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Showing posts from November, 2011

Drummond: Canada Health Act 'completely irrelevant'

Don Drummond, who is developing a report on public sector reform for the Ontario government, does not want to attack the Canada Health Act (CHA) -- or at least not directly. The CHA is the federal government legislation which enshrines the five principles of Canadian public health care:  Universal, comprehensive, accessible, portable and publicly administered health care for all Canadians. Drummond made this plain in an interview with CBC television about the Canada Health Act and privatization: "[P]ut the word privatization, say the word Canada Health Act and you've got a heart attack, you've got an increase in people going to the hospitals just at the mention of those words. You have to be so careful how you approach this thing. So you have to roll some things off the table right at the beginning and then really focus that all this is about is improving the efficiency and that what we're actually trying to drive up the quality of the care, we're not tryin

US business makes a bee line for Canadian home care

The National Post section "Entrepreneur"  ran a piece yesterday that suggests increasing business interest in Canadian home care.  The article spent some time on two new Canadian "master franchisees" for the America company BrightStar, which has 229 locations in the U SA.  The two Canadian master franchisees are Brian Evans and Jim Jacoboni: Both acknowledge the huge potential in a burgeoning industry that some estimates peg at 18% annual growth.  BrightStar plans to open about 50 franchises in the next three to five years, with 22 in Alberta and British Columbia, and 25 in Eastern Canada to be overseen by Mr. Evans.  " The health care sector demographics are obvious, " Mr Evans says. " The squeeze on provincial budgets is an obvious factor, as well. " Although provincial governments are delivering some  home care  services directly, the private sector is moving quickly to fill in gaps in service and could even be contracted out by governme

Short video on privatization of surgical clinics

A great new short video from CUPE in Saskatchewan on the privatization of surgeries is right here: Their had been plans to develop a new $14 million public surgical centre that would perform 7,000 surgeries per year and house a pre-admission clinic to relieve pressure on acute care hospital facilities.  It was supposed to be operational by March 2011 - -but the government has postponed or cancelled the plans for the centre.   Saskatchewan sources say instead the government has funded private clinics at millions of dollars with poor results. “Instead of expanding surgical capacity, the region has simply transferred the surgical work to the private sector,” said Gordon Campbell, President of the CUPE Health Care Council in Saskatchewan. To boot, an existing private clinic is suing the Regina health region for the potential loss of $10 million after a contract was awarded to a Calgary-based private clinic! Saskatchewan was the birthplace of public health care in

US studies show for-profit nursing homes inferior

The Canadian study on long term care facilities discussed yesterday noted  that US studies have indicated that for-profit long term care homes were inferior to for-profit homes.   In a 5-year examination of complaints in all US states, Stevenson 12   found that for-profit facilities had an almost two-fold greater chance of receiving a complaint compared with non-profit facilities and that chains had a significantly higher rate of complaints compared with non-chain facilities. Harrington and colleagues 5   also found that for-profit investor ownership predicted 0.679 additional “deficiencies” (a US regulatory measure similar to unmet standards), and chain ownership an additional 0.633 deficiencies per facility compared with non-profit facilities. On another issue, the Canadian study notes " that non-profit, single-site facilities demonstrate higher complaint rates in comparison with public and charitable facilities. This diversity of performance between public and non-profit gr

For-profit nursing homes inferior -- New Study

A new Canadian academic study has examined  publicly available data on complaints about long term care homes for the elderly, comparing for-profit homes with not-for profit homes.   Complaints are one way to measure the quality of  the different types of homes.   The report notes that while "studies conducted in the United States have demonstrated an association between for-profit ownership and inferior quality, relatively few Canadian studies have made performance comparisons with reference to type of ownership."  The study concludes:  Compared with for-profit chain facilities, non-profit, charitable and public facilities had significantly lower rates of complaints in Ontario. Likewise, in British Columbia’s Fraser Health region, non-profit owned facilities had significantly lower rates of complaints compared with for-profit owned facilities. Most complaints were related to resident care. Complaints were more frequent in facilities with more citations, i.e.

Health care funding plans go south

While the health care funding plans in health care are bad -- other sectors face worse, with Finance Minister Dwight Duncan telling the Star that some departments might get 30% cuts. Even, if he is exaggerating (so as to look better when the real numbers are revealed in the March Budget) there is trouble ahead for everyone. With planned funding increases cut to less than one-seventh those of recent years, there will be no where to duck. All this while the Liberals implement tax cuts for the corporations - tax rates that will hit historic lows . Attached here  is a power point presentation on falling Ontario government funding plans (and what they will mean for health care).  It was part of a presentation to the Ontario Health Coalition's Assembly this past weekend.

OECD data reveals shortcomings of privatized US health care

Here's the Organization for Economic Cooperation and Development's (OECD's) latest report on U.S. health care funding. The United States spent 17.4% of GDP on health in 2009, much more than the OECD average of 9.6%. Details: Spending per person is two-and-a-half times higher than the OECD average. Total health spending accounted for 17.4% of GDP in the United States in 2009, by far the highest share in the OECD. Following the United States were the Netherlands, France and Germany, which allocated respectively 12.0%, 11.8% and 11.6% of their GDP to health. The OECD average was 9.6%.   The United States also ranks far ahead of other OECD countries in health spending per capita, with spending of 7,960 USD in 2009, two-and-a-half times greater than the OECD average of 3,233 USD (adjusted for purchasing power parity). With less than half of health care funded by the public sector in the USA (compared to 72% for the 34 developed countries in the OECD) and with for-profit

PCs follow Drummond: major health care review?

Will the Progressive Conservatives (PCs) push for a large scale review of health care?  Ottawa Citizen reporter Pauline Tam says PC health critic Elizabeth Witmer is hinting this will be the price for the PC support for the Liberal minority government.  The review would focus on     improving elder care, chronic-disease management and disease prevention. The former health minister, who presided over hospital restructuring under Premier Mike Harris, criticized Liberal health spending as “ad hoc” and directionless. “They’ve never told us where they’re going, or why they’re going there, and I think the last time any government did that was our government under Mr. Harris.” With hospital closures, centralization of services, and service cuts, the 1990s PC review of the healthcare system was expensive, chaotic, and much hated. Key PC policies were later reversed (as discussed here many times). And there is little reason to think another major restructuring will be better this ti

Drummond sends some signals on health care

Don Drummond’s ' lecture ' for the C.D. Howe Institute does not propose too much new, but does raise some possibilities of what his Commission on Ontario public services might recommend for health care.  The main point Drummond makes is that health care restructuring must happen more quickly.  Although Drummond has tried to distance himself from the health care reforms of the Mike Harris government, the two are united in many ways.  Both are driven to system redesign by a goal of implementing austerity.  Drummond doesn’t quite have the nerve to say that public health care is unsustainable, but the threat of unsustainability sustains his argument.  Here are key parts of Drummond’s proposals in his C.D. Howe Lecture: Like the Harris reforms, a key part of the argument is to cut hospitals and increase home care.   This is a very old proposal that has been worked on for, literally, decades. It’s often presented as a new idea, especially when austerity is in the air.   Whi

2,100 new for-profit long term care beds

For-profit long term care (LTC) beds for the elderly increased by over 2,100 in Ontario between 2003/4 and 2009/10 according to new Statistics Canada data.   The number of for-profit facilities increased by 70, taking a large majority in the growth in facilities, gaining 70 out of the total of 94 new LTC facilities. However, with slightly stronger growth in the number of beds operated by not-for-profit operators, not-for-profit operators actually increased their share of the total number of LTC beds by a couple of percent.  Nevertheless, 60% of  all LTC beds are still operated by for-profit corporations.   As well, 65% of the facilities are operated by for-profit corporations. The biggest increase in beds over the six years was in not-for-profit facilities operated by lay organizations.  These lay facilities saw their number of beds increase from 9,600 beds to 13,200 beds.  Municipal homes also increased their share of total beds.  The Stats Canada reports are linked below.