Although advertising of prescription medicines to the public is generally banned in Canada on public health grounds, shifts in administrative policy have allowed two types of ads since late 2000: "reminder" ads that mention a brand name, but make no health claims; and "help-seeking" ads that mention a condition, but do not state a brand or company name. We have identified six main weaknesses in how Health Canada regulates this advertising.
While policy should be evidence-informed rather than belief-based, the complexity of health-system change makes it difficult to draw a straight line from one evidence-based improvement to health-system change as a whole. Improving the quality and quantity of evidence-based decision-making is perhaps the greatest challenge in systematically devising policies for bending the cost curve.
The Liberal government of New Brunswick appears to be stepping back from the brink of mandatory prescription drug insurance. And so they should. The drug plan chosen by the Conservatives was designed on a false premise: that the private sector can better manage things than government can. In many sectors, that might be true. But not in health care.
Most Canadians probably don't realize that health care in Canada is quietly undergoing a major transformation in funding that could significantly impact patients. Three provinces -- Quebec, Ontario and British Columbia -- are implementing a new funding model for hospitals and other provinces are watching with interest.
At present, this time-consuming service is an uninsured one and its accompanying opportunity cost -- taking physicians away from attending to other patients on a fee-for-service basis -- is borne solely by the physician. Because the College considers the medical document to access medical marijuana equivalent to a prescription and, since prescriptions and activities related to prescriptions are insured services, physicians cannot charge patients; fair enough. But what about the for-profit corporations who are benefitting at the physicians' expense?
Last fall when I visited Canada, I met a Toronto doctor named Gary Bloch who has developed a poverty tool for medical practitioners. Bloch's idea was to zoom in on the social determinants of health -- food, housing, transportation -- all poverty markers linked to bad health and poor health outcomes.
Scientific evidence does not support the presumption of Bill 10 that there will be a reduction in bureaucracy with the centralization of decision-making. National and international experience has shown time and time again that the proposed reform will not have the desired effects and, in fact, will make healthcare delivery more complex.
In the wake of new health expenditure data from the Canadian Institute for Health Information (CIHI), the evidence continues to mount that Canadian public health expenditure growth is moderating. Moreover, adjusting for inflation and population growth, per capita provincial and territorial government health expenditures have actually declined since their peak in 2010.
If the law is changed, physicians must be given a choice as to whether or not they will practice assisted suicide. In all likelihood there will be a limited number of physicians who actually offer the service, and, just as doctors who prescribe methadone are specifically registered to do so through their governing bodies, likely similar regulations will be imposed on physicians who do elect to practice assisted suicide. For that reason, in the event physician-assisted-suicide becomes legal, there needs to be a corresponding immunity protecting doctors who have acted in good faith and that prevents family members from suing them.
Dr. Mel Borins wants to you to be healthy and he wants you equipped with more than just your family doctor's orders. A family physician and associate professor of medicine at the University of Toronto, Borins is a leading expert in health and wellness who has advocated evidence-based, alternative medicine for decades.
This past week, the Supreme Court of Canada has been hearing an appeal by the BC Civil Liberties Association that could grant terminally ill Canadians the right to assisted suicide. The Court faces a daunting task. Palliative care cannot eliminate every facet of end-of life suffering. Preserving dignity for patients at the end of life requires a steadfast commitment to non-abandonment, meticulous management of suffering and a tone of care marked by kindness. In response to this dignity conserving approach, the former head of the Hemlock Society conceded that "if most individuals with a terminal illness were treated this way, the incentive to end their lives would be greatly reduced."
In recent years, provincial governments and medical associations have introduced various measures to speed up the time it takes for patients to see their primary health care providers. But relatively prompt access is still not available to a majority of Canadians. When patients can't see their family physicians, they often head to the nearest hospital -- and that contributes to longer emergency department wait times. So the issue of access has wide ramifications for the health care system.
Better pharmacare for all Canadians will be difficult to achieve without the federal government at the table. The government of Canada could lead on this issue in a way that no single province or territory can do, by supporting the development of a single national list of drugs to be covered for all Canadians and by harnessing the purchasing power of the whole nation to get the best possible bang for our buck.
Studies have shown that inadequate follow-up care after emergency room visits is common, with up to 30 per cent of patients with chronic illnesses not seeing a doctor within 30 days after they've been sent home from the ER. Why? In part, it's because fewer than one in three primary care physicians in Canada report being notified when their patients visit an emergency department.
Current media reports have highlighted that doctors can legally demand a fee to fill out this form because it is not an insured service. But really, the difference between the medical document and a prescription is clearly one of semantics. By paying hundreds of dollars to have doctors fill out medical documents, we are inadvertently reinforcing the stigma surrounding cannabis for medical purposes -- the idea that there is something "illegitimate" about cannabis' therapeutic potential and the patients who use it.
A recent court challenge before the British Columbia Supreme Court threatened to change the rules of the game for the Canadian healthcare system -- should the challenge have made its way to the Supreme Court of Canada and found success there. How our health system should be reformed, and in what measures, is nothing short of a national pastime in Canada. Too bad many get the facts wrong. Here are a few basics everyone should know.
It seems there is a disconnect between Canadians' personal views and their idea of how well the health system works for society at large. Canadians tout the public health care model as a big part of our national identity, say their experiences are mostly positive -- but then worry the system is failing.
This isn't just an American problem. Hundreds of thousands of Canadian children are growing up without enough. Low-income children, especially minorities and aboriginals, are growing up at an increased risk of preventable diseases -- diseases both classically medical and mental health related that arise as a result of their early living conditions and will affect us all. These numbers don't simply represent difficult childhoods; they mark a huge group of Canadians who are growing up without the supportive environments they need to develop into healthy adults.
A 2013 EKOS poll showed that 78 per cent of Canadians are in favour of establishing a universal pharmacare program in Canada. In spite of self-serving lobby groups who insist that the current system is working well and should not be reformed, establishing a national drug plan is the best thing to do for patients, for employers, for employees, for taxpayers, and for the Canadian economy.
he false notion that opioids are safe, effective treatments for chronic pain was inculcated by the companies that manufacture them, with self-styled "experts" preaching this gospel to front-line physicians. Incredibly, this happened in the absence of good evidence that the benefits of long-term opioid use outweigh the risks.
The situation in Canada is not different from the rest of the world. The country is already feeling the consequences of climate change: diminishing quality and quantity of water, increasing pollens and other allergens, coastal erosion, road and infrastructure degradation and floods. The health consequences of those climate change impacts are already being strongly felt.