Tag: politics of health care

The Price-Baker report: What does it mean for primary care reform in Ontario?

Making doctors responsible for the patients in their geographical area. Offering primary care after-hours and on the weekends. And pushing away from solo practitioners and towards interprofessional care. Those proposals were all in the recently released “Patient Care Groups: A new model of population based primary health care for Ontario,” led by McMaster University’s David Price…

Are family doctors cherry picking patients?

When Anne Lyddiatt’s family doctor retired, she went looking for a new one.  The Ingersoll, Ontario resident thought she’d found one for herself, her two daughters, and her granddaughter, and they filled out application forms with their health information. But only one of the four was accepted: the daughter who had no chronic conditions. “When…

Changes to temporary foreign worker program have unintended impacts on doctors

Reports of low-skilled Canadian workers being replaced with those from other countries spurred changes earlier this year to the Temporary Foreign Worker Program. But they’ve made it harder for areas in need of physicians as well. The system was overhauled this summer after reports that companies were misusing the program, with Canadian workers at RBC and…

How Norway’s innovative library made high-quality health information free for everyone

If you’re looking for evidence-based health information in Canada, a lot depends on who – and where – you are. A physician in a teaching hospital? No problem. But family doctors in rural areas, nurses or physiotherapists have a much harder time accessing up to date materials. And the general public is more likely to find…

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…

Family medicine attracts record number of graduates

Family doctor

Family medicine was a popular choice among medical graduates in the 1980s, when Roger Strasser was training at The University of Western Ontario. “The residents had almost a missionary zeal that they were going to be family doctors,” he says. He shared their passion, becoming a family physician. But when he returned to Canada in 2002, after going back…

Missing the target on health care performance?

Setting targets has long been a mechanism in industrial psychology to motivate managers and workers to achieve specific organizational objectives. In the last decade, targets have become important methods of driving performance improvement in health care. However, deciding where and when to set targets is a challenge facing health care decision makers. Politics of performance…

Decades of restructuring hurts morale of Alberta’s health care professionals

Effect on health care restructuring on Alberta's health care professionals

This is the second of a two-part series on Alberta’s health care restructuring. This article examines the impact of constant change at the highest levels of administration on those who work within the health care system. Alberta Health Services (AHS) is the largest health care delivery organization in Canada. AHS provides health care to nearly…

Restructuring Alberta’s health system

Alberta Health Services has had a tumultuous summer. There have been major changes at the highest levels of administration and governance of the province’s health system. A review of the recent history of restructuring in Alberta’s health system might be helpful to understand the recent changes. Moving towards health regions Alberta was part of the…

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…

Ontario Citizens Council: a failed experiment or a success in the making?

Ontario Citizens Council: a failed experiment or a success in the making?

Decisions about health policy often involve difficult trade-offs. This is especially true when assessing new health technologies and medications, where funding one item can mean not being able to fund another. These decisions often force policy makers to go beyond scientific considerations of a drug’s effectiveness, and address broader ethical and social considerations. Recognizing that…

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,…

Who controls how patient information is shared in Ontario?

Privacy of Medical Records in Ontario

Ontario’s Information and Privacy Commissioner recently ordered Cancer Care Ontario to stop sending paper copies of screening reports containing personal health information to physicians.   However, a massive amount of personal health information is mailed or faxed every day in Ontario.  The implications of this order to information sharing and transfer across the health care…

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…

Hospital accreditation and quality improvement

Hospital accreditation is a process that assesses a hospital’s performance against a set of standards. This process is done differently across provinces and countries. In Canada, most hospitals go through an accreditation process conducted by Accreditation Canada. The accreditation process could be more transparent and provide more information to the public about the quality of…

The influence of politics & the public on research funding in Canada

The recent controversy about a new treatment for multiple sclerosis (MS) has raised questions about the role of patients and politicians in determining health research priorities. In the past, the scientific community has generally determined what research is conducted. However the public is increasingly demanding that they be involved in setting research priorities – the…

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…

Complementary & alternative medicine in practice and policy

Complementary and alternative medicine is a billion dollar business in Canada.  Complementary and alternative medicine is rooted in different philosophies and standards of evidence than mainstream medicine.  Many patients use both systems of medicine.  Complementary and alternative medicine is defined as any medical system, product or practice that is not thought of as a standard…