Health
Opening independent non-profit hospitals would improve access to care and efficiency in Canada’s healthcare system
From the Montreal Economic Institute
Autonomous non-profit hospitals tend to perform better than government-run hospitals, shows a study published this morning by the Montreal Economic Institute.
“Interminable waits in Canadian hospitals show that our healthcare systems are struggling to deliver basic services to the population,” says Emmanuelle B. Faubert, economist at MEI and author of the study. “By allowing independent non-profit hospitals to open, our governments would help increase treatment capacity, to the benefit of patients.”
In 2023, the median wait time in Quebec ERs was 5 hours and 13 minutes, up 42 minutes from five years earlier.
It is estimated that as a result of chronic overcrowding in Canadian ERs, there are between 8,000 and 15,000 avoidable deaths each year.
The Canadian health care system ranks 10th out of 11 comparable industrialized countries, just ahead of the United States, in the Commonwealth Fund’s ranking of healthcare systems. The French, German, and Dutch systems are 8th, 5th, and 2nd respectively in the same ranking.
While the Canadian system has no independent non-profit hospitals according to the OECD’s definition, such facilities account for 14 per cent of French hospital beds, 28 per cent of German hospital beds, and 100 per cent of Dutch hospital beds.
The researcher attributes a portion of the success of these facilities to their greater managerial autonomy and to a funding method that encourages the treatment of more patients.
“One of the strengths of these hospitals is how quickly they can adapt, contrary to facilities micromanaged by government ministries, as is the case in Canada,” explains Ms. Faubert. “Since their financing depends on the type and the quantity of ailments treated, administrators see the sustainability of their facilities as being directly linked to their capacity to treat patients.”
Although Canadian hospitals generally have their own boards of directors, the management of their daily activities and their funding are subject to strict government control.
Aside from certain limited experiments, notably in Quebec, Canadian hospitals still depend largely on a global budgeting model, in which funding depends entirely on the level of activity in the previous year.
Since the annual budgetary envelope is fixed, each additional patient is seen as a cost, says the researcher.
In Europe, in contrast, hospitals are largely financed according to an activity-based funding model, whereby a hospital receives a set amount of money for each treatment carried out within its walls. With this system, each additional patient treated represents an immediate source of revenue for the facility, says the researcher.
“It’s clear that our healthcare system can and must do better, and that means changing the incentives of those who manage it,” says Ms. Faubert. “By introducing non-profit hospitals, with a better funding model, and by granting health professionals more flexibility, we will be able to provide better care to more patients, as they do in Europe.”
The MEI study is available here.
* * *
The MEI is an independent public policy think tank with offices in Montreal and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.
A B.C. pharmacy scam investigation has led the provincial government to return to a witnessed consumption model for safer supply
More than 60 pharmacies across B.C. are alleged to have participated in a kickback scheme linked to safer supply drugs, according to a provincial report released Feb. 19.
On Feb. 5, the BC Conservatives leaked a report that showed the findings of an internal investigation by the B.C. Ministry of Health. That investigation showed dozens of pharmacies were filling prescriptions patients did not require in order to overbill the government. These safer supply drugs were then diverted onto the black market.
After the report was leaked, the province committed to ending take-home safer supply models, which allow users to take hydromorphone pills home in bottles. Instead, it will require drug users to consume prescribed opioids in a witnessed program, under the oversight of a medical professional.
Gregory Sword, whose 14-year-old daughter Kamilah died in August 2022 after taking a hydromorphone pill that had been diverted from B.C.’s safer supply program, expressed outrage over the report’s findings.
“This is so frustrating to hear that [pharmacies] were making money off this program and causing more drugs [to flood] the street,” Sword told Canadian Affairs on Feb. 20.
The investigation found that pharmacies exploited B.C.’s Frequency of Dispensing policy to maximize billings. To take advantage of dispensing fees, pharmacies incentivized clients to fill prescriptions they did not require by offering them cash or rewards. Some of those clients then sold the drugs on the black market. Pharmacies earned up to $11,000 per patient a year.
“I’m positive that [the B.C. government has] known this for a long time and only made this decision when the public became aware and the scrutiny was high,” said Elenore Sturko, Conservative MLA for Surrey-Cloverdale, who released the leaked report in a statement on Feb. 5.
“As much as I am really disappointed in how long it’s taken for this decision to be made, I am also happy that this has happened,” she said.
The health ministry said it is investigating the implicated pharmacies. Those that are confirmed to have been involved could have their licenses suspended, be referred to law enforcement or become ineligible to participate in PharmaCare, the provincial program that helps residents cover the costs of prescription drugs.
Subscribe for free to get BTN’s latest news and analysis – or donate to our investigative journalism fund.
Witnessed dosing
The leaked report says that “a significant portion of the opioids being freely prescribed by doctors and pharmacists are not being consumed by their intended recipients.” It also says “prescribed alternatives are trafficked provincially, nationally and internationally.”
Critics of the safer supply program say it enables addiction, while supporters say it reduces overdoses.
Sword, Kamilah’s father, is suing the provincial and federal governments, arguing B.C.’s safer supply program made it possible for youth such as his daughter to access drugs.
Madison, Kamilah’s best friend, also became addicted to opioids dispensed through safer supply programs. Madison was just 15 when she first encountered “dillies” — hydromorphone pills dispensed through safer supply, but widely available on the streets. She developed a tolerance that led her to fentanyl.
“I do know for sure that some pharmacies and doctors were aware of the diversion,” Madison’s mother Beth told Canadian Affairs on Feb. 20.
“When I first realized what my daughter was taking and how she was getting it, I phoned the pharmacy and the doctor on the label of the pill bottle to inform them that the patient was selling their hydromorphone,” Beth said.
Masha Krupp, an Ottawa mother who has a son enrolled in a safer supply program, has said the safer supply program in her city is similarly flawed. Canadian Affairs previously reported on this program, which is run by Recovery Care’s Ottawa-based harm reduction clinics.
“I read about the B.C. pharmacy scheme and wasn’t surprised,” Krupp told Canadian Affairs on Feb. 20. Krupp lost a daughter to methadone toxicity while she was in an addiction treatment program at Recovery Care.
“Three years [after starting safer supply], my son is still using fentanyl, crack cocaine and methadone, despite being with Dr. [Charles] Breau and with Recovery Care for over three years,” Krupp testified before the House of Commons Standing Committee on Health on Oct. 22, 2024.
Krupp has been vocal about the dangers of dispensing large quantities of opioids without proper oversight, arguing many patients sell their prescriptions to buy stronger street drugs.
“You can’t give addicts 28 pills and say, ‘Oh here you go,’” she said in her testimony. “They sell for three dollars a pop on the street.”
Krupp has also advocated for witnessed consumption of safer supply medications, arguing supervised dosing would prevent diversion and ensure proper oversight of pharmacies.
“I had talked about witnessed dosing for safe supply when I appeared before the parliamentary health committee last October,” she told Canadian Affairs this week.
“I’m grateful that finally … this decision has been made to return to a witness program,” said Sturko, the B.C. MLA.
In 2020, B.C. implemented a witnessed consumption model to ensure safer supply opioids were consumed as prescribed and to reduce diversion. In 2021, the province switched to take-home models. Its stated aim was to expand access, save lives and ease pressure on health-care facilities during the pandemic.
“You’re really fighting against a group of people … working within the bureaucracy of [the B.C. NDP] government … who have been making efforts to work towards the legalization of drugs and, in doing that, have looked only for opportunities to bolster their arguments for their position, instead of examining their approach in a balanced way,” said Sturko.
“These are foreseeable outcomes when you do not put proper safeguards in place and when you completely ignore all indications of negative impacts.”
Sword also believes some drug policies fail to prioritize the safety of vulnerable individuals.
“Greed is the ultimate evil in society and this just proves it,” he said. “We don’t care about these drugs getting into the wrong hands as long as I get my money.”
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
Our content is always free – but if you want to help us commission more high-quality journalism, consider getting a voluntary paid subscription.
From LifeSiteNews
The memo concludes by defining “female,” “male,” “woman,” “girl,” “man,” “boy,” “mother,” and “father” accordingly, based on observable scientific fact rather than subjective thoughts or feelings of gender dysphoria.
It is the official policy of the United States once more to maintain a biology-based definition of “sex” across all federal agencies, according to a new memo from the U.S. Department of Health & Human Services (HHS).
The February 19 memo lays out the understanding of sex and related terminology to be used for the purposes of interpreting and abiding by federal rules, regulations, and partnerships.
“There are only two sexes, female and male, because there are only two types of gametes,” it says. “An individual human is either female or male based on whether the person is of the sex characterized by a reproductive system with the biological function of producing eggs (ova) or sperm. The sex of a human, female or male, is determined genetically at conception (fertilization), and is observable before birth.”
Sex, the memo continues, “is unchangeable and determined by objective biology. The use of hormones or surgical interventions do not change a person’s sex because such actions do not change the type of gamete that the person’s reproductive system has the biological function to produce. Rare disorders of sexual development do not constitute a third sex because these disorders do not lead to the production of a third gamete.”
The memo concludes by defining “female,” “male,” “woman,” “girl,” “man,” “boy,” “mother,” and “father” accordingly, based on observable scientific fact rather than subjective thoughts or feelings of gender dysphoria.
“It took many years of effort but we are finally back to science and common sense,” reacted Roger Severino, former director of the HHS Office for Civil Rights (OCR) in the first Trump administration.
It is an article of progressive faith that gender is no more than a matter of self-perception that individuals are free to change at will. But according to modern biology, sex is not a subjective sense of self but an objective scientific reality, established by an individual’s chromosomes from their earliest moments of existence and reflected by hundreds of genetically based characteristics.
Yet for years LGBT activists have worked to promote “gender fluidity,” the idea that sexual identity is separate from biology and discernible only by personal perception, across public education, libraries, health care, and cultural traditions such as beauty contests, school homecomings, and athletic competitions.
Critics say their efforts have yielded a wide array of harms, both to the physical and mental health of gender-confused individuals themselves as well as to the rights, health, and safety of those who disagree, such as girls and women forced to share intimate facilities with males, female athletes forced to compete against biological males with natural physical advantages, and individuals forced to affirm false sexual identities in violation of their consciences, their understanding of scientific fact, and/or their religious beliefs.
Since returning to office, President Donald Trump has taken multiple executive actions to reverse the Biden administration’s transgender policies, including an order that ends all federal support for “transition” procedures on minors, rescinds or amends all of the Biden health bureaucracy’s past endorsements of underage “transitioning,” and calls for a review of the medical literature on the subject, enforcing all existing restrictions on underage “transitioning,” and taking regulatory action to “end” the practice to the greatest extent possible under current law.
Another order prohibits males who claim to be female from competing against actual women in sex-specific athletic programs at schools receiving government funding. A third disqualifies gender-confused individuals from military service and prohibits military health services from conducting “transition” treatments and procedures.
Two New Studies Find Fewer Clouds Cause Warmer Temps
Trump gains ground in war against DEI
Quebecers starting to understand the need for Canadian pipelines
Germany’s Shocking War on Online Speech: Armed Police Raids for Online “Insults,” “Hate Speech,” and “Misinformation”
Is Our Five-Year Nightmare Finally Over?
U.S. Conditionally Approves Avian Flu Vaccine for Poultry
Are We Winning the Patient-to-Doctor Ratio War?
-
Business2 days agoGovernment debt burden increasing across Canada
-
Alberta1 day agoOpen letter to Ottawa from Alberta strongly urging National Economic Corridor
-
Addictions1 day ago
BC overhauls safer supply program in response to widespread pharmacy scam
-
International22 hours agoJihadis behead 70 Christians in DR Congo church
-
Health2 days agoTrudeau government buys 500k bird flu vaccines to be ‘ready’ for potential ‘health threats’
-
Health2 days ago
Trump HHS officially declares only two sexes: ‘Back to science and common sense’
-
Business2 days agoNew climate plan simply hides the costs to Canadians
-
Censorship Industrial Complex2 days agoBipartisan US Coalition Finally Tells Europe, and the FBI, to Shove It