So-called “high-cost users” of health care – the 5% of the population who use nearly two-thirds of health care resources – have become a major policy focus, both in Canada and abroad. But in the rush to save money on the care of patients who are already high-cost users, too little attention has been paid …
When Egon Jonsson was thinking about how best to support alcohol-addicted pregnant women, he thought of a controversial solution: paying them not to drink. The idea was inspired by studies that have offered shopping vouchers to pregnant women who succeed in giving up cigarettes. But when Jonsson and his team at the Institute of Health …
The federal government recently announced the Chief Public Health Officer – the physician at the head of the Public Health Agency of Canada – should no longer set the agency’s own budget, leaving this task to a soon-to-be appointed administrator. While the risks and benefits of this approach continue to be debated, a widely cited …
Grace (name and some details changed to protect her identity) is a nine year old girl who lives in the northern suburbs of Toronto. Her doctor diagnosed her with asthma last year, and developed a care plan and prescribed her medication. Grace’s family understands and agrees with the care plan. But Grace’s acute attacks have …
Canada spends a significant proportion of its budget on health care, while achieving average population health outcomes compared with other OECD countries. It is difficult to achieve coordinated and comprehensive care, due in part to the strain of a dependence on acute care services, accounting for nearly 30% of total health care costs. An aging …
When Nan Normand’s husband had quintuple bypass surgery, it cost them $1,500. It wasn’t the operation that was pricey, but the travel. The couple went from Kenora, a small city near the Ontario-Manitoba border, to Hamilton for the surgery. The trek included flights and a multiple-night stay. Normand was unlucky: Manitoba had temporarily stopped accepting most Ontario heart patients, …
The Canadian health care system is inefficient. It will come to no one’s surprise. Most Canadians agree that we need to improve the efficiency of the health system and get better value from the dollars invested in health care. In fact, all countries struggle with this challenge. We were interested in getting a better understanding …
In January, Ontario’s Liberal government approved legislation that would increase the minimum wage by 75 cents to $11/hour. And in March, Saskatchewan followed by increasing theirs by 20 cents to $10.20/hour. While this has ramifications for labor and the economy, it also impacts the patients in our healthcare system. This minimum wage rise came right …
Poverty is a significant public health concern affecting approximately 10% of Canadians. Recommendations to eliminate poverty have focused on areas of income, housing, access to food, and early childhood development. Calls for government action and provision of resources to healthcare professionals have been issued. Notably, educating medical trainees to address poverty has been absent from the discussion. …
At the end of January, the Ontario Ministry of Health and Long-Term Care (MOHLTC) announced almost $10 million in new funding to address type 2 diabetes, with a focus on screening and the ‘promotion of healthier lifestyles.’ There is a lot to celebrate in this announcement, particularly community-based screening initiatives. And who could complain about …
“I’d do whatever I had to do to stay warm” recalls David, who was homeless on Toronto’s streets from 2000 to 2003. David said he spent the winter nights in emergency shelters, and bitter cold days in bank ATM lobbies or riding around on public transit. “Survival was tough” he says, describing everyday life on …
Last week, a Healthy Debate column written by Dr. Ritika Goel used a patient narrative to help support her argument that the minimum wage should be increased, from $10.25 to $14 an hour. The patient, Raj, drifted between low-wage jobs as many aspects of his life and health became more difficult. Unfortunately, a higher minimum …
The first time I met Raj, I remember feeling completely helpless in what to offer him. A middle-aged South Asian man with a wife and two kids, Raj had moved to Canada looking for a better life 7 years ago. He came to the clinic looking for help, but what ailed him was more complicated …
There is little doubt that system transformation is necessary to achieve sustainable and high-quality health care for Canadians. In recent years, the care and management of high users (HU) of health care has emerged as a focal point for developing a sustainable health care system. Despite the focus on this group, one question has received …
We know that social environment plays a large role in shaping people’s health. Determinants like poverty and housing have recently received much deserved attention. The recent report by Canadian Medical Association, What Makes us Sick?, for example, identifies poverty as the leading cause of poor health outcomes and health inequity among Canadians. But poverty, housing …
Is the formula for Canada’s success to be wealthy, healthy and wise or to be healthy, wealthy and wise? The difference may appear subtle, but it gets to the heart of a question that has serious implications for the future of publicly funded health care: have we Canadians been missing out on the opportunity to …
The gap between rich and poor in Canada is growing. Organizations across the country, from the Conference Board of Canada to the Canadian Centre for Policy Alternatives have recognized the rise of income inequality in Canada. For some, this concentration of wealth is an unremarkable trend, but for many more it is worrying change in …
This past October, I met a bright and engaging man who had suffered a stroke. Luckily, a family member of his had recognized the symptoms he was having and brought him to the hospital. Unfortunately, the stroke had left him unable to use the left side of his body and, as a result, he required …
Sayid is a 65 year old South Asian man from Toronto. He has schizophrenia, but with the proper medications and supports, his illness is well controlled, allowing him to work full-time in a manufacturing job. For years, like many of Toronto’s working poor, he lived paycheque to paycheque. When his company underwent downsizing, Sayid lost …
Policy decisions on everything from childhood education to housing can have unintended consequences on the public’s health. A Healthy Equity Impact Assessment (HEIA) is a decision support tool designed to identify these unintended consequences. It walks users through the steps of identifying how a program, policy or similar initiative will impact population groups in different …