Recession Reduces Health Care Utilization

Here’s a fascinating finding from an NBER study: “The Economic Crisis and Medical Care Usage,” by Annamaria Lusardi, Daniel Schneider, and Peter Tufano (NBER study #15843). They undertook a broad public survey across 5 countries (the U.S., Canada, U.K., Germany, and France) on the economic and social impacts of the recession.  The survey covered over 6000 individuals (over 2000 in […]

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Congress Passes Healthcare – I Told You So

This evening, the U.S. House of Representatives passed Obama’s healthcare bill. Two months ago, I was the odd man out on a Business News Network panel (watch video). The day after the Massachusetts by-election, I was talking about Democrats redoubling their efforts and being more aggressive in putting forward a progressive agenda. By contrast, one of my co-panellists said, “The […]

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Inequality Kills

Population health researchers, most famously and consistently Richard Wilkinson,  have long drawn attention to the fact that the link between social class and health status is a gradient, such that an individual’s position in the class hierarchy is directly and causally linked to that person’s health status. It is not just that low income people are more likely to be […]

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Ontario’s Health Premium

Yesterday, I appeared before the Standing Committee on Finance and Economic Affairs at Queen’s Park. The committee is reviewing the Ontario Health Premium, as required by the legislation that implemented this levy. My assessment of the premium starts from the premise that the Government of Ontario needs more revenue not only for healthcare, but also for industrial development, education and […]

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No need for alarm over health care spending in BC

Jeffrey Simpson is right to lament that “there is no realistic, sensible debate” about health care in BC. Unfortunately, his May 13th Globe & Mail column “Even the redoubtable Premier Campbell struggles with health care” does not help. Simpson’s main point in the column is that health care spending in BC is rising out of control, defeating Campbell’s efforts to […]

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What the homeless need …

 … is homes. Check out this astonishing admission, as reported by CBC: St. Paul’s in downtown Vancouver, one out of every four beds is being used to treat the homeless, drug addicts and the mentally ill, said [Lorna Howes, the director of acute and community mental health for Vancouver with the Vancouver Coastal Health authority]. We are spending money on […]

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Inequality and health

There is an interesting opinion piece in The Tyee this morning, aptly named Dying for the Rich, which points out the links between inequality and life expectancy. The article’s author, Crawford Kilian, should be praised for bringing up an angle that was virtually ignored by media commentators in their coverage of the recent Census findings of growing inequality, even by […]

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Aging, Health Care and Federalism

Last December I testified before the Senate Special Committee on Aging, making the point that public health care need not fear an aging population. Today, I was invited back again to comment on their draft interim report and in particular the issue of how to address the fact that some provinces have a larger share of seniors than others, and […]

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TILMA and Medicare

An editorial in today’s Calgary Herald begins with the usual praise for TILMA, but ends by suggesting a new interprovincial deal on healthcare: Yet, for Ottawa to attempt to remedy matters by intruding itself into relations between the provinces would not only provoke reflexive opposition but, even if carried through by force majeure, be unlikely to work. Certainly, the Canada […]

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Simpson spaces out on health care

Jeffrey Simpson really loves Gordon Campbell. Having done a series of columns on BC’s carbon tax, its clever political packaging and the leader behind it – all in all, not a bad set of columns – Simpson completely loses touch on the health care side of the provincial budget. He buys hook, line and sinker the arguments about the lack […]

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BC introduces a carbon tax!

Since the provincial Liberals came to power in 2001 I have seen a lot of BC Budgets and not been too happy with any of them. Until now. Today’s 2008 model is a very interesting budget, and while I have a number of quibbles, I support the overall direction. And as in the recent past on climate change I find […]

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Federal Spending Power: The Makings of a Phoney Debate

There have been suggestions that the Conservative government’s forthcoming Throne Speech will surrender the federal spending power. Through an op-ed in today’s Globe and Mail, Bob Rae tries to position himself, and presumably the Liberal Party, as defenders of the power. This posturing will help the Conservatives woo Quebec nationalists and help the Liberals appeal to Canadians who believe in […]

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Homelessness and health in Toronto

A dispatch from Nick Falvo, the winner of the undergraduate prize in the 2007 PEF essay contest. Nick works for Street Health in Toronto, and speaks to a newly released report: In 1992, Street Health conducted a groundbreaking research study on homeless people’s health and access to health care. The updated 2007 study finds that the shocking rates of violence, […]

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Health care sustainability

I released a study today, How Sustainable is Medicare? A Closer Look at Aging, Technology and Other Cost Drivers in Canada’s Health Care System, available for download here. This essentially a national version of one I did last fall for BC only. With national data I was able to make projections 50 years into the future. The CP wire story […]

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Closing the tooth gap

In Ontario, the election campaign is on. A topic of note is public dental care. Back in July, the NDP started the ball rolling: Calling poor dental health a “silent epidemic,” the leader of the Ontario New Democratic Party said Tuesday that the provincial government should provide care for children and low-income earners. Howard Hampton said an initial four-year program […]

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Estimating Dr. Day’s conflict of interest

Sharpen your pencils, open your spreadsheets, everyone. It’s contest time! Following up on a recent post noting the major financial conflict of interest of the Canadian Medical Association calling for more private health care options, we can expect more ideological rhetoric to come in the next year as new CMA President Brian Day takes the helm next week. But as […]

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Bulk purchasing pharmaceutical drugs

The Vancouver Sun is two for two! Another front page headline, this time pressing the case for bulk purchasing of pharmaceutical drugs. Bulk purchasing is but one of many policy options for reducing the cost of pharmaceuticals, and is generally the one that is the most palatable politically as it does not overtly challenge Big Pharma. Other, more potent options, […]

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Ezra Klein on the health of nations

In the American Prospect, Ezra Klein compares five countries’ health care systems (hat tip to Mark Thoma). in spite of his general defence of Canada, there are a few areas where I think he gets it wrong and I have added in some comments in those places. The Health of Nations Here’s how Canada, France, Britain, Germany, and our own […]

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Wait-Time Guarantees

  A big conference on this topic – and key Conservative promise – gets underway in Toronto today. Here’s a CLC commentary, from Executive Vice-President Barb Byers.. “  The Federal government has been busy introducing Canadians to the idea of “Patient Wait-Times Guarantees”. If patients are unable to receive treatment in a timely manner, Conservatives argue, the public health system […]

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Can the US emulate single-payer health care?

Where I live in BC, the provincial government is doing its best to subtlely undermine public health care, rather than make the reforms countless commissions have recommended to make the system better. A full frontal assault is not possible due to the continuing popularity of a public model, but perhaps they think that if they mismanage the system enough and […]

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Wait lists and innovation

It’s amazing how much can be explained by supply and demand. The big crisis in waiting lists in recent years has been concentrated in a few procedures, mostly knee and hip replacements and cataracts. These surgeries have been made much more widely available in recent years due to the advent of relatively non-invasive day surgeries in place of long hospital […]

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Single-payer health insurance

Here’s a post from Economist’s View starting with a novel argument against single payer health insurance: that it would hurt innovation. Mark Thoma then rebuts and throws in some Paul Krugman for safe measure. Krugman makes an important point that often we assume that innovation is always a good thing. True, some innovations lead to better health outcomes. Others do […]

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The Globe on drugs (2)

Since it appears to be drug day at RPE, I should mention as a follow-up to a previous post on the National Pharmaceuticals Strategy that I did track down the document in question, a NPS Progress Report,  and that the Globe reporter did indeed misrepresent the estimates of the cost of that program. The Globe stated that the Report “pegs […]

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