Politics of Health Care

Presenting the benefits of mammography

Presenting the Benefits of Mammography

The results of research on screening for breast cancer with mammography can be presented in ways that make the benefits seem larger or smaller  Similarly, the benefits can be described as avoiding deaths from breast cancer or avoiding deaths from any cause Part of the debate about the benefits of screening mammography may be related

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

The mammography controversy

Mammography controversy

In medical journals, doctors and scientists continue to debate the relative benefits and harms of breast cancer screening for women who are at average risk of developing breast cancer. This debate is not always reflected in screening programs, most of which strongly recommend mammography to average risk women within a certain age bracket. Some experts

Should health care workers be required to get the flu vaccine?

flu vaccine

Each year several thousand Canadians die from influenza. Vaccinating health care workers against flu reduces transmission and would protect patients who are most vulnerable.  However, only about 40% of hospital staff in Ontario were vaccinated last winter. Is it time for Ontario to make the flu vaccine mandatory for health care workers? Explaining the influenza

Are bedbugs a health problem?

Bed Bug

The past ten years have seen a surge of bedbug infestations across North America, with many cities across Canada affected.  Although they do not cause or transmit disease, bedbug infestations are often perceived to be a health problem. An effective and efficient bedbug strategy requires coordination among various sectors, including public health, housing, community and

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

House calls and Ontario’s election

In the run up to the Ontario election, the Liberal party has promised $60 million to support physician house calls. The number of doctors who make house calls has declined markedly over the past fifty years, and only a small proportion of Ontario family doctors currently provide ongoing care to patients in their homes.  What

Why does the government appoint hospital supervisors?

In August 2011, a supervisor was appointed at the Niagara Health System to “restore public confidence” in the hospital.  The Ontario Public Hospitals Act  allows the government to appoint a supervisor to take over the administration of a hospital if it is considered in the public interest to do so.  While appointing a supervisor happens

What’s next for tobacco control in Ontario?

Smoking is the leading cause of preventable death and disease in Ontario, and is costly to the health care system. From the 1990s into the past decade, Ontario made significant progress in reducing smoking rates. However, smoking rates are no longer declining as steeply. More aggressive action needs to be taken if Ontario wants to

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

Why don’t more doctors do house calls?

Over the last fifty years, doctors have been making fewer and fewer house calls. There is little doubt that patients value physician house calls, particularly from a doctor with whom they have an ongoing relationship.  Lack of appropriate training and mentors, financial disincentives, and the changing culture of family medicine are all barriers to increasing

Accessing trauma care in Ontario

Every year nearly 5,000 Ontarians are injured through trauma and require specialized trauma care, which has been proven to save lives. Many Ontarians think that they can access specialized trauma care at their local emergency department. This is not true.  Timely access to specialized trauma care does not always occur in Ontario.  Melanie Carter was

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.

The risks of emergency department overcrowding

Each year one in five Ontarians visits one of the province’s 163 emergency departments.  A recent study has shown that those who present to emergency departments when waiting times are longer have worse outcomes. Since 2008, Ontario has spent a lot of money and effort to reduce waiting times and improve the quality of care

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