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Seniors’ care shouldn’t be a horror show, even when the pandemic is over

Sunday, April 12th, 2020

Both B.C. and Alberta have banned health care staff from working at multiple institutions, a common practice that allows the coronavirus to spread quickly. This should be a permanent policy, not a temporary one. There is no lack of work in nursing homes and long-term care. In fact, there are dire personnel shortages. But many employers refuse to offer full-time work so they can avoid paying benefits… who wants to put their life on the line for fifteen bucks an hour, no benefits – and no PPE?

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Shut it down: It’s time for Canada to get serious about social distancing

Thursday, March 12th, 2020

Canada needs to embrace social distancing… early implementation [of six social-distancing measures during past flu pandemics] delayed the peak in the number of infections, relieving the burden on health-care systems by spreading out the cases over a longer period of time… we can’t afford to become Italy, a country that was slow to act and is now paying a massive price, with more than 10,000 cases, 600 deaths and a collapsing economy.

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The future of medicare shouldn’t be left up to the courts

Tuesday, March 3rd, 2020

Most countries with universal health care have a mix of public and private provision and payment of care… Canada actually has more private spending and a greater dependence on private insurance than virtually every other country with universal health care… for prescription drugs, dental care, vision care, hearing aids, home care, long-term care and much more. Surely many of these services are “medically necessary,” but public access and funding is greatly lacking. Ultimately, we need to decide what is covered by medicare and what isn’t.

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Canadians with mental illness deserve access to medical assistance in dying

Tuesday, February 18th, 2020

There is no evidence vulnerable patients are being pushed into assisted death against their will. If anything, the contrary is true. MAID has become an option for the elite, while people with physical and mental disabilities have repeatedly had to turn to the courts to have their right to choose respected… We don’t insist that patients with terminal cancer content themselves with hopes and prayers, and we shouldn’t expect people with intractable mental illness to do so either.

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Should government have a say in what drugs are prescribed to patients?

Wednesday, December 18th, 2019

Canada is slow to approve new biosimilars; since 2006, Health Canada has approved only six, compared with 13 approvals by the European Medicines Agency. We also have among the highest prices in the world for both biologics and biosimilars, so more co-ordinated and aggressive price negotiations are required.

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Is a national pharmacare program any closer to reality?

Wednesday, December 11th, 2019

it’s delusional to think the Liberals will act anything other than slowly. While the purported savings are compelling, shifting spending from private drug plans to the public treasury is much less so. Not to mention that the provinces are, at best, lukewarm about the idea… The premiers want the escalator to increase to 5.2 per cent before they even consider pharmacare.

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A tricky operation: Finding a place for private health insurance in a public system

Tuesday, December 3rd, 2019

Every health insurance program in the developed world, public and private, is struggling with a daunting triple challenge: An aging population, the soaring cost of new technologies and rising consumer expectations… private sector efficiency is a myth. Private hospitals keep patients longer, order more tests, prescribe more drugs and provide a lot of low-value or no-value care. They overtreat and overcharge… private hospitals are not going to solve the woes of Canadian medicare

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Posted in Health Policy Context | 1 Comment »


Some harsh lessons on the failings of eldercare from Down Under

Wednesday, November 13th, 2019

The 272-page Australian report, in striking contrast, uses blunt language to reflect the frustrations and fears of patients and family members. It also demands immediate action, including an injection of funding for long-term home care services as a way to keep people out of institutional care.

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Posted in Child & Family Delivery System | No Comments »


How can we ration health care, without discrimination?

Wednesday, October 30th, 2019

Health-care providers cannot refuse care based on prejudices or stereotypes, but they can refuse or limit care if a medical condition could result in significant complications or costs. But exclusion criteria must be clear and based on evidence, and we can’t let bias creep in when making difficult rationing decisions… we have to debate these mind-bogglingly complex questions openly, not just punt them to the courts.

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To improve health care, we need to plan our work force of the future

Friday, October 25th, 2019

We need to rethink our traditional approach of strictly controlling the number of health workers we educate and train and turn to oversupply, knowing that many will be wooed away… One in five nurses in Canada leaves their job each year, and the turnover costs are enormous… [We must] ensure jobs are meaningful, appropriate and, most of all, that there are people to fill the posts that are so essential to our care.

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