Archive for the ‘Health Policy Context’ Category

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Ontario health quality will suffer under the Peoples Health Act

Wednesday, July 3rd, 2019

The board of Ontario Health seems to think that only front-line workers are needed to provide health care and the back-office staff responsible for measuring and comparing quality as well as holding clinical programs accountable for high quality results can be disposed of. It is naïve to think that busy clinicians can both provide care and do the data collection and analysis that quality improvement requires without back office support.

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Should there be ‘presumed consent’ for organ donations?

Wednesday, June 26th, 2019

Yes – Ontario, with these things in place, has seen donation rates double to 25 donors per million (DPM). Could an “opt-out” approach help Canada get from a donor rate of 22 DPM toward 40 DPM, the rates in the most successful countries in the world? / No – loosening permission requirements around donation could strike the more circumspect among us as too much boundary revision, too fast, with too little accountability.

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Why are we forever chasing the dream of a universal drug plan?

Tuesday, June 18th, 2019

… derailed by opposing political agendas, fierce resistance from private insurers, public ambivalence and voter apathy… universal pharmacare isn’t merely about equity and ideology, but efficacy and efficiency… The challenge is to make those savings feel real, not notional… that cost-benefit tradeoff must be spelled out clearly to persuade people that the savings end up in their pockets.

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Report goes all in on pharmacare, and that may be a mistake

Saturday, June 15th, 2019

The bottom line is that Canada’s inconsistent drug coverage can’t be fixed without government intervention of some kind. That includes lowering the nation’s drug bill by creating a government system of bulk purchases, limiting drug co-pays and regulating premiums.

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Five decades in the making, our national pharmacare still has a long way to go

Friday, June 14th, 2019

Canada should take a leap forward here and look to include in a national formulary not only with the most important medicines, but the most important medical devices. The secret sauce in all of this will be smart, strategic negotiations on behalf of all Canadians with drug and device manufacturers to reward real breakthroughs and the backbone to say no to coverage for drugs and devices that just don’t deliver on value for money.

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Putting values into practice on pharmacare will come at a cost

Friday, June 14th, 2019

The catch is that there would be a massive shift of drug costs from private plans to public plans, an “incremental public cost” of $15.3-billion… Practically, it also means the feds would have to raise taxes by at least $15-billion a year. That, not poor values, is the single biggest impediment to national pharmacare. The other related hurdle is that a national plan would require an unprecedented level of federal-provincial-territorial co-operation.

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The Fallacy of Federal Advantage in Delivering Pharmacare

Friday, May 17th, 2019

… the 2019 federal budget proposed the creation of a new Canadian Drug Agency to conduct health technology assessments, negotiate prices and listing terms… That is, the new agency could substantially lower the national drug budget even if the federal and provincial/territorial governments are not able to agree on a single-payer government plan… Prescription drugs are an increasingly large component of total healthcare costs, and should be integrated with other areas of health spending and policies to control it.

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Ontario’s top court rules religious doctors must offer patients an ‘effective referral’ for assisted dying, abortion

Wednesday, May 15th, 2019

The Court of Appeal for Ontario is now the highest court in the country to have ruled on the thorny question of how the conscience rights of doctors should be balanced against the rights of patients to access publicly funded health services – a question that became more pressing after the legalization of assisted dying three years ago.

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Cutting out-of-country OHIP coverage is wrong and pointless

Thursday, April 25th, 2019

… the government paid out just $9 million last year for emergency coverage… a tiny fraction of one percentage point, of overall Ontario medical spending of $63.5 billion (with a b)… The government’s argument is that the existing program covers only a fraction of medical costs abroad. On that it’s correct… And it’s a gift to private insurers who no doubt will see a spike in business if all out-of-country coverage is yanked away.

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Doug Ford’s OHIP move strikes at the heart of medicare

Thursday, April 25th, 2019

In the case of those who are “temporarily absent” from the country, the Canada Health Act reads as follows: “Where the insured services are provided out of Canada, payment is made on the basis of the amount that would have been paid by the province for similar services rendered in the province.” … By attacking the key principle of portability — the notion that Canadian residents take their health insurance with them wherever they go — it is aiming a dagger at medicare’s throat.

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