive campaign by the two chains to derail a new bill that would dramatically lower generic drug prices. … John Crocker, President of the Healthcare of Ontario Pension Plan (HOOP) is calling upon government to change the pension rules to allow for large multi-employer defined benefit plans. “I worry that as a country we are undoing decades of success at rasing the standard of living for retired people,” he said April 14 before the Conference Board of Canada’s Pension Summit. Crocker called upon all governments to “get the rules right” and take leadership in forming new sectoral plans. If multi-employer defined benefit plans were formed to serve various sectors of the economy, “no longer would the full weight of funding be on one set of corporate shoulders,” he said. …Two more U.S. hospitals are in big financial trouble. Founded in 1849 to serve the poor, New York’s St. Vincent’s Hospital filed for bankruptcy protection on Wednesday. The hospital board had voted to halt inpatient services and transfer or close outpatient clinics eight days earlier. The hospital had weathered bankruptcy in 2005, but lost $80 million last year. Meanwhile, in Washington 184-bed United Medical Center was taken over by the District of Columbia after it defaulted on loans to the city. The city will operate the hospital until a new owner can be found.

Much attention has been focused on the war of words between Shoppers Drug Mart and the Ontario government over a new regulation that would amend the Transparent Drug System for Patients Act (DIDFA) and the Ontario Drug Benefit Act (ODBA). However, little attention has been paid to the impact on employer benefit plans.

The amendment would reduce the cost of generic drugs to 25 per cent of brand names. The regulation would also eliminate professional allowances given by the generic drug companies to the pharmacies, something the health minister has compared to a kickback.

These professional allowances would be accounted for in the price of these drugs, many much higher in cost in Ontario than in the United States.

When the Transparent Drug System for Patients Act (2006) was passed, it created substantial differences between the public Ontario Drug Plan (ODP) and the employer-based private sector plans.

With this amendment, regulated prices of generics will also be passed on to the private sector.

Aon consulting, in their newsletter “Ready,” says with patents of major brand name drugs like Lipitor expiring soon, “the cumulative savings for employers may be significant and employers have an opportunity to explore how best to capitalize on these savings within a broader approach to cost management through the adoption of strategic and fully integrated employee wellness management.”

Implementation of the regulation will be swift – many of the terms come into force beginning May 15 of this year, including elimination of professional allowances for ODP.

Dispensing fees would rise by about 20 cents per year over the next four years, depending on the class of pharmacy. By 2014 dispensing fees will range from $8.83 to $12.14.

The government is also sweetening the deal by providing an additional $100 million for the MedsCheck program, a program that pays for an annual 30 minute consultation between the pharmacist and any patient taking more than three prescription medications.

OPSEU has publicly supported the plans, alongside most other trade unions and the Ontario Federation of Labour.

The OFL is also calling upon Shoppers Drug Mart not to hold their patients to ransom amid the chain’s moves to shorten pharmacy hours in the Minister’s home riding of London North.

“If the attack by Shoppers Drug Mart continues we urge the government to follow Ireland’s example when it was embroiled in the same fight last year and contemplate establishing publicly run pharmacies,” says OFL President Sid Ryan.

The battle between big pharmacy and the Ontario government has pitted Health Minister Deb Matthews against her brother-in-law, former Premier David Peterson, who sits on the board of Shoppers Drug Mart.

Stakeholders have until 5 pm on May 8 to respond to the new regulation.

An editorial in the Kitchener-Waterloo Record suggests Cambridge Memorial Hospital may be experiencing a drop in capital donations from the public due to uncertainty over the hospital’s future. While the editorial acknowledges that donations are down across Canada, they aren’t for the other two nearby hospitals. The hospital has had to recently trim 35 beds to balance its budget, while the LHIN has given a reprieve on 10 rehab beds. The KW Record writes: “The Health Ministry has a responsibility to say whether it wants Cambridge Memorial to be a strong regional hospital or a more modest community hospital. Cambridge residents would certainly prefer the former, but the ministry, so far, seems more inclined to support the latter.” … Smoking bans work. A Canadian Medical Association Journal article claims that in Toronto there was a 39 per cent decrease in admissions for respiratory conditions and a 33 per cent decrease in admissions for cardiovascular issues since 1999, the year the city issued the first phase of its public smoking ban. The biggest decline followed the 2001 ban on smoking in restaurants. … The Victorian Order of Nurses (VON) is downsizing its corporate services based out of Peterborough. VON says no local services will be impacted, although the local intake and planning department will be consolidating to London, Ontario, eliminating 20 local jobs. … Running neck and neck with the Labour Party, the UK Tories are promising a “big society” rather than “big government.” The Brit Tories platform includes putting more money into health care “in real terms”, including to private clinics willing to perform services at National Health System (NHS) prices. Leader David Cameron said he would guarantee access to a local GP 12-hours a day, seven days a week. Unlike Ontario, which is attempting to freeze wages for two years, the UK Tories are proposing a one-year public sector wage freeze for 2011, exempting the lowest paid workers. … The U.S. is failing in its efforts to eliminate hospital-acquired infections. A Health and Human Services department to Congress called for “urgent attention” to the problem. Of five major types of serious hospital-related infections, rates of illnesses increased for three, one showed no progress, and one showed a decline. As many as 98,000 people a year die from medical errors and preventable infections in the U.S. The same report also found deep disparities in access to health care between those with and without insurance. Examples include 74 percent of women ages 40 to 64 who had insurance had received a mammogram in the previous two years, compared with 38 percent of those without insurance. Children were twice as likely to have had a dental exam in the past year if they were insured.

Oppositions is expected to be fierce as the Province of Quebec is promoting the idea of user fees for public health care services as part of its spring budget.

The Quebec government is looking at a fee of $25 per visit, charged not up front at the doctor’s office, which would likely violate the Canada Health Act, but annually, as a “deductible” included in their income tax. 

Under the proposal, the fees would be capped so that total charges do not exceed 1 per cent of a family’s annual income. It was estimated under one proposal that a couple with two children making 10 medical visits a year would pay a maximum of $250 annually.

 The Quebec government also announced a new health tax to commence in June, 2010, that will be levied on individuals when they file their income taxes. The “health contribution” will cost adults $25 this year and eventually climb to $200 in 2012. Lower-income families will be exempt. When fully implemented, the new tax will generate $945-million a year.

 “There’s no doubt that user fees violate the spirit of the Canada Health Act, which is quite clear that user fees cannot be charged,” Dr. Irfan Dhalla, Co-Chair of Canadian Doctors for Medicare told the Globe and Mail.

The Globe reports that a number of Quebec academics, unions and social activists will be challenging the plan.

 “The decision has been taken and we will proceed,” Premier Jean Charest told reporters. “We will first proceed with a debate on the methods and on the way we will do it.”