A prescription for health care reform: think integration & collaboration

By Iglika Ivanova
Progressive Economics Forum
January 16th, 2012

This morning the CCPA released a new report (co-authored by yours truly) that looks at the thorny issue of health care reform in BC (and Canada) and identifies some practical, evidence-based strategies that have been successful in improving quality of care and controlling costs in other jurisdictions.

The papers comes out at a time when all Canadian provinces face significant pressure to reduce the rate of growth of health spending while continuing to improve access and quality of care but when there is no agreement on the specific changes needed to ensure that public healthcare dollars are more efficiently utilized. As a result, individual provinces are experimenting with a variety of reforms. In BC, the two major policy options being introduced are an activity based funding (ABF) model for hospital surgical procedures; and an integrated model for caring for people with chronic conditions and complex needs in the community. Though both of these are formally priorities of the Ministry of Health, ABF is receiving the vast majority of the financial resources and technical expertise.

Harper’s plan would kill medicare in Canada

The Harper government has set in motion a strategy that will lead to the unravelling of Canada’s national health system. All Harper has to do is nothing. By abdicating the essential federal responsibilities in health care, the system will fragment on its own into 14 separate pieces.

By MICHAEL MCBANE
The Hill Times
Jan. 16, 2012

There is a deficit of political leadership in health care, especially at the federal level. Prime Minister Stephen Harper stated in a year-end interview recently that he had no idea how to secure the future of health care in Canada. Instead, he said it is up to the provinces to find “solutions.”

Harper’s recent unilateral, non-negotiable decision on the future of federal health financing stunned provinces. It seems the federal government intends to limit its role to signing blank cheques with no strings attached and no accountability. If rumours on the Hill are true, once the current arrangement expires Harper may replace cash transfers entirely with tax credits.

Romania rebels as health care threatened

By Stef Newton
CounterFire
January 16, 2012

Thousands of protesters waving flags sing the national anthem, ‘Awaken thee, Romanian!’ among burning trash cans and broken windows. No, it’s not historical footage of the 1989 Revolution, but the fourth consecutive day of protests against the Romanian government’s austerity measures.

It all kicked off when Deputy Health Minister Raed Arafat, a widely popular Romanian physician of Palestinian origin, resigned in opposition to a draft healthcare reform bill that represented a partial privatisation of the healthcare system.

Why medicare needs Ottawa

ROMANOW, SILAS and LEWIS
From Monday's Globe and Mail

The federal government has signalled its intention to reduce its role in shaping medicare to writing cheques. This would complete a 35-year journey that began in 1977, when Ottawa first capped its financial contributions to the provinces. At its peak, Ottawa’s share of publicly financed health-care spending reached 41 per cent. Today, its cash contribution is just over 20 per cent.

The provinces run health care and have traditionally welcomed federal cash transfers with few strings attached. So what’s wrong with Ottawa’s self-imposed exile – is it not merely recognition that it has no legitimate role in shaping how the system develops?

Labour calls for Premiers to stand up for healthcare

FEDERATION OF LABOUR PRESIDENTS 
Monday, January 16, 2012

The Presidents of the Provincial and Territorial Federations of Labour are calling on Canada’s Premiers to reject an irresponsible Federal Conservative “plan” for healthcare. In an open letter from the labour leaders to the Premiers, attending a meeting of the Council of the Federation in Victoria today, the Premiers are asked to stand up and support Canada’s most important social program: universal healthcare.

“We believe, as many Canadians do, that the Harper Government’s December announcement is an abdication of its responsibility,” said Larry Hubich, President of the Saskatchewan Federation of Labour. “Our letter to the Premiers is a call for true leadership on healthcare - leadership that we are not getting from Ottawa.”

As the Federation Presidents outline in their letter, the Harper Government has proposed significant cuts to healthcare funding, beginning in 2017. The announced cuts come after the federal government made the decision to ignore the issue of establishing a new Health Accord, the latest of which is set to expire in 2014.

“In a style that has become typical of the Harper Government, the provinces are going to be handed a take-it-or-leave-it decision without any meaningful dialogue whatsoever. If Prime Minister Harper is not willing to play a leadership role in securing the future of the healthcare system, then the Premiers need to make a stand on behalf of Canadians, on behalf of the values upon which our nation and our healthcare system are founded.

Health Care Accord: Provinces must take the lead

Health centres to Canada's First Ministers: "Collaboration can't wait. Let's achieve Second Stage of Medicare together."

CACHCA
January 13, 2012

The association representing Community Health Centres (CHCs) across Canada is again urging federal, provincial and territorial leaders to focus on collaboration and innovation to improve health care and Canada’s overall health system.

On the occasion of the upcoming meeting of Premiers from across the country in Victoria, BC, this week, the Canadian Alliance of Community Health Centre Associations (CACHCA) is calling on the federal government to take its seat alongside the provinces and territories in negotiating a meaningful health accord for Canadians. In the meantime, the association is urging the Premiers to use their time together in Victoria to carry this process forward, focusing on collaboration and priority-setting in health care across the country’s jurisdictions.

Harper's Health Transfer Plan Offloads Costs to Provinces: Budget Officer

By Heather Scoffield
The Canadian Press
January 12, 2012

OTTAWA - Parliament's budget watchdog says the new health-care funding formula will slowly reduce Ottawa's support for medicare, but it will also put the federal government on a solid fiscal footing for the future.

The trouble is the provinces will have to shoulder a growing health-care burden over the long run and they can't afford to do that without cutting spending elsewhere or raising taxes.

Kevin Page, the parliamentary budget officer, crunched numbers from the federal government's recent announcement on how health care will be funded until 2024. He projected costs and revenues out to 2040-41.

Ottawa needs to fix medicare

By Stan Rice
The StarPhoenix 
January 13, 2012

Rice is a retired pharmacist and health-care administrator, who has experience in developing a drug formulary for the Saskatoon Community Clinic.

Prime Minister Stephen Harper stated in a year-end interview that it's up to the provinces to fix the problems with medicare.

Yet lack of federal coordination and guardianship means that more and more Canadians lack access to comparable services in primary health care, prescriptions drugs, home care, rehabilitation and long-term care. Harper's unilateral action on future federal funding indicates that Ottawa no longer will take any responsibility for ensuring that all Canadians receive universal quality health care.

Crisis in care: Ontario pioneers the privatization of long-term care

By Justin Panos
Briarpatch magazine
Nov 1, 2011

A pill trolley rattles urgently as it makes its rounds in one of Ontario’s many long-term care homes. The support worker pushing it looks visibly exhausted, while a nurse practitioner moves stressfully under the imperatives of time and patient needs, tending to the unwashed, unshaved, undressed, unturned and unfed.

Ontario’s long-term care homes, which provide 24-hour nursing services to chronically ill residents who require some form of basic assistance for daily living, suffer intolerably from an understaffing crisis.

As the pioneer of privatized care in Canada, Ontario has opened the doors for a corporate takeover of long-term care homes, resulting in chronic understaffing by profit-seeking multinational providers.

Harper's hands-off stance a threat to health-care system, unity: Romanow

By Mark Kennedy
Postmedia News
January 8, 2012

OTTAWA — Prime Minister Stephen Harper must join Canada’s premiers at the negotiating table to discuss medicare reforms or the country’s public health-care system will grow weaker, medical privatization will spread and national unity will be imperilled, says Roy Romanow.

The former Saskatchewan premier, who led a royal commission on health care a decade ago, made the comments in an exclusive interview with Postmedia News.

Romanow said he is worried the Harper government has adopted a deliberate strategy to leave health care to the provinces — possibly to foster the development of more private, for-profit medical companies.