Navigation
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. 

 

 

 

 

Login
« Predictions for 2015 to 2019 in Ontario | Main | The Baker-Price Report »
Monday
Sep282015

Politics and Pharmacare

I've written on this topic before several times but pharmacare keeps popping up during the lead up to the federal election on October 19. The political parties aren't talking about it much but others are.

One of the obstacles to creating a national pharmacare program in Canada is cost but an article that appeared in the CMAJ some months ago suggested billions of dollars in health care costs could be saved through such a plan. Others chimed in. It sounds so good.

But there are a few problems with the depth of this study.

In order to understand how billions of dollars in savings from a national pharmacare program are NOT possible, we need to understand several points.

1. The study looked backward not forward.

New medications associated with new screening tests and new biomarkers are on the horizon. Immunologics and biologics for chronic disease will not be curative but they will be expensive. New tests to assess who will benefit and who will not and new modalities for assessing cancer survivorship. It is not reasonable to exclude the costs of these medications and the costs of the tests and the costs of increasing chronic diseases from the assessment of potential cost savings.

2. National Pharmacare is intended as a sister program to Medicare in Canada.

While this may seem noble, our single payer health care system is not managing very well. Adding another big, bureaucratic system when we are already unable to meet demand in its predecessor does not make sense. Albeit that medicine is changing and more medications are taking the place of various procedures, the possibility of creating a "free" system for pharmacare will increase demand. We have seen the result of limitless "free" medical care with growing wait times and closures of hospitals to drive more care to the community where much of it remains unfunded.

What would be the result of a national pharmacare program that will be required to ration its availability? Which diseases would remain orphaned? Which would become new orphans? Which lobbying group would obtain coverage? Which political group will aim to benefit by promising what it can't later deliver?

3. Health care is a Complex System.

No matter how many times one puts "National" in front of a government program there can be no guarantee of the results. Making pharmacare a national program is an attempt to nudge more tax dollars from the federal government when the likelihood of savings is highly unlikely.

Once a national pharmacare program is in place it can't be taken back even if its costs soar to higher levels than expected. The supporters will say "Who could have known?"

Health care is like a balloon. Squeezing one area results in a bulge somewhere else. Blowing it up past its capacity results in a great big POP and structural failure.

While it is not possible to predict cost savings in such a system with so many variables beyond the actual cost of medication, it IS possible to predict that the demand for medications to be included in such a program will be ongoing. Political games will be played and effects will be felt elsewhere in the system...we just won't be able to predict where.

Does the unpredictability of such a system mean we should be doing nothing about creating a more universal system of pharmaceutical coverage?

No. It means that we should be looking at more reasonable ways to create coverage for the one in ten people who reportedly cannot afford their medications.

Instead of creating another complex bureaucratic system that will inevitably become politicized, let's look at the various programs that are working well to provide coverage for those in need.

4. A national pharmacare program requires provinces to relenquish power.

There are a multitude of provincial and territorial pharmaceutical plans in place to assist in medication coverage. Provinces hold the power when it comes to how to fund and how to manage publicly funded medications.

Will the provinces and territories accept that a national pharmacare program will define what they will have to provide? When it comes to provincial medical care provision, the provinces tend to show their disdain for federal direction. Sure, the provinces want more federal funding but when it comes down to directing the funds to their final destination, historically it appears that the provinces resist federal directives--happy to take the money, unhappy to be told how to spend it. And the federal government has limited tools with which to force the provinces to comply.

Will the provinces be willing to give up their power to the federal government? I doubt it.

5. If a national pharmacare program were to emerge, what happens to the ability of citizens to access private drug plans? Would they still be affordable or would they be so reduced in capability that their offerings would either be redundant or limited in nature?

Nothing in a complex system happens in isolation. Creating a national pharmacare program seems simple. It is far from it.

If we lose the ability of private insurance plans to cover certain medications what happens when a national pharmacare program determines that the cost of a certain drug is beyond funding? What happens when there is no significant private option to turn to?

We've seen this before. The single payer health care system has become monopolistic and denies patients care based on cost, availability, and rationing by other means.

What happens to patients when they are promised government pharmaceutical coverage but then the promises are broken? Sound familiar?

A national pharmacare program is not a solution. Instead, let us enhance the coverage for the one in ten Canadians who say they are unable to afford their medications. Hoping for billions in savings from a National Pharmacare program is unrealistic and misleading.

 

 

 

Reader Comments (376)

Just call it what it is, a shared national drug purchasing program. It might help squeeze some money out of big Pharma, but at an expense down the road, like reduced investment in research.

Labelling it as Pharmacare is an oversimplification of an incredibly complicated industry (as we have all learned here thanks to the posts of many) and heightens expectations - like Medicare - that are impossible to deliver.
September 28, 2015 | Unregistered CommenterExecutive Lead Blogger
You can say that again ELB!
September 28, 2015 | Unregistered CommenterMerrilee Fullerton (realist)
Easy to do. Establish a voluntary shared national program. Each province gets to opt in. Opting in means province accepts everything solely through the national program. Not opting in, current status.

How many provinces will transfer their powers to the national board?

Just a power thing.
September 28, 2015 | Unregistered CommentermovingforwardOntario
The Province of XXXXXXX has passed legislation to join the national pharmacare system, and agree to transfer our yearly allocated budget for complete use by the nationally purchasing board for its use. We agree that only drugs approve for use will be allow to be prescribed by our providers, and used by our citizens. We agree that once the national budgetary per capita figure for drugs is established, to provide that per capita rate completely to the national purchasing board.
September 28, 2015 | Unregistered CommentermovingforwardOntario
I'm sure the provinces will love that!
September 28, 2015 | Unregistered CommenterRealist
This is all, solely, about power. Canada could have, almost tomrrow, a national purchasing distribution system. Just need each province and territory to sign it off, transferring theirpowers to a national system. Just as each province and territory has transfered their powers to the national medicare system. Oops sorry about that, Ontario takes the national transfer payments and diverts them to panam bonuses. Missed that issue.
September 28, 2015 | Unregistered CommentermovingforwardOntario
R

I wish you success in discussing the reality of economics and politics, with the maypole dancers.
September 28, 2015 | Unregistered CommentermovingforwardOntario
Thanks mfO.
There are many people with good intentions. They just don't or won't think the whole process through.
There are others who just want power or conversely, they want others to decide their lives for them.
My wish is for better balance.
September 28, 2015 | Unregistered CommenterRealist
http://www.thespec.com/opinion-story/5934369-the-doctor-is-out/



The doctor is out
Hamilton Spectator
By Dr. Douglas Mark


I never thought it would come to this. When I entered medical school, all those years ago, I never imagined in my wildest dreams there'd come a day when the Government of Ontario would declare war on doctors.

But with their recent announcement that, starting Oct. 1, more cuts to services and clawbacks to physician billings are about to kick in, it's become painfully obvious that Premier Kathleen Wynne and Treasury Board President Deb Matthews have not only decided to go on the attack against doctors, but have also chosen to declare war on our patients, who are likely to end up innocent civilian casualties in this conflict.

In addition to the cuts announced last February, when the Liberals made the decision to go it alone and unilaterally make changes to the Schedule of Benefits, Wynne and Matthews announced they'll be making an additional 1.3% across-the-board reduction in fee-for-service payments — which will result in a further $235 million being cut from our health-care system.

Now, this is alarming enough, but the Ontario Government has also made it clear that should physician billings go over their pulled-out-of-a-hat so-called "hard cap" they imposed on the medical profession Feb. 1, then further cuts will have to be made, most likely by clawing back as much as 10 or 20 per cent of each individual doctor's OHIP payments.

To put this in terms everyone can understand, a 10% clawback would mean that every tenth patient a doctor sees would be for free. A 20% clawback would mean that one out of every five patients a doctor treats would result in that physician receiving no remuneration for providing those services. Doctors would still be expected to cover the rent and other office expenses, keep the lights on, and pay their staff. Oh, and maybe feed their families.

By now, you're probably wondering why the Liberals would do such a thing, putting your health and that of your loved ones at risk. After all, funding couldn't possibly be an issue, could it? — what with the billions in Canada Health Transfer payments the Ontario Government receives every year from the feds, and their own Health Care Levy that former Premier Dalton McGuinty foisted upon us shortly after he became premier back in 2003.

Truth is, money is the issue. In addition to squandering billions of dollars on one fiasco after another, the Liberals have decided to make labour peace with the province's teachers by paying for the expensive deals they've either reached with the teacher unions, or are in the process of negotiating, with — get this — the money they're cutting from our health-care system. Money that's meant to cover medical services so doctors can diagnose, treat and heal you, our patients, in the most cost-effective and timely manner possible — all while keeping in mind the current fiscal realities facing us.

As a result of these reckless and irresponsible actions taken by Wynne and Matthews, the doctors of Ontario are left with no choice but to escalate our job actions. Starting Oct. 1, when the latest round of cuts are set to commence, and continuing throughout the fall and winter, DoctorsOntario will engage in the following activities in order to get the public's attention and force the Ontario Government to go back to the table and negotiate a fair and reasonable agreement with doctors:

1. Designate two days a month as "Wynne Daze" and persuade every doctor in the province to close their offices to their patients for 24 hours on those designated days.

2. Set up a M*A*S*H tent on the front lawn of Queen's Park, where doctors will see patients for free, and hand out band-aids in recognition of the Liberals' "band-aid solution" approach toward fixing our health-care system.

3. Encourage every family doctor in Ontario to do away with appointments and turn their offices into makeshift walk-in clinics.

4. Recommend that all obstetricians and gynecologists stop taking on newly-pregnant patients as of Jan. 1, 2016.

5. Set up a Job Fair and Retirement Planning Workshop in February, 2016, for those doctors who've had enough and either want to leave the province and go elsewhere or simply pack it in and retire.

In addition, DoctorsOntario plans on making a formal complaint to the College of Physicians and Surgeons of Ontario against Health Minister Eric Hoskins and Deputy Health Minister Robert Bell. As physicians, both Dr. Hoskins and Dr. Bell should understand the damage these ill-advised cuts to our health-care system will cause, and be speaking out against the Ontario Government's plan instead of going along with — and even promoting it.

Harsh medicine, for sure. But if doctors don't speak up now and stand up for our patients, the time may not be that far away when, instead of going to see your doctor upon discovering you or a family member is sick, you'll have no option but to make an appointment to go and see your child's teacher in order to see what they can do for you.

After all, that's where Premier Wynne and Treasury Board President Matthews are redirecting your health-care dollars.

Feel good about that?

Dr. Douglas Mark is the Interim President of DoctorsOntario. Follow him on Twitter @DocsOntario.
September 29, 2015 | Unregistered CommenterStephen Skyvington
<<4. Recommend that all obstetricians and gynecologists stop taking on newly-pregnant patients as of Jan. 1, 2016.>>

Seriously?

Where the %$#& did that come from? Talk about pulling-out-of-a-hat, this tactic must have been pulled out of a southerly orifice.

None of the other suggestions target (and I use the term precisely) a specific population...I wonder why DoctorsOntario decided to paint a bullseye on the newly pregnant?

Talk about introducing a discriminatory practice. Why not target newly diangosed prostate cancer patients? Or anyone over the age of 80 requiring a new stent placement for dialysis.

In my less-than-reasoned knee-jerk Tuesday morning opinion, DoctorsOntario has opened a Pandora's Box with option number 4. I am not looking forward to seeing where it ultimately goes because it can get real ugly real quick.

And we all remember the myth...the only thing left in the box after it was closed was hope.
September 29, 2015 | Unregistered CommenterExecutive Lead Blogger
At this time no doctor is obliged to accept an elective referral.

Please recall society has accepted -

"Midwives are experts in normal pregnancy, birth and newborn care. Ontario midwives are funded by the Ontario Ministry of Health and Long-Term Care so services are free to clients. Give birth at a hospital or at home and receive safe, skilled care from your midwife."

- See more at: http://www.ontariomidwives.ca/#sthash.SWQV2GOI.dpuf
September 29, 2015 | Unregistered Commentereklimek
HIstorically, when the obs and gyns refused to take newly-pregnant patients in 1997 the government caved in and the impasse was over in two weeks.

Having worked at the OMA, I not only remember what worked during previous troubled times, I also studied the inhouse archives to understand why the 1986 strike failed.

I could write a book on the screw ups there.

And no, this wasn't pulled out of a hat.

Unlike the OMA, DoctorsOntario has been working on a viable job action plan for the past year.

So unless you like the OMA's virtually useless virtual day of action scheduled for October 1, I'd highly suggest you think again about what we're proposing.

Cheers.

Stephen
September 29, 2015 | Unregistered CommenterStephen Skyvington
HIstorically, when the obs and gyns refused to take newly-pregnant patients in 1997 the government caved in and the impasse was over in two weeks.

Having worked at the OMA, I not only remember what worked during previous troubled times, I also studied the inhouse archives to understand why the 1986 strike failed.

I could write a book on the screw ups there.

And no, this wasn't pulled out of a hat.

Unlike the OMA, DoctorsOntario has been working on a viable job action plan for the past year.

So unless you like the OMA's virtually useless virtual day of action scheduled for October 1, I'd highly suggest you think again about what we're proposing.

Cheers.

Stephen
September 29, 2015 | Unregistered CommenterStephen Skyvington
Ob-Gyn did this before and the government caved

I started my OB practice in Sept 96. Not only did I have the 10% cut to deal with, those in practice then will recall that they also wanted us to pay the entire CMPA fees. They were to take a huge hike, which for OB was up to $31,000. It would have taken 78 deliveries to pay for malpractice alone, before paying for anything else. The Ontario Society of OB-Gyn (OSOG) under the leadership of Dick Johnston commenced a job action. We took no new OB patients, and only dealt with a referral for OB in the delivery room, when either they presented in labour and their family doc was called, and they referred to OB, or with a complication of pregnancy. We also put women and the MOH on notice that we would not renew our OB privileges and would only practice Gynecology as of Jan 1, 1997. It was a business decision. Women of the province were up in arms and flooded their MPPs with letters and phone calls. It was successful, and is why we all continue to have CMPA coverage today , soon to be $95,000 for ON. Who could afford to do it otherwise? Is there some sort of similar thing that we could do that would be apply a lot of public pressure?

Remember?
September 29, 2015 | Unregistered CommenterGasman
Yes, thanks for reminding me.

I meant to mention the government refusing to cover CMPA fees, in addition to the clawbacks.

The reason this is one of the five actions proposed by DoctorsOntario is that I'm hearing rumblings that government is looking at not covering CMPA fees in the future.

And before you tell me there's a 10-year agreement in place, remember how much the Liberals respect agreements.

Cheers.

Stephen
September 29, 2015 | Unregistered CommenterStephen Skyvington
Hoskins said. - “We have asked the OMA, who is the sole representative for doctors on these issues, to provide feedback‎ on our proposed changes and they chose not to.”
http://www.thestar.com/news/canada/2015/09/28/ontario-doctors-urge-binding-arbitration-as-fee-cut-looms.html


"providing feed back" without an existing agreed-upon structure in which to provide such feedback is called collaboration. There seems to be quite a bit of that already without the OMA being involved.
September 29, 2015 | Unregistered Commentereklimek
As part of its Pharmacare 2.0 initiative the CPhA published a national survey on the public's attitudes regarding pharmacare.

1. 79% of Canadians support the idea of a pan-Canadian pharmacare program
2. 74% are concerned about replacing their current private drug plan with a public plan that would have fewer choices
3. 85% are concerned about the ability of government to administer the plan efficiently and effectively
4. 79% are concerned about increased costs to government if patients use more prescription drugs than they do now (which is very likely and may not necessarily mean improve health)
5. 78% of Canadians feel that pharmacare should also cover services provided by pharmacists (cost containment may included mandated mail order pharmacies, virtual pharmacies or kiosks, central fill [all Rx filled in one site then mailed out etc])
6. 77% believe pharmacare should cover other health advice and services provided by pharmacists


The public is not fooled
September 29, 2015 | Unregistered CommenterOutPatientPharmD
Doctors need to work through their own issues:
•Do they believe high incomes indicate moral corruption and/or fraudulent care?
•Do doctors want salaries?
•Do they maintain faith in price-fixing?

Doctors stand at a crossroads. As Medicare crumbles around them, what do they want? More of the same, or something better.

http://shawnwhatley.com/envy/#comments
September 29, 2015 | Unregistered CommenterCanary in a Coal Mine
I came across the first physician departure today due to the clawbacks. Two elderly patients came in saying that their young doc (she graduated in 2008) had quit her practice suddenly last Friday and is moving to British Columbia.

I fully expect this trickle to soon become a flood in the new year. We lost a doc to Calgary a year ago and two others are now actively looking at moving if things worsen.

The government's thinking on just how 'sticky' docs may be could be flawed.
September 30, 2015 | Unregistered CommenterCanary in a Coal Mine
CICM:

Lots of FMGs waiting. Central will accelerate the accreditation pathways. In addition, lots of alternative providers. This is the politics of envy, and central is winning.
September 30, 2015 | Unregistered CommentermovingforwardOntario
<<Central will accelerate the accreditation pathways.>> - mfO

Have you ever had to deal with the CPSO to facilitate the credentialing of a non-Ontario graduate? Its "paper-tsunami-meets-bureaucratic-nightmare" sprinkled with a healthy dusting of disdain and indignation.

I would be disappointed if the College 'caves' into Central's requests/demands. It would signal the return to the old adage: "We have principles...and if you don't like them, we have other principles."
September 30, 2015 | Unregistered CommenterExecutive Lead Blogger
The next step in accelerating accreditation of health care providers is to simply establish another category of regulated care providers - the College of First Health Care Providers. No longer need we wait for existing obstructive regulatory bodies recalcitrant to the needs of society and duly elected officials. A 2 year College diploma extended from the existing 16 week PSW course should do. As Kinky Freeman said when running for governor of Texas, "How hard can it be?"
September 30, 2015 | Unregistered Commentereklimek
Not sure if this was posted earlier but if not this is truly a sinister looking development. Physicians will be nothing more than teachers working for school boards with little control over their livelihoods. Patients will likely fare about as well as students have fared in Ontario's school system over the last decade.

Be afraid, very afraid of the Price report.


"Citizens are assigned to a PCG based on geography, “akin to the assignment of public school students to the local school in their neighbourhood”. Funding to each PCG would be on a per capita basis, “reflecting the demographics, geographic rurality of the population, socio-economic status, and projected health needs of the catchment area”. The PCG then contracts with its local primary care providers, “honouring existing relationships and agreements currently in place”, to deliver primary care services. That would include physicians, nurses, and other health care professionals. “Provider groups and individual providers, who may be subcontracted to provider groups, earn the right, based on their ability to achieve quality benchmarks and any additional criteria/metrics captured in their accountability agreement, to participate in the system. The right to deliver service is not guaranteed but is performance-based.” Essentially Family Health Teams, Family Health Organizations, Family Health Groups, fee for service physicians, Community Health Centres, Community Care Access Centres, and Nurse-Practitioner-led Clinics would all fall under the banner of the PCG. The PCG, for example, would have the ability to decide whether a particular physician could work in a specific region governed by the PCG."

https://drmarioelia.wordpress.com/2015/09/16/more-moh-secrecy-patient-care-groups-implemented-behind-the-scenes/
September 30, 2015 | Unregistered CommenterCanary in a Coal Mine
CICM

Sounds like the NHS Commissioning Boards
Physician administrators in charge of both service, quality and costs
http://www.england.nhs.uk/wp-content/uploads/2012/09/fs-ccg-respon.pdf

Note what else is included...drug costs (but not the dispensing fees)

Ask the UK docs how that's working out
September 30, 2015 | Unregistered CommenterOutpatientPharmD
Physicians will be like teachers and managed the same way.

The plan is the plan, and good.
September 30, 2015 | Unregistered CommentermovingforwardOntario
Medical Doctors will be like teachers sans the protection of unions....so they will lose ground year by year...the non medical primary care providers who have such protection will gain ground on the medical primary care providers and soon not only dominate the PCGs, but will marginalize the MDs into oblivion.
September 30, 2015 | Unregistered CommenterAndris
All patients regionally rostered, all providers rostered to the regions, all PCPs paid equally for same group of outcome based services. All PCPs will be unincorporated service providers.
September 30, 2015 | Unregistered CommentermovingforwardOntario
So , incorporation will go out of the window?

How would malpractice costs be covered...spread across the PCG...or individually?

OBGYN's malpractice fees are $75,000 with Ontario covering 90% st present, who knows tomorrow.

New Zealand , Sweden , Denmark, Norway and France have no-fault insurance...the Prichard Report of 1990 recommended the same for Canada.
September 30, 2015 | Unregistered CommenterAndris
mfo,

Is everyone at central a complete and total moron?

Where does this idiocy come from?

It's one thing to drive the bus over the cliff.

But is it really necessary to have your foot to the floor while you're doing it?

I'll have to add another chapter to my book if this keeps up.

Cheers.

Stephen
September 30, 2015 | Unregistered CommenterStephen Skyvington
"earn the right, based on their ability to achieve quality benchmarks and any additional criteria/metrics captured in their accountability agreement, to participate in the system. The right to deliver service is not guaranteed but is performance-based.”

this is nutty stuff
Patients are not widgets.
"Quality benchmarks" can be agonizingly frustrating. Having seen this afoot at the board of health in the past couple years, it seems to me that these benchmarks are typically designed for ensuring money does not flow without great difficulty.

The more the government tries to find "efficiencies", the more inefficient health care becomes.

Well, I certainly hope the medical schools are producing sufficiently brain washed young MDs so that they will flow into these PCGs effortlessly. Somehow I doubt it.

Maybe they've been pre-selected.
September 30, 2015 | Unregistered CommenterMerrilee Fullerton (realist)
Preselected?

Note how the OCFP have been relatively silent...its hierarchy is full of silver spooned Marxists hostile to the " rich", levellers according to the Orwellian tradition of " All pigs are equal, but some pigs are more equal than others"( do they read Animal Farm any more ? ).

We know that moderns from Canadian Universities with Masters degrees in Sociology etc., have never heard of Auschwitz or the Gulag and the totalitarian socialist regimes that inspired them....many of these are ensconced in the health care ministry and the medical schools, and they have every intention of becoming Napoleons the most equal of the more equal.
September 30, 2015 | Unregistered CommenterAndris
Central is not stupid. Central is central. Trained that all must be equal, outside central because that is good and right. Those who don't get that fundamental principle, need to.
October 1, 2015 | Unregistered CommentermovingforwardOntario
"TORONTO | A national, single-payer pharmacare program would add $13.2 billion in new costs to taxpayers and force the 24 million Canadians who now have private drug plans to accept inferior coverage, according to new research published at the online journal of the Canadian Health Policy Institute (CHPI)."

"Experience with public drug plans in Canada strongly suggests that pharmacare would reduce access to the most innovative medicines for Canadians who now have private drug plans, without improving benefits for those eligible for public drug plans.
As well as shifting billions of dollars onto the federal budget, there would be additional indirect economic costs of more than $4 billion in the first year.
Under the current pluralistic public-private system, Canada already has universal drug insurance coverage for catastrophic expenses, and near-universal insurance coverage for ordinary prescription drug costs.
International experience shows there are other ways to achieve universal drug insurance coverage, such as mandatory universal private drug insurance systems supported by means-tested public subsidies."
I don't believe that Central is populated by "the stupid ", far from it is populated by the very bright, by ' Humphries' of ' Yes Minister' fame.

They have different goals, goals that are in conflict with the goals of the greater society...they both serve and manipulate their masters to achieve those goals.

If they have a flaw it is that they seem to be oblivious to the unintended consequences of their actions until they appear on their spread sheets.
October 1, 2015 | Unregistered CommenterAndris
The goal is budget control. These adjustments are built into the budget control plan until 2018. There are not getting changed. It is a majority government with an agenda. It does not need to change..
October 1, 2015 | Unregistered CommentermovingforwardOntario
Wait until patients start dropping dead thanks to your transformation agenda.

Killing voters is never a good way to win an election -- even one as far away as 2018.
October 1, 2015 | Unregistered CommenterStephen Skyvington
Mr. Skyvington, even deaths will not change issues if direct attributable causation and culpability cannot be proven -- and, sadly, even it can. You can't sue the Crown without its permission. The design engineers responsible for the Pinto, probably the unsafest vehicle ever to see the road, assumed a certain risk when building the vehicle with the faulty positioning of the gas tank. There were deaths, directly attributable, but the car manufacturer remains in business.
October 1, 2015 | Unregistered CommenterSybil
Less money is being made available, based on decisions by the provincial government, including moving federal health transfer payments into other area. It happens. Some patients will wait longer, accelerated deaths will be encouraged, it will all work out, as the doctors fight it out, to deal with the fixed amount. The infighting for share from a fixed pot is always painful. The real issue will be how the OMA controls the infighting. This is not going to be pleasant.
October 1, 2015 | Unregistered CommentermovingforwardOntario
The OMA cannot " control" anything , it is discredited in the eyes of the membership, it is perceived as being impotent.

Who would follow an organisation that had been so thoroughly hoodwinked and out maneuvered by the government?
October 1, 2015 | Unregistered CommenterAndris
Well the OMA carried out a successful "thunderclap" today meanwhile bone scan wait lists are skyrocketing.
October 1, 2015 | Unregistered CommenterCanary in a Coal Mine
It is noted that the CPSO is drafting a patients' bill of rights with no accompanying bill of responsibilities.

We have one segment of society to be given rights to the services of another segment of society with no rights, only responsibilities....the very definition of slavery.
October 2, 2015 | Unregistered CommenterAndris
Andirs not entirely true.

Patients do have responsibility. The office policy affecting them are:

Show up on time for scheduled appointments,
Have a valid health card
Be polite to office staff.

Doctors do have some rights.

They may decline to see patients who are outside their scope of practice or present a conflict of interest.

They may decline to see patients who break the above three office policies.
October 2, 2015 | Unregistered Commentereklimek
Ed....you are probably right, but the draft seems to be very broad in its list of patient rights...there is nothing in the proposed bill regarding patient responsibility.
October 2, 2015 | Unregistered CommenterAndris
CICM:

Consensus among 11,000 Facebook Docs: the Thunderclap was a massive failure. The OMA sucks at SoMe.

This, on the other hand, has reached over 500,000 Facebook users and over 20,000 Likes/shares/comments:

https://www.facebook.com/concernedontariodoctors/photos/a.723508891116553.1073741828.720893411378101/726063897527719/?type=3&theater

From https://www.facebook.com/concernedontariodoctors
If anyone is interested, the OCFP has released a draft position paper on PcGs, and I gather some thing has now ask so surfaced from the OMA including where to find the report although we are still being told it's confidential....I haven't read the latter and only took a cursory glance at the former. The OCFP appears not only to have drunk deep of the KoolAid; it's flowing through their veins...
October 3, 2015 | Unregistered CommenterSybil
Sybil,
Thanks for the update. I've always had doubts about the OCFP.
Not drinking the Kool-Aid, reveling in the transformation, comrades. You're born, assigned to work the fields, you leave the fields, you die.
October 3, 2015 | Unregistered CommentermovingforwardOntario
The OCFP has been a haven for old school left-wing NDP socialists for years.

I recall talking to one of its ex-Presidents who said health care in Ontario should be like raising a barn of yesteryear. We all come together for the community and assist each other but at the end of the day for remuneration we should just dance and enjoy a pot luck dinner together.

A year later while drawing a salary/stipend from the OCFP this doc was leaving his practice for days at a time to collect a stipend from the MOH during fee negotiations with the OMA. A full fledged turncoat. I suspect the OCFP culture has not changed one iota over the years.

One just look at the type of CME offerings from the OCFP to realize they are populated by maypole dancers.
October 3, 2015 | Unregistered CommenterCanary in a Coal Mine

PostPost a New Comment

Enter your information below to add a new comment.
Author Email (optional):
Author URL (optional):
Post:
 
All HTML will be escaped. Hyperlinks will be created for URLs automatically.