SEIU HEALTHCARE RESPONSE TO NEW FEDERAL FUNDING FOR PERSONAL SUPPORT WORKERS


RICHMOND HILL, ON, Feb. 7, 2023 /CNW/ - The following statement can be attributed to SEIU Healthcare president, Sharleen Stewart:

Canada's Healthcare Union (CNW Group/SEIU Healthcare)

"SEIU Healthcare welcomes the federal government's commitment today of $1.709 billion to invest in personal support workers (PSWs) and care workers like them who support our vulnerable loved ones.

This funding marks a giant step forward towards achieving a $25 per hour national minimum wage for all PSWs across Canada.

Our message to provincial and territorial governments is simple: the time for excuses is over—it's time to raise wages for PSWs and provide better healthcare jobs—it's time for $25 for Canada's PSWs and all underpaid healthcare workers like them.

We call on Canada's premiers to accept this money and raise wages for healthcare workers immediately because good healthcare jobs mean better care for seniors and patients.

Canada's health human resources are in crisis and workers on the frontline are demanding that all governments invest in safe staffing levels. That's why SEIU Healthcare will never stop fighting for all healthcare workers who are overworked and underpaid, and with action from all levels of government we can end the exploitation of women in the care economy more broadly, and all healthcare workers in particular."

SEIU Healthcare represents more than 60,000 healthcare and community service workers across Ontario. The union's members work in hospitals, homecare, nursing and retirement homes, and community services throughout the province. www.seiuhealthcare.ca

SOURCE SEIU Healthcare

View original content to download multimedia: http://www.newswire.ca/en/releases/archive/February2023/07/c6390.html

Gallup: Fewer than half of Americans believe U.S. healthcare is good enough

The findings of the 2022 annual Health and Healthcare survey mark the first time in its 20-year history that the healthcare system has failed to meet the expectations of most Americans, Gallup said Thursday about its new poll.

Jan. 19 (UPI) -- A majority of Americans rate healthcare in the United States as substandard for the first time, according to a new Gallup poll released Thursday.

The results show 52% of those surveyed believe U.S. healthcare is subpar, with 31% saying it was "only fair" and 21% -- a new high -- rating it "poor." That compares to 48% who rated it ''excellent'' or ''good''.

The findings of the 2022 annual Health and Healthcare survey mark the first time in its 20-year history that the healthcare system has failed to meet the expectations of most Americans, Gallup said in a news release.

Although the excellent/good score is only 2 percentage points lower than 2021, it fell well below the 62% high point twice recorded in the early 2010s. It also lags behind the average 55% reading since 2001.

RELATED Gallup: Costs deter more Americans than ever from seeking healthcare

Gallup sought to explain the downward trend as a feature of the partisan divide among those surveyed, with Republicans' satisfaction levels falling year-on-year while Democrats' views have remained steady.

''Republicans' positive ratings have been subdued since President Donald Trump left office. Currently, 56% of Republicans rate healthcare quality as excellent or good, whereas 69% felt this way in 2020 and 75% in 2019,'' Gallup said.

''Republicans' views of healthcare quality also dropped in 2014 after implementation of the Affordable Care Act before rebounding under Trump. Meanwhile, Democrats' positive ratings have been steady at a lower level (currently 44%).''

RELATED More Americans with employer-sponsored insurance can't afford healthcare

The survey also unearthed an age divide, showing that public satisfaction with healthcare has trended downward among middle-age and younger adults while remaining high among those 55 and older.

Gallup says it is unclear whether the change across party lines is a result of rising healthcare costs for those not on Medicaid, perceived changes brought about by the ACA, or something else.

The more recent declines among young adults may reflect changes to healthcare since the COVID-19 pandemic or restricted access to abortion following the Supreme Court's Dobbs decision last year.

RELATED Pandemic funding eased medical debt for many Americans

This latest poll comes as U.S. healthcare garners growing criticism amid concerns it is becoming prohibitively costly and insurance coverage is, for a small but increasing number of Americans, failing to keep pace with rising costs

Earlier this week, another Gallup poll found that a record number of Americans postponed getting medical treatment in 2022 due to the high cost. In the survey, 38% reported that they or a family member had put off seeking medical care because of the high bills they would incur.

Meanwhile, an American Medical Association study published last month found an increasing number of Americans struggle to afford medical care -- even if they have health insurance through their employer.

Researchers from New York University discovered that over the past two decades, the number of Americans with job-based health insurance who skimp on medical care has been on the rise. One possible explanation the study postulated was efforts by insurers to push a larger portion of the payment for treatment onto consumers.

It’s time to guarantee healthcare to all Americans as a human right



It is time to end the international embarrassment of the US being the only major country that does not guarantee healthcare

OPINION

Bernie Sanders

THE GUARDIAN

Thu 18 May 2023 

Let’s be clear. The current healthcare system in the United States is totally broken, dysfunctional and cruel. It is a system which spends twice as much per capita as any other major country, while 85 million Americans are uninsured or underinsured, one out of four Americans cannot afford the cost of the prescription drugs their doctors prescribe, and where over 60,000 die each year because they don’t get to a doctor on time.

It is a system in which our life expectancy is lower than almost all other major countries and is actually declining, a system in which working class and low-income Americans die at least ten years younger than wealthier Americans.

It’s not just trans kids: Republicans are coming after trans adults like me, too
Alex Myers

It is a system in which some 500,000 people go bankrupt because of medically related debt.

It is a system in which large parts of our country are medically underserved, where rural hospitals are being shut down, and where people, even with decent insurance, have to travel hours in order to find a doctor.

It is a system in which, in the midst of a major mental health crisis, Americans are unable to find the affordable mental health treatment they need.

It is a system where, despite our huge expenditures, we don’t have enough doctors, nurses, dentists, mental health professionals, pharmacists and other healthcare professionals – and where we spend less than half as much of our healthcare dollars on primary care as do most other countries.

It is a system in which, while we are desperately in need of more health professionals, young people are graduating medical school, dental school or nursing school, hundreds of thousands of dollars in debt; a system in which Black, Latino and Native American doctors and nurses are grossly under-represented as medical professionals.

It is a system in which health care for most Americans remains attached to employment. Incredibly, during the pandemic when millions lost their jobs, they also lost their healthcare. It is a system in which the quality of care you receive in this country is dependent on the generosity of your employer or whether you have a union. Not surprisingly, workers at McDonald’s do not receive the same quality care as executives on Wall Street.

All of that has got to change. The function of a rational and humane healthcare system is to provide quality care for all as a human right. It is not to make tens of billions of dollars every year for the insurance companies and the drug companies.

Yes. It is long overdue for us to end the international embarrassment of the United States being the only major country on earth that does not guarantee healthcare to all of our people. Now is the time to finally pass a Medicare for All single-payer program. And that is the legislation that I am introducing in the Senate this week with 14 co-sponsors. In the House there will be over 100 co-sponsors.

Let’s be honest. The debate over Medicare for All really has nothing to do with healthcare. It has everything to do with the extraordinary greed of the healthcare industry and their desire to maintain a system which makes them huge profits.

While ordinary Americans struggle to pay for healthcare, the seven largest health insurance companies in our country made over $69bn in profits last year and the top ten pharmaceutical companies made over $112bn.

The corporate opposition to the desperately needed reforms of our disastrous healthcare system is extraordinary.

Since 1998, the private health care industry has spent more than $11.4bn on lobbying and, over the last 30 years, has spent more than $1.8bn on campaign contributions to get Congress to do its bidding.

The pharmaceutical industry alone has over 1,800 lobbyists on Capitol Hill – including the former leadership of both political parties.

That’s how business is done in Washington. Well, we intend to change that dynamic. We intend to fight for legislation which ordinary Americans want, not what powerful special interests want.

Our Medicare For All legislation would provide comprehensive healthcare coverage to all without out-of-pocket expenses and, unlike the current system, it would provide full freedom of choice regarding healthcare providers.

No more insurance premiums, no more deductibles, no more co-payments, no more filling out endless forms and fighting with insurance companies.

And comprehensive means the coverage of dental care, vision, hearing aids, prescription drugs and home and community-based care.

Would a Medicare-for-all healthcare system be expensive? Yes. But, while providing comprehensive healthcare for all, it would be significantly LESS expensive than our current dysfunctional system because it would eliminate an enormous amount of the bureaucracy, profiteering, administrative costs and misplaced priorities inherent in our current for-profit system.

Under Medicare for All there would no longer be armies of people billing us, telling us what is covered and what is not covered and hounding us to pay our hospital bills. This simplicity not only substantially reduces administrative costs, but it would make life a lot easier for the American people who would never again have to fight their way through the nightmare of insurance company bureaucracy.

In fact, the congressional budget office has estimated that Medicare for All would save Americans $650bn a year.

Guaranteeing healthcare to all Americans as a human right would be a transformative moment for our country. It would not only keep people healthier, happier and increase life expectancy, it would be a major step forward in creating a more vibrant democracy. Imagine what it would mean if our government worked for ordinary people and not just powerful corporate interests.

Bernie Sanders is a US Senator and the ranking member of the Senate budget committee. He represents the state of Vermont

 

Why India Urgently Needs a Union Law to Protect Healthcare Workers

Jehosh Paul | 06 Sep 2024

It is ironic that in an era where the government is obsessed with the Uniform Civil Code, ‘One Nation, One Poll’ and other centralising policies— it hesitates to apply the same logic to safeguarding those who risk their lives for public health.

 

Image Credit: The Leaflet

The Union government’s stance, reiterated recently, that there is no need for a specific Union law to protect healthcare workers— citing that 26 states and Union territories have already enacted legislation for the purpose— belies the ground reality.

State-specific laws suffer from inconsistent application and weak enforcement. According to an analysis by Deccan Herald, states such as Karnataka, West Bengal and Tamil Nadu do not extend legal protections to ‘auxiliary nurse midwives’ (ANMs), ancillary workers, and health visitors— roles critical to the healthcare system, especially in rural areas. This leaves these workers vulnerable, without legal recourse in the event of violence.

Further complicating the issue, only Goa has adopted provisions for graded penalties, which allow for punishments to be proportionate to the severity of the crime.

In contrast, the absence of such provisions in other states weakens the law’s deterrent effect, either by failing to properly address minor offences or by imposing disproportionately harsh penalties for less severe crimes.

Moreover, only Uttarakhand includes specific provisions for repeat offenders, meaning that most states allow individuals who repeatedly commit violence against healthcare workers to evade escalating consequences.

Additionally, in Bihar, offences against healthcare workers are compoundable, meaning they can be settled out of court. This undermines the severity of these crimes and allows offenders to escape stringent punishment.

These disparities create a confusing and inadequate legal landscape, where healthcare workers in states such as Goa or Uttarakhand might enjoy stronger protections than those in West Bengal or Karnataka, leading to unequal standards of safety and justice.

Also read: An analysis of how ill-managed the Covid pandemic was in India

Enforcement is another major challenge. Many police officers are unaware of the specific state laws protecting healthcare workers or unsure how to enforce them.

According to Dr Neeraj Nagpal, convener and managing trustee of the Medicos Legal Action Group in Chandigarh, “Without any provision in the Indian Penal Code (IPC), filing a case can sometimes mean taking a copy of the Act to the police because she or he may not even know about it.”

Dr Nagpal further explains that the “police may not even be sure under which Section to file such a case, highlighting the enforcement gaps that leave healthcare workers vulnerable.”

These failures are not just theoretical; they have real and dangerous consequences. The Indian Medical Association (IMA) estimates that 75 percent of doctors have encountered violence in their careers.

A plea filed by the Association of Healthcare Providers (India), Tamil Nadu chapter and Dr B. Kannan in the Supreme Court stated that not even 10 percent of cases registered under state laws against culprits reached the courts after a chargesheet was filed.

A study conducted at New Delhi’s Ram Manohar Lohia Hospital found that only 20 percent of cases were referred to the police, and none resulted in punishment for the perpetrators.

In Karnataka, a 2018 report by the Karnataka Law Commission revealed that between 2010 and 2017, only 173 cases were registered, with a mere 23 going to trial and only three resulting in convictions.

No cases awarded compensation to victims— a clear sign of the law’s ineffectiveness. These findings demonstrate that existing laws have failed to prevent attacks on healthcare workers.

Despite these realities, the Union government has been reluctant to enact a law. Previously, in 2019, the Healthcare Services Personnel and Clinical Establishments (Prohibition of Violence and Damage to Property) Bill was introduced to create a dedicated legal framework to protect healthcare workers.

Also read: R.G. Kar murder and rape case: SC issues slew of directions, some missing from the written Order

However, this effort was shelved, as it was argued that these protections could be better implemented under the Epidemic Diseases Act (EDA), 1897 during the COVID-19 pandemic.

The Union home ministry had also expressed its “concerns that similar protections might be demanded by other professional communities”.

This reasoning was extended in 2022 when the Prevention of Violence Against Healthcare Professionals and Clinical Establishments Bill was introduced in the Lok Sabha, only to be shelved again with the argument that its objectives were covered by the Epidemic Diseases (Amendment) Ordinance, 2020.

This reliance on the EDA is problematic. The EDA’s provisions are tied to specific health emergencies and include a sunset clause, meaning the protections are temporary and will lapse after the pandemic ends. Limiting the protection of healthcare workers to such a narrow context fails to address the ongoing, systemic violence that they face.

However, a Union law could overcome these issues by integrating itself with the recently enacted Bharatiya Nyaya Sanhita (BNS) that has replaced the IPC. This integration could ensure that protections for healthcare workers are embedded in a more permanent, uniform and widely recognised legal framework, addressing the enforcement challenges that have plagued state laws in the past.

It is ironic that the Bharatiya Janata Party (BJP), a party often obsessed with uniformity— whether it is the ‘Uniform Civil Code’, ‘One Nation, One Poll’, or other centralising policies— hesitates to apply the same logic to safeguarding those who risk their lives for public health.

The need for a Union law is clear and urgent. It is not just about filling the gaps left by state laws, but about affirming a national commitment to the safety and dignity of all healthcare workers.

The government must act decisively, enacting a Union law that will protect healthcare workers across India, ensuring that they can continue their vital work without fear or hesitation.

 

Jehosh Paul is a lawyer and research consultant. He holds an LLM in Law and Development from Azim Premji University, Bengaluru. The views are personal.

Courtesy: The Leaflet

U.S. healthcare workers face rising levels of burnout

By Dennis Thompson, HealthDay Reporter

Physicians, nurses, clinical staff and non-clinical support workers in health care all are experiencing substantial levels of burnout, according to a report published recently in the Journal of General Internal Medicine. 

Photo by HalcyonMarine/Pixbay


Cafeteria workers. Receptionists. Pharmacists. Janitors. Administrators. Physical therapists.

Much has been made of burnout among doctors and nurses, but a new survey has found high rates of work fatigue in nearly every type of job associated with healthcare.

Physicians, nurses, clinical staff and non-clinical support workers in healthcare all are experiencing substantial levels of burnout, according to a report published recently in the Journal of General Internal Medicine.

For example, the percentage reporting burnout was very similar between nurses (56%), clinical staff (54%), doctors (47%) and non-clinical staff (46%).

Staffing shortage in healthcare affecting more Americans

"Every member of the healthcare team is really critical to patient outcomes and patient experiences of care," said lead researcher Dr. Lisa Rotenstein, an assistant professor of medicine at Harvard Medical School. "It's just really important for us to remember that as we are trying to optimize both patient outcomes and experiences for our workforce."

For this study, Rotenstein and her colleagues surveyed workers at 206 large healthcare organizations between April and December 2020, at the height of the pandemic.

The participants included more than 15,000 physicians and 11,000 nurses.

But researchers also surveyed more than 5,000 clinical staff such as pharmacists, nurse assistants, therapists and social workers, as well as more than 11,000 non-clinical staff including housekeeping, administrators, lab technicians and food service workers.

In addition to high levels of burnout, the researchers also found that many workers intended to leave their jobs within two years -- nurses (41%), clinical and non-clinical staff (32%) and doctors (24%).

Substantial numbers also reported work overload, including 47% of nurses and clinical staff, 44% of non-clinical staff and 37% of doctors.

Little improvement after 2020

Even though the survey was conducted during the height of the pandemic, Rotenstein suspects that things haven't improved for healthcare workers in the subsequent years.

"Some of the stresses have persisted as we have moved into a new phase of the pandemic," Rotenstein said. "There are staffing shortages. There are patients who have delayed care because of the COVID pandemic, and so now we're seeing an increase in demand for healthcare. Oftentimes, healthcare workers are being asked to do more with less."

One shouldn't overlook that the pandemic extended well past 2020, adds Dr. Joe Betancourt, a primary care physician and president of The Commonwealth Fund.

"We had the hard work of the next couple of surges after that," Betancourt said. "As I reflect on that time, we were tired then and burned out, then we thought we had gotten through it -- and then we had the next surge, and then another surge. Over time, that really amplified the burnout."

A recent HealthDay/Harris Poll showed that burnout continues to be a factor in healthcare. The survey reported in February that two-thirds of doctors and nurses said they are experiencing moderate to severe burnout at work.

Cost-cutting in healthcare has led to tremendous pressure among workers at all levels, said Dr. Atul Grover, executive director of the Association of American Medical Colleges' Research and Action Institute.

"Healthcare is a very labor-intensive endeavor. Over half the costs in health systems are attributable to labor," Grover said. "If you're asking us to remove costs out of the healthcare system, you're essentially asking us to figure out either how to pay people less or get rid of people. I think that is kind of impossible, at least right now."

People seeking care these days also tend to be sicker and require more treatment, attention and paperwork, Grover added.

"We have done biomedically a very good job at improving the care of chronically ill patients, whether that is renal disease, diabetes, pulmonary disease, cancers," Grover said. "But that means that patients have multiple medical problems. They present much, much sicker in every setting."

Administrative staff have to coordinate complex care coverage with insurance companies. Nurses and doctors have more data to file into electronic health records. Support staff have to work harder to meet the basic needs of sicker patients.

Asking all these workers to do more with less can't help but affect patient care, Rotenstein said.

"We know from existing studies that burnout is associated with lower quality of care in some circumstances and then additionally with medical errors," Rotenstein said.

"The whole reason we did this study is that every member of the healthcare team impacts a patient's journey, whether that is the person at the front desk checking in the patient or seeing when the next available appointment is, to the social worker who's working with the patient or home health aides who are interacting with patients on a daily basis," Rotenstein added.

"All of those roles are critical for high quality healthcare, and so we would expect these types of workplace experiences and stress to ultimately have an impact on care delivery and, importantly, also the availability of care," she added.

Toll on empathy

Burnout also can take a toll on one of the most important emotional aspects of healthcare -- the empathy that workers have for the sick, Grover said.

"If the clinicians and counselors and even the people in food service in their health system are really stressed and unhappy, it's that much more difficult to be empathetic," Grover said.

Health systems have been trying to manage burnout through a "cottage industry" of wellness offerings, Betancourt said -- gift certificates, yoga classes, meditation groups.

"What I hear from a lot of my peers is, it's not about needing those perks," Betancourt said. "I don't have time or the energy to do those things, even if I wanted to."

Instead, attention needs to be given to developing and increasing the workforce rather than cutting it back, as well as streamlining the paperwork and approvals needed to provide care, Betancourt said.

For example, electronic health record companies could be asked to tweak their systems in ways that make it easier to enter data, through artificial intelligence and voice-to-speech recognition, Grover said.

"What can we be asking of these electronic health record companies that get billions of dollars a year from the U.S. healthcare system? What can they do to make programmatic changes and use AI to help improve and ease the burden on clinicians?" Grover said.

Healthcare systems also can be doing a better job tracking work overload and burnout among all staffers, Rotenstein said.

"We have an instrument to measure work overload, and it may be beneficial for organizations to start measuring that actually upstream of burnout and intent to leave, because once you're at the point of burnout or intent to leave, in some ways it's a little late," Rotenstein said.

"There's an opportunity to measure work overload and then to modulate workload for employees in all role types," she added. "And I'll underscore that that's particularly important in a time of healthcare staffing shortages, where certain individuals may be picking up the work of others. That is a really, I would say, important and tangible opportunity."

More information

The Office of the U.S. Surgeon General has more about health worker burnout.

Copyright © 2023 HealthDay. All rights reserved.

Canada pledges C$46.2 billion in new funding to fix strained healthcare system



Tue, February 7, 2023 
By Ismail Shakil and Anna Mehler Paperny

OTTAWA/TORONTO (Reuters) -Canada's federal government will provide an additional C$46.2 billion ($34.4 billion) in new funding for the country's public healthcare system over 10 years, it said on Tuesday following a meeting with its provincial and territorial counterparts to hammer out a deal to fix the overburdened system.

Canada's public healthcare systems have been under strain thanks in part to the pandemic and staffing shortages that have left hospitals stretched to the breaking point.

For years the provincial governments, which are responsible for healthcare delivery, have asked Ottawa to increase its contribution to health spending. The federal government, for its part, said it wanted new money to come with conditions.

Provincial premiers told reporters they had to digest the proposal but were underwhelmed by the dollar amount. Manitoba Premier Heather Stefanson said they were "a little disappointed."

"What we see this as, is a starting point. It's a down payment on further discussion," said Ontario Premier Doug Ford.

Long a source of pride, Canada's publicly funded healthcare system has been strained by the pandemic and staff shortages.

Some of the new funds promised Tuesday are unconditional; others are earmarked for certain priority areas. The federal government is asking the provinces to commit to better data gathering and sharing in order to access the increased funds.

But the proposal, which seeks to use bilateral agreements to target priority areas such as primary care and mental health, suggests the federal government has more ability to dictate health spending than they do, said Sara Allin, an assistant professor at the University of Toronto's Institute of Health Policy, Management and Evaluation.

"It just sounds so much more prescriptive than the federal government actually can be."

A cash infusion could help Canada's healthcare, Allin said. But the real problem is one of governance.

"How do we manage the system? How do we hold the different actors accountable?"

The additional C$46.2 billion in funding unveiled Tuesday is part of a larger C$196.1 billion package in increased health funding over a decade.

"Canadians deserve better health care and we need immediate actions to address current and future challenges," Health Minister Jean-Yves Duclos said in a statement.

The deal needs signoff from the provinces, which have previously pushed back against the federal government's conditions.

Tuesday's meeting in Ottawa could result in an agreement over a general outline of healthcare funding, but the federal government and the provinces have cautioned not to expect finalized deals on Tuesday.

Tuesday's package includes C$25 billion over 10 years to be hammered out in bilateral agreements to target shared health priorities in the fields of family health services, healthcare workers and backlogs, mental health and substance use, and "a modernized healthcare system."

The Canada Health Act governs the country's publicly funded healthcare system, which is meant to offer Canadians equitable access to medical care based on their needs, not their ability to pay.

($1 = 1.3414 Canadian dollars)

(Reporting by Steve Scherer and Ismail Shakil in Ottawa and Anna Mehler Paperny in Toronto; Editing by Sandra Maler, Aurora Ellis and Jonathan Oatis)

Factbox-Details on Canadian government new healthcare funding


Tue, February 7, 2023 

Provincial and Territorial premiers gather to discuss healthcare in Ottawa


TORONTO (Reuters) - The Canadian government on Tuesday announced C$46.2 billion ($34.4 billion) in new funding for provinces and territories to tackle the country's strained public health system.

Here are some of the key aspects of the plan:

* An immediate C$2 billion Canada Health Transfer (CHT) to

address pressures on the healthcare system, especially in pediatric hospitals and emergency rooms, and long wait times for surgeries.

* A 5% CHT guarantee for the next five years, which will be provided through annual top-up payments as required.

* C$25 billion over 10 years to advance shared health priorities through tailored bilateral agreements that will support the needs of people in each province and territory in four areas of shared priority: family health services; health workers and backlogs; mental health and substance use; and a modernized health system.

* These additional federal investments will be contingent on continued healthcare investments by provinces and territories.

* C$1.7 billion over five years to support hourly wage increases for personal support workers and related professions, as federal, provincial, and territorial governments work together on how best to support recruitment and retention.

* C$2 billion over 10 years to address the unique challenges indigenous peoples face when it comes to fair and equitable access to quality and culturally safe healthcare services.

($1 = 1.3414 Canadian dollars)

(Compiled by Denny Thomas; Editing by Bill Berkrot)

Cuba helps improve community healthcare in HCM City

Cuba and Ho Chi Minh City are cooperating to improve the quality of community healthcare.

VNA Monday, March 27, 2023 


A virtual meeting on community healthcare development between HCM City’s Department of Health and the primary health care board of Cuba’s Ministry of Health held on March 23. (Photo www.sggp.org.vn) Ho Chi Minh City (VNS/VNA) - Cuba and Ho Chi Minh City are cooperating to improve the quality of community healthcare.

The city’s Department of Health last week had a virtual meeting with the primary health care board of the Cuban Ministry of Health.

Attending the meeting, Ailuj Casanova Baroto, head of the primary health care board, said Cuba’s public healthcare system is recognised as one of the most effective systems in the world.

The system is operated by the Ministry of Health to guarantee that all Cuban residents can easily access it.

It focuses on disease prevention and enhancing education of public healthcare.

Community health centres are an important part of the country’s public healthcare system, which have been established in urban and rural areas nationwide.

It estimated that there is one community health centre for 1,000 households.

The community health centres provide healthcare services, such as vaccinations, regular health checks, and care for pregnant women and newborns.

Medical staff at community health centres are trained to diagnose and treat basic illnesses and provide disease preventive measures.

Groups of specialised doctors of hospitals periodically cooperate with community health centres to give medical examinations and treatment to local residents.

Cuba’s public healthcare system also pays attention to studying and developing new healthcare technologies and methods, ensuring the system always provides the best approaches in healthcare to people.

Tang Chi Thuong, Director of the city’s Department of Health, said the Cuban Ministry of Health is willing to support the city in implementing a project of community healthcare development.

Cuba will send two specialised doctors to the city to carry out surveys and come to an agreement with the city’s Department of Health on content that needs to be developed in the coming time.

The ministry expects to welcome the city’s healthcare professionals to visit Cuba to learn about its public healthcare models./.

 

U$A

New study reveals more struggling to afford healthcare

West Health-Gallup Healthcare Affordability Index trending downward

Reports and Proceedings

WEST HEALTH INSTITUTE

 

IMAGE: 

THE PERCENTAGE OF AMERICAN ADULTS OF AMERICAN ADULTS CATEGORIZED AS COST SECURE HAS DROPPED TO A NEW LOW OF 55%, LED BY AN EIGHT-POINT DROP AMONG AMERICANS AGED 65 AND OLDER TO 71%.

view more 

CREDIT: WEST HEALTH-GALLUP

WASHINGTON, D.C. — July 17, 2024 — The percentage of Americans who can afford and access prescription drugs and quality healthcare stands at a new low of 55%, a six-point decline since 2022, according to the West Health-Gallup Healthcare Affordability Index. The index was developed in 2021 to track the percentage of Americans who say they have avoided medical care or not filled prescription medications in the last three months and whether they believe they could afford care if they needed it today.

The downturn is largely attributed to two groups — adults aged 50 to 64 (down eight points to 55%) and those aged 65 and older (down eight points to 71%), a troubling sign since Medicare eligibility for most Americans begins at 65. The percentage of adults under 50 who could readily afford healthcare was the lowest of any age group at 47%, a five-point decline since 2022.

For the index, researchers grouped Americans into one of the following three categories depending on how they reported their ease or difficulty paying for and accessing medical care, including prescribed drugs: 1. Cost Secure — no recent problems with affording and accessing healthcare and prescriptions, 2. Cost Insecure — recently unable to either pay for care or medicine or unable to access it, 3. Cost Desperate — recently unable to pay for care and medicine and lack immediate access to quality care.

“After an uptick in 2022, healthcare affordability in America is headed in the wrong direction,” said Timothy Lash, President, West Health, a nonprofit focused on aging and healthcare research, policy and philanthropy. “The good news is that healthcare provisions in the Inflation Reduction Act — including empowering Medicare to negotiate lower drug prices, which has not yet taken effect — may help slow these negative trends and provide more stability. But much more must be done to rein in prices for Americans of all ages. High prices are one of the biggest impediments to a healthy aging population and a prosperous economy.”

Forty-five percent of American adults report struggling to cover their medical bills and are either Cost Insecure or Cost Desperate. Younger adults are more than three times as likely to be Cost Desperate than those 65 and older (10% vs. 3%). The percentage of people aged 50 to 64 years old considered Cost Desperate has risen to 10%, the highest level measured for this group so far. Racial and gender divides have also widened, with Black (11%) and Hispanic (14%) adults considerably more likely to fall in the Cost Desperate category than their White counterparts (7%) and women (11%) nearly twice as likely as men (6%).

According to the recently released West Health-Gallup 2024 Survey on Aging in America, an estimated 72.2 million — or nearly one in three — American adults did not seek needed healthcare in the prior three months due to cost, including an estimated 8.1 million Americans aged 65 and older. Nearly one-third (31%) were concerned about their ability to pay for prescription drugs in the next 12 months, up from 25% in 2022.

"The year 2022 showed encouraging trends of increased healthcare affordability post-pandemic," says Dan Witters, Senior Researcher at Gallup. “The decline in 2024 is concerning in that it shows the fragility of Americans' purchasing power amid a high-priced healthcare system. In a relatively short time, many adults have gone from feeling confident they can cover their health costs to struggling to cover their medical bills.”

In addition to the index on affordability, a West Health-Gallup Healthcare Value Index was developed in 2021 to track public sentiment as to the perceived worth of the medical care Americans receive relative to the amount they pay. This index provided one of the few slightly positive trends. Though more than a third (36%) of Americans in 2024 believe that they — and Americans generally — are paying too much for the quality of care they receive and that their most recent care experience was not worth the cost, this is nine percentage points less than was reported three years ago. Read the complete Indices report here. For more information about surveys on aging and healthcare visit the West Health-Gallup National Healthcare & Aging Data Dashboard.

Methodology
Results are based on a survey conducted by both mail (focused on older Americans) and web from Nov. 13, 2023, to Jan. 8, 2024, with 5,149 adults aged 18 and older, living in all 50 U.S. states and the District of Columbia as a part of the Gallup Panel. For results based on these monthly samples of national adults, the margin of sampling error at the 95% confidence level is ±1.7 percentage points for response percentages around 50% and is ±1 percentage point for response percentages around 10% or 90%, design effect included. For reported age subgroups, the margin of error will be larger, typically ranging from ±3 to ±5 percentage points.

About West Health
Solely funded by philanthropists Gary and Mary West, West Health is a family of nonprofit and nonpartisan organizations including the Gary and Mary West Foundation and Gary and Mary West Health Institute in San Diego and the Gary and Mary West Health Policy Center in Washington, D.C. West Health is dedicated to lowering healthcare costs to enable seniors to successfully age in place with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life and independence. Learn more at westhealth.org.

About Gallup
Gallup delivers analytics and advice to help leaders and organizations solve their most pressing problems. Combining more than 80 years of experience with its global reach, Gallup knows more about the attitudes and behaviors of employees, customers, students and citizens than any other organization in the world.

###

---

METHOD OF RESEARCH

Survey

‘Health for All Collective’

Zafar Mirza 

Published August 23, 2024 

DAWN

HEALTH needs to be understood as a holistic and normative concept. ‘Holistic’ would mean covering the physical, mental and social well-being dimensions, while ‘normative’ indicates an independent and normal state of well-being, and not just the absence of disease. This is how the World Health Organisation has defined health in its constitution: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

A clear understanding of health has important implications for healthcare. The healthcare system should be so organised as to protect, promote and restore physical, mental and social health and well-being.

This was a prelude to making the real point: for such a huge and growing population as we have and with such a health crisis and such low government spending as ours, what can we expect from Pakistan’s future healthcare system? Despite a huge government health infrastructure in the country, its functioning is far below acceptable levels of access and quality vis-à-vis our burden of disease. What little we are spending as a government is not only lopsided — much less on primary healthcare than on big hospitals — but also fraught with huge inefficiencies. The commercial private health sector is into ruthless profit-making and the not-for-profit private health sector is trying to fill the gaps left by the government’s inadequate health services primarily for the have-nots and those left out.

The not-for-profit health sector in Pakistan has grown to respond to unmet healthcare needs and is driven by a passion for caring, the spirit of giving back, charity, philanthropy and in-kind support in the form of trust hospitals, telemedicine, mobile clinics, health camps and health relief operations during emergencies, which are exacerbated now due to the frequent and unexpected manifestations of climate change. This sector is huge and growing, unquantified and diverse. It operates at various levels and scales.


Right to health should underscore the ‘Health for All Collective’.

The quality of care provided by this sector is variable and the bulk of its work falls in the domain of curative care. It is aimed almost entirely at physical health, ignoring mental health and social well-being. It is generally disjointed rather than in the form of systematic integrated care consisting of preventive, promotive, curative, rehabilitative and palliative services. Most of these initiatives are aimed at improving access to care rather than improving access to quality healthcare. A general observation is also that most of these initiatives, even the big ones operating at a national level, do not have a defined package of health services. Sadly, despite the core intention to serve, these organisations and initiatives are not cooperating with each other.

I am deliberately not naming any organisations though I have visited many of them across the length and breadth of the country in the last three years. On the one hand, I have felt inspired by the service they are providing in difficult circumstances, and on the other, I have always wondered how little they know about each other and how much stronger the sector would be if there was a mechanism for cooperation between them.

I use the word ‘cooperation’ in a larger sense. Some of them admittedly are better than others and a few of them have seriously invested continuously to improve the quality of their services. But there are hardly any cross-learnings. There are best-practice models here and there but they remain isolated. I see this as a huge opportunity loss and an ironic one. Why don’t they cooperate with each other and learn? Not only this, some of them I find to be quite territorial and in competitive mode. This is a question which has made me think about a ‘Health for All Collective’ (HFAC).

How about creating a platform in Pakistan for all healthcare organisations, especially not-for-profits but not necessarily limited to them? A platform where they can share their learnings, best practices, challenges etc. A kind of ‘marketplace’ for healthcare where there are opportunities for learning and collaboration. Where every new organisation or a particular project in health doesn’t have to start from scratch and where potential partners for particular work in healthcare can be found and where basic definitions, concepts and approaches in healthcare can be standardised. Today, even primary healthcare is understood differently by different players in the field.

The right to health should underscore the HFAC. Organisations, projects and even individuals who subscribe to the importance of the idea of collectively working towards realising the right to health and add their voice to this cause can come together under the umbrella of the HFAC.

A possible vision of the HFAC can be a world where all human beings have an equal opportunity to be healthy and equal access to reliable quality healthcare according to their needs and where appropriate public health measures are in place for effectively addressing the social, economic and political determinants of health, risks to health and prevention of diseases, and a well-prepared and resilient health system to deal with health emergencies.

The mission of the HFAC will be to work towards realising this vision through creating a platform for joint action for the following: relevant policy research and advocacy; joint healthcare projects; capacity-building activities; harnessing IT/AI for qPHC and healthcare at large; and establishing a health fund to develop jointly agreed projects among partners.

‘Health for all’ is another name for UHC (universal health coverage) and it is a collective responsibility. It is too important to be left to governments alone. A Health for All Collective for those interested in delivering holistic quality healthcare to fellow citizens would be a great step and would have immense spin-offs. A great place to start this would be among not-for-profit healthcare organisations and those interested in supporting them. Readers are most welcome to provide their views on this idea.

The writer is a former health minister, currently a professor of health systems & population health at Shifa Tameer-i-Millat University.
zedefar@gmail.com

Published in Dawn, August 23rd, 2024

FOR PROFIT PRIVATE HEALTHCARE
Inflation pushes many Americans to cut back on healthcare
By Dennis Thompson, HealthDay News


About 26% of Americans have put off medical care or prescription purchases due to higher prices, according to a recent poll. 

Photo by TBIT/Pixabay

Inflation is putting Americans' health at risk, with nearly 2 in 5 struggling to pay for the care they need, according to a new West Health-Gallup poll.

About 38% -- which translates to an estimated 98 million Americans -- said rising healthcare prices had caused them to skip treatments, delay buying prescription drugs or pay for their care by borrowing money or cutting back on driving, utilities or food in the past six months.

The poll was conducted online in June, the same month inflation reached a 40-year high of 9.1%, pollsters noted. In June, healthcare inflation hit 4.5%.

"We've known for decades that healthcare has been a financial pain for people, and that people have had to make trade-offs," said Timothy Lash, president of West Health, a nonprofit healthcare advocacy group. "When you layer inflation on top of that, it's like putting gasoline on a fire."

The poll revealed that

:One in 4 Americans (26%) have put off medical care or prescription purchases due to higher prices.

About 17% drove less, 10% cut back on utilities and 7% skipped a meal to cover medical costs.

About 6% had to borrow money to afford their care or pay medical bills.

What's more, inflation is influencing healthcare choices at every income level, the poll revealed.

More than half of U.S. households earning less than $48,000 a year have had to curb spending due to higher healthcare prices, results showed.

RELATED Staffing crisis leads to shortage of nursing home beds in U.S.

But nearly 20% of households pulling in more than $180,000 a year also have been forced to cut back, the poll found.

Women are more worried than men about medical costs, 42% to 36%. Lash said that probably reflects both the gender income gap and women's tendency to use healthcare more often than men.

These new results jibe with polling performed in the spring by the Kaiser Family Foundation, said Lunna Lopes, a KFF senior survey analyst for public opinion and survey research.

"We asked earlier this year if they or another family member had not gotten a test or treatment that was recommended by a doctor because of cost," Lopes said. "We found about a third of adults say that was the case in the past 12 months. And likewise, 4 in 10 adults say that they've put off or postponed getting healthcare they needed because of the cost."

Inflation likely has made things even harder on American families, she said.

"There's only so many dollars that people have to spend," Lopes said. "When they look at where to cut or potentially reduce spending, that's when you see people making these decisions of maybe not getting the healthcare that they need, because that's an additional expense that they'll have to budget into their monthly finances."

But Lash said the fact that healthcare costs are pinching people at every economic level and of every political stripe could make it more likely that policymakers will do something about it.

"It crosses party lines, with Republicans being more worried than Democrats," he said. The poll found that 44% of Republicans were concerned about their ability to cover needed healthcare costs over the next six months, compared with 33% of Democrats and 42% of independents.

"And so, in this sort of environment heading into the midterm elections, there's legislation right now on the table in Congress to lower the cost of prescription drugs by allowing Medicare to directly negotiate with pharmaceutical companies," Lash said.

"That would have a very significant impact over a six-year period on the cost of prescription drugs. My hope would be, with voters energized on this issue, that that puts pressure on our elected officials," he said.

The nationwide poll was conducted online June 2-16 with 3,001 adults. The overall margin of error is plus or minus 2.2 percentage points.

More information

Kaiser Family Foundation has more about healthcare costs.

Copyright © 2022 HealthDay. All rights reserved.

Canada's single-payer healthcare system - a system in turbulence, but beloved nonetheless

Publishing Details
Hospitals & Healthcare
3 Feb 2020
Milan Korcok
Featured in International Hospitals & Healthcare Review | February 2020

The war on doctors
Milan Korcok investigates the real cost of ‘free healthcare’ in Canada, the impact on employment within the healthcare sector, and the effect this has on access to care

For a nation that prides itself on its universal healthcare system, Canadians become ambivalent when faced with headlines proclaiming that their wait times for emergency room (ER) services are not only punishingly long, but among the ‘worst in the Western world’ as has been reported in the media by Robert Salois, a former Quebec Healthcare Commissioner, referring to conditions in his own province.

Citing data from 2016, Salois claimed that 35 per cent of Quebec’s ER patients had to wait five hours or more for care (with 10 per cent leaving without having seen a doctor), as did 19 per cent of Canadians overall. That compared – not too well – to only five per cent of Americans, Germans or Australians; or two per cent of Swiss, who hit the five-hour delay mark.

Fast forward to December 2019: The Canadian Press reported that on the weekend before Christmas, the Montreal Jewish General Hospital (one of the city’s core healthcare facilities) was working at 157-per-cent capacity; the Montreal Children’s Hospital at 217-per-cent capacity; and hospitals and their ERs in outlying areas were just as overloaded. To put that into perspective, the international standard for optimal hospital occupancy has long been 85 per cent – with anything below 75 per cent being wasteful, and 100 per cent being too tight, with no room left for error.


Only 43 per cent of Canadians reported that they were able to get a same- or next-day appointment at their regular place of care



According to the Canadian Institute for Health Information (Canada’s primary source of healthcare data), in 2018-2019, Canadians nationwide spent a median of 3.2 hours in the ER per visit. But for 90 per cent of those visits, patients were there for 10.9 hours or less. In 2017-2018, the median time was 2.8 hours per visit, while for 90 per cent of visits, it was 7.9 hours or less.

According to the US-based Commonwealth Fund, a respected monitor of international health trends, Canada continues to perform below the international average for timely access to patient care: only 43 per cent of Canadians reported that they were able to get a same- or next-day appointment at their regular place of care the last time they needed medical attention. And, when compared to those in Australia, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK and the US, Canada was rated the worst in terms of the ability to get a same- or next-day appointment when sick; waiting for treatment in the emergency department; waiting to see a specialist; or waiting for elective surgery. In terms of the ability to get after-hours care without resorting to an ER, it was second worst.
Fortunately, however, Canadians are a forgiving people. Most surveys indicate that once they get into the care of their doctors, they rate it as ‘excellent’ or ‘very good’.
Keep on reading




Canada lags behind OECD countries for patient safety
A new report from the Canadian Institute for Health Information (CIHI) suggests that Canada is falling behind its international counterparts in terms of patient safetyRead More
8 Nov 2019
Robyn Bainbridge

Canadians actually do pay, a lot, for a system that is supposedly ‘free’ – they pay every time they fill their SUV with gas, buy a sweater, skates, or a bag of legal cannabis.


Hurry up and wait

Dr Kevin Smith, President and CEO of Toronto’s University Health Network (a consortium of five downtown university-affiliated hospitals), wrote in a Globe and Mail op-ed in November 2019: “Expecting high performance and the best patient experience in this condition is impossible. Overcrowded emergency rooms, long waits for inpatient beds or delays in getting care at home are the norm. Across Ontario, more than 5,300 people are in the wrong environment for their care or recovery. Most often, they are in acute care hospitals when they would be better cared for at home, in long-term care or rehabilitation.”


To attribute Canada’s healthcare access problem to sparseness of hospital beds or a low ratio of physicians to population would be to ignore the elephant in the room



Dr Smith urges a ‘renewed contract for healthcare’. “We must see a significant investment fueled by our federal government if we want universally accessible, medically necessary care to remain part of our national identity,” he said. He also warned that the challenges facing Canadians have an ‘extensive history’. “Those privileged to provide care have long sounded the foghorn. But never before has there been such a perfect storm. We are seeing an ill-timed collision of several factors: a growing population, clinician burnout, mental health and addiction issues, high occupancy rates of hospitals, crumbling infrastructure, funding that doesn’t keep pace with inflation, increasing need to help vulnerable patients, and rising expectations about the use of technology from patients and providers,” he said.

Dr Smith concluded that although many have spent entire careers working to improve the system through efficiency and redesign – and that many, including himself, will continue to do so – without increasing capacity in the health and social services systems, Canadians cannot enjoy the kind of care and innovation they deserve and have paid for.

And Canadians do pay – a lot, for a system many boast about as being ‘free’. It may be free in that Canadians don’t pay the high private insurance premiums that their neighbours in the US pay, but in 2019, total health expenditure in Canada was estimated to reach CAN$264 billion, or $7,068 per person. And overall, health spending will represent 11.6 per cent of Canada’s gross domestic product (GDP)*. And they pay every time they fill their SUV with gas, buy a sweater, skates, or a bag of legal cannabis.

Healthcare bureaucracies often shackle doctors with regulations that keep them from doing their work.

It’s not all in the numbers

Certainly, Canada’s hospital bed count is not rich: only 2.8 beds per 1,000 people, about the same as the US (2.6) or the UK (2.9); but far below Germany’s 4.3 and Austria’s 5.2. But numbers such as those don’t tell the whole story. They don’t reflect how those resources are used. More beds or more physicians don’t necessarily reflect better care. And to attribute Canada’s healthcare access problem to sparseness of hospital beds or a low ratio of physicians to population would be to ignore the elephant in the room: a chronic maldistribution of physicians in many communities throughout the country, as well as persistent underfunding by both provincial and federal governments and regulatory hurdles that keep physicians from doing what they were trained to do. That’s as pertinent in Canada as it is in the US, the UK or France.

In Nova Scotia, for example, maldistribution is endemic, and shortages of physicians – whose earnings are below those of colleagues in other provinces – have led to frequent closures of hospital emergency rooms. There just aren’t enough doctors to cover them all.

In one television interview, Dr Brian Ferguson – a family practitioner in Amherst, Nova Scotia – noted that when he recently closed his practice due to his own health problems, he had to leave 3,000 patients to seek out other practices. And he admitted that he has also had to advise young potential recruits to move to other provinces where they would get paid more and taxed less.


We are in the midst of the worst healthcare crisis that Ontario has ever seen


No shortage of health bureaucrats

But there is one healthcare ranking in which Canada excels: healthcare bureaucrats.
Canadian healthcare blogger Dr Shawn Whatley has starkly underlined what many doctors see as a major impediment to patient access: bureaucracies and their tendencies to shackle doctors with regulations and useless requirements that keep them from doing their work. He writes that Ontario closed 17,000 hospital beds between 1990 and 2013, yet has not cut a similar number of bureaucrats. In fact, it has allowed their numbers to blossom.

Citing data compiled in 2015 by healthcare analyst Matthew Lister, Dr Whatley notes that Canada has 32,000 healthcare bureaucrats (these are government appointed managers and directors of local or regional boards, networks charged with evaluating and facilitating the work of doctors, nurses and physicians’ assistants who are the hands-on healthcare providers). That number, reports Lister, equals 0.9 healthcare bureaucrats per 1,000 population. To compare this to other regions, Sweden has 0.4 bureaucrats per 1,000 population; Australia, 0.255; Japan, 0.23; and Germany only 0.06 bureaucrats per 1,000 population. From a different perspective, Japan has 30,000 healthcare bureaucrats for 130 million people. Canada had 32,000 bureaucrats for 35 million people (in 2015).

Jeff Yurek, Environment Minister and Conservative party MPP for Ontario, wrote in 2017 that the Ontario College of Family Physicians listed some 10,500 family physicians in the province (in most of Canada, certified family physicians provide the core of primary care doctors). At the same time, the Ministry of Health and its various agencies, consultancies and partnerships were charged with employing an additional 13,000 employees to administer within the system.
Is the ship tilting?

If there seems some imbalance here, that may account for the fractious relationships not only between doctors and their Health Ministry paymasters, but within the organisations that have been representing physicians in their dealings with the health ministries that fund hospitals, direct and channel healthcare resources, and determine how much of the public purse can be devoted to physicians’ costs.

Though the great majority of Canadian physicians are private practitioners responsible for paying their own facility rents, staff salaries, equipment and all other components of their businesses, their incomes are tightly controlled through Schedules of Benefits negotiated between Health Ministry number crunchers and provincial physician associations. These schedules list the allowable fees for thousands of medical services, and they are not guidelines. They are firm and procedure-specific. No ‘balance’ or extra billing of patients is permitted, and private insurance for those services is banned, although two-thirds of Canadians have some private insurance for supplemental services such as drugs, eyeglasses, dental services and some elective items such as cosmetic services.

For over 139 years, the Ontario Medical Association (OMA) has represented doctors in the province, but for five years has been unable to win a Schedule of Benefits contract from either the previous Liberal government or the current Conservative one. And the troops are restless.

Dr Brian noted that he has had to advise young potential recruits to move to other provinces where they would get paid more and taxed less.

In 2017, the executive committee of the OMA was pressured into resigning after a no-confidence measure against its proposed contract with the provincial government was passed by the association’s 260-member governing council. That contract offer would have provided an annual 2.5-per-cent increase to Ontario’s physician services but was criticised as not sufficient to keep up with inflation and other physician attrition issues.

In the meantime, several groups have splintered off from the OMA, among them the Concerned Ontario Doctors – composed mostly of frontline, primary care and family physicians advocating a reduced bureaucracy, a stripping down of the health system to a more lean and efficient mechanism that puts patients first and addresses the problem of physician burnout (early retirements are rampant) and high suicide rates.
Said Dr Kulvinder Gill, President of Concerned Ontario Doctors: “Today we are in the midst of the worst healthcare crisis Ontario has ever seen... this did not happen overnight. It is the result of years of complete and utter neglect and gross mismanagement of our once great healthcare system.”

Specialists too have torn away from the OMA to form their own Ontario Specialist Association, believing they can do a better job of representing their interests vis-a-vis government negotiators.


the average Ontario doctor billed $348,000 in the 2017-2018 fiscal year


Negotiations turn ‘hardball’

In 2018, partly to bolster its assertion that Ontario’s physicians’ wages were more than adequate, the Health Ministry released earnings data on the top 100 physician billers to the Ontario Health Insurance Plan (OHIP), and then followed up with the names of 518 physicians who billed more than $1 million.
The reaction of physicians (and their advocacy organisations) was predictably curt – emphasising that many of those individual bills actually covered group-type practices billed under lead physician’s names – however, the doctors and other professional and clerical staff weren’t listed on these. Such billings also accounted for the cost of facility rents, equipment, pensions, and all of the overhead operating costs of running a business serving thousands of patients.
The OMA emphasised that the Schedule of Benefits needed to be totally updated, that they were complex and confusing with more than 7,000 different, often arcane, billing codes.

To roil the storm waters even more, the politically left-leaning Toronto Star – Canada’s largest circulation newspaper – won a freedom of information action against the Health Ministry, gaining online access to the billings data for all 30,167 doctors who received fee-for-service payments from OHIP in 2017-2018, and made them accessible through its website (just please contribute to the paywall first). All that Star subscribers have to do is punch the doctor’s name into their laptop and there it is, bold as brass: how much their friendly obstetrician or family physician ‘made’ last year.
To give it its dues, the Star did mention that the total billings shown were not the same as income, that there were overhead costs such as rentals and staff to consider. But despite that footnote, the damaged was done,
and even reinforced, when Ontario Health Minister Helena Jaczek confirmed to media that the average Ontario doctor billed $348,000 in the 2017-2018 fiscal year**.

Ever since medicare was enacted in Canada in 1966, when federal legislation pledged that the financing of provincial healthcare plans would be cost-shared by the provinces and Ottawa on a 50:50 basis (a pledge long since abandoned by the feds in favour of a contorted system of tax point trade-offs), tensions between the care providers on the front line and their paymasters have continued to intensify, becoming ever more turbulent. But, quite astonishingly, even as those tensions proliferate and access becomes more limited, poll after poll shows that the vast majority of Canadians love their medicare. In fact, 94 per cent consider it a source of national pride***. Go figure. ■

References:


* Estimates from CIHI
** www.cbc.ca/news/canada/toronto/concerned-ontario-doctors-legislature-news-conference-neglect-health-care-1.4602728
*** Association for Canadian Studies


This article originally appeared in
International Hospitals & Healthcare Review | February 2020 READ FULL ISSUE

Milan Korcok is a national award-wining medical writer who has been covering international healthcare activities and trends in Canada, the US and abroad for many years. He has long served as contributing editor to the Canadian Medical Association Journal and the Journal of the American Medical Association. He is a founder of – and has served as editor of – the US Journal of Drug and Alcohol Dependence; a founder of the Travel Health Insurance Association of Canada, and currently serves as contributor to ITIJ