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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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Thursday
Sep082016

B.C. Courts will bring into Focus the Hard Questions about Canada’s Health Care System

 

Canada’s health care system has been called many things including a “jewel” and “the very essence of what Canada is all about”. It has also been called “sclerotic”, “archaic” and for politicians it has become “a sacred cow”. For many Canadians, our health care system has become a mirage. Aside from the illusory notion that our health care is “free”, many cannot explain how it works and how it is financially sustained. Many cannot access the care they need.

However, this mirage is going to be drawn into clear focus in the weeks and months ahead as the B.C. Court is hearing a case put forward by surgeons and patients that accuse the B.C. government of denying them their rights to timely medical care.

Perhaps the B.C. case will allow Canadians to begin the necessary discussions about how our health care must change to address the serious systemic shortfalls within it. We have a strained health care system due to an increasingly aging population, more pharmaceutical options, more medical technology with associated potential interventions, and emerging science that requires more medical research and money.   

For people waiting for care, or denied care, or whose disease is treatable elsewhere but not here, the limitations of our current system have become numbingly clear.  We should walk a mile in patients’ shoes to understand the importance of the B.C. Charter Challenge for those who have been denied timely care. While the outcome of the case is important at an individual level, it will also resonate at a societal level – throughout our country.

Some people choose to frame the case as a “private vs public” health care battle and foresee the destruction of Medicare if B.C.’s provincial health care service loses the case. However, at a foundational level, the case is a challenge about the rights of Canadian patients in a system that denies timely care.  What rights does a patient have? What recourse should a patient have? What suffering can the government health insurance plan fairly impose on an individual patient, if any?  (In a country that has recently witnessed the Supreme Court of Canada rule in favour of an individual’s right to die, one might expect that it would also rule in favour of an individual’s right to live.)

Now is the time to ask the difficult questions about what we want from our health care system that was designed for another era and which, despite transformation, is a laggard in the developed world. Many of us who have been part of the on-going debate about patients’ rights and the short-comings of the system recognize that we can and must preserve what is fair and equitable about Canada’s health care system and move forward to improve what is not.  

There are some important questions that must be fully discussed.

Must we pit patient against the system? What is more important, the patient or the system? Can we not all agree the system must exist for patients? So, the question then becomes “How to provide more care to more patients?” In that context, how is it ethical to preserve a system that cannot meet patient demand despite almost fifty years of trying?

How comprehensive a system can we afford? Do Canadians want modern health care that keeps up with change, or do they want an archaic system designed for fifty years ago? As pharmaceuticals become more and more prominent in treatment options, many Canadians want to include pharmacare in our country. However, the cost of Canada’s government funded system makes it difficult to move forward in publicly funding other areas of care such as eye care, dental care, and newer pharmaceuticals for cancer and other previously untreatable diseases.  How can a better balance of services be achieved that will meet our expectations for an advanced health care system?

There’s the important issue of “Universality”. Do Canadians want universal health care coverage in theory or in reality? The term “universal” does not mean “government funded”. It simply means coverage for everyone. There are many ways to provide coverage for everyone in a truly universal system that creates access instead of imposed rationing. Many other countries have hybrid systems for medically necessary care and manage to achieve universality at lower cost and with better outcomes. Why aren’t we looking at and learning from other better performing systems? And, what of portability of care in Canada? Do Canadians want a system that provides similar services across the country, or do they want the system to be determined simply by the degree of rationing required in each province?

What is to be done about the under-utilized infrastructure and medical workforce? What do Canadians want, more government rationing of care or more ways for more patients to access care? Canada has less than the average number of physicians per capita compared to many developed countries yet we cannot fully employ our medical workforce due to costs associated with utilization of government funded services. Operating rooms and surgeons sit idle, hospital beds may exist but are “unfunded”. Hybrid systems of other developed countries have more providers, more hospital beds, and better access to medically necessary care at lower cost than Canada’s health care system.

Canadians must have this honest and difficult discussion about our health care system if we are to create a truly universal system with quality health care that addresses patient need. I believe the B.C. Charter Challenge will help in this dialogue. Contrary to rhetoric about the case being an attack on Medicare, it is not. Given the history of our country, Medicare will continue, but we must acknowledge its faults. A more robust health care system is needed, one that is truly universal, comprehensive, and accessible and not so negatively impacted by government short comings both in funding and in vision.

The B.C. case will bring our health care system into much clearer focus. It will drill to the core of the debate. If we are to give patients the dignity and respect they deserve, then we must acknowledge that they are part of the solution and give them the necessary freedoms that are currently lacking.

Reader Comments (556)

Thanks for the post CICM. It's troubling. It's bizarre that the OMA would take the position that Sections cannot communicate with their own membership through the organization to which the dues are paid. We saw a disclaimer being added to the SGFP communications a few years ago. Who does the OMA really represent?


"Interesting that the OMA was purposely editing section communications into a format that members could not read or not sending out communications at all prior to the ballot."
Can you provide proof of this statement?
September 19, 2016 | Unregistered CommenterMerrilee Fullerton (realist)
5 OMA emails in one day, this might be a record.

The membership re-engagement push is on. Unforunately for the OMA, it's analogous to being pursued by someone you find odd/creepy/disturbing.
September 19, 2016 | Unregistered Commenterdocinthepark
"Can you provide proof of this statement? "

Sent to your info@merrileefullerton.com.
September 20, 2016 | Unregistered CommenterCanary in a Coal Mine
"Can you provide proof of this statement? "

Sent to your info@merrileefullerton.com.
September 20, 2016 | Unregistered CommenterCanary in a Coal Mine
Thank you CICM.
September 20, 2016 | Unregistered CommenterMerrilee Fullerton (realist)
Section on Emergency Medicine and the Emergency Physicians of Ontario

September 16, 2016

On August 3rd, 2016 the Section on Emergency Medicine sought to send an urgent time sensitive communication to our members. The current OMA Executive failed to send out our communication and we officially complained. This is our reply which we are releasing as an open letter.

An Open Letter to the OMA President on the recent failure of the current OMA Executive to send out an official, urgent and time sensitive Section on Emergency Medicine communication.

Dear Dr. Walley,

Thank you for your email dated August 26th (attached). Our Section appreciates your reply to our official complaint. However, the information that you have provided is not entirely accurate or complete. We will start with a review of our Section PSA communication timelines and OMA responses below:

1) On August 3rd at 127 pm our Section sent a communication to the OMA regarding the tentative Physician Services Agreement (TPSA), boldly marked as urgent, for immediate release to all Section members.

2) On August 3rd at 129 pm OMA staff acknowledged receipt of the communication, advising that they will "process this communication and let (us) know once it has been sent".

3) On August 5th at 632 pm our Section again emailed OMA staff expressing disappointment that our communication had not been distributed. We again asked that the communication be sent urgently. Another reminder was sent to a different OMA staff member at 641 pm on August 5th as well.

4) On August 8th at 1024 am we were advised that OMA staff "have followed up with our communications staff and will let you know as soon as we have more information and an estimated send time". Note that, at this time, we were nearly 5 days out from our initial, urgent request to release our communication immediately.

5) After August 8th, there were further emails. Repeatedly, OMA staff sent our Section emails with attachments that we could not open, in a winmail.dat format. We advised the OMA we could not open these attachments and therefore had no idea what the current OMA Executive was attempting to edit in our communication.

6) On August 12th, OMA staff started a new email trail, and again attached a winmail.dat document edit of our urgent time sensitive communication. Note that this is now 9 days after we sent our urgent, time sensitive communication.

7) On August 12th at 1028 pm we again advised OMA staff that our Section was unable to read the attachments sent as winmail.dat file, and again requested a .doc or .pdf version of your edits to our now, extremely dated communication request. We specifically pointed out to OMA staff that our Section had recently received a .pdf file from the OMA regarding a Ministry of Transport reporting issue.

8) On August 15th at 1133 am (one day after the OMA General Membership meeting) our Section finally received the requested copies of the OMA Executive's highlighted edit (a single sentence) for our review, in both .doc and .pdf formats. Note that this is the first time we were provided with a readable edit of our communication -- 12 days after our urgent request, and one day after the OMA General meeting.

We have copied and pasted the sentence hi-lighted by the OMA Executive below.

"As a major OMA Section we expect that the OMA will issue new proxy forms according to the judge's ruling below and in full consultation with and approval by the Coalition"

You will note that on August 3rd when we forwarded this communication to the OMA, this sentence was entirely correct and timely. The OMA only issued new proxy forms after the Section requested distribution of this urgent, time-sensitive communication. Regardless of the timeliness of this sentence, there was no reason for the OMA Executive to hold up then completely fail to send our communication. The OMA attaches a broad disclaimer to all Section communications. This OMA disclaimer specifically notes that the OMA does not warrant the timeliness or accuracy of Section communications. A copy of the OMA disclaimer will be found attached to this communication.

Of course, after the OMA General meeting, our communication became irrelevant as the meeting and voting had already taken place. We hold the current OMA Executive, as gatekeepers and censors of our Section communication responsible for denying us access to our membership.

This was a critical time for our Section, and a critical time for the future of our profession, as you have noted in your regular Presidential messages to the general membership.

The current OMA Executive's failure to distribute our communication in a timely matter greatly disadvantaged our position vis-a-vis the voting process at the specially convened OMA General Membership meeting held on August 14th.

We must ask, were Presidential Updates subject to such unjust delays during this time period?
Also, why did the current OMA Executive only permit the posting of pro-TPSA opinions on the OMA web site? By not posting all Section and District positions, including those that did not support the TPSA, the current OMA Executive was acted grossly undemocratically. These actions are counter to that of a representative Association.

In addition, the new, special communication tool that you have noted does not "guarantee that emails will go out, unedited and unreviewed, within 24 hours.” In fact, the email preamble to the new communication tool very clearly stated that communications will be reviewed, and its utilization would require our Section to sign a multipage contract before utilizing the service. We are not going a sign a multipage legal contract just for the ‘privilege’ of communicating with our members. Our ability to communicate with our membership is a right. Setting all that aside, you have told us point blank that this alternate communications network is vastly incomplete as many members have unsubscribed. In effect then the only way to communicate with our full membership is to go through the regular OMA channels that for ten years has held-up, blocked, edited, and censored our communications.

Furthermore, nothing in the OMA bylaws, or the PIPEDA/CASL legislation you reference prevents the OMA from releasing Section contact information by consenting Section members to their respective Executives. In fact, as we have pointed out in prior emails, this would be entirely consistent with the official OMA Policy on this matter, including the binding resolution passed by Council in Nov 2015 that the OMA release email lists to the Sections.

And finally, in relation to member privacy, do members have a way of unsubscribing from Presidential “robocalls” to their private telephone numbers, should they occur again in the future?

The actions of the current OMA Executive in these matters have been shameful. Authoritarian maneuvers like these are among the reasons that many Section leaders and much of the general membership no longer trust the current OMA Executive.

Sincerely,
******** MD
September 20, 2016 | Unregistered CommenterMerrilee Fullerton (realist)
Unbelievable.

$2,196 in annual dues and this is what we get?
September 20, 2016 | Unregistered Commentereklimek
Dr. Walley should resign.
September 20, 2016 | Unregistered CommenterCanary in a Coal Mine
It's simply about aligning with government.
The best solutions come from friction at the interface of diverse views. I suppose a steamroller is not aware of friction.
How do we bring a more balanced approach to health care "transformation" when it is being driven by Groupthink?

Believe, Align, or Shut Up is not my idea of collaboration.

It's simply self-preservation by the OMA. Good? Bad? Depends on who you are but when the sharing of relevant information is squashed, the sense is that there is effort prevent freedom of discussion.
September 20, 2016 | Unregistered CommenterMerrilee Fullerton
R

People forget there is agenda. Survive as the changes are forced. Central has pick its agenda of social justice by capping physicians with a single pot. They will squeeze that pot, because the resistance is not that bad.
September 20, 2016 | Unregistered CommenterMovingforwardOntario
R:

Without passing judgement on central, MDs,in Ontario,need to get they are, possibly, in the "perfect storm" of changing policy.

Both federally and provincially, have signed onto UN 2030 agenda. That mandates income redistribution. The "rich" get less, the "poor" get more. This is "regression to the mean" policy. Average everything out. A concentration of power to the political level.

Within Ontario, a health care monopoly exists. One pot.

That pot has one group that is well off, as group (MDs). Almost half of that group accepts "averaging" in that they do get "easier work" than those whom work piece work (fee for service). However 92% of the MDs whom did vote are concerned the system is failing them, and be that, failing good patient care. They recognizing that overt rationing will be coming, and do not want to own that.

Central doesn't see that. It needs to move things ahead, despite any concerns. More people are being helped, than hurt, on a population basis. On an individual basis, fewer and fewer politicians care. The population is being served.

Thus the MDs will be hit,in that as a government funded group,they have too much wealth. Things will not be reversed. Accept it, or leave.The politicians have made a global commitment to "equity" in a system where "equity" can not be obtained. a"catch 22"issue. Policy and reality can not meet.

There are fewer and fewer places, that have better solutions.

MDs in Ontario have the additional issue, in that their "union" has accepted the "buy in", but does not wish to tell its members.

Stay away from the margins,you haven't seen how complex this is going to get.

The plan is good, if you accept it!
September 20, 2016 | Unregistered CommenterMovingforwardOntario
I hear you mfO. The issue I have is that what you describe does not solve our problems, it just concentrates the power to a very small group of people.

How's that Charter Challenge going anyway? Has the OMA made any progress? Filing anything?
September 21, 2016 | Unregistered CommenterMerrilee Fullerton
R:

Power.No one wants the power structure to change..
September 21, 2016 | Unregistered CommenterMovingforwardOntario
R:

Power.No one wants the power structure to change..
September 21, 2016 | Unregistered CommenterMovingforwardOntario
R

Over time, we will being moving to a more authouritian style of government. Do as you are told, not as you wish.

It is a changing world.
September 21, 2016 | Unregistered CommenterMovingforwardOntario
Hon. Eric Hoskins: Mr. Speaker, I am doing absolutely everything I can. I think it’s important for all of us to understand that difficult decisions such as this are governed by the Health Insurance Act and the associated regulations. I have absolutely no discretion or ability to approve or reject an application that comes forward in that context. To do so would be a violation of that act by myself.
I do understand, having spoken with Mayor Macmillan, that his prognosis may have in fact changed for the better in terms of the staging of his illness. I believe it’s important that as a society, from the bureaucrats to the highest level of clinical experts, we demonstrate the flexibility, if a condition changes, if a prognosis changes, to have the ability to provide the appropriate and best course of care in that case.

http://www.ontla.on.ca/web/house-proceedings/house_detail.do?Date=2016-09-15&Parl=41&Sess=2&locale=en#P671_152045
September 21, 2016 | Unregistered Commentereklimek
Mr. Patrick Brown:
The Premier let her minister pick a fight with our province’s physicians. He singled out doctors’ compensation, but implied that overhead was part of salaries. If you counted money that way and included overhead in terms of compensation, the highest-paid doctor in the province of Ontario would be the Minister of Health at $7.7 million.
Does the Premier believe it’s okay to allow the Minister of Health to include staff—

Hon. Eric Hoskins: Of course, he’s including my entire office: all of the assistant deputy ministers and the deputy minister. But my overhead would be 99.5%. What I need to know—because he talked about Scarborough and the recent by-election—we’d like to know whether the—
Interjection.
The Speaker (Hon. Dave Levac): The member from Leeds–Grenville will withdraw.
Mr. Steve Clark: Withdrawn.
Interjection.
The Speaker (Hon. Dave Levac): Minister of Transportation.
Minister.
Hon. Eric Hoskins: I would like to know from the member opposite whether his party would immediately offer binding arbitration before negotiations. They have a responsibility to the people of Ontario. Because what we’ve seen from Scarborough, what we’ve seen from the sex ed question, is that the party across from me will say what they believe is in their political interest in the moment.
Will you support binding arbitration prior to negotiations? Yes or no?
September 21, 2016 | Unregistered Commentereklimek
Interesting email from the Coalition...where the Charter Challenge is concerned it is evident that the OMA is simply going through the motions....according to Court documents there has been squat activity over the last 11 months....the OMA's apathy on the matter is palpable.

The OMA promised an independent review after the dissidents thwarted it this summer with its overwhelmingly negative vote....it promptly carried out a self review carried out those very same individuals who made the original mal decision that the membership rejected....the OMA Board then promptly accepted their predictable conclusions (and may well present them to Council in November) .

It is evident that the OMA's goal is to have the government's Primary Care scheme and Bill 210 nouveau implemented no matter what....one anticipates that it will present the recommendations of its self review to Council in November ( a Council that has been purged in recent years) which will be persuaded to vote for it....perhaps there will be motions passed to head off any more embarrassments from the grass roots such as the Coalition.

So, November 2016 may well be " it"....with the government pushing forwards with its schemes with the stamp of approval of its creature, the OMA.
September 21, 2016 | Unregistered CommenterAndris
There is agreement at senior levels of central and the OMA,on the agenda. The voting rejection by 92% has shocked both parties(central and the OMA), but the agenda will be obtained. The policy of "social justice" mandates the MD population must be constrained for the good of the population.

For those who believe it can be stopped, it can not be. Quebec has shown,most MDs will not move,despite issues affecting their jobs. The clever figure out ways around the issues,the average ones just settle in and accept. For those who don't get it,the various Ministries share policies that have worked.The biggest issues they are having are getting MDs out of urban areas. Bill 210 will address that by limiting spots by region,forcing new MDs to take the only spots available in the rural areas.
September 21, 2016 | Unregistered CommenterMovingforwardOntario
Judging by the tone of this latest coalition email I gather the animal has awoken again, and it's angry. I predict more fireworks this fall and won't be surprised if they push the OMA pres to step down.

The coalition and it's followers will however have to up their game to have influence on the political process. Job or strike action may be the only way to show the MOH they mean business. Legal avenues won't be heard until long after the system is wrecked further and mangled beyond recognition.
September 21, 2016 | Unregistered Commenterdocinthepark
" A bad system will beat a good person every time".( W. Edwards Deming).

A bad system is about to get worse....old Norwegian saying, " No matter how bad things are, they can get worse"...and it will.
September 21, 2016 | Unregistered CommenterAndris
Mfo most Quebec MDs can't move because their English is not good enough. Likewise many of us anglophones could not pass the French test required to practice in Quebec.
September 22, 2016 | Unregistered CommenterCanary in a Coal Mine
CICM

Most MDs will not move.
September 22, 2016 | Unregistered CommenterMovingforwardOntario
They don't need to move. They adjust what they provide. Unintended consequences of over-regulation. I've seen it before.
September 22, 2016 | Unregistered CommenterMerrilee Fullerton
I have hope that we can look ahead and adjust for the future but we need the freedom to innovate
September 22, 2016 | Unregistered CommenterMerrilee Fullerton
<<we need the freedom to innovate>> - Dr. F

Nope. Sorry. Central now has a "Chief Innovation Officer" for that.
September 22, 2016 | Unregistered CommenterExecutive Lead Blogger
"The Office of the Chief Health Innovation Strategist (OCHIS) is a catalyst to help accelerate health technology commercialization efforts in Ontario. OCHIS works on behalf of health technology innovators to remove barriers and improve access to Ontario’s health care system. Our goal is to grow businesses and build a health innovation ecosystem in Ontario.

Purpose
To drive collaboration across the health care system to accelerate the adoption and diffusion of new innovative health technologies and processes to:
Improve patient outcomes (in accordance with the Ministry of Health and Long-Term Care’s Patients First: Action Plan for Health Care)
Add value to the system
Create jobs in Ontario.
September 23, 2016 | Unregistered Commentereklimek
"The Office of the Chief Health Innovation Strategist (OCHIS) is a catalyst to help accelerate health technology commercialization efforts in Ontario. OCHIS works on behalf of health technology innovators to remove barriers and improve access to Ontario’s health care system. Our goal is to grow businesses and build a health innovation ecosystem in Ontario.

Purpose
To drive collaboration across the health care system to accelerate the adoption and diffusion of new innovative health technologies and processes to:
Improve patient outcomes (in accordance with the Ministry of Health and Long-Term Care’s Patients First: Action Plan for Health Care)
Add value to the system
Create jobs in Ontario.
September 23, 2016 | Unregistered Commentereklimek
This is a bit off topic but for those of you who live in Ottawa can you recommend a neurologist whose area of expertise or interest is in assessing lesions of the prefrontal cortex?

Similar interests to this neurologist.
http://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=26439
September 23, 2016 | Unregistered CommenterCanary in a Coal Mine
I'd be happy never to hear "health ecosystem" ever again.
CICM, I'm out of that loop. Eklimek might know.
September 23, 2016 | Unregistered CommenterMerrilee Fullerton
Cicm

Will inquire on your behalf
September 23, 2016 | Unregistered CommenterEklimek
2016 Mandate letters

No mention in any letter of mandate of resolving the OMA contract issue. Not an item for central. They know the budget for the next 2 years. Fixed in stone.
September 23, 2016 | Unregistered CommenterMovingforwardOntario
Cicm

PIERRE Bourque
September 24, 2016 | Unregistered CommenterEklimek
Bill 210 will passed this session. Regional LHINs get established, then affordable care organization (ACOs) get started.
September 24, 2016 | Unregistered CommenterMovingforwardOntario
Thanks Eklimek.for the suggestion.
September 24, 2016 | Unregistered CommenterCanary in a Coal Mine
Yvridiophobia...Greek for an overwhelming and irrational fear of things that are hybrid.

Those that oppose the introduction of a hybrid health care system as per the top rated countries, in fact hate it with an overwhelming and irrational fear of a hybrid health care system can be described as being Yvridiophobic.

As for the introduction of ACO's....any time frame?

In view of the fact that Saskatchewan had the forethought of introducing SSI in 2010, with a roaring success ....are the Feds objecting to it?....as far as I can see it doesn't violate the CHA...it is presumed that our own government has turned a blind eye to it on ideological Yvridiophobic grounds...
September 24, 2016 | Unregistered CommenterAndris
With plenty of new resources rolling in,and morectome,with the new mandate letters, two new major programs will be started.

First basic income guarantee for all individuals.

Second, pharmacare
September 25, 2016 | Unregistered CommenterMovingforwardOntario
Crackdown on extra-billing is long overdue: Walkom

Federal Health Minister Jane Philpott has served notice that she will enforce the Canada Health Act in Quebec. Good for her.

https://www.thestar.com/opinion/commentary/2016/09/22/crackdown-on-extra-billing-is-long-overdue-walkom.html
September 26, 2016 | Unregistered CommenterCanary in a Coal Mine
"Politicians tell us that there is no more money for healthcare. And in many ways, doctors have already given away all the important levers of control.

Maybe it’s time to stop fighting about money and discuss “a little rebellion” instead?"

http://shawnwhatley.com/money/
September 26, 2016 | Unregistered CommenterCanary in a Coal Mine
No more money for doctors in healthcare.

Is more money for healthcare.
September 26, 2016 | Unregistered CommenterMovingforwardOntario
Less money for the medical profession is more money for the health care system which means more money for the burgeoning health care bureacracy...the essential element of Primary Care Reform, Bill 210
September 26, 2016 | Unregistered CommenterAndris
The Ontario election cycle starts ...

“Net zero has been a parameter of negotiations for some time and so now . . . we’re going into a new round of negotiations recognizing . . . we need to continue to find ways to make decisions on compensation, on service delivery, that recognize the needs of the system — and the needs of the individuals who work in the system.” pkw
September 26, 2016 | Unregistered CommenterEklimek
Which vested interest group, has the most available votes,for money,not good policy.

Politics is simple.
September 26, 2016 | Unregistered CommenterMovingforwardOntario
The ever sensible Swiss have just had a referrendum on the idea of giving an unconditional basic income ( the First Nation to do so ) to all of its citizens...and they rejected it ...76.9% voted NO...they foresaw increased joblessness , the weakening of the economy, with the scrapping of social and pension payments .

Finland is now considering a referendum on the matter.

All that is required in Switzerland is a 100,000 signatures to trigger a referendum.

I gather that our essentially bankrupt Ontario government intends to introduce a basic income guarantee for its citizens that the solvent prudent Swiss people just rejected ...which is why the Swiss are rich and solvent and will remain so even as Ontario is becoming increasingly impoverished and insolvent.
September 26, 2016 | Unregistered CommenterAndris
With much fanfare in April 2016 the MOH announced it was to now vaccinate young boys in Ontario for HPV.
https://news.ontario.ca/mohltc/en/2016/4/ontario-expanding-hpv-vaccine-program-to-include-boys.html

The best vaccine available produced by Merck is Gardasil 9 which now covers nine HPV serotypes or five more than the older Gardasil. Gardasil 9 became available in December 2015.

The problem is that the MOH has decided to purchase the older quadravalent Gardasil and not the newer 9-valent vaccine. So Ontario kids are to receive an older and cheaper version of the vaccine in order to save the government money when in fact the $US50 retail price difference is likely close to being inconsequential when one factors in the total cost of running the program with salaried nurses and administrators attending every school in the province.

Realist I think the PC health critic should be raising this in the Legislature. Why if I prescribe the HPV vaccine for a 20 year old do they receive Gardasil 9 but the young boys and girls of Ontario are to receive the older quadravalent vaccine? Did the MOH and Merck strike a deal to use up all the older vaccine in the country before they switch to the newer one?

Just asking.
September 27, 2016 | Unregistered CommenterCanary in a Coal Mine
Good question CICM!
More corners cut..
September 28, 2016 | Unregistered CommenterMerrilee Fullerton
Wow...you take your eye off the ball for a moment and poof...it moves. Sounds like a character from Dr. Who.

When did Lorelle Taylor move from Assistant Deputy Minister to Associate Deputy Minister?

◙ 3 Associate Deputy Ministers
◙ 14 Assistant Deputy Ministers (including the Chief Health Innovation Strategist and Chief Medical Officer of Health)

Also noteworthy are three LHIN-related boxes:

◙ ADM LHIN Corporate Services Initiative
◙ Director LHIN Liaison
◙ Director, LHIN Renewal

It is just like what mfO continues to reinforce with us...the bureaucracy keeps growing!
September 28, 2016 | Unregistered CommenterExecutive Lead Blogger
As central adds staff, it means more meetings, more consultants, etc, all whom have more expenses. Since the budget is not growing, overall, more efficiencies need to be found out on the front lines.
September 28, 2016 | Unregistered CommenterMovingforwardOntario

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