Tag: health care costs

Telemedicine on the rise across Canada

It’s still far from routine, but telemedicine is quietly growing across Canada. Last year, a pilot project with a portable robot was launched in Saskatchewan. And telemedicine programs in Ontario have been growing by around 30% per year for the last several years, according to David Jensen, spokesperson for the Ministry of Health. Telemedicine can…

Ontario’s private outpatient lab sector needs overhaul, say critics

Community labs

Ontario’s system for funding private medical laboratories has been controversial since it was set up almost two decades ago. Now, facing critics who have only gotten louder, the government may be considering reform. In her mandate letter after last year’s election, Premier Kathleen Wynne asked Health Minister Eric Hoskins to “explore opportunities to optimize quality…

Regulators grapple with Canada’s first generic biologic drug

Biologic drugs have revolutionized treatments for diseases from cancer to multiple sclerosis. But because they’re developed out of living organisms, they’re more expensive than conventional drugs, adding to the strain on publicly funded drug plans. Fortunately, a new shift should make them cheaper. Many biologics will soon have their patents expire. That means Subsequent Entry Biologics (SEB) – which are…

From the factory floor to the emergency department: Hospitals explore Lean method

Lean healthcare whiteboard

Can health care learn from assembly lines? Manitoba’s St. Boniface General Hospital thinks so. It’s been using Lean, a system inspired by Toyota, on processes around the institution. Last year, one of its projects was to reduce wait times for CT scans. Staff ran a Rapid Improvement Event, where a team mapped out patient flow and…

Should the public know how much doctors are paid?

The United States began releasing the Medicare payments it made to individual doctors on April 9, a move that sparked sensational headlines and debates about privacy. The data offer insights into the $77 billion paid by Medicare’s fee-for-service program to more than 880,000 health care professionals in 2012. Should Canadian provinces follow the U.S.’s lead and publicly…

Pulling back the curtain on Canada’s rising C-section rate

Caesarian sections (C-sections) are among the most common surgical procedures performed on women of child-bearing age. Canada’s C-section rate has increased dramatically in the past two decades. The national C-section rate  has increased from 17% of all births in 1995 to nearly 27% in  2010. In Ontario, nearly 29% of births in 2011/12 were by C-section, with a similar rate in Alberta of…

Non-invasive prenatal testing and chromosomal microarray: changing the landscape of prenatal genetic testing

Prenatal testing is a routine part of pregnancy care in much of the world. Every pregnant woman in Canada is offered blood tests and ultrasounds to evaluate the health of her pregnancy. When testing suggests potential genetic abnormalities, doctors offer a further test such as amniocentesis to make a definitive diagnosis. While amniocentesis is very…

Cord blood banking in Canada

cord blood banking

Minutes after giving birth, blood from the umbilical cord is collected and sent off to a central cord blood bank to be cryogenically frozen.  Years later this cord blood could be used to cure some cancers and treat rare diseases. While to some this sounds like the stuff of science fiction,  the use of cord…

Family Care Clinics – filling a gap or costly duplication?

During her campaign for reelection in 2012, Alberta premier Alison Redford promised to create 140 Family Care Clinics (FCCs) over three years. She articulated a vision of primary care that would be one-stop, with many different health care providers under one roof. These clinics would have expanded hours to improve patient access, and would focus…

The controversy over “pay-at-risk” for hospital executives

The controversy over “pay-at-risk” for hospital executives

“Pay-at-risk” became a political flash point in Alberta last month when Health Minister Fred Horne fired the Alberta Health Services board when it didn’t agree to withhold the at-risk part of the compensation package for about 100 executives. Alberta Health Services (AHS) had introduced pay-at-risk for health care executives in 2009. With pay-at-risk — also…

Access to expensive drugs: greater demand, improved transparency

Each weekday, staff at the Exceptional Access Program (EAP) of the Ontario Ministry of Health and Long-Term Care receive between 250 and 300 requests for special prescription medications. These prescription drugs—typically expensive medications that are felt to be cost effective only when used to treat selected patients with specific problems—are not on the province’s regular…

Health Links: Ontario’s bid to provide more efficient and effective care for its sickest citizens

Health Links: Ontario's bid to provide more efficient and effective care for its sickest citizens

Ontario’s Health Links initiative is a “big manoeuvre” in a complex provincial system, acknowledges Helen Angus, associate deputy minister with the transformation secretariat of the Ministry of Health and Long Term Care (MOHLTC). The initiative aims to facilitate coordination of care at a local level for high needs patients. It comes in the wake of…

Hospital crowding: despite strains, Ontario hospitals aren’t lobbying for more beds

Are Canadian Hospitals Overcrowded?

Patients languishing on stretchers in hospital hallways, hospitals issuing capacity alerts when they can’t take more patients, tension in emergency departments as patients wait hours and even days to be admitted. That’s too often the reality in our hospitals. And, given the statistics, you’d think that hospital executives—especially in Ontario—would be pushing hard for more…

Changes called for as 1% of population accounts for 1/3 of health care spending

Changes called for as 1% of population accounts for 1/3 of health care spending

Ontario’s Health and Long-term Care Minister is calling for a change in how health care costs are scrutinized in light of research showing that a tiny proportion of the Ontario population accounts for a very large proportion of health care expenditures. “We need to shift our focus” away from line-by-line scrutiny of hospital, drug and…

What does the government’s tentative agreement with doctors mean for Ontario’s health care system?

What does the government’s tentative agreement with doctors mean for Ontario’s health care system?

Last week, the Ontario Medical Association and the Ontario government announced they had reached a tentative agreement that they hope will end their current dispute. The tentative agreement, which will run until March of 2014, will affect doctors in a number of ways and also has implications for the wider health care system. In this article,…

Does more care mean better care?

Canada United States Health Care Reform Health Care Policy

A recent study found that Ontario hospitals that used more resources and spent more money had better outcomes for acutely ill patients than hospitals that used fewer resources.  These findings go against a previous study that looked at the same question in the United States and found that more resources didn’t impact outcomes.  A better…

Head first: birth centres in Ontario

Integrated Maternity Care

Ontario recently announced funding for two birth centres that will be led by midwives. The government has indicated it is opening birth centres partly to move care out of hospitals and save money. Although birth centres are probably safe and may improve maternity care, it is less clear whether Ontario’s birth centres will indeed reduce…

Should clinical practice guidelines consider value for money?

clinical practice guidelines cost effectiveness health care economics health care policy

In Canada, doctors’ associations regularly incorporate new evidence about medications into clinical practice guidelines that are intended to influence patient care. The Ontario Ministry of Health and Long-Term Care reviews the same evidence to decide which medications it will pay for, and often comes to different conclusions. This results in doctors recommending medications which are…

Charging patients for services: much confusion, little consensus

The Ontario Health Insurance Plan (OHIP) does not cover all health services that can be provided by a doctor. These “uninsured” services include telephone renewal of prescriptions, writing sick notes for work or school and transferring medical records. Doctors can offer patients the option of paying for a set of uninsured services with a single…

The future of the federal health transfer

With the expiry of the Health Accord in 2014 looming, the debate about the role of the federal government in paying for health care is once again taking centre stage.   The School of Public Policy and Governance at the University of Toronto hosted a roundtable on the future of how the federal government transfers…

Need & access to bariatric surgery in Ontario

The frequency of obesity has skyrocketed across Canada, and its treatment is a major challenge to the health care system.  Bariatric surgery is an effective treatment for obesity that appears to be good value for money.  Although Ontario is expanding bariatric surgery capacity, some are concerned that capacity remains below current needs.  What is bariatric…

Public and private payment for health care in Canada

It is inaccurate to say that Canada has an entirely publicly funded health care system.  While often described as a publicly-funded system, only about 70% of health care costs are paid for publicly, with the remaining 30% paid for privately.  In Ontario, medically necessary hospital and physician costs are entirely covered by the public health care system.…

National pharmacare: who are the winners and losers?

The Canada Health Act includes public coverage of services provided in hospitals and by doctors, but not prescription medications taken outside of hospital. Most provincial drug plans do provide some public coverage, but many Canadians lack drug coverage. In the last 25 years, prescription medications have become both more important and more expensive. Bringing prescription…

Why isn’t there a system of integrated maternity care in Ontario?

Midwives provide high quality care for normal, low risk pregnancy and child birth, but provide this care to relatively few women in Ontario. The demand for midwifery services is outstripping capacity.  The philosophy and actual practice of care provided by midwives and obstetricians is different. Obstetricians deliver many more babies, but obstetrician-led care is more…