Looking for Solutions in Health Care for 2006 and Beyond

Our health care system needs to change to accommodate new demographics, new technologies and new pharmacologic advancement.

The roots of compassion and caring in health care should not change however, and it is with this in mind that the dialogue of change should be had surrounding health care.

How can we adapt to different needs that emerge as our population ages?

How can we  find sustainability in the midst of so many new advancements?

How can individuals become more empowered in serving their own health care needs?

What role does the individual have in enabling the  health care of others  beyond paying taxes?

Many questions like these need to be answered and if we are willing to look with open minds at the problems within our health care system, and beyond political posturing, then we can find new  solutions to take us further into this century. 





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Defining the Problem in Health Care....with Vision

A number of current events have prompted this journal entry. We've recently heard from the Health Council of Canada, soon to be moth-balled, where Jack Kitts, chair of the Council's panel was quoted as saying:

"Most Canadians think that they have good health care; yet, the evidence suggests the system is not as good as they think it is."

The newest report from the HCC discusses how the health reforms that governments have taken in Canada have not created the transformation required. So good to hear some honesty about wait times and the failure of billions of tax dollars to make any significant change. Some of you may take this as negative but after so many years of being advised that to lead in health care we must take part in Groupthink it is a relief to see an  evidence based report that confronts reality.

And that made me reaffirm my thinking:

The happy thoughts and attempting to deliver "the right care, to the right people, at the right time, in the right places" might not be working the way the decision-makers intended.

Why is this?

With so many talented, dedicated people trying to innovate in health care, why are the changes not resulting in the improvements that were anticipated and why are there so many unintended consequences?

Quite possibly, it is because we have defined the wrong problem(s) to be solved.

I'm a keen reader of the Harvard Business Review Blog Network and an article by Bart Barthelemy and Candace Dalmagne-Rouge from September 13, 2013 caught my eye. Here are some snippets from "When You're Innovating, Resist Looking for Solutions" :

"...as soon as you start thinking of a solution, you unconsciously begin shutting off possibilities for getting a deeper understanding of the problem and therefore of finding a truly breakthrough solution....It's better to stay in what we call the "problem space" for as long as possible."

"So go deep. Look for underlying issues. What's the real obstacle you face? Once you've found it, go deeper still. What's the essence of that obstacle?"

"Search for different viewpoints."

"Don't be afraid to bring outsiders into the discussion."

"Staying in the problem space, in particular, can be difficult."

Over the past decade, decision-makers, consultants, politicians, bureaucrats, Ministers of Health and Deputy Ministers as well as organized physician representation have been focussed on efficiencies, doing "more with less", teams, ehealth, coordinating care, improving "value" (however that is defined) and big data. 

But what if the essence of the problem isn't really related to any of these things?

What if the areas mentioned above make the health care situation worse by moving tax dollars for health care to other endeavors that don't improve care or improve access or improve health?

Isn't the problem we are facing in health care really the inability of government to fund all of the medical services  required and demanded by a population that has grown to believe that government can provide for all of its needs?

If we want to find solutions in health care that improve access, maintain or improve quality, and decrease government costs to a sustainable level then we need to redefine the problem with long term vision.

According to a recent report from the Society of Actuaries and Canadian Institute of Actuaries released September 17, 2013, Canada's current health care system is not sustainable over a 25-year horizon. As reported by the Rock Hill Herald, the study predicts that provincial and territorial governments' annual spending on health care will increase by approximately 133% from 2012 to 2037 and the expenditures will be close to 86% of governments' own source revenues.

Key findings:

*Growth rates will make it almost impossible for provincial and territorial governments to service their debts and program other services such as education, social welfare and infrastructure."

*There are two key causes of growth in the proportion of the budget: real growth in health care expenditures largely due to the aging of the population and reduced growth in GDP as the working population grows much slower that in the past."

*The revised Canada Health Transfer formula anticipates the future share of the federal government will drop to 14% by 2037, further reducing the amount available to provincial and territorial governments for other program expenditures."

"This report's findings confirm that funding future health care expenditures will be challenging for provincial and territorial governments even if the CHT remains unchanged."-Gary Walters, member of the report's Project Oversight Group.

Which brings me to the article I first spotted in the Kelowna Daily Courier a few weeks ago regarding the plans of the Westbank First Nations to build a 100 bed private hospital. The first phase would include 10 operating rooms and full lab and diagnostic services. Tentatively called the "Lake Okanagan Wellness Clinic", it would use public funds to treat aboriginal people but would also treat Canadians paying out of pocket including joint replacement surgery and cosmetic surgery.

There are also plans to conduct research into diabetes and heart disease and "treat people long-distance using closed-circuit TV".

The National Post reported on this exciting health care development in the last few days and so far I have not heard any vociferous backlash from DoctorsforMedicare or Friends of Medicare or other loud union-backed groups that prefer to support creating and maintaining dependency on a health care system unable to meet the overall demand for care.

Perhaps by defining the problem in health care as an overwhelming dependency on an overburdened public health care system we can move to truly innovative solutions that create more opportunity for care, strengthen initiative and support truly vulnerable populations.

I am hopeful.

Once again, thank you for your support over the years and for your ongoing participation in this important health care dialogue. I truly value my contributors.

Thank you.

Reader Comments (408)


First we need to agree this isn't about health care. This is about a social support system, where, one in the system we've got an unwritten commitment to cover all costs of support. As we learn more, we are covering more and more marginal issues, at the expense of reasonable health care to those have minor morbidity issues, that if fixed promptly, would get the back to go health.

A large proportion of the monies we spend are not for health, but for long term care for those who can not return to "healthy" because they have biological issues not amenable to repair. Does every life born have a "right" to unlimited consumption of pooled resources?

We're going to have to agree on principles first.
September 21, 2013 | Unregistered CommentermovingforwardOntario
Time and time again we get death bed confessions from such government sponsored councils and Boards....they regurgitate the usual politically correct platitudes throughout the lives of their committees, rarely offending their masters and then...as they get wound up ,as this Council will be in 2014, a little bit of truth blurts out as they rend their clothes in anguish.

As for these so called health care experts ,mostly blinkered and ideologically driven,decision makers, consultants, politicians, bureaucrats the capable and talented and the more numerous pointy headed...brainstorming until their brains hurt...cannot achieve what the free market, exposed to the realities of market forces could do relatively effortlessly.

Let governments set the paradigm...a reasonable paradigm...and then step out of the way.

One thinks of the Highway Code, let decisions be made by governments from the municipal to the Federal,about which side of the road vehicles should drive on, traffic lights, stop signs , speed limits, vehicle safety matters, the role of traffic police etc., ...but then butt out, no huge Transportation Ministry with Local Transportation Integrative Networks micromanaging , trying to tell people when they are allowed to back out of their garages, when they are allowed go to the petrol stations and to which ones and what petrol should be put in and how many litres. That they should log into the highway computer to get permission to go to work or the mall..." For efficiency"...tick boxing before they are allowed to switch on the ignition....with auditors to make certain that vehicle usage was not being abused....and, of course, the end of vehicle life pathways...one wakes up one morning to find that one's ageing vehicle having been taken away during the night by a Ministry tow truck with bonuses being paid to the identifier of the ageing vehicle and to the scrap heap vehicle demolishers and recyclers.
September 21, 2013 | Unregistered CommenterAndris
There is no " right" to consume anything...but one should have the right to pursue good health and to preserve one's own life and that of one's loved ones to one's full ability.
September 21, 2013 | Unregistered CommenterAndris
Oh..and JRL, if you are still out there, thanks for the comment the other day.
September 21, 2013 | Unregistered CommenterMerrilee Fullerton (realist)

An infrastructure designed to stabilize things, access to more public resources as needed, assured benefit programs for both patients and providers, an aging population with less and less family support structure, an active research searching for causes of disease in more and more detail leading to more pricey targeted care.

We just have to raise taxes,
September 22, 2013 | Unregistered CommentermovingforwardOntario
I have not checked the comments to this article but worth doing:

September 22, 2013 | Unregistered CommenterMerrilee Fullerton ( realist)
Good luck on raising taxes. It will have to wait until we have a majority government. I think the most recent Stats Can survey said that anyone earning over $80.5K was in the top ten percent of income earners in the country.

Let's see that now includes doctors, teachers, nurses, firefigthers, police, midwives, PAs, paramedics, etc. I don't think the problem is taxes but the fact pretty much anyone is the public service these days seems to be in the top ten percent at least in Ontario.

The problem is not inadequate taxes it is excessive spending on public sector salaries and benefits.
September 22, 2013 | Unregistered CommenterCanary in a Coal Mine
The First Nations have a good set up...sell tobacco to the intruders undermining their health...run casinos to deprive them of their money...run private hospitals to treat them...so that they can return to their casinos to spend their remaining money.

Pity that the First Nations don't look after their own health so that they can experience the full benefit of their excellent strategy.

On a political note , have the Ontario PC's done enough at their convention to become a credible threat to NDP/ Liberal cabal?
September 22, 2013 | Unregistered CommenterAndris
Charles Kettering said "a problem thoroughly understood is always fairly simple. Found your opinions on facts, not prejudices. We know too many things that are not true."

Einstein said that "If I had only one hour to save the world, I would spend fifty-five minutes defining the problem, and only five minutes finding the solution."

Those in charge do not understand the problem - they want to skip straight to action and results. This is not done to improve the system but for political expediency.
September 22, 2013 | Unregistered CommenterExecutive Lead Blogger
<<Most Canadians think that they have good health care; yet, the evidence suggests the system is not as good as they think it is.>> Dr. J.B. Kitts

I have the utmost respect for Dr. Kitts and I think the statement nails it precisely on the head: I do not know of a single health care provider who wakes up in the morning and pledges to provide anything less than the best possible care every single day.

We are getting good care. It is the system that hinders us from getting great, appropriate, continuous and coordinated care.

Take your time to properly define the problem, listen to the providers...then act. And as Andris recommends...then get the heck out of the way.
September 22, 2013 | Unregistered CommenterExecutive Lead Blogger
The problem is not with haelth care.

It's with the politics of owning health care - who owns the process. It is now owed by politicians, who, by their job, must cater to the lowest common point to gather votes, rather than striving to hit high points.

This isn't going to get any better.
September 22, 2013 | Unregistered CommentermovingforwardOntario
" Politics owning the process"...in the UK the GP's are rebelling against where their EMR'ed ....under General Practice Extraction Service ( GPES) GP's are to be FORCED to send confidential patient records to a central database to share the information with whomever NHS central chooses...at this time with universities and private companies...next week?
September 22, 2013 | Unregistered CommenterAndris
Those in a position of authority are become so dependent upon maintaining the system that change will not come from within. If it were so, there is more than enough data to suggest a change in course would already have occurred.

This is the lumpenstate where all development is accredited to central fiscal policy and production carries the economic burden of the supervisory and regulatory beaucracy. This leads to income disparity with producers supporting the regulators sheltered employment with generous benefits and lifestyle. Internally the drive to thin the burdensome ranks is lost. Misplaced like the moral compass that was to guide "good" government.

Has too little government ever caused a society to collapse?

But, I rant too much , ... if it is "impossible for provincial and territorial governments to service their debts and program other services such as education, social welfare and infrastructure." Then they can't. And change will come.
September 22, 2013 | Unregistered CommenterEklimek
Lumpenbourgoisie...I had forgotten that term...it fits.
September 22, 2013 | Unregistered CommenterAndris
No rebellion will occur. Most are happy with either their free change, or their access to the public purse. The plan is good.
September 22, 2013 | Unregistered CommentermovingforwardOntario
Rebellion will not be needed. It's exhaustion and external pressure. But the government knows this. If they could protect theirs, they would not only let change occur, they would herald it.
September 22, 2013 | Unregistered CommenterEklimek
The lumpen bourgeoise prey on the people in the name of the people...at one point in time , and it will be inevitable, the penny will drop in the minds of the "people" and they will react angrily and ferociously...it's not in the plan we know...
September 22, 2013 | Unregistered CommenterAndris
In the interim, let them eat cake. We are in charge.
September 22, 2013 | Unregistered CommentermovingforwardOntario
Interesting posts today.

After almost a decade of trying, at all different levels, I am convinced that change cannot come from within. Believe me, I have tried.

As eklimek says, it is external pressure that will create the change as it builds but if we are truly to be able to respond (and the time is at hand) the public must have a better understanding of what is coming.

Unfortunately, the journalists have very little insight into that and along with other media and union types they perpetuate the status quo. One could argue that they are creating pressure to drive change to create coordinated, collaborative care that will be more efficient, but I suggest that this is misguided as a true solution because the problem in health care is much, much bigger than these efforts can ever possibly hope to solve.

One again, the real problem has not been identified or communicated to the public and we still see the happy experiences from grateful patients overriding the negative experiences. Wishful thinking for the future for sure.
September 22, 2013 | Unregistered CommenterMerrilee Fullerton (realist)
and Lumpenbourgoisie...a new term for me!
September 22, 2013 | Unregistered CommenterMerrilee Fullerton (realist)
"Lumpenbourgeoisie : "a militant, openly anti-democratic enclave within a functioning, however half-hearted and thus helpless democracy"."
September 22, 2013 | Unregistered CommenterMerrilee Fullerton (realist)
Gee, that sure does describe Ontario's health care system....profoundly.
September 22, 2013 | Unregistered CommenterMerrilee Fullerton (realist)
ELB: "Take your time to properly define the problem, listen to the providers...then act."

MFO: "It is now owed by politicians"

These two statements clarify what should be done and why nothing is working. The providers are the front line workers.......not the govt's bought 'best practice' physician soothsayers. Politicians want bureaucracy to dilute the blame by hiding their responsibility in the hierarchy of the MOHLTC/LHINs/etc. Politicians should learn the re-inventing the wheel, means you are still working with a wheel, know matter what the 'focus groups' wish to call it now. Egos and super IDs need not apply.

To Do List:
1) all pharm computer systems linked province/country wide (will stop Doc shopping for scripts and decrease narcotic fraud)
2) all pharm/lab/imaging facilities' computers will be linked with hospitals (will help ER Docs from reordering recent investigations and allow them to know what drugs the pt is on).
3) only inpatients and ER pts are allowed to use the hospitals' imaging facilities unless the pt fulfills a set criteria determined by front line providers (will help costs and wait-times for ER pts)
4) get pts back to their prior residence (complex scenario involving $$, family members, out pt healthcare professions, PT, RPNs, etc)
5) appropriate Pre-op, intra-op and post-op routine meds to decrease surgical beds. Role of family members in helping???
6) role of 'non-intervention pathway' (RCT, best practice and front line providers) for those whose life expectance is deemed non-viable (I see it daily for many surgical pts). If family wishes to ignore the pt's wishes of 'AND' (the new DNR) or the MOHLTC's 'non-intervention pathway' then a cost will occur to the family.
7) Cost and quality analysis of the LHINs/NP/MWs/alphabet FP grps/PAs/etc. If they are not cost effective with approp pt outcomes then admit the mistake and move on.
8) hospital administration should be defined and their numbers dictated by area population and number of hospital beds. Accountability, responsibility and transparency applies to all (including healthcare professionals). Failure means possibility of termination. Criminal inquire can occur for egregious decisions that cause poor pt outcomes (no free ride).
9) pharm to give routine and long term meds without Doc renewing script
10) all imaging facilities are to be reproducible in their descriptions (stop specialist from re-order imaging from a better location, e.g.., U/S)
11) look at other provinces, countries, etc and take what works and then tweak it. Quit with the egos
12) etc, etc, etc
September 22, 2013 | Unregistered Commentergordo
gordo...you are ER doc?
September 22, 2013 | Unregistered CommenterMerrilee Fullerton (realist)
Re : Shoppers drug mart...Paps in isle 5 is closer than I thought.

Re: Gordo' 's list...I think that I'm developing a headache....reconstructing an aeroplane to government specifications during flight is going to be " interesting" .
September 22, 2013 | Unregistered CommenterAndris
Please tell me this isn't the list you perceive as the solution but "merely" the SOLUTION sent from above.
September 22, 2013 | Unregistered CommenterMerrilee Fullerton ( realist)
Just lie back and relax. Nothing's is going to change. Since the goal is vote buying, that will drive the transformation. Since the votes are acquired by catering to vested interest groups, it will be a process, enriched by vested self interests.

Watch the Toronto subway fiasco to learn how this is done. Heath for the next decade, will function as well as subway planning and implementation.

Power will remain intact.

Stay away from the margins
September 23, 2013 | Unregistered CommentermovingforwardOntario
Partial List of issues blocking "transformation":

1. 15 isolated health care plans, functioning in a federated system, struggling to develop a national network. A doomed plan. Each province/territory has different legislative rules making a linked electronic system almost impossible.
2. !5 isolated political structures, all driven by vote gathering activity, rather than planned evidence based, openly vetted plans (the backroom stuff now is the worse in years).
3. Recognition that some province/territories are too small to support Tertiary care services.
4. Recognition that, one does receive reduced access to secondary and tertiary care when you live in remote areas, and the system can merely assure a transportation grid exists that can get you into secondary and tertiary care.
September 23, 2013 | Unregistered CommentermovingforwardOntario
Dr F

They are using this app: https://itunes.apple.com/ca/app/arthritisid-pro/id457968697?mt=8

At least this intervention was based on RCTs.
An RCT showed pharmacists were able to identify OA of the knee with >90% accuracy and also provided education, pain medication management, physical therapy exercises, and primary care physician communication. The study showed a significantly higher quality of OA care as measured by a quality indicator pass rate among patients in the intervention arm.

But, as I discussed with a rheumatologist, will those with RA get identified and treated earlier? Or are pharmacists going to identify more patients who need knee replacements?....no money saved there...
September 23, 2013 | Unregistered CommenterOutpatientPharmD

The balkanization of health services both within and among jurisdictions speaks to the parasitic drag by interposed administration. How many of these sheltered job opportunities have been added simply to accomodate service shortfalls? In other words, if the services were accessible, would you need less administration?
September 23, 2013 | Unregistered CommenterEklimek
Why offer such apps to only the pharmacies...cut out primary care altogether , have an app for all of medicine/ surgery/ pharmacology handing out iPhones to the whole population a la ' Obamaphones' ...that should cut down the number of visits to the FHNOTs who wouldn't feel threatened since , being capitated, they would welcome the down time allowing them to watch Netflicks on theirs as they sit around the conference table supposedly discussing the placement of the waste paper bins.
September 23, 2013 | Unregistered CommenterAndris

Ahh, but we now have the nurse navigator programmes, designed to help the helpless patient link up the needed services. Of course, nurse navigators, a US product, developed because of a fragment coverage system, shouldn't have been necessary in Ontario's seamless system, with no financial blockages in place.

Sadly, much of the ministerial advice has been based on a fundamental misunderstanding of the Ontario health system, by individuals trained based on the US model.
September 23, 2013 | Unregistered CommentermovingforwardOntario
<<4. Recognition that, one does receive reduced access to secondary and tertiary care when you live in remote areas, and the system can merely assure a transportation grid exists that can get you into secondary and tertiary care. >> -mfO

Have you ever lived in a rural or remote area, mfO? The system does not assure a transportation grid.

It is a hybrid of a recovering provincial air ambulance system that struggles with Advanced Care Paramedic staffing on a daily basis, seasoned by a land ambulance system that is governed by municipalities that are more concerned with the impact on the local tax base and basted in a roux of decrepit non-urgent transportation vehicles.

Transitions between the three are not coordinated and the province doesn't consider transportation as an integral component of care outside of metropolitan areas.

Ontario used to be a national leader in EMS prior to municipal downloading in 1999. Now the system is nothing more than a Balkanized patchwork of dedicated front line paramedics trying to do the best they can while Reeve Elmer belches his way through a council meeting worried about who gets to drive the convertible at the fall fair parade.
September 23, 2013 | Unregistered CommenterExecutive Lead Blogger
Yup ELB sounds exactly like the dozen or small towns I've worked in over the years north of North Bay.

Not sure if it has changed but I gave up going on those long ambulance transfers bagging a patient from Geraldton to Thunderbay because the MOH only paid for our time one way.

Complete patchwork of a system up there.
September 24, 2013 | Unregistered CommenterCanary in a Coal Mine

One must agree. There SHOULD be a grid. It does not exist today. Despite ORNGE.
September 24, 2013 | Unregistered CommentermovingforwardOntario

Early diagnosis means more cost!
September 24, 2013 | Unregistered CommentermovingforwardOntario
Yes, more cost....but the patients will feel better and that's what important, isn't it???

Dr F
I have a confession to make.

I thought I had a pretty good idea of what primary care docs do and what get thrown their way from my experience working as a primary care consultant in the military where I worked in an office, booked patients, sent out referrals, wrote Rx and labs etc etc etc

I was wrong.

We underwent an accreditation from the college by a young eager pharmacist who was quite concerned regarding our small 2 person pharmacy had a lack of a policy and procedure manual, for things like.... showing someone how to use a Ventolin inhaler or in case we panicked if there was a fainting or anaphylaxis to the flu shot. Never mind that I was once ACLS trained and have been to more codes in one month than she will ever see in a lifetime.

Good grief.

THe inmates have really taken over the asylum. I guess all those excess lawyers need a job too.
September 24, 2013 | Unregistered CommenterOutpatientPharmD
OpPD, I feel for you.
The bureaucrats, consultants and regulators are killing any efficiency that could have been found and their costs somehow get skimmed over.
September 24, 2013 | Unregistered CommenterMerrilee Fullerton (realist)
The concept of "universal" health care and equality in health care is a bit of a regional myth, sorry to say. The regional disparities between rural and urban are quite distinct in terms of available resources and access. Just saying.
September 24, 2013 | Unregistered CommenterMerrilee Fullerton (realist)

It's not about making the patient feel better. It's about control. Your health must be under my control, because I know better what's good for you.

We are moving quickly from a system where your health care concerns triggers you to seek care, to a system where you must report for regular check ins to assure we are watching you for things that trigger disease that we can make you avoid doing. we will have rigourous guidelines and check lists that will be followed to keep things in check. All set by government committees designed to save costs. Where previously the professional colleges tried to do that.based on best care.
September 25, 2013 | Unregistered CommentermovingforwardOntario
"Health care in Canada has been a major source of attraction for multinationals in search of a reliable, healthy workforce. When the public healthcare system is perceived as delivering good value for money, emphasizing prevention as well as treatment, and providing services efficiently, it becomes a selling point for business.

Unfortunately, the opposite is also true."

September 25, 2013 | Unregistered CommenterCanary in a Coal Mine
Thanks CICM..

Here is an article from Dr. Brian Day in the Ottawa Citizen--there is hope:

September 25, 2013 | Unregistered CommenterMerrilee Fullerton (realist)
I'm stymied by the concept in the article you link to that the only way to provide private coverage is through employment. This simply isn't true and quite misleading.
September 25, 2013 | Unregistered CommenterMerrilee Fullerton (realist)

Central will not allow a parallel medically necessary private pay system.
September 25, 2013 | Unregistered CommentermovingforwardOntario

I think you missed the point. Private coverage through employment is not mentioned as the only option.

It points to the concern of business attracting and maintaing employees. If care is delayed employess are reluctant to enter the province. iIf services not covered by OHIP are billed to the employee,they, in turn, will seek insurance coverage, which will then impact the employer who may offer the benefit at their cost.

So much for the $4,000 healthcare cost in each automobile no longer produced in Ontario.
September 25, 2013 | Unregistered CommenterEklimek
As workers become harder to find, speed to diagnosis and treatment will be become an additional value employers want. It may be reasonable to put your retirees and aged on waiting lists for services, but you can't put your productive high powered 35 on the same list. Things aren't going to be pretty unless we up the taxes.
September 25, 2013 | Unregistered CommentermovingforwardOntario
Well, I do acknowledge the point about access being a drawing card or a deterrent but just having come from a discussion about people not wanting the US system which is employer-based, I wanted to make the point that private options can be much more than simply tied to employment.
September 25, 2013 | Unregistered CommenterMerrilee Fullerton
Excellent article:
Lowering Health Care Costs Is Hard Because Every Patient Is Unique - Atlantic Mobile http://www.theatlantic.com/health/archive/2013/09/lowering-health-care-costs-is-hard-because-every-patient-is-unique/279950/
September 25, 2013 | Unregistered CommenterMerrilee Fullerton
“Pharmacists already help in the management of chronic conditions, but they can do so much more,” says Domenic Pilla, President and CEO, Shoppers Drug Mart. “Governments have identified chronic disease as an immense challenge and they are investing significant dollars in prevention and treatment of these illnesses; using pharmacists more effectively can help achieve the goal of improving care for Canadians, while at the same time actually reducing costs to the health care system.”


This arthritis initiative stinks to high heaven and I would certainly like to know why it is Shopper's Drug Mart launching the program rather than the College of Pharmacists.

We have the previous premier of Ontario, David Peterson, on the board of directors of Shopper's and the current Health Minister Matthews in Ontario is his sister in law. Could this be further evidence of crony capitalism where rather than a transparent launch of such a program it is launched at the pharmacy which has the strongest connections to the ruling party.

And what is in it for the Arthritis Research Centre of Canada (ARC) in this "partnership" which only involves one pharmacy it appears. Patients are screened using some vague questionnaire asking if you have any joint pain. Shopper's then gets to push the front line OTC drugs such as acetominophen, ibuprofen, and glucosamine to new patients who scored 6/10 on the screening test. LIttle does the pharmacist know that the patient has hep C or NSAID induced nephropathy.

So we are going to put women on these OTC meds earlier than we should, and transfer more taxpayer monies to corporate Shopper's with each questionnaire administered. I know our local big box pharmacists all complain about having to administer the flu shot with the added responsibility but no improvement in their hourly wage.

OPPD please tell me this is not just more crony capitalism infecting our health care system.
September 25, 2013 | Unregistered CommenterCanary in a Coal Mine

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