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By Ross Sutherland, on December 20, 2012, at 2:46 pm Every day there are stories of how the fragmentation of health care hurts patients. A few, when a patient dies, make the media. Most often fragmentation causes small inconveniences, but there are many and they affect patients in very real ways.
December 19th’s story is about a patient with a serious chronic illness. She lives at home and manages her illness fairly well. Monitoring her condition requires weekly blood work which is taken by a home care nurse through a PIC line, a semi-permanent intravenous access port. She then walks the blood a fairly (Read more…)
By Ross Sutherland, on October 28, 2012, at 8:31 pm This year Independent Health Facilities (IHFs) in Ontario will start paying an annual administrative fee to cover the costs of their quality control program plus a new fee for the direct costs of each quality assessment. Prior to June 2012 the Ministry of Health had paid the College of Physicians and Surgeons out of Ministry funds to run the quality program.
The administrative fee per license is set at 860 dollars for the first year. The amount per license is not large but it is continuous. Many IHFs also have more than one license, for instance, they may be (Read more…)
By Ross Sutherland, on October 14, 2012, at 2:52 pm Andrew Duffy, in an article syndicated by Postmedia, made the logical equivalent of mixing metaphors when he used the Canada Health Act (CHA) to legitimize the use of private clinics. The result, as with mixed metaphors, is a “head-scratching” argument in favour of Centric’s takeover of the Shouldice Clinic.
Duffy uses a confidential government manual found by Jeffery Simpson, author of a recent book on Canada’s health care system, to argue that the CHA was not intended to prohibit the use of for-profit companies to deliver essential medical services. This expose, complete with grainy pictures, is used to undermine what (Read more…)
By Ross Sutherland, on August 30, 2012, at 11:52 am A new study by the Health Care Compliance Association (HCCA) in the United States found that non-profit health care institutions are audited by Medicare more often than their for-profit counterparts: 6 times per year compared to 4 for the for-profit facilities. 47% of non-profits were also audited by more than one government agency compared to only 27% of the for-profits.
No explanation was given for these findings, but the authors found the results “surprising”. They are correct: it makes no sense. Media headlines in the last year include many reports of fraud by major drug companies, hundreds of millions of dollars
. . . → Read More: False positive: private profit in Canada’s health care: Monitoring Benefits For-Profit Health Care
By Ross Sutherland, on August 19, 2012, at 5:18 pm One of Ontario’s little known private secrets is that most methadone, a staple of opiate addiction treatment, is primarily provided by for-profit clinics. Last week a doctor who works in one of these private clinics casually told me that her contract with the clinic forbade her from working for another methadone provider.
The context for the comment was that a clinic was looking for a part-time physician and she could not apply for the job. I guess her “employer” is concerned that she might steer some of her patients, and their money, to the other clinic.
This artificial barrier to
. . . → Read More: False positive: private profit in Canada’s health care: Methadone Clinic Limits Doctor’s Employment
By Ross Sutherland, on June 23, 2012, at 5:49 pm It seems that the government is now using changes in the OHIP fee schedule give more work to the for-profit laboratory corporations. This reduction in patient access is documented by Rita Marshall in the June 22 edition of the Mitchell Advocate. Mitchell is a town in the Municipality of West Perth near Stratford Ontario.
Don’t like the fact that Mitchell Family Doctors send patients out-of-town for blood work now? Blame the province, says the office.
“Blood work is an important diagnostic tool and we were pleased to provide that service to our patients so they did not have to leave
. . . → Read More: False positive: private profit in Canada’s health care: More Local Lab Service Cuts
By False Postitive: for profit medical labs, on May 22, 2012, at 8:09 am Who said these words and when?
We have three broad objectives: to develop a more community-based health care system to ensure that patients receive quality medical care as close to home as possible; that the procedures are carried out in a safe, effective manner; and to regulate facilities so that they are appropriately located and established in a planned way.
What we want to see is the freeing up of hospitals to do what they do best: provide the patient care and the patient care services that require a hospital setting. As a result, our institutions will be free to
. . . → Read More: False positive: private profit in Canada’s health care: Independent Health Facilities and For-Profit Delivery: Reassuring Words, Troubling Results
By False Postitive: for profit medical labs, on May 18, 2012, at 10:41 am The American Medical News reports that Fitch, a global investment rating service, found that incentives paid to hospitals for adoption of electronic health records (EHR) went to increased profits. Fitch also concluded that:
“…the hospital companies analyzed in the report are not expected to use their positive cash flow to reduce debt. They are expecting acquisitions of other hospitals to remain a top priority. Fitch could not provide specifics on expected acquisition activity, but did say that Community and HCA had the most acquisition activity in 2011.”
A paradox in free market societies, especially the United Sates, the
. . . → Read More: False positive: private profit in Canada’s health care: Government Incentives Build Empires
By False Postitive: for profit medical labs, on May 7, 2012, at 8:32 am I was surprised when the Canadian Medical Association Journal (CMAJ) asked me to write an analysis piece on Canada’s medical laboratories. My book, False Positive, clearly lays out my position that for-profit labs have no place in our health care system, which is at odds with the close, and profitable, relationship between the labs and many doctors. And I am a well-known critic of private health care delivery in general, a policy option that doctors have often supported.
Regardless, I was interested because an article in the CMAJ would reach a different audience than I had already
. . . → Read More: False positive: private profit in Canada’s health care: Medical Journal Kills For-Profit Lab Debate
By False Postitive: for profit medical labs, on April 18, 2012, at 10:50 am The categories we use to make sense of the world structure how we act.
In his April 17th column Andre Picard, the health reporter for Toronto’s Globe and Mail newspaper, repeated one the most misleading justifications for more for-profit health care: most of the system is already private. After all, as Picard points out, many family physicians are self-employed and almost all hospitals are private, albeit non-profit, corporations. To equate public hospitals and family physicians with for-profit corporations, like Gamma-Dynacare, the Gambie Surgical Center, and the AIM Health Group, is to bury your head in legalistic sand.
. . . → Read More: False positive: private profit in Canada’s health care: Legal Abstractions and For-Profit Delivery
By False Postitive: for profit medical labs, on April 12, 2012, at 3:23 pm I am sure there is a plan to improve health care. There must be: Ontario’s recent budget says it wants to improve integration, control costs and increase access. Yet Ontario’s provincial budget just does not do it.
The section heading says “Providing the right care, at the right time, in the right place”. Praise worthy sentiments. The regional governments, the LHINs, responsible for meeting this goal are going to be reformed again to increase their power. But the next point says that routine procedures in hospitals will be shifted to non-profit community based clinics.
The problem is that
. . . → Read More: False positive: private profit in Canada’s health care: Health Integration: Not in Ontario
By False Postitive: for profit medical labs, on February 21, 2012, at 10:18 pm Considering the 1,500 dollars a day Don Drummond was paid and the research staff at his disposal you would figure that his analysis would be more subtle and better informed.
It is not news that Don Drummond supports for-profit health care but his rationale is shockingly simplistic. The following is the key paragraph from his report supporting more private health care:
There should not be an a priori or ideological bias towards public- or private-sector service delivery. Both options should be fully tested to see which provides the best service. This should not be defined simply with respect to cost, but
. . . → Read More: False positive: private profit in Canada’s health care: Drummond and For-Profit Health Care
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