Under Budget Pressure, Canada Slowly Rethinks Health Care Model
By: Tabassum Rahmani
Publisher: The Heartland Institute 07/12/2010

In response to pressure from budget problems, Canada and its provinces are rethinking their national health care model as they seek to curb healthcare costs without demolishing the justifications for the state-funded system.

According to Devon Herrick, a senior fellow at the National Center for Policy Analysis in Dallas, Texas, the problems now facing Canada already affect other countries.

"Canada is facing the same problems as other developed countries with socialized health care systems," Herrick said. "There are never enough resources to provide care for all who demand it, and tax hikes are unpopular. Today, Canada is forced to increasingly rely on the private sector to boost access to care."

Cost Controls Have Failed

Health care in Canada is delivered through a publicly funded system, with a pricetag of roughly $183 billion in Canadian dollars ($174 billion U.S.) for FY 2009. A temporary spending fix to fill current funding gaps ends in 2013 and is unlikely to be extended.

Canada's system has not restrained the rising costs of health care, such as salaries for top hospital executives and doctors and spiraling costs for new medical technologies and drugs.

One province, Ontario, recently conducted an analysis which found health care costs could eat up 70 percent of its budget by 2022. Legislation has been introduced to tie hospital executive pay to the quality of patient care, and the province is considering saving money by putting more physicians on lower salaries. . .

‘Raise Taxes, Ration Access'

Brett Skinner, president of the Fraser Institute, a Canadian think tank, says Canada's national and provincial governments have been avoiding real reform.

"Canada is a federal state. The provincial governments have autonomous constitutional jurisdiction over health policy, and the national government intervenes extra-constitutionally by offering federal transfer payments to support health care systems in the Provinces, on the condition that they comply with the Canada Health Act," Skinner said.

Skinner says the provinces generally comply to avoid losing the government funding, but he maintains they have the constitutional jurisdiction to privatize health insurance if they choose.

"Canada has not announced any formal intentions to reassess the health model it imposes on the provinces, nor are the provinces formally reassessing their provincial health models," Skinner said. "Reform is incremental and reactionary, and continues to be characterized by a ‘pay more, get less' approach—which translates to ‘raise taxes, ration access.'"

Tabassum Rahmani (trahmani74@yahoo.com) writes from Dublin, California.

Read the entire article. . .
Feedback . . .
Subscribe MedicalTuesday . . .
Subscribe HealthPlanUSA . . .

Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.

--Canadian Supreme Court Decision 2005 SCC 35, [2005] 1 S.C.R. 791

http://scc.lexum.umontreal.ca/en/2005/2005scc35/2005scc35.html

subscribe

UK Doctors Barred From Using Innovative Machine by Tabassum Rahmani

Publisher: The Heartland Institute, 07/09/2010

Mount Vernon Cancer Centre in London, England has become the first National Health Service (NHS) hospital to buy a CyberKnife machine, a new robotic radiosurgery system, but England's specialized commissioning group (SCG) has banned NHS patients from being treated with the device.

According to Dr. James G. Schwade, executive director of the Cyberknife Center of Miami, the Cyberknife is a system for delivery of highly concentrated radiation to perform image-guided radiosurgery.

"The Cyberknife may be useful for many cancers, including primary and metastatic lung cancer, brain, spine, and other central nervous system tumors, and tumors in the liver, pancreas, prostate, and elsewhere," said Schwade. "It is often useful in patients who have previously had other treatments and have persistent or recurrent tumors. But it is increasingly being used as a primary treatment in many sites, specifically prostate and lung cancer."

Authorities Rule: Not Cost-Effective

Cancer sufferers from Bedfordshire, Hertfordshire, Essex, Norfolk, Suffolk, and Cambridgeshire have taken to the pages of England's newspapers to complain about this decision. Although doctors may recommend the treatment for their patients, only private patients whose insurers agree to pay will have access to the devices - not those who have only traditional NHS coverage.

There are two CyberKnife machines now in use in the UK, both located at private hospitals in Harley Street, London, where patients pay more than £20,000 pounds for a course of treatment (roughly $30,000).

According to Trevor Myers, the SCG's chief operating officer, its clinical advisory group (CAG) was given a presentation by some of Mount Vernon's doctors about their Cyberknife machine, in an attempt to achieve approval.

"The CAG came to the conclusion that there is not enough evidence in regard to both the clinical and cost-effectiveness of the service. Given the limited resources in the NHS, it is vital that we buy services that have been proven to be clinically effective in accordance with national policy," Myers said.

NICE Study in Progress

It is possible NHS could reconsider. . .

According to a spokesperson for NICE, the institute intends to undertake a "fast-track" evaluation of the system and similar technologies, and it expects to report on its findings later this year.

Tabassum Rahmani (trahmani74@yahoo.com) writes from Dublin, California.

Read the entire article . . .
Feedback . . .
Subscribe MedicalTuesday . . .
Subscribe HealthPlanUSA . . .

NHS does not give timely access to healthcare, it only gives access to a waiting list if the treatment is approved by the government.