The crunch approaches
By Aaron Wherry - Tuesday, November 15, 2011 - 0 Comments
Government spending has increased and the future looks expensive.
In figures for government budgeting for the fiscal year to date, the PBO shows health care allocations up by $1.6 billion. That transfer will continue to increase at a six-per-cent clip every year for at least the next four years if the government sticks to its election promises.
Servicing charges on the public debt have also jumped $1.4 billion from the same period a year earlier because higher deficits are more than offsetting the benefits of low interest rates. Those costs, too, will continue to grow as long as the government keeps adding to its debt. And old-age security payments rose $1.1 billion from last year — partly because of a growing number of beneficiaries and partly because the benefit has been enriched.
Kevin Page questions the government’s fiscal plans going forward. Of course, the Conservatives are openly dismissive of Mr. Page at this point.
On health care, the government has apparently considered a transfer formula based on age.
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Healthier, but not cheaper
By Aaron Wherry - Thursday, October 27, 2011 at 10:31 AM - 8 Comments
Chris Auld debunks the notion that encouraging healthier lifestyles will decrease public health care costs.
The evidence suggests that unhealthy lifestyles tend to increase health care use at any given age and reduce life expectancy, so more is spent per year but for fewer years. For example, statistical estimates from a well-known 1997 paper are displayed in the graph. The lower two lines show that if we compare a smoker and a non-smoker who are the same age, we should expect to find that the smoker consumes more health care. But the top two lines show that health care costs for non-smokers eventually become much higher than those for smokers simply because smokers on average die sooner than non-smokers. This study estimated that if every smoker were to spontaneously quit, demand on the health care system would first fall, as the quitters become healthier than they otherwise would be, but eventually rise by 7 per cent in the long run as smokers live longer.
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Ottawa clinic may have exposed 6,000 to hepatitis, HIV
By macleans.ca - Monday, October 17, 2011 at 3:06 PM - 2 Comments
Cleaning and infection prevention protocols found to be lacking
A private clinic in Ottawa may have exposed up to 7,000 patients to hepatitis B, hepatitis C and HIV. It was revealed Monday that infection prevention and cleaning protocols were “not always followed” at the clinic located at 1081 Carling Ave., Suite 606. Letters were sent to the 6,800 patients who underwent a procedure at the clinic between April 2002 and June 2011 after an inspection by the College of Physicians and Surgeons of Ontario unvcovered what Ottawa Public Health termed “lapses in infection control.” The concerns about the clinic revolve around endoscopies, which are no longer performed there.
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The Insite ruling
By Aaron Wherry - Friday, September 30, 2011 at 9:53 AM - 41 Comments
Brian Howell/Maclean's
(This post last updated at 7:46pm)
The Supreme Court’s ruling on the Insite safe injection facility—a unanimous ruling in the facility’s favour—is here.
The Minister made a decision not to extend the exemption from the application of the federal drug laws to Insite. The effect of that decision, but for the trial judge’s interim order, would have been to prevent injection drug users from accessing the health services offered by Insite, threatening the health and indeed the lives of the potential clients. The Minister’s decision thus engages the claimants’ s. 7 interests and constitutes a limit on their s. 7 rights. Based on the information available to the Minister, this limit is not in accordance with the principles of fundamental justice. It is arbitrary, undermining the very purposes of the CDSA, which include public health and safety. It is also grossly disproportionate: the potential denial of health services and the correlative increase in the risk of death and disease to injection drug users outweigh any benefit that might be derived from maintaining an absolute prohibition on possession of illegal drugs on Insite’s premises.
Early reads from the Globe, Canadian Press, Postmedia, Star and CBC.
10:33am. Libby Davies, whose riding includes the Insite facility, applauds. Three years ago she lectured Tony Clement and called on him to abandon the government’s appeal.
10:46am. Liberal health critic Hedy Fry applauds.
10:51am. The Canadian Public Health Association applauds.
11:37am. Ms. Davies raised the court’s decision in QP just now, provoking a response from Health Minister Leona Aglukkaq. Continue…
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And if you don’t get in…
By Josh Dehaas - Thursday, September 15, 2011 at 1:45 PM - 0 Comments
There are plenty of high-demand, well-paying options in health care
Joe Raedle/Getty Images
Roughly three-quarters of medical school applicants are rejected each year. Bummer. Luckily for them, wannabe doctors have better alternatives than ever. These four professional health care programs can be completed in just a few years, are in high demand, and pay well directly out of school. That means graduates can start paying off their student loans while medical residents are still driving beat-up old cars to 24-hour shifts.
Health Care Manager
The Job: Health care managers work in hospitals, medical clinics and nursing homes where they direct teams of health care providers. Their job is to make sure patients get excellent care and, simultaneously, that Canadians get good value for the nearly $200 billion they spend on health care each year.
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Stockwell Day holds up a new sign
By Aaron Wherry - Thursday, September 8, 2011 at 11:05 AM - 12 Comments
Five and a half months removed from cabinet, Stockwell Day says we must summon the courage to consider two-tier health care.
By stubbornly refusing to allow the development of a modern system that allows those who can willingly afford it to buy services, while still providing properly for the rest of us, we are dooming every provincial budget … if we continue to demonize every MLA or MP who wants to at least look at the options and possibilities then we condemn ourselves to higher costs, higher deficits, higher taxes and lower levels of care. Even the socialized systems of European nations allow for fee for service (translation: two tier) systems.
“Two-tier health care” is a rather fraught phrase that can be interpreted variously, but the idea of “fee for service” health care is seemingly what Mr. Day rejected when confronted with this issue in 2000.
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The end of hospitals
By Julia Belluz - Thursday, September 1, 2011 at 12:15 PM - 70 Comments
Luca Rossato/Flickr
For the last several years, there’s been a lot of apocalyptic chatter about whether the aging population—or “gray tsunami”—will overwhelm the health system. That, coupled with the fact that there seems to be a shortage of hospital beds, has politicians offering up home-care services as an alternative to hospital and long-term care, and health-policy wonks pondering what a system without hospitals would look like.
This week, Ontario Health Minister Deb Matthews was the latest such politico to announce the Liberal plan to invest $60 million in home-care for seniors and the disabled. Though details about the program were not yet available, Matthews said it would offer services ranging from a health professional’s house visit, to phone and online consultations.
The supposed benefits? Improved access, more cost-effective care, reduced visits to hospital, and less pressure on long-term care facilities. As Matthews’ campaign office spokesperson put it, a hospital stay can cost $1,000 per patient per day while long-term care rings in at $150 per day.
But is the suggestion that home-care programs are an efficient alternative evidence-based? Continue…
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If demographics is destiny, the future looks relaxing
By From the editors - Thursday, July 28, 2011 at 2:00 PM - 6 Comments
Canada’s population may be aging, but it’s also less stressed
David J. Green/Alamy/Getstock
There may be a silver lining to Canada’s looming grey wave.
An aging population, we’ve been warned repeatedly, threatens to put unprecedented pressure on our health care and pension systems. This tidal wave of baby boomers will inevitably swamp existing social programs, steal funding away from education and child care and dominate all levels of politics for decades to come, say the doomsters.
Now for the good news: whatever impact demographic destiny may have on public policy, it seems set to produce a country that’s as cool and calm as a cucumber, and with plenty of time for fun. Suddenly the future is looking…relaxed.
Last week Statistics Canada released an intriguing, if under-reported, study on how Canadians spend their time. The report is part of StatsCan’s General Social Survey, an ambitious undertaking that involves 15,000 Canadians filling out daily diaries. Evidence from last year was compared with similar answers from 1998; the results suggest a dramatic decline in the amount of tension in our lives.
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The case for a national drug plan
By Ken MacQueen - Wednesday, June 8, 2011 at 10:35 AM - 42 Comments
The country’s current mishmash of health coverage is leaving too many Canadians out in the cold
Photographs by Simon Hayter
On June 7, Maclean’s hosts “Health Care in Canada: Time to Rebuild Medicare,” a town hall discussion at the National Gallery of Canada, in Ottawa. The public forum is held in conjunction with the Canadian Medical Association and broadcast by CPAC.
Garrett Shakespeare is 22. He lives in North Vancouver where he supports himself as a lifeguard and swimming instructor at the local recreation centre. Many nights you’ll find him working as “DJ G-Ratt,” spinning electronic music and mixes at Vancouver nightclubs. Shakespeare exists in a world of chronic pain caused by an exceptionally rare and fatal blood disease, paroxysmal nocturnal haemoglobinuria (PNH), in which his red blood cells are attacked by the body’s immune system. There are, perhaps, 80 or 90 people in Canada similarly afflicted. Without treatment, about one-third of patients die within five years of diagnosis, and half die within 10 years, says the Canadian Association of PNH Patients. Shakespeare was diagnosed 11 years ago. And he is just one example of the many ways in which Canada’s health care system is neither universal, nor equitable, as far as our drug policy is concerned.
What is the life of a guy like Garrett Shakespeare worth? Should he be allowed to live if it costs $10,000 a year? What if $50,000 is the price of his life? How about $500,000? Is Garrett Shakespeare’s life worth $500,000 a year?
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The health care debate Stephen Harper is ready to have
By Aaron Wherry - Tuesday, June 7, 2011 at 12:46 PM - 100 Comments
For those interested in a health care debate ahead of impending federal-provincial negotiations, the Harper government seems keen to start the discussion on their terms. Or rather, their term.
Prime Minister Stephen Harper, May 18.
I do think that the public wants to understand better from all governments how the amounts of money we’re putting into health care are going to lead to better outcomes, greater accountability for results.
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Tommy Douglas takes Vermont
By Aaron Wherry - Friday, May 27, 2011 at 3:53 PM - 8 Comments
Vermont’s governor signs into law a single payer health care system. Tommy Douglas references ensue.
Vermont has become an incubator for innovative public policy. Canada’s single payer healthcare system started as an experiment in one province, Saskatchewan. It was pushed through in the early 1960s by Saskatchewan’s premier, Tommy Douglas, considered by many to be the greatest Canadian. It was so successful, it was rapidly adopted by all of Canada. (Douglas is the grandfather of actor Kiefer Sutherland.) Perhaps Vermont’s healthcare law will start a similar, national transformation.
A Washington congressman similarly invoked the father of Canadian health care earlier this month.
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Sheila Fraser's straight talk express
By Aaron Wherry - Thursday, May 26, 2011 at 9:07 AM - 7 Comments
The Auditor General bids adieu.
“We all know Canada’s population is getting older, but we are still grappling with its implications — fewer people in the labour force, less economic growth and less tax revenue,” Fraser said in a speech. “At the same time, we can expect people will need more health-care services and will be drawing on public pensions. Obviously, balancing these fiscal pressures will be a major challenge.”
At a later news conference, she expanded on why Canadians need to know more about potentially significant costs looming down the road. ”There may be some very hard choices that have to be made. And unless Canadians can understand the pressures that are coming and that government has to deal with, I think it will be very difficult for them to accept, perhaps, decisions that the government will have to make.”
More here, here and here. Ms. Fraser has also released a final report looking back on her decade in office.
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Policy alert
By Aaron Wherry - Thursday, April 28, 2011 at 2:34 PM - 4 Comments
The Canadian Medical Association Journal surveyed the major political parties on various matters relevant to health care.
The responses are collected here.
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A country gets its back up
By Paul Wells - Thursday, April 28, 2011 at 9:30 AM - 95 Comments
WELLS: Even if Jack Layton fades in the stretch, something permanent will remain
Andrew Vaughan/CP
Maybe now we can stop telling ourselves Canadian elections are predictable.
It is fashionable in Ottawa circles before every election campaign to draw oneself back from the lunch table, let one’s gaze wander toward the ceiling, and announce to the room, “I don’t know why we’re even bothering to have an election, anyway. It’s not like it’ll change anything.” More often than not these weary predictions are wildly wrong.
The 2000 election killed the Progressive Conservative Party of Canada and—because Jean Chrétien was able to win a plurality in Quebec less than a year after he passed the Clarity Act—the political career of Lucien Bouchard. In 2004, Paul Martin came within an ace of losing power to an upstart Calgarian whom Liberals had viewed with contempt. In 2006, Stephen Harper took Martin down. In 2008, Harper confirmed his hold on the seats he’d won and drove Stéphane Dion’s Liberals to their lowest share of the popular vote since Confederation.
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Patient, help thyself
By Ken MacQueen - Tuesday, April 26, 2011 at 11:30 AM - 17 Comments
The role of individual responsibility for wellness is under debate. Should healthy choices be rewarded?
Andrew Vaughan/CP
On April 27, Maclean’s hosts “Health Care in Canada: Time to Rebuild Medicare,” a town hall discussion at the Marriott Pinnacle Downtown Hotel in Vancouver. The public forum is held in conjunction with the Canadian Medical Association and broadcast by CPAC.
Numerous polls put health care as the top priority in the federal election campaign, yet until recent days there was little debate about the failures of a health system that is a middling performer among most wealthy nations in its scope, cost and outcomes.
There’s an alarming lack of new ideas among national leaders on ways to either help provinces improve delivery of public health services or to rein in what a new report by the C.D. Howe Institute calls “chronic health care spending disease.”
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This week: Good news, bad news
By macleans.ca - Tuesday, April 26, 2011 at 9:00 AM - 0 Comments
Good news/bad news
Good News
Issei Kato/Reuters
Cuba libre?
Signs of glasnost appeared in Cuba as the ruling Communists held a party congress and Fidel Castro prepared to step down as first secretary. Fidel’s successor as president, brother Raul, opened the meeting with a speech endorsing term limits for senior leadership—a surprising suggestion, coming from half of the duo that has held power since 1959. Delegates discussed an astonishing package of market-based reforms, including property rights, free currency flows, and the elimination of universal food rationing.
More news is good news
Quebecor launched its Sun News Network cable channel, receiving praise and catcalls for its “populist” programming in the visual style of Fox News. Key figures in the day-one lineup included talk-radio star Charles Adler, multimedia reporting vets David Akin and Brian Lilley, and daytime anchor Krista Erickson, who provided a special fillip to the rollout by posing as the Sun papers’ Sunshine Girl. Perhaps the biggest surprise was the presence of Liberal campaign advertising; party president Alf Apps noted that “the price was right.”
Disaster control
Researchers at the Swiss Federal Institute of Technology in Zurich announced results from simulations of crowds that may help police prevent fatal panics like the one that killed 21 at a music festival in Duisburg, Germany, last year. New models show that when a crowd reaches a critical density, a coordinated “undulation” begins, signalling the potential onset of a turbulent “crowd quake” of deadly physical force. Review of video from Duisburg confirms that a wavelike motion preceded the stampede, raising hopes that similar disasters could be averted in real time.
A real shell game
The University of Maine and the Canada-U.S. Lobster Institute introduced a biodegradable golf ball made from discarded lobster shells. The balls can survive just a few swings, but they are a good fit for use on cruise ships, since they break down in water within a few weeks. The cost of the lobster balls is lower than that of existing biodegradable alternatives, and the lobster industry is eager to find profitable uses for the shells, which make up half of the weight of the total catch.
Bad News
Edward Echwalu/Reuters
Flood risks
Residents of the southern Prairies coming off a wet growing season and a very snowy winter are facing spring flooding. In Manitoba, a total of 700 people, including 576 from the Peguis First Nation, had to evacuate threatened homes, and Highway 75, the province’s key overland link to the U.S. border, was closed. Floodways and dikes have performed well during the crisis, protecting all but a handful of homes, but two rural Manitoba motorists were killed trying to navigate flooded roads.
Bad medicine
A Fraser Institute study shed harsh light on the recent increase in Canadian health care costs, showing that provincial health spending grew by an average of 7.5 per cent a year from 2001 to 2010; during the same period provincial revenues expanded at a pace of 5.7 per cent and the Canadian economy by 5.2 per cent. Ontario and Quebec will already be spending 50 per cent of total revenues on health by the end of 2011, said analysts Brett Skinner and Mark Rovere. But their proposed solution—a five-year waiver of Canada Health Act provisions outlawing private insurance and care providers—found no takers among those running for election.
MinUS sign
Bond rating agency Standard & Poor’s stunned markets by downgrading the debt of the United States Treasury. U.S. bonds remain AAA-rated, but S&P, firing a warning shot across Washington’s bow, adjusted the outlook from “stable” to “negative.” An S&P analyst noted that “policymakers have still not agreed on how to reverse recent fiscal deterioration,” adding that S&P estimates the likelihood of the U.S. losing its triple-A status within the next two years at “at least one in three.”
Head feint
As the NHL playoffs began amidst a clamour over ill-defined “head shot” rules—which came into play after Vancouver Canucks forward Raffi Torres received only a two-minute minor for blindsiding Chicago’s Brent Seabrook—new research from the University of Calgary confirmed estimates that players experience about 1.8 concussions per 1,000 hours of ice time. Breakdowns of the numbers emphasize the risks of repeat concussion and of attempting to play through one.
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The Bull Meter: Michael Ignatieff on the Conservatives' investments in health care
By Julia Belluz - Thursday, April 21, 2011 at 4:57 PM - 29 Comments
Is it true Harper hasn’t invested “a new dime” in health care?
"[Harper] has not added a new dime to the money committed [to health care] by [former] prime minister [Paul] Martin."- Michael Ignatieff
April 17, 2011Bull Meter score:
In 2004, then Liberal Prime Minister Paul Martin promised to “fix health care for a generation” by committing to a 10-year guaranteed six per cent yearly increase on health transfers from the federal government to the provinces and territories. This deal doesn’t expire until 2014, meaning Harper has not had to commit “a new dime” to health care—there’s a six per cent escalator built in to the agreement Martin negotiated in 2004. And the Department of Finance breakdown of federal support to the provinces and territories shows the Canada Health Transfer has indeed increased by 6 per cent annually over the past few years.
So the Liberal leader is being misleading when he says Harper hasn’t added a “new dime” to health care. As Morris Barer, director of UBC’s Centre for Health Services and Policy Research, put it, “It looks to me like Iggy is being a bit disingenuous by suggesting that the 6 per cent was an old commitment and that the feds would need to be committing to annual increases greater than 6 per cent in order for the Liberals to view any of it as ‘new money.’”
Heard something that doesn’t sound quite right? Send quotes from the campaign trail to macbullmeter@gmail.com and we’ll tell you just how much bull they contain.
Sources:
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Direct appeal
By Aaron Wherry - Thursday, April 21, 2011 at 9:35 AM - 34 Comments
The Liberals will air a half-hour program on Sunday afternoon showcasing Mr. Ignatieff and the Liberal platform. From the official release:
“Michael Ignatieff’s Town Hall for Canada” will feature candid interviews with Mr. Ignatieff, and exclusive footage of him on the campaign trail in this election as he brings his message of hope to Canadians … “Michael Ignatieff’s Town Hall for Canada” will make the case directly to Canadians why the Liberal Party is the only choice in this election that can protect Canada’s universal public health care system and bring a new level of economic stability to Canadian families through the Liberal Family Pack.
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What Harper has planned for Ottawa
By Paul Wells - Wednesday, April 20, 2011 at 6:40 PM - 215 Comments
The PM plans to continue shrinking government; health care transfers will help
Frank Gunn/CP
What if this election were about something big? What if it were a fundamental debate about the role of government in a modern society? Maybe it is and you just have to scratch a bit to find it.
With their backs to the wall, Michael Ignatieff’s stalled Liberals have finally begun broadcasting the sort of attack ads that always feature in the later stages of Liberal campaigns. “Stephen Harper is demanding more time in power,” this year’s ads say, over pictures of the Conservative leader in an unphotogenic moment of repose. “Can you trust him with your health care?”
Well, why wouldn’t you? In reply, the Liberal ad rehashes some scare quotes from 2000 and 2001, when Harper was beating the right-wing drums at the National Citizens’ Coalition. Then the breathless voice-over adds: “Last year, Harper’s finance minister called for massive cuts to increases in health spending. Now Harper has a risky plan to cut $11 billion from government spending. Where would Harper’s cuts leave your family’s health?”
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What’s the real issue here?
By Josh Dehaas - Wednesday, April 20, 2011 at 5:40 PM - 3 Comments
In this election, debate on policy has taken a back seat
In last week’s English-language debate, Stephen Harper didn’t bother mentioning his income-splitting plan or proposed fitness tax credit. Neither Jack Layton nor Michael Ignatieff talked about their support for cap and trade policies. Layton only brought up old age pensions once and Ignatieff only squeezed in one mention of his home renovation tax-credit promise. In fact, there was almost no policy discussion at all.
That explains why there were significantly fewer mentions of the major policy issues in newspapers following the debate, says Stuart Soroka, the McGill University political scientist who runs the Federal Election Newspaper Analysis Project. (Soroka tracks which issues get written about in eight major English language papers, and the tone of the coverage. Maclean’s publishes analysis of the results each week.) “The debate seems almost invisible,” says Soroka, referring to its impact on the statistics. “If the objective was to get people to think more seriously about policy differences, it sure didn’t happen.” Only health care was written about in a greater share of stories following the debate, up from 12 to 14 per cent. Crime and justice fell from 54 to 31 per cent. Even the economy dropped from 32 to 22 per cent.
Not all debates are so unmoving. When Martin challenged Harper on gay marriage and abortion in 2004, social issues moved to the front pages. In 2008, coverage shifted to the economy after the debate.
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Harper on health care: hard to make it a vote-driving issue
By John Geddes - Wednesday, April 20, 2011 at 12:31 PM - 23 Comments
The Liberals have been making a late-campaign push to turn Stephen Harper’s past remarks about health care into a big election issue, and it’s hard to blame them. Those painstakingly selected quotes from Harper are certainly more germane to an actual policy file than any of miscellaneous old Michael Ignatieff lines the Conservatives creatively cut and paste into their attack ads.
Still, I doubt dredging up Harper’s past pronouncements on health is doing him much harm. He has a solid track record of not tampering with the status quo. His calls for Ottawa to step away from dictating health policy and let the provinces overhaul the system date from back before his creation of the new, more cautious Conservative party in 2003.
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Back and forth
By Aaron Wherry - Wednesday, April 20, 2011 at 12:22 PM - 12 Comments
While the Conservatives aim an attack ad at an attack ad that is no longer running, the Liberals release a new spot based on their online poll.
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Does Stephen Harper approve of this message?
By Aaron Wherry - Tuesday, April 19, 2011 at 6:23 PM - 24 Comments
The Liberals have edited and rereleased their disputed ad.
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'When you've said something, you've said it'
By Aaron Wherry - Tuesday, April 19, 2011 at 9:51 AM - 36 Comments
Further to this, Tim Naumetz finds a blurb from Stephen Harper’s past.
“Gratzer proposes a workable solution for the biggest public policy problem of the coming generation—our government-controlled health care monopoly,” Mr. Harper said in comments that are quoted on the back cover of the book. “Our health care isn’t just sick, it’s killing people. Canada needs Gratzer’s new prescription.”
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Stephen Harper and the Canada Health Act
By Aaron Wherry - Monday, April 18, 2011 at 1:32 PM - 190 Comments
Greetings from the Northwest Territories, where the Conservative and Liberal campaigns have come to debate Stephen Harper’s feelings for the Canada Health Act.
Specifically, the Conservative side is demanding that the Liberal side pull an ad that suggests Mr. Harper once suggested aloud that the Canada Health Act be scrapped. The ad cites the Globe and Mail, but it now seems the comment in question should have been attributed to a different former president of the National Citizens Coalition. (The Globe has now added a correction to the article in question.)
The Conservatives further claim that Mr. Harper “has always supported the Canada Health Act.” There may be quibbles on that point to be found below in the backgrounder the Liberal campaign has distributed, which sets out their sourcing for the ad in question (including, er, Maclean’s) and other comments attributed to Mr. Harper.
Speaking with reporters here, Mr. Ignatieff said that if the Liberal ad is mistaken, necessary action will be taken.Indeed, the Liberals now say they will replace the “scrapped” quote from the current ad with one of the other comments cited here. Furthermore, they say they will post an online poll to ask Canadians which of Mr. Harper’s quotes should be used in the new cut.
