Population health researchers, most famously and consistently Richard Wilkinson, have long drawn attention to the fact that the link between social class and health status is a gradient, such that an individual’s position in the class hierarchy is directly and causally linked to that person’s health status. It is not just that low income people are more likely to be […]
Read moreYesterday, I appeared before the Standing Committee on Finance and Economic Affairs at Queen’s Park. The committee is reviewing the Ontario Health Premium, as required by the legislation that implemented this levy. My assessment of the premium starts from the premise that the Government of Ontario needs more revenue not only for healthcare, but also for industrial development, education and […]
Read moreJeffrey Simpson is right to lament that “there is no realistic, sensible debate†about health care in BC. Unfortunately, his May 13th Globe & Mail column “Even the redoubtable Premier Campbell struggles with health care†does not help. Simpson’s main point in the column is that health care spending in BC is rising out of control, defeating Campbell’s efforts to […]
Read more … is homes. Check out this astonishing admission, as reported by CBC: St. Paul’s in downtown Vancouver, one out of every four beds is being used to treat the homeless, drug addicts and the mentally ill, said [Lorna Howes, the director of acute and community mental health for Vancouver with the Vancouver Coastal Health authority]. We are spending money on […]
Read moreThere is an interesting opinion piece in The Tyee this morning, aptly named Dying for the Rich, which points out the links between inequality and life expectancy. The article’s author, Crawford Kilian, should be praised for bringing up an angle that was virtually ignored by media commentators in their coverage of the recent Census findings of growing inequality, even by […]
Read moreLast December I testified before the Senate Special Committee on Aging, making the point that public health care need not fear an aging population. Today, I was invited back again to comment on their draft interim report and in particular the issue of how to address the fact that some provinces have a larger share of seniors than others, and […]
Read moreAn editorial in today’s Calgary Herald begins with the usual praise for TILMA, but ends by suggesting a new interprovincial deal on healthcare: Yet, for Ottawa to attempt to remedy matters by intruding itself into relations between the provinces would not only provoke reflexive opposition but, even if carried through by force majeure, be unlikely to work. Certainly, the Canada […]
Read moreJeffrey Simpson really loves Gordon Campbell. Having done a series of columns on BC’s carbon tax, its clever political packaging and the leader behind it – all in all, not a bad set of columns – Simpson completely loses touch on the health care side of the provincial budget. He buys hook, line and sinker the arguments about the lack […]
Read moreSince the provincial Liberals came to power in 2001 I have seen a lot of BC Budgets and not been too happy with any of them. Until now. Today’s 2008 model is a very interesting budget, and while I have a number of quibbles, I support the overall direction. And as in the recent past on climate change I find […]
Read moreJust came across this interesting article relating comments by Frank Dobson, former UK health minister under Blair, on the plan by BC liberals to bring in the private sector in health care. Essentially, he thinks it was a fairly bad idea for Britain and advises BC not to go ahead. The following well represents his conclusion: [T]he changes made to […]
Read moreI was a testator (if I was a woman I’d be a testatrix!) to the Senate Special Committee on Aging today, along with national treasure, Bob Evans, a couple reps from the Canadian Institute on Health Information, and UNB’s Joe Ruggeri. We all pretty much agreed that aging is not the issue it is made out to be. As Evans […]
Read moreThere have been suggestions that the Conservative government’s forthcoming Throne Speech will surrender the federal spending power. Through an op-ed in today’s Globe and Mail, Bob Rae tries to position himself, and presumably the Liberal Party, as defenders of the power. This posturing will help the Conservatives woo Quebec nationalists and help the Liberals appeal to Canadians who believe in […]
Read moreA dispatch from Nick Falvo, the winner of the undergraduate prize in the 2007 PEF essay contest. Nick works for Street Health in Toronto, and speaks to a newly released report: In 1992, Street Health conducted a groundbreaking research study on homeless people’s health and access to health care. The updated 2007 study finds that the shocking rates of violence, […]
Read moreI released a study today, How Sustainable is Medicare? A Closer Look at Aging, Technology and Other Cost Drivers in Canada’s Health Care System, available for download here. This essentially a national version of one I did last fall for BC only. With national data I was able to make projections 50 years into the future. The CP wire story […]
Read moreIn Ontario, the election campaign is on. A topic of note is public dental care. Back in July, the NDP started the ball rolling: Calling poor dental health a “silent epidemic,” the leader of the Ontario New Democratic Party said Tuesday that the provincial government should provide care for children and low-income earners. Howard Hampton said an initial four-year program […]
Read moreSharpen your pencils, open your spreadsheets, everyone. It’s contest time! Following up on a recent post noting the major financial conflict of interest of the Canadian Medical Association calling for more private health care options, we can expect more ideological rhetoric to come in the next year as new CMA President Brian Day takes the helm next week. But as […]
Read moreThe Vancouver Sun is two for two! Another front page headline, this time pressing the case for bulk purchasing of pharmaceutical drugs. Bulk purchasing is but one of many policy options for reducing the cost of pharmaceuticals, and is generally the one that is the most palatable politically as it does not overtly challenge Big Pharma. Other, more potent options, […]
Read moreI just watched Sicko for the second time last night. The catastrophe that is US health care is a clear demonstration that universal, public health insurance works a whole lot better that a system based on for-profit private insurance companies. So, I was thinking about the Canadian system in comparison with Europe, and wondering why we do not have more […]
Read moreIn a number of areas of health care, the rapid advance of technology may pose challenges to public systems, as technology tends to increase to costs associated with care by expanding both the realm of the possible and the number of people who can avail themselves of it (I review some cases of this in a CCPA paper). I argue […]
Read moreThis was referred to by Ezra Klein at the very bottom of the last post, and it deserves its own. Abstract and the concluding “discussion” section are pasted below: A systematic review of studies comparing health outcomes in Canada and the United States Gordon H. Guyatt, P.J. Devereaux, Joel Lexchin, Samuel B. Stone, Armine Yalnizyan, David Himmelstein, Steffie Woolhandler, […]
Read moreIn the American Prospect, Ezra Klein compares five countries’ health care systems (hat tip to Mark Thoma). in spite of his general defence of Canada, there are a few areas where I think he gets it wrong and I have added in some comments in those places. The Health of Nations Here’s how Canada, France, Britain, Germany, and our own […]
Read moreA big conference on this topic – and key Conservative promise – gets underway in Toronto today. Here’s a CLC commentary, from Executive Vice-President Barb Byers.. “ The Federal government has been busy introducing Canadians to the idea of “Patient Wait-Times Guaranteesâ€. If patients are unable to receive treatment in a timely manner, Conservatives argue, the public health system […]
Read moreWhere I live in BC, the provincial government is doing its best to subtlely undermine public health care, rather than make the reforms countless commissions have recommended to make the system better. A full frontal assault is not possible due to the continuing popularity of a public model, but perhaps they think that if they mismanage the system enough and […]
Read moreA few months back, the BC government launched a “conversation on health care” that will last almost two years and will feature forums around the province engaging people on what they would like their public health care system to be. Having such discussions should be seen as a part of a health democracy, even though we have had numerous tomes […]
Read moreIt’s amazing how much can be explained by supply and demand. The big crisis in waiting lists in recent years has been concentrated in a few procedures, mostly knee and hip replacements and cataracts. These surgeries have been made much more widely available in recent years due to the advent of relatively non-invasive day surgeries in place of long hospital […]
Read moreHere’s a post from Economist’s View starting with a novel argument against single payer health insurance: that it would hurt innovation. Mark Thoma then rebuts and throws in some Paul Krugman for safe measure. Krugman makes an important point that often we assume that innovation is always a good thing. True, some innovations lead to better health outcomes. Others do […]
Read moreSince it appears to be drug day at RPE, I should mention as a follow-up to a previous post on the National Pharmaceuticals Strategy that I did track down the document in question, a NPS Progress Report, and that the Globe reporter did indeed misrepresent the estimates of the cost of that program. The Globe stated that the Report “pegs […]
Read moreToday’s Globe and Mail features two excellent articles about drugs in Canada. The first makes some great points about what might be possible with a national pharmacare plan and how politics is getting in the way of doing the right thing. The second is about how profit-seeking by pharmaceutical companies is distorting the cost of treatment. In this case, doctors […]
Read moreToday’s report from the Fraser Institute finds that, surprise surprise, health care spending is unsustainable. Or at least that is what the Fraser’s funders want you to think. I find the Fraser Institute has an excellent knack for putting out media-friendly goodies that on closer examination do not stand up to scrutiny. But the media are generally not that interested […]
Read moreIt is fascinating to me that in the wake of the Chaoulli decision by the Supreme Court private options are becoming more commonplace in Canada, just as more and more sensible people in the US are calling for a Canadian-style universal public insurance model. Here’s Paul Krugman in the New York Times (as edited by Economist’s View) with a reminder […]
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