Cost of Care

Slowing growth in health care spending: temporary blip or permanent gain?

Health care spending

For years, health care spending in Canada (both public and private) grew much faster than the economy. Until very recently, this trend was expected to continue, casting doubt on the sustainability of Canada’s health care system. However, recent data from the Canadian Institute for Health Information shows that growth in health care spending in 2013

Canadian provinces take first steps towards lower drug prices

Pan-Canadian Pharmaceutical Alliance

Prescription drugs provide important benefits to patients, and are an essential component of the health care system. They also have significant costs: Canadians spent roughly $35 billion on drugs in 2013, or about 16% of total health care spending. Drug costs have put significant strain on provincial budgets. In response, most of Canada’s provinces and

Paying for plasma – Canada’s double standard?

Sandra Duvlock was 58 when she was diagnosed with dermatomyositis. The gradual inflammation of her muscles had gotten to the point where she was unable to walk, clean or feed herself. When this relatively rare disease was diagnosed, Duvlock was prescribed intravenous immunoglobulin (IVIG) treatment and long-term physical rehabilitation. IVIG is a blood product that uses plasma proteins

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Andreas Laupacis healthy debate editor in chief

Why Healthy Debate? We founded Healthy Debate with a simple goal: to create a destination where Canadians can go for credible, unbiased information about their health care system, and where patients, health care professionals and policy makers can come together and debate the challenges facing our system. We now need your support to continue to achieve our

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

Can Canada pay less for generic drugs?

Can Canada pay less for generic drugs?

Generic drugs may seem cheap, at least in comparison to brand name drugs. But Canadians pay more for generic drugs than people who live in many other countries. Last summer, the premiers of several provinces announced that they would attempt to take advantage of competition between generic manufacturers to drive down prices. The generic manufacturers’

Planning for disaster: the state of emergency preparedness in Ontario

Recent events in Ontario have focused public attention on emergency response capacity.  Making the case to continue to invest in services and programs available to respond in an emergency is a challenge in the current fiscal climate.  Elliot Lake is a picturesque mining town of 11,000 residents on the north shores of Lake Huron, located

Does evidence support expanding telehomecare in Ontario?

Telehomecare programs offer remote monitoring for people living with chronic diseases, linking patients to providers without requiring an in-person visit.  Ontario is currently developing a number of large-scale telehomecare programs with the promise that they are patient centred, cost effective approaches to care. While there is great enthusiasm for telehomecare programs from patients, providers and

The challenges of improving hospital food

The saying “you are what you eat” has taken on more meaning in Canadian society, with growing interest in the quality, origins and farming practices of the food we eat. For some hospitals, this phrase is “you are what you serve” with food service being increasingly scrutinized, and there are many Ontario hospitals with efforts

Money matters: does ‘pay-for-performance’ improve quality?

Ontario physician payment "Ontario Medical Association" OMA Ministry of Health Negotiations health policy health care

In Ontario, new ways of paying doctors have been introduced in an attempt to improve the quality of their services.  One approach is pay-for-performance, which pays doctors for meeting certain treatment goals. However, there is little high quality evidence that pay-for-performance improves the quality of care, and it appears to have had limited impact in

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

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

Ontario hospital funding: confusion for 2012/2013?

The Ontario Ministry of Health and Long-Term Care is changing the way it funds hospitals for the upcoming fiscal year, which starts on April 1. The new funding formula is intended to improve efficiency. However, many hospitals are unprepared for the change. We spoke with hospital executives and other experts to better understand what is

Controversies about Community Care Access Centres and home care

Shortened hospital lengths of stay, and a growing number of people living with chronic diseases has meant that more Ontarians than ever are receiving health care services in their homes. In 2010, the Ontario Auditor General raised concerns about the quality and value of home care services, some of which remain outstanding. Resolving these issues

What is driving health care costs?

Health Care Cost Drivers

A recent report by the Canadian Institute for Health Information provides information about the major drivers of health care costs in the past decade, which include growing salaries for health care workers and greater intensity of treatment.  The report suggests that the aging population is not a major contributor to rising health care costs. These findings clash

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