Health Care - the battle continues

I'm sure that you have all seen those commercials opposing health care reform in the United States from the Americans for Prosperity Foundation that includes a clip of Shona Holmes from Canada. In this commercial, Ms. Holmes makes that claim that if she relied on governments in Canada for treatment she would be dead.

There has been much ink spilled on her illness and the treatment she paid for in the US. Some of the opponents of health care reform in the US have used the "socialized" medicine bogeyman to try to defeat the public health option being discussed in Congress. They have said that they do not want to have a government "bureaucrat" decide on treatment. Unless the treatment is not covered by the provincial health plan, the government "bureaucrat" has nothing to say about the treatment prescribed by your physician. In the US, insurance company representatives can refuse treatment or payment after treatment on a number of grounds. The most recent example is of a women with brain tumors who was refused treatment by her insurance company. Read about it here.

There are many studies that show that a single payer system, as in Canada, is much more efficient that multiple payer systems as in the US. This is on top of providing universal coverage to the population. In the US, 50 million people are not insured and a significant number have inadequate coverage. The US spends almost 20% of its GDP on health care and yet have worse health outcomes than Canada and Western European countries who spend much less through universal programs.

Canada's system is by no means perfect and we still have work to do to ensure better efficiency, effectiveness and affordability of our system.

Happy Holiday

Today being the first Monday of August it is a holiday in a number of regions of the country...that is:

Ontario - Simcoe Day/Civic Day
Nova Scotia - Natal Day
New Brunswick - New Brunswick Day
Manitoba - Civic Day
British Columbia - British Columbia Day
Prince Edward Island - Natal Day
Saskatchewan - Civic Day
Alberta - Heritage Day
North West Territories - Civic Day
Nunavut - Civic Day

So if you have today off, enjoy!

Government Motors....oops I mean General Motors

The last number of months has seen that cornerstone of American capitalism, General Motors spiral downward and almost disappear as a corporation. Without the financial backing of the US, Canadian and Ontario governments, the company that was too big to fail would have failed. Not long ago our neighbours to the south used to say "What is Good for GM is good for America". That was when American designed cars ruled the road.

Now GM has gone through bankruptcy and a new General Motors has been created from its best assets with its other so-called assets part of a "Motors Liquidation Company". A friend forwarded me an interesting article from the New York Times about the restructuring of GM.

GM is now a public company, owned by the 3 governments and by the United Auto Workers. The plan is for governments to slowly exit the company over the next 5 years or so. In the meantime, there are some in Canada who are calling for increased transparency from this publicly backed company. I guess all Canadian citizens are now shareholders of GM and that those of us who live in Ontario are doubly lucky as we are also shareholders. Should we expect that GM adhere to the same rules on transparency and accountability that other government funded enterprises (eg: LCBO, Lottery Corp) must follow? This is an interesting question but there are substantial differences between a "government enterprise" and the financial backing that governments have given GM. The biggest is that the government enterprises will remain in the public sphere for policy and regulatory reasons (control of the sale of alcohol or games of chance), whereas governments' foray into the automobile sector is only (hopefully) temporary to salvage important manufacturing jobs and research & development capacity.

Another thought that comes to mind is whether those who have espoused the proposition that "government is the problem" (enunciated famously by Ronald Reagan) have changed their minds as now it seems that "government is the solution" to the financial crisis - just look at the various bank and brokerage house bailouts by government as well as the GM and Chrysler supports plus all the stimulus spending that governments around the world are engaged in. I wait to see what they say!

Conference Updates

I was recently at two international conferences. The first was the meeting of CAFRAD - The African Training & Research Centre in Administration for Development which is based in Tangiers, Morocco. The conference included delegates from approximately 36 African countries as well as observers such as IPAC. The conference was quite interesting & involved a full day for the Board Meeting (went till past 22h00) as well as two days of presentations and discussions on different topics. I will be writing more about this conference in the next while. IPAC and CAFRAD are in the process of finalizing an MOU that will involve the exchange of information, research and knowledge in public administration.

The second conference I attended was the Annual Meeting of IIAS - the International Institute of Administrative Sciences. The conference took place in Helsinki and was attended by approximately 250 delegates from around the world. The theme of this conference was:"History and future of nation-building, The role of public administrations, civil servants and public finances in nation-building." It was a very interesting conference with a number of great keynote presentations, for example by Jocelyne Bourgon, former Federal Clerk on the new framework for public administration. I will be writing about this in the next week or so as it is very interesting and thought provoking. It is in line with my thoughts about the evolution of public administration from the "New Public Management" model that was espoused in the 1980's and 1990's. There were a number of very interesting workshop presentations, including one by Geraldine Fraser-Molekti and Demetrios Argyriades on the state of Democratic Governance. Also noteworthy was the presentation by the Egyptian Deputy Minister of the Ministry of Administrative Development, Mr. Ashraf Abdelwahab. Egypt has made tremendous strides in e-government. I will be writing about all these presentations in future posts

I should note that IPAC is the Canadian "national section" of IIAS and we are reinvigorating our relationship with IIAS.

To those who have Monday off (it is Simcoe Day in Ontario), have a great long weekend.

Health Care - the battle is on

Well it seems that our friends to the south are in the midst of another Health care battle. The President wants health care reform that would provide coverage to the 50 million American citizens without coverage and also wants to make health care more affordable. Some of those who have come out against his proposals have once again decided to use the Canadian system as the whipping boy.

And then there are the illogical ones such as this so-called pundit...click here Did you understand that????

I will be posting some more on the US Health Care debate in the near future...stay tuned.

Health Care - Electronic Patient Records

I received a press release today from the National Governors Association in the US about the innovative strategies that many US States are using to achieve integrated health records. There could be some lessons for Canada in this as Electronic Health Records are key to reducing medical errors as well as reducing duplicate & triplicate tests. The brief came from the NGA Center for Best Practices.

Accelerating the Adoption of Electronic Prescribing examines electronic prescribing, or e-prescribing-the computer-based electronic generation and transmission of a prescription. E-prescribing improves patient safety and quality of care, increases prescribing accuracy and efficiency and reduces health care costs by making critical information available to health care providers. The use of e-prescribing will grow as states and others provide support for e-prescribing. In recent years, states annually have doubled the number of prescriptions sent electronically. If states stay the course, this rate of adoption will reach at least 50 percent by 2012, according to State Alliance for e-Health Call to Action for NGA.

Developing and implementing plans to promote e-prescribing can help governors achieve critical health reform goals: achieving higher quality care and enhancing the delivery of health care services. Several strategies are available to states to promote an e-prescribing agenda. These include:

* Developing e-prescribing policies;
* Incorporating e-prescribing into state publicly funded health programs; and
* Implementing financial incentive programs for e-prescribing.

This is very interesting development in the US. I recall a Rand Corporation study from 2005 that estimated the savings from EPR implementation in the USA in the billions of dollars. I will write more about this in the near future.

With the demographic trends and with health care making up close to 50% of provincial budgets, we must find all the efficiencies we can in the delivery of quality and accessible health care.

150!Canada

In just a few short years – on July 1, 2017 – Canada will turn 150 years old. It will be our sesquicentennial (trying saying that 3 times in a row quickly) – 150 years since that great experiment of Canadian Confederation was started. Why should you care you may ask. Especially, why start talking about it now in 2009??

Did you know that planning for the 1967 events – our Centennial year – started in 1958 and were at first led by Canadian Association of Adult Education? By that measure we are starting one year late.

1967 marked a period of rejuvenation and renewal for Canada – a time when anything was possible. In that time period, Canada grew up as a nation – a new flag in 1965, the start of many of our most cherished social programs (Medicare for example), and of course a year of celebration that included Expo ’67 in Montréal. I remember that time well. We had just moved from Montréal to Beloeil on the south shore. I remember taking the Metro and visiting many pavilions - I still have my Expo passport with stamps from the Canadian, US, USSR, French, etc pavilions. I also remember that year because the Canadiens were beaten in the Stanley Cup finals by the Maple Leafs (it is the last time that Toronto won the Cup, and of course my beloved Canadiens won many more times after 1967).

It was an exciting time when the potential of Canada seemed limitless and optimism was in the air – or are we looking back at that time with rose coloured glasses? We were all much younger then, so forgive the rose coloured glasses.

I think it is time once again to imagine the possibilities that the future can bring. That is why IPAC in conjunction with MASS LBP is organizing the 150!Canada conference that will be held in March 2010 in Ottawa at the National Arts Centre (The NAC was built in 1967).

We hope that this conference acts as a catalyst to the 2017 celebrations and we plan to bring together community leaders from across Canada to celebrate Canada and to develop a 150!Canada Declaration and Framework that will set out the principles and guide further planning of the Sesquicentennial.

Check out our 150!Canada website and add in your suggestions for 2017 as well as your memories and pictures from 1967. Stay tuned for more information on this important initiative including the exciting conference program, guest speakers and performers.