Pay attention, because medicare is about to change

By Jo-Ann Fellows
Daily Gleaner
October 18th, 2011

In 2014, the current agreement on medicare between the federal government and the provinces will expire, and a new agreement will be required.

Significant amounts of money will be involved, and the shape of our health-care system for the next few years will be determined.

There is general agreement in Canada about what the new health-care system should contain. The problem will be in "transforming" our current system to get to the new one.

The new system must accommodate the advances continuously being made in medical science. We must move from a "sickness" system, where diseased and injured patients are treated, to a system where keeping people healthy predominates.

We must move from a hospital-based, acute-care system, with primary care being delivered in family doctors' offices, to a narrowing of the scope of hospitals and a considerable enlargement of primary care being delivered in the community.

This care will be delivered by various agencies, including community care centres, augmented doctors' offices and clinics. As well as making referrals, these organizations will assist the patient in the management of chronic disease, and contribute to encouraging good health.

There will be tremendous resistance in making these changes. Hospitals will resist, as well as some physicians. There are many with a vested interest in the current system.

Making these changes will take courageous leadership. It would be impossible to over-emphasize the political and administrative skills that will be required. We need people to think about the provision of good care first, and their own interests second. The public will have to be alert so that they can assist in this transformation.

The amount of money presently being spent, with an adjustment for inflation, is sufficient to pay for the new system. If you are going to add services, then cuts will be required in the old system. The transformation should be revenue neutral. At the moment, the cost of Canada's health-care system as a percent of GDP is higher than that of a number of European countries, and their systems are better than ours.

As part of the up-grading of our system, we need a national prescription drug insurance plan, and we should add a dental plan. We need to revolutionize the way we deliver long-term care, and to strengthen home care. A better source of rehabilitation between the hospital and the home is also required. There has always been a gap in our system for this service.

Remember that these improvements must be made with current funding provided by both the federal and provincial governments. The new funding from the federal partners is already promised to be increased by six per cent annually, as a result of a promise made by the Conservatives during the recent election campaign.

We need a revitalized system. The status quo is not acceptable. Too much funding is going to the wrong things. There is no other way to achieve an accessible, fair, equitable and high quality health-care system. Canadians place great value on their health-care system. The public will have to exert pressure on all the governments to facilitate this decision-making process.

Once agreement is reached, it will take a highly skilled and dedicated group of administrators to drive these changes, with support from all the players in the health-care system.

Basically, we need to decide on the shape of medicare for the next few years. The federal government has been waiting for the provincial elections to be completed, in order to determine the players in this negotiation.

The public should pay close attention to these discussions.

Jo-Ann Fellows is a writer with an interest in health care. She lives in Fredericton.

Why Healthcare Reform Matters to Occupy Wall Street

By Healthcare-NOW!

October 25, 2011
By E.D. Kain for Forbes –

Nearly every country in the developed world has some form of universal access to health insurance. The glaring exception to this rule is the United States. As a proponent of free markets, I find this to be a glaring failure on the part of American policy makers and business leaders.

So we see Occupy Wall Street rallying for healthcare reform, where healthcare workers ”joined the Occupy Wall Street protesters Sunday to rally for health care reform, and tourists continued to funnel in and out of Zuccotti Park to witness the demonstrations for themselves” featuring ”speakers demanding significant health care reform across the country.”

This is a natural and frankly long overdue reaction to the way capitalism works – and doesn’t work – in America.

Beyond the inherent humanity of providing services for those who cannot provide them for themselves, the purpose of safety nets is to enable capitalism. Without a mechanism to stabilize the human cost of market failure, public opinion will turn against a market economy. People will clamor for command and control, for stability, for guaranteed wages and price freezes – for disaster, if truth be told.

Many would argue that the problem with our system is that it’s not a system of safety nets, but rather a system of entitlements for the middle class. This sort of thinking is basically pity-charity liberalism. The idea that we should slash back all services to simply cover the poor in order to save money may sound good on its face, but the lack of universality makes these poor-only programs politically vulnerable. Medicaid faces the chopping block before Medicare because it is largely a pity-charity program geared toward the poor rather than the broad middle class.

Just as importantly, the nature of healthcare costs lends itself to large risk pools. A single-payer healthcare system works so well because there is one very large risk pool with an enormous amount of bargaining power. You can’t match that bargaining power in a fragmented system like the one we have, comprised of myriad regional insurers with de facto monopolies over their area.

Of course, the problems with our healthcare system gouge much deeper than that, and there are many ways you could improve upon the status quo. Some combination of market reforms to loosen up the supply and increase access to providers, coupled with a single-payer insurance framework or even a system of HSA’s and universal catastrophic would be a major leap forward.

In any case, the lack of universal access to healthcare in this country actually hampers business. It makes capitalism more risky for workers, and the cost of healthcare weighs down workers and businesses. The economic cost is huge, and makes American firms less competitive and American workers less secure.

Occupy Wall Street protesters demanding a change to this abysmal system are right. It’s long past due. As more firms shed benefits – such as Wal-Mart – this issue becomes even more important.

Tommy Douglas Remembered- CBC

Happy Birthday Tommy Douglas!

The death panels are already here

What happens when drug shortages spike? You hope to get lucky, like me

By Mary Elizabeth Williams
Salon
October 17, 2011

Bad news, right-wing nutjobs – it turns out that getting sick is not just a problem for those freeloading, uninsured socialist troublemakers. With drug shortages on the rise – and other countries tightening the reins on treatment coverage – who lives and who doesn’t won’t be determined by politics but by the frightening economics of supply and demand.

A piece last month for the Wall Street Journal highlights the problem: Severe shortages of chemotherapy drugs, antibiotics and nutritional supplementation are leading to limited treatments and have caused “hundreds of clinical trials to be stopped.” Drug shortages have tripled in the last six years. And with a new high of 213 different drug shortages this year, patients with life-threatening conditions like high blood pressure, breast cancer, Kaposi’s sarcoma and leukemia have been affected.

Read more HERE.

Canadian Government "missing in action" at global health meeting

CACHCA
October 19, 2011

The World Conference on Social Determinants of Health got underway today in Rio De Janeiro, Brazil, with visible concern from Canadian and global delegates regarding the absence at the conference of Ministers from Canada's federal government.

Over 60 Ministers of Health, including U.S. Secretary of Health and Human Services, Kathleen Sebelius, prioritized participation in the global meeting, deeming it a critical stage on which to demonstrate commitment to local, national and global action in improving health around the world.

CACHCA Board Member and lead representative at the Rio conference, Jack McCarthy, described reactions on the ground in Brazil:

"There is a clear sense of disappointment and frustration here from Canadian delegates and our global partners that the Government of Canada has turned its back on this global gathering. On the one hand, it is exciting and encouraging to see Ministers of Health gathered from countries around the world, while on the other hand it is very troubling and quite embarrassing that Canada's Minister of Health and her government colleagues are conspicuously absent."

McCarthy noted the shared sense of frustration that Canadian delegates at the conference are dealing with in trying to explain the lack of Ministerial representation on the part of Canada: "Canadian delegates are at a loss for words, quite frankly. Global delegates are inquiring about Canada's absence when our country has, in the past, taken a lead on global cooperation related to action on health, including a critical role in bringing the WHO's Commission on Social Determinants of Health into being. We're left holding the bag, ourselves wondering why our federal government has decided to turn its back on the health of Canadians and on the global community."

The three-day world conference got underway this afternoon with addresses from Brazil's President and Minister of Health, the Director-General of the World Health Organization and other leaders who welcomed delegates and declared the conference officially open.

Introduction to “Sick and Sicker”

By Susan Rosenthal
Solidarity is the Best Medicine

“What does it mean to strive for health in a sick society run by psychopaths?”

After 35 years of practising medicine, I found myself asking this question. This wasn’t the question I asked at the beginning of my career. I began by asking, “How can I help Jane Jones and Sam Smith?”

For decades, I immersed myself in the details of people’s miseries until, gradually, I saw a pattern emerge – an exploitive and heartless system was making people sick, the medical system was blaming them for being sick, and funding agencies were moaning about the cost of caring for the sick.

I had wanted to be an agent of health, but I had become an agent of damage control for an utterly damaging social system.

In the following essays, I share the information that led me to conclude that human sickness is a product of sick social relationships and human health is a product of healthy social relationships.

A profit-driven society needs an ever-expanding medical system to contain the damage it creates. We can do more than debate the best way to contain this damage, we can eliminate it.

We can build a health-generating society that provides everyone with the means to a healthy life, including a healthful environment. This is now possible, but the profit-motive stands in the way.

Our health, our lives, our environment and our future depend on replacing divide-and-rule capitalism with a cooperative socialist society. This can happen only if the majority organize to fight for it and build it.

These essays provide some of the ideas needed for that fight.

"Reducing income inequality in the United States would save as many lives as would be saved by eradicating heart disease or by preventing all deaths from lung cancer, diabetes, motor vehicle crashes, HIV infection, suicide and homicide combined. 

Even greater benefits would flow from eliminating class inequality entirely."

CONTENTS

• Introduction
• Inequality: The Root Source of Sickness
• Engels and the WHO Report
• Mental Illness or Social Sickness?
• The Myth of Scarcity
• The US and Canada: Different Forms of Medical Rationing
• The Fight for Medicare in Canada
• Assembly-Line Medicine
• Health Care or Damage Control?
• The Lessons of Chile

To purchase by personal check, contact the author

Tell Canada to "Show Up" for health

Africa Files October 17, 2011 Action Requested: The Government of Canada is currently refusing to send Ministerial representation to a crucial global health conference taking place in Brazil, from October 19-21, 2011. The World Conference on Social Determinants of Health is a gathering of over 100 member states of the United Nations, and will be attended by heads of state and Ministers of Health from around the world — all coming together to discuss key national and global measures to improve health and well-being around the globe.  Please add your name to a new online petition calling on Canadian Prime Minister Stephen Harper and the Government of Canada to "show up" for health by ensuring that Canada’s Minister of Health attends and participates in the conference. CJW Act By: 19 October 2011
Sponsor: Health for All	Target: Prime Minister, government officials
Action Site: http://www.gopetition.com/petitions/tell-canada-to-show-up-for-health.html	Other Contact Info: n/a
African Charter Article #16: Every individual shall have the right to enjoy the best attainable state of physical and mental health. (Click for full text...)

Tommy Douglas on Future of Medicare (1983)

Clip from his Speech to the 50th Anniversary NDP Convention.

Tommy Douglas was present at the Regina Convention that founded the CCF. At the 50th Anniversary Convention in 1983, he delivered what many consider his greatest speech. Those present cheered him for over 20 minutes.

Careworker testimonies: the privatised future of the NHS

By Marienna Pope-Weidemann
Counterfire
Friday, 14 October 2011

Marienna Pope-Weidemann spoke to NHS care workers battling the disastrous re-ablement scheme that puts market imperatives ahead of the needs and interests of the most vulnerable in our society.

When up to 2,000 protesters joined UK Uncut and blocked Westminster Bridge for two hours on Sunday, they were seeking to stop a bill which will be the last nail in the coffin of our National Health Service. This is just the latest legislative Frankenstein from this government. We’ve been descending down this slope for years.

NHS care workers have been trying to stop waves of privatisation drowning their department since 2007. In many respects the new bill represents a monolithic expansion of the spirit of structural adjustment. In Middleton, for example, the so-called ‘re-ablement scheme’ promised to save the council £8.5 million: about as much as it costs us to run each of the Eurofighter Typhoon bombers in Afghanistan for three days.

Healthcare-NOW! Supports Occupy Wall St. Movement

By Healthcare-NOW!  

October 12, 2011

In 1,368 cities across the country and around the world, people are standing up to the top 1% who collectively have more wealth and power than the lower 99% of the population. These occupations are self-sustaining communities focused on creating a space for free and open dialogue and action on the issues–from healthcare to education to unemployment–that plague the 99%.

Healthcare-NOW! endorses the occupation movement and urges all who can to join them, bringing the message of improved Medicare-for-all as a solution to the crisis of inequality in wealth and in health.

We’re being told by the Super Committee and other politicians that our already too modest safety-net is bankrupting us, but the reality is that Wall Street is bankrupting us. Social Security, Medicaid, and Medicare are not the problem. Instead of being cut, they should be maintained and strengthened. Single-payer, improved Medicare for all, like H.R. 676, would save millions of lives and reduce healthcare spending by $400 billion per year.

We need to take the single-payer healthcare message to the occupations, as is happening already in many cities (New York City, Denver, Washington, DC, Philadelphia). We need to make sure that improved Medicare-for-all is on the lists of demands.

The Future of Medicare by Tommy Douglas

Canadian Health Care Coalition 

"We can’t stand still.
We can either go back or we can go forward.
The choice we make today will decide the future of Medicare in Canada."
 

The following text from a 1984 speech of my father is in response to Premier Klein and others who would have us believe that Tommy Douglas had a limited vision for the future of Medicare. He saw much further than most governments in Canada today.
- Shirley Douglas, Spokesperson
Canadian Health Coaltion

The Future of Medicare

There’s not any doubt at all that the present Medicare program in Canada is in serious danger of being sabotaged. One danger is extra-billing, which is growing and which has meant only one thing: that we are rapidly developing two types of people in the health care field–those who come under the general program and whose care is paid for out of government funds, and those who pay “a little extra” to doctors who want a little extra.

The state of single payer in the states: Saskatchewan a model

By Joan McCarterFollow
Daily Kos
October 4, 2011

Last week, Daily Kos asked Governor Brian Schweitzer about his plan to pursue a single payer health system for the state, modeled on the system pioneered by Saskatchewan Province in Canada.

"Montana has a population of 990,000 people," he explains. "Saskatchewan has a population of 1,050,000. Their average age is about the same average age of Montana. They're about 10 percent Indian, we're about 7 and a half percent Indian. The other ethnic groups—they're a mirror image of us.... So we have the same ethnic population, we're farmers, we're loggers, we're miners, we're oil developers.... They, in Saskatchewan, live two years longer and have lower infant mortality."[...] "We have an $8 billion health care industry in Montana right now, and 50 percent of it, or $4 billion, is coming directly from the federal government," he continued. "That may be enough so that we can get the rest of Montana in it. We turn to the rest of Montana and say to them we've got this $4 billion, and we're taking care of all these people, and now we've run the rates and if you want to pay into this system, here's how much it's going to be. If you don't want to buy into that system, you don't have to."

"If you want to pay twice as much for Blue Cross and Blue Shield and have their accountants lie to you," the governor said, "you just stay right where you're at. But I think they'll knock our door down."

Leftwords: Defending Public Healthcare

Healthcare News & Opinion by Doug Allan for The Ontario Council of Hospital Unions/CUPE

Visit the site HERE. 

Lifespan shorter in USA than other developed countries

LeftWords
October 6, 2011

World Bank data suggests that the United States has a lower life expectancy compared to the other major developed economies. Canadian life expectancy is now (2009) 2.5 years longer than in the USA. In 1960, before the development of Canada's public medicare system, the difference was a little less, 1.3 years.

Indeed, the USA has fallen behind its long term nemesis, Cuba. Cubans now live 78.9 years, a couple of ticks more than the U.S. lifespan of 78.7 years.

In 1960 (at the beginning of the Cuban revolution) Cuban's lived 5.9 years less than Americans.

The Coming Battle: Healthcare Privatization and the Ontario Election

By Doug Allan
Socialist Project Bullet
October 5, 2011

In the past, capitalists had given many aspects of healthcare a pass in Canada and Ontario. There was a general preference to leave medicare intact from the lower costs it provided employers, especially in export sectors like auto, that gave Canadian companies a cost advantage. But, with the shifting balance of class power and the turn to an ‘age of austerity’ in the midst of the economic crisis, this has changed. With cuts to public healthcare set for the post-election period in Ontario whatever the electoral outcome, that balance is poised to change again with further attempts to privatize and marketize the healthcare system.

The 1990s: Origins of Healthcare Privatization

In the early 1990s, delivery of healthcare in Ontario by for-profit businesses had been centred in the long term care and ambulance industries. Even hospital support services were mostly publicly delivered. Public insurance sufficed for hospital and physician services.

During the hard right government of Conservative Mike Harris, there was a significant development of for-profit long term care facilities. The Harris government also embarked on two other major attempts to privatize healthcare: [1] the creation of public-private partnership (P3) hospitals where for-profit corporations would finance new hospital facilities and operate the hospital support services, and [2] the establishment of for-profit diagnostic clinics for MRIs and CT scans.

Saskatchewan Doctor's Strike settled - Time magazine 1962

Canada: Condition: Fair

Time
Friday, Aug. 03, 1962

After it was over, Britain's Lord Taylor, a bluff Labor Party peer and an architect of the British National Health Service, last week gave Saskatchewan a doctor's order. "This province has had a major operation," said he. "I prescribe for it absolute rest." The major operation was the settlement of the bitter, 22-day strike of Saskatchewan's doctors, who closed their offices rather than practice under the Socialist government's new compulsory medical insurance scheme.

Largely mediated by Lord Taylor, the settlement let each side claim moral victory. The government won the doctors' agreement to North America's first comprehensive, tax-supported state medical insurance plan. But by their stubborn fight, the doctors won modifications in the plan removing what they had feared as political controls over the practice of medicine. In the key concessions, Saskatchewan's Premier Woodrow Lloyd made clear that the doctors could practice inside or outside the scheme, agreed to let the province's two major doctor-operated voluntary insurance plans continue in business, and expanded the doctors' representation on the medicare plan's governing commission.

The weary Taylor hailed the agreement as a model for what he hopes will come to the rest of Canada and the U.S.—and, following his own prescription for a rest, headed off to fish in the seclusion of northern Saskatchewan.

T.C. Douglas' December 1959 Speech

Medicare: A People's Issue

“If we can do this – and I feel we can – then I would like to hazard the prophecy that before 1970 almost every other province in Canada will follow the lead of Saskatchewan.”
- Tommy Clement Douglas, Provincial Affairs radio broadcast, 16 December 1959

As the 1950s drew to a close, Saskatchewan stood at a crossroad. Funding of medical care was a mixture of direct patient physician payment, public programs or voluntary and commercial plans. The CCF, first elected in 1944, had consistently advocated universal health care, yet only one of the province’s health regions had successfully implemented such a plan. They would soon be looking for their fifth mandate from the people and felt the time was right to make the final push.

On 16 December 1959, Premier Douglas speaking in a dramatic provincial affairs radio broadcast, outlined his party’s health care policy. Douglas outlined the five principles on which CCF medical care would be based:

• A portion of the cost of the program would be paid directly by the people on a prepayment basis.

• There would be universal coverage-everyone would have to join.

• There must be high quality of service.

• This must be a government-sponsored program administered by a public body responsible to legislature.

• The plan must be in a form acceptable both to those providing the service and those receiving it.

Douglas also announced the creation of a ten-member Advisory Planning Committee on Medical Care. Three persons would represent the medical profession, three the government, three the public and one the University of Saskatchewan College of Medicine.

The health care issue would dominate Saskatchewan politics for the next two years. The CCF would win the election and pass the Medical Care Act which would create a crisis culminating in the “Doctor’s Strike” of 1962.

Former Albertan doctor with public and private system experience favours public health care

Politicians pushing privatization not doing their jobs.

Public Values
September 23, 2011

Dr. Robert Ross

Dr. Robert Ross is well qualified to pass judgment on the private, for-profit delivery of health care, having experienced systems in Canada and the USA. Returning to Canada to care for an elderly parent allows Dr. Ross to compare systems and offer unconditional support for public health care. He writes in the Edmonton Journal.

"It is said that one measure of a society's evolution is how it cares for the old and infirm. On this measure, my home province fails miserably.

I have just returned from the Canmore Hospital where my father was admitted with a fractured hip.

He is 94 years of age, still relatively mobile and of comparatively sound mind so I don't expect miracles, but I do want enough hospital staff to physically help with care when he is in severe pain and requires my assistance just to transfer from bed to chair, or use a commode while maintaining some degree of dignity..."

For the complete article, please click HERE.

60 UK hospitals facing closure due to PFI debt

Public funds to be taken out of NHS to support private deals. 

Public Values
September 22, 2011

England's National Health Service (NHS) is set to suffer cutbacks as hospital closures put extra strain on the system, reports Daniel Martin of the Daily Mail. Trusts operating hospitals are unable to pay debt accumulated through the private financing [PFI=Private Funding Initiative] of building the hospitals.

"Hospitals could be forced to close as they buckle under the huge debt left behind by private finance initiative deals, the Health Secretary warned yesterday. 

Andrew Lansley said 22 NHS trusts are facing major financial difficulties because they cannot afford to repay huge annual fees for building work carried out under Labour. 

In some cases, the repayments account for a third of their entire budget — putting pressure on finances and threatening front-line patient services. Mr. Lansley said Labour had left the Health Service with an 'enormous legacy of debt'…"
 
For the complete article, please click here.