For the last 30 years or so, Canadians have repeatedly flagged healthcare as the most important national concern and the issue they want their political leaders to prioritize. Surveys and studies and polls and panels -- there have been plenty -- all come up with the same finding: Canadians care about healthcare.
For almost 30 years I've tried to help Canadians understand their health system and their medical care. In that time, I've seen tremendous advances in medicine. Modern medicine has become so specialized that many physicians treat specific syndromes and body parts, and the patient herself gets lost in the process. We have filled our temples of medicine with such bedazzling hi-tech tools that we've forgotten that we should treat people where they live. In our desire to cure, we over-treat.
Recently, I was fortunate to attend the Global Symposium on the Role of Physicians and National Medical Associations in Addressing Health Equity and the Social Determinants of Health held in London, England. I sat down with Dr. Simpson to explore the stories, the evidence and the politics that come into play when doctors are actors for social change.
Cities have to spend this money, taken from local taxpayers, because Canada's medicare system is the only universal, public health care system among developed countries that does not include universal coverage of prescription drugs. It is not wrong for cities to care for their employees. But leaving these costs to the cities makes about as much sense as requiring every homeowner to maintain the roads and infrastructure surrounding their property. Here's why.
Desensitization, which involves gradual reintroduction of a drug, starting with very small doses, makes it possible for some people to take a medication that would normally trigger an allergic reaction. The procedure, of course, must be done under direct supervision of a health-care professional in case you develop a severe reaction.
I had a vision of cultivating a practice where patients felt heard and cared for, and where I could provide full-spectrum family medicine care, including obstetrical care. My practice embraced the principles of patient-centered collaborative care. It employed the latest in 21st-century technology. I loved my work and my patients. But after five years of constant fighting with multiple private insurance companies in order to get paid, I ultimately made the heart-wrenching decision to close my practice down. The emotional stress was too great.
Today it seems that we're bombarded with news about some great new medical hope or fear of the moment, and I worry that we are all suffering from health-information overload. Fortunately, there are a few simple steps we can take when reading medical news that will help us to put it all in perspective.
A case emerged in response to an audit of Cambie Surgeries, a private for-profit corporation by the B.C. Medical Services Commission. The audit found from a sample of Cambie's billing that it (and another private clinic) had charged patients hundreds of thousands of dollars more for health services covered by medicare than is permitted by law. Dr. Day and Cambie Surgeries claim that the law preventing a doctor charging patients more is unconstitutional.
A new study in the Canadian Medical Association Journal with health economist Steve Morgan as lead author argues a national universal care drug program would not result in substantial tax increases. It seems the time is ripe to finally complete our universal system of public healthcare coverage by adding a national public drug plan. If anything, these cautions should serve as guideposts to make sure a new national drug plan is not only effective but also designed in a fiscally sustainable manner.
Last week, much ado was made about a fascinating story coming out of the United Kingdom. A thousand year old remedy for a common eye problem -- styes -- was tested in the lab against the pathogen, Methicillin Resistant Staphylococcus aureus (MRSA). The concoction was not only effective at killing the bacterium but also outperformed a common antibiotic, vancomycin.
Experiencing a medical emergency is an incredibly stressful experience for patients and their families. This stress should not be compounded by worries about getting an ambulance bill they can't afford. As physicians, we know the importance of the first few minutes of an emergency situation, and the crucial role of Emergency Medical Services (EMS) in saving lives. And yet ambulance fees remain a significant barrier to people receiving necessary care across Canada.
A federal election could be called any time in the next few months, judging by the media coverage and the ramping up of political activity. Many issues have been crowding into the media headlines in anticipation of the election -- but with a notable absence of any consideration of healthcare by our political parties. Apparently the subject is still on the minds of the electorate though, at least amongst my own circle of friends, colleagues and neighbours, many of whom note the leading edge of our baby-boomers have now turned 65.
So when no evidence exists to show that e-cigarettes are safe for long-term use by humans, when laboratory studies demonstrate worrisome potential physiological risks, and when strong evidence is mounting that e-cigarettes are leading our youth to consider smoking tobacco cigarettes, I would contend that caution here is the only reasonable approach.
In a public healthcare system, too often system failures end up as fodder for Question Period battles rather than impetus for learning. When investments have been made in new models of health service funding and delivery that don't work out, it can be difficult to proclaim failure as a means to move toward success.
The continuum of patient-centred care could include a consistency of health care professionals familiar with a patient's case and who are buttressed by the flow of relevant patient history and investigations. Patient centredness by the professional care-giver would target care, communication and common ground or a shared understanding between those receiving the care and those providing it.
Employers want their drug plans to be as competitive as those offered by other employers. So what happens when the norm is to cover all new drugs at any cost, even if the drugs do not provide additional therapeutic value? Well, the end result is that everyone buys "generous" plans instead of increasing employee compensation. Everyone we spoke with agrees about the need to educate employees and employers alike. And in fact, everyone agrees (even insurers) that exorbitant drug costs are a big issue for Canadians.
Last week in Berlin more than 15 countries pledged over US$7.5 billion to buy vaccines for the children of the world's poorest countries for the next five years. While this is great news for the millions of children living in the 73 countries supported by Gavi, there were other big winners: the pharmaceutical companies that benefit from the soaring vaccine prices they charge for vaccines worldwide.
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.