Wednesday, August 31, 2011

Everything You Ever Wanted to Know about Health Care and Taxes

Ontario Health Care Coalition
August 31, 2011

Leading into the provincial election on October 6 we are working to make sure that Ontarians are aware that there is a choice to improve health care within our public health care system. To that end, OHC has produced an easy-to-read colourful newsprint tabloid that gives the real story on how much we all benefit from public services, and who is benefiting from tax cuts.

PDF HERE.


Bad medicine from advisory panel at CMA annual meeting

By Dr. Danielle Martin 
Canadian Doctors for Medicare
Rabble.ca
August 31, 2011

Imagine you're feeling sick. You have an inexplicable pain in your stomach. So you go to your doctor, and she sends you for a test. The test for your stomach pain is inconclusive.

"I think I know what the problem is. And I probably have something I could give you for it," says your doctor. "How about you pay me an extra $50, and then we can discuss it further?"

Most of us would think that's unacceptable. We already pay taxes to finance our universal health care. We would want our doctors to run more tests, give us a diagnosis and write us a prescription.

Sadly, asking Canadians for more money is exactly the kind of solution many economists and policymakers are suggesting as a fix for Canada's health care system. At this year's annual meeting of the Canadian Medical Association an independent advisory panel, including Don Drummond, former federal Finance assistant deputy minister and chief economist at TD Bank, suggested we look at more funding options, like user fees, and private funding.

Tuesday, August 30, 2011

Medicare's pageviews by country



Canada
                   964
United States          
463
France
                      85
Mexico
                      33
Germany
                  29
United Kingdom
        25
India
                         20
Russia
                      17
Philippines
                12
Denmark                    
9

The Saskatchewan Doctors Strike - CBC 1962

CBC Archives
Broadcast Date: July 1, 1962

July 1, 1962: Saskatchewan's Medical Care Act becomes law. However, taking advantage of the public health scheme proves difficult since most of Saskatchewan's MDs have responded by going on strike.

With Cold War tensions approaching their climax in October's Cuban Missile Crisis, this showdown between the CCF's socialist ideals and the individual rights the doctors say they are defending puts Saskatchewan on front pages throughout the Western world.

Click HERE to watch the CBC's coverage.

Monday, August 29, 2011

The UK's Health Industry Lobbying Tour

Keep Our NHS Public

Watch this short film about how the private health care industry has its tentacles in the heart of government.



The Health Industry Lobbying Tour from Mancha Productions on Vimeo.

Health Care: False Arguments, Class Arguments

By Colin Leys
From Whose Health Care
December 2005

Health care must remain a right of citizenship for two fundamental reasons: for the sake of democracy, and for the sake of good health care. We need equal access to health care for the same reason that we need equal access to schooling and university; real democracy cannot survive without a basic equality of life chances for every voter, and health care is crucial for that.

But health care, like education, also needs equal involvement of all citizens. So long as judges depend on the same health services as janitors, judges (and politicians and senior policy-makers) will see that they are adequately funded and well run. As soon as the powerful stop relying on it, it starts to be allowed to decline. The rich don’t use it and they don’t want to pay taxes for it.

U.S. Healthcare: Why it’s so expensive

By  
The Tuscon Citizen
Aug. 29, 2011


My primary care physician has three employees to handle phone calls, set appointments, and check in patients. Those are the front desk duties of the office staff, but there is much more:  Checking a person’s insurance coverage to determine the patient’s  co-pay;  Contacting insurance companies to get prior approval for tests and referrals;  Resubmitting documentation to insurance companies that won’t pay  a bill until they get one more piece of paper.  The list goes on and on.

I always figured the way the American health care system works, with dozens of insurance companies requiring different paperwork and paying different fees for services rendered, was inefficient.  But now there is a study that shows just how inefficient and expensive our convoluted system is.

A study published in the Health Affairs Journal says that American doctors pay out more than four times as much as Canadian doctors because American doctors must deal with dozens of insurance companies (and Medicare).

Saturday, August 27, 2011

The 1960 Saskatchewan Election

Medicare: A People's Issue

Saskatchewan voters went to the polls in June of 1960. The main issue of the campaign was the pre-paid, universal, compulsory medical-care plan promised by the government. Premier Douglas asked the electorate for a strong mandate. Of the three opposition parties only the Socreds completely opposed Medicare. Criticism from the Liberals and Conservatives focused on the details and the timing of implementation.

The most vocal opposition came from the province’s doctors, represented by the College of Physicians and Surgeons. Douglas used the physicians' lack of political experience and division in their ranks to portray himself and the province as underdogs. The doctors’ campaign was badly handled.


Throughout 1961, the proposed medical care plan remained the top political issue in Saskatchewan. To fulfill its promise of consultation, the government created the Advisory Planning Commission on Medical Care, mandated “to study and report upon a medical care insurance program for the province and on the public need in other fields of health.”

The former President of the University of Saskatchewan, Dr. W.P. Thompson, was invited to act as chair. It was an onerous job, made especially difficult by the attitude of the medical members of the committee. 49 briefs of more than 1,200 pages were submitted by individuals and groups from across the province. In September of 1961 the Committee produced an Interim Report which recommended:
  • Universal coverage for all residents.
  • Comprehensive benefits based on residence, registration and payment of personal premiums with additional finances to be drawn from general government revenues.
  • Utilization fees.
  • Fee-for-service payment.
  • The creation of a commission responsible to the government to administer the plan.

From Tommy to Jack: A (Hallucinatory) Dream of Universal Health Care

By Julie Devaney
The Huffington Post
August 26, 2011

Tommy Douglas appeared to me once in a drug and trauma-induced hallucination. It was 2002 and I was bearing the brunt of British Columbian Premier Gordon Campbell's vile cuts to healthcare. My immobile body on a stretcher was literally being stored in a closet in an over-crowded Vancouver emergency ward. Unfortunately, the drugs were all medically-administered and more disorienting than pleasurable. As the Archangel of Canadian health care, Tommy had come to fly me and my leaking, numb and closeted body away to the well-funded public facility of all of our dreams.

It didn't really surprise me that Tommy showed up. I'd always counted him among my closest comrades (and also, I was very ill and medicated). I cut my political teeth in Mike Harris' Ontario. As a teenager on the lawn of Queen's Park as hundreds of thousands of people shut down the city of Toronto, I got the impression that this is what always happened when health care and other social program cuts are unjustly meted out on a population -- we rise up, fight back. And Tommy knows a lot about fighting back.

Friday, August 26, 2011

P3s in Health Care

Public-Private ‘Partnerships’ (P3s)

Canadian Health Coalition

The Issue:

A Public-Private ‘Partnership’ (P3) is a business venture which is funded and operated through a partnership of government and private sector companies. Problem is, P3 schemes costs taxpayers: the public pays and private investors profit. That’s not a partnership! Furthermore, evidence shows that in P3 schemes, costs go up, quality goes down and there is little or no accountability.

Resources:

P3 hospitals – the wrong direction  New report from CUPE, April 2011
P3s = Private Profits, Public Pays  Canadian Health Coalition Factsheet, 2010
Health Care Privatization Research Archive  Canadian Health Coalition, 2010
Report: Eroding Public Medicare   Ontario Health Coalition, 2009
Expert tells Romanow: Public-Private Partnerships Are Not The Answer  Dr. Allyson Pollack, May 2002

Media:

Québec Auditor General pans PPPs, says cost estimates wrong  Montreal Gazelle, June 10, 2010
P3 bailouts expose health-care hypocrisy  The Globe and Mail, February 12, 2009
In this P3, taxpayers are the ones who paid  The Globe and Mail, February 5, 2009
Warning: The P3s are coming  Winnipeg Free Press, July 21, 2002

Thursday, August 25, 2011

A Look at the Venezuelan Healthcare System


The right to health care is guaranteed in the Venezuelan Constitution, which was written and ratified by the people in 1999.  Through implementing a state-funded social program called Barrio Adentro, or inside the barrio, free comprehensive health care is available to all Venezuelans. Beginning in June 2003 through a trade pact with Cuba, Venezuela began to bring Cuban doctors, medical technology, and medications into rural and urban communities free of charge in exchange for low-cost oil.

The 1.5 million dollar per year program expanded to provide a broad network of small neighborhood clinics, larger regional clinics, and hospitals which aim to serve the entire Venezuelan population. (1) Chavez has referred to this new health care system as the "democratization of health care" stating that "health care has become a fundamental social right and the state will assume the principal role in the construction of a participatory system for national public health." (2) In Venezuela, not only is health care a right; it is recognized as essential for true participatory democracy.

Wednesday, August 24, 2011

UNISON calls for a halt to UK Health and Social Care Bill

Unison
24/08/2011

UNISON, the UK’s largest union, is today calling for an immediate halt to the Government’s Health and Social Care Bill. A lethal cocktail of economic uncertainty, spiraling waiting lists, and budget deficits, means that now is the worst possible time to bring in a major, untried, untested reorganisation, warns the union.

The latest statistics show NHS waiting times are increasing - those waiting 6 months or more for treatment have increased by 61% in the last year. And the Government’s demand for £20bn in so called “efficiency savings” is leading to ward closures, staff cuts and rationing across the country.

Christina McAnea, Head of Health for UNISON said: “If the Health and Social Care Bill goes ahead, the outlook for the NHS and patients looks bleak. The Government’s polices have already led to NHS patients waiting longer, often in great pain, for their operations.

“The Bill will make matters worse by taking the cap off the number of private patients that hospitals are allowed to treat. It will be an enormous temptation for cash strapped hospitals to boost their income by prioritising paying patients, pushing NHS patients even further down the ever-spiraling waiting lists.

“Even fourteen of the elite group of foundation trusts ended the last financial year in deficit, a grim warning for the future of NHS finances.

“The economic uncertainty and budget deficits add to this lethal cocktail and should be obvious to the Government that now is not the time to bring in this massive, damaging NHS reorganisation."

Keep our Doctors Committees in the Saskatchewan medicare controversy

By Ahmed Mohiddin  Mohamed
University of Saskatchewan
September, 1963

Shortly after the doctor's strike in Saksatchewan, Ahmed Mohiddin Mohamed researched and wrote his MA thesis on the Keep Our Doctor's Committees that had been formed to support the doctors.

It remains an important and valuable resource for those researching and understanding the fight for medicare in Saskatchewan. - NYC

Abstract: The main task of the study has been to trace the development of the KODs - how, when, where and why did they come into being. Chapter II discussed the background to the Medicare controversy, the doctors' "unalterable" opposition to "State-Medicine", the College's efforts to educate the profession and the public on the matter and the Government's endeavours to meet what it considered the doctors' legitimate concerns.

As the controversy developed, however, it soon became apparent that the real issues were those of differing social and political philosophies, of the concept of society and of the place of the individual and his relation to political authority. As neither the College nor the Government trusted the other, the issue became insoluble.

Download full report HERE. (large PDF)

Public Voice for Medical Care Insurance, Issue #1

Medicare: A People's Issue

As the struggle for medicare escalated to the doctor's strike in Saskatchewan, citizens supporting medicare started their own publication to counter the expensive ads and commercials launched by the KOD.

Initiated through the Saskatchewan Federation of Labour, "Public Voice" was issued four times in July of 1962.

Below is the first issue of the Public Voice.- NYC

The Case for Medicare

Canadian Doctors for Medicare

The 40-year struggle for universal health care - from private failure to public success

Private medicine dominated Canadian health care until the mid-1940s. Canadians who couldn't afford to pay for a doctor or hospital bed generally relied on charity or went without care. Some sacrificed homes and life savings to get medical attention for desperately ill family members. This still happens in the United States, the only developed nation without a universal, publicly-funded health care system.

The federal government establishes Medicare 1966-68; and strengthens it with the Canada Health Act, 1984

Saskatchewan Premier Tommy Douglas - the Father of Canadian Medicare - set the stage for Canadian Medicare when he introduced a public insurance plan for hospital services in his province in 1947, and physicians' services in 1962.

Canadian Medical Hall of Fame: Dr. Norman Bethune

Dr. Norman Bethune
Born: March 3, 1890, Gravenhurst, Ontario
Died: November 12, 1939
Education: M.D. - University of Toronto, 1916
Category: Mobile Blood

In 1890, Norman Bethune was born in Gravenhurst, Ontario. He went to the University of Toronto, where his education was interrupted when he enlisted as a stretcher bearer in World War I. He received his M.D. in 1916. Dr. Bethune's impact on medicine can be categorized into three distinct areas. Bethune wrote extensively on the development of new surgical instruments, helping to establish a body of work that would be an essential reference for any surgeon.

In 1936, while living in Montreal, Bethune proposed a universal health care system for Canada. Although the suggestion was not readily accepted, Bethune's good works abroad and compelling recommendations would eventually find a place in the Canadian medical system. And finally, Bethune is probably most remembered as being the first to introduce the mobile blood bank to the battlefield, where he performed countless blood transfusions in the midst of heavy fighting. A doctor to the very end, Bethune died of blood poisoning in 1939, while ministering to a Chinese Army. Canada remembers Bethune as a medical genius, China reveres him as a saint.

Monday, August 22, 2011

Jack Layton: R.I.P.

"When you're sick, you present your medicare card, not your credit card. New Democrats will not stand idly by. We will be fighting each and every day for our precious medicare system."

- Jack Layton

Sunday, August 21, 2011

The Saskatchewan doctor's strike and nurses

100 Years of Nursing on the Prairies
2005

Although the doctors' strike is a large part of Saskatchewan's medicare history, nurses, surprisingly, did not take a partisan role in the conflict. The Saskatchewan Registered Nurses' Association (SRNA) urged nurses to decide for themselves where their loyalties lay. Some nurses were in favour of implementing the medicare scheme while others were adamantly opposed, taking part in the Keep Our Doctor Committees (KODs). The implementation of medicare did not even merit close attention in The First Fifty Years , the history of the first fifty years of the SRNA.

The fact that medicare was such a non-issue for nurses is interesting in itself. While the whole province was in turmoil over a change to the health care system as it had existed for decades, nurses showed professional integrity and stayed in at work. They did not walk off the job in support of doctors, but rather picked up the slack in hospitals and dealt with the large numbers of patients who needed medical care.

Georgiana Chartier, a nurse, remembers being outraged at the hospital's treatment of patients during this time. Her son had been out playing in the campground where the family was vacationing and had taken quite a vicious fall. His mother, being a nurse, automatically thought of all of the things that could have been wrong with her son due to his injury and thus rushed him to St. Paul's Hospital in Saskatoon. Chartier remembers her feelings at the time:

"And there was a form I had to sign before they would care for him, and it was literally, to me, the way I read it, was that if anything goes wrong, nobody was responsible. So I signed the form. But then in brackets, I put "under duress," which made me very unpopular...I thought that this was against their oath...that you're literally leaving your patients...I didn't think it was right, and I guess it was this sort of thing that you took an oath to look after people. You didn't leave them like that. I guess I found it sort of against what you were supposed to be doing. You were caring for the sick and there were oaths that you took to care for your patients" (Interview: Georgiana Chartier).

While Chartier's views are not representative of all nurses, they do reflect some of the frustrations at the time.

Nurses at KOD rally, 1962

The Foundations of National Public Hospital Insurance

BY ALECK OSTRY
CBMH/BCHM / Volume 26:2 2009

This paper first describes the development of two-tiered hospitals in many Canadian cities to the 1920s. The second section illustrates the chronic fiscal problems these two-tiered institutions faced and demonstrates the failure of this model of hospital financing under the economic stress of the Depression.

The third and fourth sections of the paper shift to a discussion of Saskatchewan focusing on the roots of the rural hospital system and the implementation of a province-wide public hospital insurance plan. The fifth section outlines the continuing fiscal stresses facing hospitals in provinces without public or with partly public hospital insurance plans in the 1950s as they faced postwar pressures with inadequate financing mechanisms derived from the Victorian era.  The final section outlines the main reasons why all the provinces signed onto a national public hospital insurance plan.

The purpose of this paper is to provide the background to provincial and federal government acceptance of a national public hospital insurance plan in Canada.

Read this paper HERE.

Canadian Doctors for Medicare Endorses CMA/CNA Principles

Canadian Doctors for Medicare
August 21, 2011

ST. JOHN'S, NEWFOUNDLAND --  Canadian Doctors for Medicare is pleased to endorse the CMA and CNA's "Principles to Guide Health Care Transformation in Canada" - and it has thoughtful ideas about how to apply them.

"The CMA and CNA principles demonstrate a clear commitment to a national framework that builds on the Canada Health Act to ensure our system is based on need, not ability to pay," said Dr. Bob Woollard, a board member of Canadian Doctors for Medicare. "The principles reflect what Canadians said at the CMA town halls this summer, and they recognize the need for an equitable system that respects the foundations of publicly funded health care: universality, accessibility and quality."

CDM recognizes that the principles in the CHA are key to enhancing the patient experience, improving population health and getting value for money in our health care system, and all are critical to any transformation. In particular, the principle of an equitable system that addresses the social determinants of health is a significant inclusion.

In the spirit of heath care transformation, Canadian Doctors for Medicare has proposed a number of ways to apply these principles to Canada's health care system. CDM's "Health Care Transformation Top 10" outlines ways to improve Canada's health care system, and the "Bottom 10" highlights the practices that are doing the most harm, and ought to be stopped.

"We know that there are smart, cost-effective ways to make our system more efficient, and to ensure that patients are at the centre of our system," said Woollard. "We are delighted to add them to the debate. At the same time, we need to be vigilant to ensure that reforms uphold the CMA/CNA principles, and strengthen our publicly-funded system."

The Health Care Transformation Top Ten and Bottom Ten are available at: www.canadiandoctorsformedicare.ca

Friday, August 19, 2011

Defending health care is not enough

By Sam Gindin
Introduction to Whose Health Care?
Challenging the corporate struggle to rule  our system

Most Canadians reject a private health care system that is driven by the accumulation of profit, that limits people’s access to the size of their wallets and provides health in exchange for the risk of financial debt. Affordable public health care – for one’s own family and as a shared right with others – is something worth
defending.

Defending public health care is not enough. It doesn’t prevent a slower ‘death by a thousand cuts.’ Indignant government campaign speeches against privatization only lead to more subtle forms of privatization – privatization by stealth. Even where privatizations are curbed, the rules under which hospitals are run are transformed so they reflect the thinking and practice of competitiveness and commercial values, not social values. Cutbacks may be checked today, but revived tomorrow after tax cuts or an economic downturn lead to budget deficits that ‘demand’ new restraints. Any problems in the health care system that do occur lead to public frustrations which are then politically manipulated to develop support for ‘repairs’ and ‘innovations’ (based on giving private corporations greater control over our health).

Debunking Canadian health care myths

Written by Rhonda Hackett
The Best Article Everyday


As a Canadian living in the United States for the past 17 years, I am frequently asked by Americans and Canadians alike to declare one health care system as the better one.

Often I’ll avoid answering, regardless of the questioner’s nationality. To choose one or the other system usually translates into a heated discussion of each one’s merits, pitfalls, and an intense recitation of commonly cited statistical comparisons of the two systems.

Because if the only way we compared the two systems was with statistics, there is a clear victor. It is becoming increasingly more difficult to dispute the fact that Canada spends less money on health care to get better outcomes.

Yet, the debate rages on. Indeed, it has reached a fever pitch since President Barack Obama took office, with Americans either dreading or hoping for the dawn of a single-payer health care system. Opponents of such a system cite Canada as the best example of what not to do, while proponents laud that very same Canadian system as the answer to all of America’s health care problems. Frankly, both sides often get things wrong when trotting out Canada to further their respective arguments.

As America comes to grips with the reality that changes are desperately needed within its health care infrastructure, it might prove useful to first debunk some myths about the Canadian system.

Thursday, August 18, 2011

CCF in Saskatchewan led the way in the 1940s

Medicare: A People's Issue

The four years between the provincial elections of 1944 and 1948 were times of rapid change in health care delivery in Saskatchewan. It was the initial mandate of North America’s first social democratic government whose election platform had included a promise to set up medical, dental and hospital services “available to all without counting the ability of the individual to pay”. Some of the changes were innovations while others were developments of existing programs.

The newly elected premier, T.C. Douglas, wasted little time in contacting Dr. Henry Sigerist, professor of the history of medicine at Johns Hopkins University, and author of Socialized Medicine in the Soviet Union, to head a health study commission. Sigerist quickly produced a report that recommended several changes be made.

He called for the establishment of district health regions for preventive medicine, advocated rural health centres of eight to ten maternity beds, and noted that the public should seek medical advice at the centre, so that each doctor would no longer “spend a large part of his time driving around the country.” Sigerist’s recommendations were quickly incorporated into the Health Services Act which was passed before the year was out.

As a result of the Health Services Act and other enabling legislation Saskatchewan took several steps toward its goal of universal health care. Some the changes and developments of the next three years included:
  • First comprehensive plan for pensioners and widows.
  • Formation of the Saskatchewan Health Services Planning Commission.
  • Health Region No. 1, Swift Current created.
  • Saskatchewan first province to provide capital grants for hospital construction.
  • Appointment of Canada’s first full-time cancer physicist, Harold Johns.
  • Swift Current becomes the first region in Canada to combine public health with medical care.
  • Cornerstone laid for the College of Medicine at the University of Saskatchewan.
  • Funding approved for the construction of the University Hospital in Saskatoon.
  • First universal hospitalization insurance program in North America.

Health Care - The Movie

The HealthCare Movie

The United States health care system is the most expensive in the world, but the U.S. consistently under-performs relative to other countries on most dimensions of performance.

This feature length documentary explores the health care system in Canada: how it came to be, how it works for ordinary Canadians, how it is paid for, and how it compares to its American counterpart.



The issue of health care in America goes far beyond a line in the budget. It reaches into the center of the American soul and answers the question, "How in the world do we want to treat each other?"

We interviewed Health Policy and Economics experts in both the United Sates and Canada, a Canadian Senator, and the incoming president of a provincial medical association, who told us what doctors are saying about the health care system in Canada.

It was our privilege to interview a former Premier of Saskatchewan who was the Minister of Health at the time when Canada was fighting for what is now its universal medicare plan. We visited two Community Clinics in Saskatoon, and met with patients there, and then we had a chance to talk with a Saskatchewan politician.

We had the honor of meeting an author whose new book about the heroes behind the scenes in Saskatchewan was hot off the press. We drove through unusually wet prairies to visit the small Saskatchewan town where some say Canada's health care system was born.

And we visited a family in Winnipeg, Manitoba whose challenging health care story began with the birth of their first child almost three years ago.

Many, many more people in both Canada and the United States have become a part of the Healthcare Movie. Now we are putting it all together, with historical images and video clips to bring the story to life. We need your help.

Support the HealthCare Movie HERE.

"The real health care crisis is in public confidence and understanding, not in financial sustainability… the public needs much more and better information about the real strengths and weaknesses of the health care system"

Dr. Bob Evans, professor at the Center for Health Services and Policy Research, University of British Columbia.

"Outstanding film. 
A must see."

D.E.  Healthcare Advocate

"Excellent"
I.L. Saskatoon Clinic

"We're being duped"

R. C., Physician, Salem OR

Wednesday, August 17, 2011

Canadian alliance urges parties to step up action on health and health care

CACHCA
August 17, 2011

This week, the association representing Canada's Community Health Centres (CHCs) submitted key health and healthcare questions to the leaders of all political parties seeking office this Fall during provincial elections in Manitoba, Newfoundland and Labrador, Ontario, Prince Edward Island and Saskatchewan. These questions will also be submitted in early September to all candidates seeking office in the Northwest Territories, once official candidate lists are released.

The survey of political parties, submitted by the Canadian Alliance of Community Health Centre Associations (CACHCA), is intended to help voters in each province understand where each party stands on key commitments to improving health and health care. Responses from all parties will be posted and circulated in mid-September.

You can read a general version of the letter and survey here.

Beginning today, CACHCA is also encouraging members of the public to become involved in calling for key measures that will boost provincial health systems and improve access to high-quality, comprehensive health services. The association today released online petitions in each of the six provinces and territories, calling on the next government in each of these provinces/territories to commit to improving health and health care.
Canadians are urged to sign the online petitions, which may be found here:
Over the coming weeks, CACHCA will be providing further updates about how Canadians can become involved in calling for a more effective health system for all Canadians -- what Tommy Douglas and Medicare's other founders called the "second stage/phase of Medicare".

Ontario targets for-profit medicine

Tom Blackwell 
National Post
Aug 17, 2011

As provincial governments across the country grapple with the thorny issue of for-profit medicine, Ontario has taken the unprecedented step of setting up a toll-free snitch line for people to report cases of illegal private health care — and says it has triggered 35 investigations in barely a month.

The service was prompted by evidence that doctors and clinics are routinely flouting medicare rules with sometimes creative methods of generating extra income, Deb Matthews, the province’s Health Minister, said Tuesday.