2022.09.10 [OLX] ERT—Vaccine Effects on Menstrual Cycles

Vaccine Effects on Menstrual Cycles .docx


Where have all the workers gone? Don’t blame COVID, economists say

Where have all the workers gone? Don’t blame COVID, economists say Φ 所有的工人都去哪兒了?經濟學家說,不要責怪新冠病毒

Where have all the workers gone? Don’t blame COVID, economists say


Canada is in the throes of a serious labour shortage, but economists say it’s not all the pandemic’s fault — it’s the inevitable culmination of a seismic demographic shift decades in the making.

“It’s the slowest-moving train on the planet. It was predictable 60 to 65 years ago, and we have done nothing about it,” said Armine Yalnizyan, an economist and Atkinson Fellow on the Future of Workers. “We knew this transition was going to happen.”

The numbers behind all those help wanted signs are startling.

According to Statistics Canada, the unemployment-to-job vacancy ratio — a key measure comparing the number of Canadians looking for work to the number of available jobs — is currently hovering at a historic low in every province. In fact, the ratio is significantly lower now than it was before the COVID-19 pandemic began.

The reason isn’t that there are fewer jobs opening up — remember the help wanted signs? It’s that there are fewer workers available to fill them. And the reason for that, economists say, can be traced back to the post-war baby boom.

Construction workers prepare a form in downtown Toronto in May. According to Statistics Canada, their industry is the among the hardest-hit by the current labour shortage. (Alex Lupul/CBC)

Not enough replacements

While those 55 and older have been steadily exiting the Canadian workforce — an exodus that some economists believe was accelerated by the pandemic, as many older workers opted for early retirement — there simply aren’t enough younger workers to replace them.

In fact, participation in the workforce among those ages 25-54 approached 88 per cent in May, up more than one percentage point from February 2020, before the pandemic had taken hold in Canada.

“That’s what happens when a baby boom finally starts exiting from stage left, and there’s not enough people entering from stage right,” Yalnizyan said. “We’ve actually got a higher share of the working-age population working than ever.”

Armine Yalnizyan is an economist and Atkinson Fellow on the Future of Workers. (Christopher Katsarov/The Atkinson Foundation)

That contradicts the theory that some sort of “great resignation” among working-age Canadians, many of whom took advantage of pandemic income supports, is to blame for all those job vacancies, according to Ian Lee, associate professor at Carleton University’s Sprott School of Business.

“I just found that very suspicious because unless you’re independently wealthy … most of us have to have income to survive,” Lee said. “It just didn’t make sense.”

“Your first suspicion as a labour economist is, well, are people just not in the labour force anymore?” said Gordon Betcherman, professor emeritus at the University of Ottawa’s school of international development and global studies. “But that’s not the case. It’s back up to levels that we had before COVID.”

An employees’ market

Instead, economists say the data points to the emergence of an employees’ market where workers are enjoying an enormous amount of leverage over employers.

“It’s undeniable this trend we’re in where the balance between job seekers and job vacancies has definitely shifted,” Betcherman said.

According to Statistics Canada, that has led to virtually unprecedented labour shortages across nearly every employment sector.

There just aren’t enough people willing to do poorly paid jobs that are marginal at best.– Armine Yalnizyan, economist

In particular, the construction and manufacturing sectors are having a difficult time recruiting skilled workers, followed closely by accommodation and food services, which includes hotels, restaurants and bars. 

“People are finding other places to work. There just aren’t enough people willing to do poorly paid jobs that are marginal at best,” Yalnizyan noted. 

“Workers have a lot more choices now,” Lee agreed. “If you have more choices and you don’t have to work in that industry, you’ll go and work in an industry where there’s a better career stream and where the wages are higher and the hours are more predictable.”

That could force employers in certain industries to raise wages, Lee said.

“I’m not suggesting that the demand for these jobs is going to go away. It’s not,” he said. “It suggests to me that we’re going to see some pretty serious wage inflation in these industries over the years ahead.”

The restaurant sector is also struggling to attract new hires as many opt for higher-paying jobs with better working conditions. (Paige Parsons/CBC)

Wages predicted to rise

According to Yalnizyan, this competitive new environment means employers in certain sectors will need to raise wages if they hope to retain skilled workers.

“We are losing people who are trained as early childhood educators because we won’t pay them more than we pay pet groomers. Well why would they stay if they can get a better job in some other sector?”

That’s borne out by Statistics Canada data showing the reservation wage — the minimum hourly rate at which job seekers are willing to accept a position — surpassing the current offered wage in nearly every sector, whereas Canadian workers have historically been willing to settle for less.

Economists believe there are other possible outcomes — increasing automation to fill the vacuum left by the labour shortage, for one. Some industries could also bring in more temporary foreign workers to help fill gaps at the lower end of the labour market, potentially blunting the gains made by domestic workers.

Ian Lee is an associate professor at Carleton University’s Sprott School of Business. (CBC)

But Yalnizyan said rising wages could help erase some of the inequalities caused by a labour market that has for years paid some workers well and the rest poorly.

“If we actually improve wages and working conditions, particularly at the bottom, we could be creating the conditions for making a more resilient middle class that can actually afford to buy stuff. That’s what we’ve been missing out on for quite a while now,” she said.

“Population aging can be our friend, not our enemy. But we have to treat it as something more than just a labour shortage for business. We have to treat it as an opportunity to make every job a good job.”


Source: https://www.cbc.ca/news/canada/ottawa/ottawa-workers-covid-retirements-1.6529325
This web page was saved on Saturday, Jul 23 2022.


2. [^^] More than 10,000 Canadians received a medically-assisted death in 2021: report

More than 10,000 Canadians received a medically-assisted death in 2021: report Φ 報告稱,2021年有超過10,000名加拿大人接受了醫療協助死亡:

More than 10,000 Canadians received a medically-assisted death in 2021: report


More Canadians are ending their lives with a medically-assisted death, says the third federal annual report on medical assistance in dying (MAID). Data shows that 10,064 people died in 2021 with medical aid, an increase of 32 per cent over 2020.

The report says that 3.3 per cent of all deaths in Canada in 2021 were assisted deaths. On a provincial level, the rate was higher in provinces such as Quebec, at 4.7 per cent, and British Columbia, at 4.8 per cent.

“It is rising remarkably fast,” University of Toronto law professor Trudo Lemmens, who was a member of the Council of Canadian Academies Expert Panel on Medical Assistance in Dying, wrote in an email to CTV News. He noted that some regions in the country have quickly matched or surpassed rates in Belgium and the Netherlands, where the practice has been in place for over two decades.

Advocates say it isn’t surprising because Canadians are growing more comfortable with MAID and some expect the rising rates may level off.

“The…. expectation has always been it (the rate) will be something around four to five per cent, (as in) Europe. We will probably, in the end, saw off at around the same rate,” said Dr. Jean Marmoreo, a family physician and MAID provider in Toronto.

The report uses data collected from files submitted by doctors, nurse practitioners and pharmacists across the country involving written requests for MAID.

Among the findings:

  • All provinces saw increases in MAID deaths, ranging from 1.2 per cent (Newfoundland & Labrador) to a high of 4.8 per cent (British Columbia);
  • More men (52.3 per cent) than women (47.7 per cent) received MAID;
  • The average age was 76.3 years;
  • Sixty-five per cent of those provided with assisted death had cancer. Heart disease or strokes were cited in 19 per cent of cases, followed by chronic lung diseases (12 per cent) and neurological conditions like ALS (12 per cent);
  • Just over two per cent of assisted deaths were offered to a newer group of patients: those with chronic illnesses but who were not dying of their condition, with new legislation in 2021 allowing expanded access to MAID.

Documents show that 81 per cent of written applications for MAID were approved.

Thirteen per cent of patients died before MAID could be provided, with almost two per cent withdrawing their application before the procedure was offered.

Four per cent of people who made written applications for medical assistance were rejected. The report says some were deemed ineligible because assessors felt the patient was not voluntarily applying for MAID. The majority of requests were denied because patients were deemed not mentally capable of making the decision.

But other countries with long-established programs reject far more assisted death requests, said Lemmens, citing data that shows 12 to 16 per cent of applicants in the Netherlands are told no.

“It ….may be an indication that restrictions (in my view safeguards) are weaker here than in the most liberal euthanasia regimes,” he wrote in his email to CTV News.

But Marmoreo, who has offered MAID since 2016, sees Canada’s low rejection rate differently.

“It is more like that the right cases are put forward,” she said.

“We have a very good screening process right from the get-go. So before people actually even make a formal request to have assisted dying, they have a lot of information that’s been given to them by the intake….here’s what’s involved in seeking an assisted death, you must meet these eligibility criteria.”


Source: https://www.ctvnews.ca/health/more-than-10-000-canadians-received-a-medically-assisted-death-in-2021-report-1.6025922
This web page was saved on Saturday, Aug 13 2022.


3. [^^] Summer bonus program prompting airport screening staff to work while sick, unions say

Summer bonus program prompting airport screening staff to work while sick, unions say Φ 工會表示,夏季獎金計劃促使機場安檢人員在生病時工作

Summer bonus program prompting airport screening staff to work while sick, unions say


A union representing airport screening officers in Alberta says some of its members have shown up to work feeling sick in order to access a summer attendance bonus program being studied by a House of Commons committee.

“It’s a reward to circumvent doing what’s right,” said Richard Brown, president of Teamsters Canada Local Union 362.

“I’ve personally spoken to people that feel they’re ill and they should not go to work or not stay, and they’ve chosen to show up and stay just to make sure they qualify.”

Earlier this year — as air traffic surged after taking a nosedive during the first two years of the COVID-19 pandemic — screening officers contracted by the Canadian Air Transport Security Authority (CATSA) were told of the bonus program. 

According to a memo sent out by one company, screening officers would receive $200 for every week in which they worked their scheduled shifts in full. The program was set to run for 12 weeks from June 5 to this Saturday.

With additional $500 incentives thrown in, workers were told they could earn bonuses as large as $3,900.

A less “lucrative” version of the program was offered last Christmas, according to the memo.

Brown said the program has forced workers to weigh their health against their wallets. 

“It’s created an atmosphere, especially right now with inflation … and people struggling,” he said. “This is a way to make extra money, so people have cancelled their vacation and they’re coming in sick.”

Brown said the incentive is especially frustrating because the union has been negotiating a new contract with GardaWorld since January and has been calling for increased wages.

“It’s extra income that should have been applied directly to wages, rather than as a bonus to show up when you’re not quite right,” he said.

Brown said the incentive is masking other problems with the screening system, such as a shortage of job applicants, poor staff retention and bad working conditions.

Union official Richard Brown says the money used for the incentive program should have gone directly to workers’ wages. (Jonathan Hayward/Canadian Press)

CBC News reached out to CATSA for comment and statistics on program uptake but had not received answers in time for publication.

Dave Flowers is president of District 140 of the International Association of Machinists and Aerospace Workers, which represents thousands of screening officers in Ontario and B.C. He said the bonus program has also convinced some of his members to go to work sick. 

“Our hope is that this doesn’t result in outbreaks of sickness or mistakes being made in an industry where mistakes cannot be made at the flying public’s expense,” Flowers said via email.

‘There’s $200 on the line’ 

A CATSA official came to the bonus program’s defence when questioned last week by NDP MP Taylor Bachrach, the party’s transport critic. 

Bachrach and other members of the House of Commons’ standing committee on transport, infrastructure and communities met to discuss the controversial ArriveCAN screening app and the staffing issues and flight delays at airports over the summer.

Late into the meeting, Bachrach turned to CATSA’s incentive program. The committee heard that CATSA, a publicly-funded Crown corporation, allows contractors to bill CATSA for the costs of the program.

“Can you not see how this puts workers in a very difficult situation? Because essentially, you wake up with a sore throat and you’re making that decision about whether to go into work and there’s $200 on the line. Is this not an incentive to go to work sick?” Bachrach asked Neil Parry, a vice president with CATSA.

Parry said that while workers who feel sick and stay home can’t take part in the incentive program for that week, they are eligible for subsequent weeks in which they meet the terms of the program and remain entitled to all their base compensation, including paid sick leave. 

“We don’t see it as an incentive to go to work sick,” he said. “It is supernumerary to that compensation, so they’re not out of pocket in any capacity.

“The incentive program is an additional bonus structure that they can avail themselves of when it’s the best opportunity for them.” 

WATCH / CATSA official defends bonus program amid criticism

CATSA official defends bonus program from criticism

NDP MP Taylor Bachrach, the party’s transport critic, questions Neil Parry, the vice-president of operations for the Canadian Air Transport Security Authority (CATSA), about a bonus program for contracted screening officers during a parliamentary committee meeting on Aug. 19, 2022.

Parry added that CATSA trusts workers to “act professionally” if they’re not feeling well.

“They’ve demonstrated that for over two years during the pandemic, that they would stay home, be responsible,” Parry said. “When they have planned vacation, we encourage them to take it because … it is an extremely busy environment and they have done a noble job under these under these pressures.”

The program has been effective, Parry added.

“Our absenteeism throughout the country has been down over the summer,” he said. 


Source: https://www.cbc.ca/news/politics/catsa-airport-screening-officers-summer-bonus-incentive-concern-1.6559695
This web page was saved on Wednesday, Aug 24 2022.


4. [^^] CBC Situation Critical Articles

CBC Situation Critical Articles Φ CBC 情況危急文章

CBC Situation Critical Articles


Situation Critical

Vancouver man advertises $5K reward for help finding a family doctor

“I have young kids, and if something were to happen to me, it would really be a disaster for them,” said Gary Shuster, who suffers from a rare metabolic disease known as CPT2 deficiency.

Investigation launched after infant in B.C. Interior reportedly dies while waiting for an ambulance

British Columbia’s emergency health service says the death in Barriere, B.C. is a “heartbreaking loss.”

B.C. announces $118M in funding as ‘first step’ to support family doctors

British Columbia’s health minister has announced $118M in interim funding in to support family doctors.


Playing with fire: Why some volunteer firefighters refuse to offer medical service, amid health-care shortages

As communities across British Columbia struggle with a shortage of both ambulances and paramedics, many volunteer fire departments find themselves filling in the gaps, providing emergency medical services to small towns that are often situated an hour or more away from the nearest hospital.


Sick leaves among B.C. health-care workers have increased since start of pandemic, data shows

Data shows that sick leaves in B.C.’s health-care sector are up by a marked amount compared to pre-pandemic levels. It has led to advocates calling for better support for staff, and steps to reduce COVID transmission to reduce the burden on hospital workers.


Man dies of heart attack in B.C. Interior village with only ambulance 35 minutes away

An Ashcroft, B.C., man died on Sunday from a heart attack while waiting for an ambulance that took more than 30 minutes to arrive. A month ago a woman from the same town died of a heart attack while also waiting for an ambulance.


Promised SFU medical school still years from opening despite doctor shortage

In 2020, the NDP made an election pledge to create the province’s second medical faculty, with its first cohort of students starting next year. Patients and advocates are asking whether it’s on track.


B.C. 911 dispatch operators plead for more staff amid rising emergency call wait times

The union representing E-Comm 911 dispatch operators says staff shortages are leading to unacceptable wait times for callers.


ER in Clearwater closing again due to staffing shortages — this time for 5 nights

The emergency department at the Dr. Helmcken Memorial Hospital in Clearwater, B.C., is set to be closed overnight for five days, adding more pressure on the B.C. community worst-affected by ongoing closures this year.


This family doctor is leaving B.C. Other physicians are among her ‘orphaned’ patients

In June, Coquitlam family doctor Anna Chodyra closed her practice before relocating to New Zealand. She leaves behind thousands of patients, including several doctors, who worry the system may struggle to absorb Chodyra’s roster.


Woman died of cardiac arrest in B.C. Interior town where ER was closed, only ambulance was half an hour away

The mayor of Ashcroft, B.C., is raising major concerns about health-care staffing shortages after a local woman who found her friend unresponsive was told by 911 operators that the only ambulance on call was a half-hour drive away.


Foreign-trained doctors say they could help with B.C.’s doctor shortage but face too many barriers

As emergency rooms across some rural parts of the province had to close this weekend amid staffing shortages, some internationally trained doctors say the barriers to practise in Canada have forced them to seek a different career.


Patients turned to telehealth during the pandemic. B.C. doctors say it isn’t a long-term solution

As an estimated one million British Columbians struggle to find a family doctor, health-care providers say they are providing more long-distance health care to patients.


We looked at data on temporary closures, reduced services in B.C. hospitals this year. Here’s what we found

According to data verified by CBC News, hospitals in the province’s Interior have experienced the most emergency room closures this year, and most closures occurred in hospitals outside urban centres.


Rural emergency rooms are bearing the brunt of health-care shortages, B.C. doctors warn

ER doctors warn that the pandemic highlighted, rather than created, persistent problems in B.C.’s health-care system — with ERs bearing the brunt of the breakdowns in other areas of the system.


Expecting parents have to relocate to give birth due to midwife shortage on Salt Spring Island

Robyn Millerd wanted to give birth to her baby on Salt Spring Island, where she was raised and still lives. But instead, due to staffing shortages at the only hospital in the Southern Gulf Islands, she had to uproot her life and move to Vancouver Island at 38 weeks pregnant. 

Situation Critical

Woman who had miscarriage at Surrey hospital seeks answers over alleged poor standard of care

Kirandeep Kaur Mangat claims she endured a harrowing ordeal at Surrey Memorial Hospital that ended with her having a miscarriage in a hospital room after a doctor told her to go home for the night.

Quebec tourist waited a week for emergency surgery after B.C. doctor refused to operate over billing

A Quebec man who fell and broke his jaw, cheekbone and a bone around his left eye while visiting British Columbia says his surgery was cancelled after he was told his home province “won’t pay” for the procedure.

Some non-urgent procedures postponed as B.C. deals with worldwide medical dye shortage

A worldwide shortage of medical contrast dye is forcing the postponement of non-urgent and elective imaging procedures in B.C.


Vancouver Island emergency room latest to face temporary closure due to staff shortage

The emergency room at Port Alberni’s West Coast General Hospital could potentially be closed through much of August and September due to staff shortages — the latest in a series of temporary ER shutdowns in small communities.

Patients in labour may be diverted from Squamish hospital due to staff shortage

Expectant patients in the Sea to Sky region might be diverted to hospitals in Metro Vancouver this month due to staffing issues at Squamish General Hospital.

Cancer patients in B.C. waiting months rather than weeks for treatment

Cancer patients in B.C. are waiting longer than they should for treatment due to serious staffing shortages throughout the province.

Near doctor or daughter? Metro Vancouver senior faces tough decision about where to live after hospitalization

Kristal Garbers says her 78-year-old father cannot live on his own after he’s discharged from hospital, but he will face living without primary care if he lives with her in the Lower Mainland.

How a small B.C. town is fighting to recruit family doctors amid provincewide shortage

Creston, B.C., has found comparative success recruiting family doctors, thanks to the help of a dedicated recruiter working in partnership with the Interior Health Authority.

British Columbians call for more family doctors, money for health-care system at B.C. Legislature rally

About 400 people gathered at the B.C. Legislature for the two-hour B.C. Health Care Matters rally on Thursday in support of “timely access to appropriate in-person health services for every resident of British Columbia.”


Source: https://www.cbc.ca/news/canada/british-columbia/topic/Tag/Situation Critical
This web page was saved on Thursday, Sep 01 2022.


5. [^^] Most doctors took financial hit in 1st year of COVID, but top earners did just fine

Most doctors took financial hit in 1st year of COVID, but top earners did just fine Φ 大多數醫生在COVID的第一年遭受了經濟打擊,但高收入者做得很好

Most doctors took financial hit in 1st year of COVID, but top earners did just fine


Twenty-twenty was a brutal year for doctors. The COVID-19 pandemic struck, lockdowns forced the cancellation of scores of non-essential surgeries, hospitals faced a capacity crisis and health-care workers of all kinds endured threats of violence and even death.

For most physicians in Canada, the first full year of the pandemic also delivered a financial gut punch, according to a CBC News analysis of government health plan payments to 58,000 doctors in six provinces that make such data available.

A quarter of those doctors suffered a drop of at least 20 per cent in their billings compared with the year before, according to CBC’s analysis. In a country where the average doctor makes $350,000 a year, that means that on average, one in four of those physicians was out around $70,000 in revenue. 

“People need to remember right back at the beginning of the pandemic, things were really shut down hard,” said Michael Green, a family physician and a professor and chair of the department of family medicine at Queen’s University in Kingston, Ont.

In the early months of the pandemic, he noted, everyone was told to stay home, so few people saw their doctor in person. For about 60 per cent of physicians who get paid for each procedure or service they do — a payment system called “fee-for-service” — the lack of patients in the first few months of the pandemic meant a noticeable dent in their revenues for the year. 

But for a select group of highly paid doctors, it was a different story, CBC’s analysis found.

Among the 100 doctors in each province who billed the most to their provincial health plan — a group that mostly comprises specialist physicians — only about seven per cent suffered the same 20 per cent drop in payments during the first year of the pandemic.

In fact, twice as many of these high-billing doctors had a 20 per cent increase in their fee-for-service revenues.

CBC’s analysis also found a large number of them got federal money, too, in the form of the Canada Emergency Wage Subsidy.

Woe for pediatricians, dermatologists

Plenty of governments publish “sunshine lists” of public-sector salaries, but provincial health-plan payments to physicians are a bit of a slippery fish. Only five provinces (B.C., Saskatchewan, Manitoba, New Brunswick, and Newfoundland and Labrador) routinely make the data public, while a sixth, Ontario, requires an access-to-information request.

The figures come with caveats: Generally only fee-for-service payments are included, which leaves out the many doctors paid by salary, hourly wage or by how many patients are enrolled in their family practice. And the payment numbers don’t account for overhead, which typically ranges from 13 to 43 per cent of a doctor’s billings.

Family doctor Michael Green said that at the start of the pandemic, patient visits to doctor offices dropped ‘like a rock.’ Later, some physicians were able to make back the resulting lost revenue — and then some. (CBC)

The provincial payment data shows that COVID-19 lockdowns hit some specialties particularly hard. For instance, 45 per cent of ophthalmologists in Ontario lost at least a fifth of their billing revenue. The figure was nearly as high for pediatricians (42 per cent), dermatologists (40 per cent), ear-nose-and-throat specialists (39 per cent) and plastic surgeons (37 per cent).

Other specialists in Ontario fared relatively well. Only five per cent of endocrinologists saw their billings drop by a fifth, as well as nine per cent of hematologists and 11 per cent of vascular surgeons.

Green, the Queen’s University professor and doctor, theorizes that some of these differences in how the pandemic affected doctors might be because once lockdowns ended, certain kinds of physicians had backlogs of work they could burn through, while others who tend to treat transient illnesses did not.

“Groups that would [be] able to, say, catch up on numbers of procedures later in the year — to make up for their backlog — would have a chance to get their billings back up overall for the whole year, even if they had a very low period during those initial months,” he said. 

Among them was Gdih Gdih, a Winnipeg ophthalmologist who was the fifth-highest-billing medical doctor in Manitoba last year, and one of the highest-billing doctors in all of Canada, according to the publicly available data gathered by CBC.

He said the first weeks of the pandemic were a trying time for his laser eye surgery clinic. 

“When Covid hit, things went so slow and we literally had close to no income to pay 10 salaries… rent, insurance, equipment, lease, etc.,” Gidh wrote in an email in response to questions from CBC News. He said his overhead costs normally run above $80,000 a month, or close to $1 million a year.

By the end of the year, though, business was booming for the ophthalmologist. On average, he had billed about $2.2 million a year in services from 2016-17 to 2019-20. But for the fiscal year from April 1, 2020, to March 31, 2021, his total billings climbed to $3 million. 

Cardiologist’s revenues jumped from $1.5M to $2M

Gdih said there are a “few reasons for the unexpected increase,” including heightened demand for some of the higher-paying interventional procedures he performs; more work becoming available because of colleagues who decided to retire early or take stress leave; and extra time in his schedule to do that work since travel was mostly shut down.

The onset of COVID was Gdih’s best year for billings since at least 2016, and he’s not alone in that regard. An Ontario cardiologist billed the province $1.5 million for his services in the 2019 fiscal year, then upped his billings to more than $2 million during the first year of the pandemic. A urologist in B.C. who averaged $875,000 in revenues for the four years prior to the pandemic billed for $1.24 million in procedures in fiscal 2020.

Mohamed Awad was the 29th-highest-billing doctor in Ontario during the first year of the pandemic. The pain specialist’s gross payments from the Ontario Health Insurance Plan jumped from $1.4 million to $2.35 million.

Awad told CBC News in an email that he, too, took on “numerous new patients whose primary physicians retired during the pandemic,” and also boosted his work hours. By coincidence, he also opened another clinic in March 2020, just as the pandemic was getting under way, he said.

CBC reached out to a dozen other doctors who saw some of the highest spikes in billings during the first year of the pandemic. Two of them explained it was because they had only begun their medical practice partway through the previous year; another said it was because she was on leave before COVID, so her pre-pandemic billings were unusually low. None of those three doctors agreed to speak on the record.

The rest did not reply.

Overall, CBC News found at least 60 of the 600 highest-billing doctors had their best financial year in the 12-month period that began as COVID took over.

What’s more, CBC discovered that some of them even took federal subsidies meant to help slumping businesses keep workers on their payrolls.

WATCH | Some of the country’s top-billing doctors accessed COVID-19 benefits:

Some of Canada’s highest-paid doctors benefitted from emergency COVID funds

A CBC News analysis has found that some of Canada’s highest billing doctors benefitted from emergency COVID-19 funding. While accepting the funding was not illegal, one business ethics professor says these doctors should pay the money back.

Federal subsidies for highest billers

Launched in March 2020, the Canada Emergency Wage Subsidy was the federal government’s single-largest COVID relief measure, providing up to $960 a week to employers per worker on their payroll so that they could keep paying staff instead of laying them off when business waned.

In the 600-strong group of top-billing doctors from each of six provinces, more than a quarter received CEWS money.

Winnipeg ophthalmologist Gdih resorted to the subsidy in the early months of COVID. He said the uncertainty of how the pandemic was going to affect “the future and the continuity of our business” prompted him to seek out the money.

“However, when we picked up later, I paid it back in full as soon as funds [were] available,” Gdih said.

Awad also received some CEWS money. His accountant applied for it without his knowledge, he said, but he never accessed the funds and “promptly repaid” it once it became apparent his billings were surging and not plunging. He provided CBC with his CEWS account statement, which shows offsetting credits and refunds.

It’s not known how much CEWS money the top-billing doctors received or for how long, because the federal government has only published the names of CEWS recipients. But there is no suggestion of any wrongdoing or that they didn’t qualify under the terms of the subsidy, which only required that a business have a drop in revenue during certain four-week periods in order to receive federal funds.

Richard Leblanc, a professor of governance, law and ethics at York University in Toronto, said doctors who got CEWS should pay it back if they ultimately had a banner year financially. (CBC)

In an odd quirk, CBC’s analysis found that doctors who received CEWS payments during the first year of the pandemic billed more money to provincial health insurance, on average, than those who didn’t get the subsidy. 

Among the 600 top-billing doctors in the provincial data, the average physician who benefited from CEWS billed $1.7 million, while those who didn’t get the federal cash billed their province roughly $1.25 million on average. It’s unclear exactly why, but it could be that higher-billing doctors have more — and more specialized — staff who can handle financial matters like applying for a subsidy. Or they might have higher overhead and felt more pressure to shore up their finances when, in the early pandemic, the outlook for all businesses was bleak.

‘Give the money back’

Though the doctors were all entitled to get the federal subsidy, York University law and ethics professor Richard Leblanc said it goes against the spirit of the government’s COVID emergency relief measures.

“If you’re a doctor and your revenue has been at a certain level and then during the pandemic it jumps 20, 30, 40, 50, 60, I think I saw a figure close to 90 per cent… That wasn’t the intent of CEWS,” Leblanc said. 

“The spirit of CEWS is not a windfall. The spirit of CEWS is to make you whole.”

He suggested that doctors who got the subsidy but, at the end of the year, showed a marked improvement in their bottom line during the pandemic should do like Gdih, the Winnipeg ophthalmologist. 

“Do the right thing and give the money back. Because it’s not their money. It’s taxpayers’ money.”

CBC News asked the Department of Finance, which designed the $100.7-billion CEWS program, whether it was always intended that businesses could collect CEWS money early on in the pandemic and not have it clawed back if they ended the year with extra revenues.

The department said forcing employers to pay back CEWS for that reason wouldn’t have been wise.

“Had additional conditions such as these been introduced to the program, together with anti-avoidance rules necessary to maintain the integrity of the conditions, they would have added considerable complexity to the rules and their administration,” a Finance spokesperson wrote in an email. 

“Such complexity and the accompanying uncertainty would have undermined the primary objective of the program, which was to support Canadian workers in a timely manner.”

How did CBC News analyze doctor billings data?

To build a database of the highest-billing doctors in each province, CBC News compiled doctors’ gross fee-for-service billing totals that five provinces publish every year, with information for Ontario obtained via an access-to-information request. The full names, specialty, years of practice and gender of the 100 doctors who billed the highest amount to their province’s health insurance plan during fiscal year 2020-21 (April 1, 2020 – March 31, 2021) were compiled, as well as historical billings for fiscal years 2016-17 to 2019-20. 

The full data sets of all doctor billings in each province were used to calculate the percentage change in all doctors’ billings for fiscal years 2018, 2019 and 2020. Our analysis identified doctors in both data sets who had seen their billings increase or decrease by 20 per cent or more during fiscal years 2019-20 and 2020-21. 

To find doctors who had received the Canadian Emergency Wage Subsidy (CEWS), CBC compared a Canada Revenue Agency list of CEWS beneficiaries dating back to Jan. 19, 2021, against the names of top-billing doctors as obtained from public records. When a corporate entity was composed of multiple doctors registered as partners, their names were separated and matched individually. Matches between the CEWS list and doctor names were confirmed through supplementary research, including professional licensing information, corporate registry searches, associated clinics and other documentation. The CRA’s CEWS list does not specify the amount of each subsidy or how long it was provided. 

In order to develop its methodology and better understand the data and any caveats, CBC consulted Dr. Michael Green of Queen’s University and three other academics who have done research on fee-for-service physician billings. 

Data analysis: Valérie Ouellet, Katie Newman (April-August 2022)

Additional research: Madeline McNair, Zach Dubinsky, Mohammed Abdul-Hussain (April-August 2022)

Send tips on this or any other story to zach.dubinsky@cbc.ca


Source: https://www.cbc.ca/news/investigates/doctors-payment-data-covid-cews-1.6568343
This web page was saved on Thursday, Sep 01 2022.


6. [^^] LILLEY: Trudeau punishes home owners rather than cut spending to fight inflation

LILLEY: Trudeau punishes home owners rather than cut spending to fight inflation Φ 利利:特魯多懲罰房主,而不是削減支出以對抗通貨膨脹

LILLEY: Trudeau punishes home owners rather than cut spending to fight inflation


Economists have told the Trudeau government that only increasing interest rates will put the inflation fight on the backs of home owners. Prime Minister Justin Trudeau is pictured while speaking to media after a visit with nursing students at the School of Nursing at St. Boniface University in Winnipeg, on Sept. 1, 2022. Photo by JOHN WOODS /THE CANADIAN PRESS

The Bank of Canada has to do something about inflation; however, it is the only tool the government is using, and it’s going to hit many like a wrecking ball.

On Wednesday, the bank announced its latest interest rate hike of 75 basis points, taking the overnight rate from 2.5% to 3.25%.

Bank officials also promised more hikes in the months to come.

At the start of the year, the rate was 0.25%, where it had been since March 2020. We’ve been through an unusually long period of low interest rates, the last time the rate was as high as it is now was in spring 2008.

According to the calculations from Lowestrates.ca, people who bought homes earlier this year at the local average price and used a variable rate mortgage could see huge increases in monthly payments as a result of this rate hike. In Toronto, they calculate the average payment increasing by $351 per month; in Vancouver, $394 per month; in Calgary, $194 per month; and in Edmonton, $146 per month.

That’s for people on variable rate mortgages.  Those who have been making payments for the last several years on low fixed rate mortgages and are about to renew will see huge jumps. Homeowners are about to pay a steep price as the Bank of Canada seeks to tame inflation, but they aren’t the only ones.

Personal and business lines of credit are about to get more expensive to service, as are many credit card balances.

Interest rate hikes shouldn’t be the only tool

The Trudeau government has been warned about inflation for well over a year now and done little to act, leaving it all to the central bank. Back in June, Scotiabank called for the Trudeau Liberals to cut back on government spending to aid the bank in the inflation fight.

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“Lower government spending on goods and services could help lower inflation,” the report from Scotiabank stated.

Chrystia Freeland, Trudeau’s finance minister and deputy prime minister, dismissed that idea at the time, saying that they had already done their part by ending COVID support measures. It’s true those COVID measures ended, but government spending is still up from $317 billion in total expenses in the 2016 budget to $428 billion in the 2022 budget.

That’s a massive $111-billion increase.

Even accounting for inflation, in constant 2022 dollars, spending is up by $52 billion after the government says it has tightened its belt and ended COVID relief programs. Increasing spending by 14% in constant 2022 dollars will lead to inflation — it is bound to happen — and everyone can see that except the Trudeau government.

For the last several months, the Trudeau government has tried to place all the blame for inflation on outside forces. Supply chain disruptions due to COVID-19 and Russia’s invasion of Ukraine are the most cited sources, and while there is some truth to that, it’s not the whole story.

Government spending has been a part of the growth of inflation, domestic and international factors are at play, and anyone saying it’s just one of these factors while denying the other isn’t telling you the truth. Now comes a worrying report from TD Economics.

In a note to clients regarding the Bank of Canada’s interest rate hike, TD’s chief economist Beata Caranci and senior economist James Orlando state that domestic factors are becoming the “main influencer” in the inflation situation in Canada.

What’s worse is that inflation is now hitting the service sector as opposed to just the goods sector, and that will keep inflation running high for some time.

Freeland was asked what her government would do about inflation and if the central bank raising interest rates was the best idea at this time, but she offered little more than platitudes. The message from the Trudeau government: ride it out.

This is what you get when you elect a prime minister who doesn’t think about monetary policy.


Source: https://torontosun.com/opinion/columnists/trudeau-punishes-home-owners-rather-than-cut-spending-to-fight-inflation?utm_source=newsshowcase&utm_medium=gnews&utm_campaign=CDAQnJuJyobV080BGLP58eClifupqAEqEAgAKgcICjCVifQKMLKMvAI&utm_content=rundown
This web page was saved on Thursday, Sep 08 2022.


7. 2022.09.10 [OXL] THS—The Hospital Story—NEWS MIX

8. [^^] Their trip to Canada has led to tragedy — and more than $1M in medical bills | The Star

Their trip to Canada has led to tragedy — and more than $1M in medical bills | The Star Φ 他們的加拿大之行導致了悲劇 – 超過100萬美元的醫療費用|星星

Their trip to Canada has led to tragedy — and more than $1M in medical bills | The Star


This copy is for your personal non-commercial use only. To order presentation-ready copies of Toronto Star content for distribution to colleagues, clients or customers, or inquire about permissions/licensing, please go to: www.TorontoStarReprints.com

This Iranian couple came to visit their adult children in Canada and were stranded here due to the pandemic. The family is now mired in a $1.4 million hospital bill, and climbing, while the husband/father is in palliative care in hospital.

Nicholas Keung
By Nicholas KeungImmigration Reporter

Sat., Aug. 13, 2022timer7 min. read




Pegah Khaki spends each day with her husband.

She bathes and shaves him; she brushes his teeth.

Copyright owned or licensed by Toronto Star Newspapers Limited. All rights reserved. Republication or distribution of this content is expressly prohibited without the prior written consent of Toronto Star Newspapers Limited and/or its licensors. To order copies of Toronto Star articles, please go to: www.TorontoStarReprints.com


Source: https://www.thestar.com/news/canada/2022/08/13/how-a-couples-trip-to-canada-has-led-to-tragedy-and-more-than-1-million-in-medical-bills.html
This web page was saved on Saturday, Aug 13 2022.


9. [^^] The Unintended Consequences of COVID-19 Vaccine Policy: Why Mandates, Passports and Restrictions May Cause more Harm than Good (Accepted for Publication BMJ Global Health, May 2022)

The Unintended Consequences of COVID-19 Vaccine Policy: Why Mandates, Passports and Restrictions May Cause more Harm than Good (Accepted for Publication BMJ Global Health, May 2022) Φ COVID-19疫苗政策的意外後果:為什麼授權、護照和限制可能弊大於利(已接受BMJ Global Health出版,2022年5月)

10. [^^] Quebec tourist waited a week for emergency surgery after B.C. doctor refused to operate over billing | CBC News

Quebec tourist waited a week for emergency surgery after B.C. doctor refused to operate over billing | CBC News Φ 魁北克遊客在卑詩省醫生拒絕手術后等待了一周的緊急手術|加拿大廣播公司新聞

Quebec tourist waited a week for emergency surgery after B.C. doctor refused to operate over billing | CBC News


A Quebec man who fell and broke his jaw, cheekbone and a bone around his left eye while visiting British Columbia says his surgery was cancelled after he was told his home province “won’t pay” for the procedure.

Patrick Belanger, 23, said his experience is a warning for residents of Quebec and all Canadians who take pride in a universal health-care system because doctors in other provinces could deny treatment to Quebecers by maintaining they won’t be compensated.

Belanger’s ordeal began when he and his girlfriend were walking along a trail in the southern B.C. resort town of Sun Peaks on the evening of June 10. He tripped and stumbled backwards in the dark and hit his face on a boulder.

He was taken by ambulance to Royal Inland Hospital in nearby Kamloops just before midnight and was told he needed surgery for a “broken face.” But a surgeon was not available on Saturday, so he was discharged with a prescription for the opioid-containing drug Percocet to manage his pain, Belanger said.

The following morning, he returned to the hospital with his girlfriend, Beth Cooper. But Belanger said as he was being prepared for the operating room, the surgeon cancelled the procedure.

“He said the hospital would not let him do the surgery because I was from Quebec,” Belanger said, adding he’d presented his provincial health card when he arrived at Royal Inland.

“I was kind of in shock. As I thought about it more, I thought that doesn’t make sense. Normally, you’d do the surgery and figure out billing afterwards, or at least I thought that’s what was going to happen.

“I was pretty scared. I was still pretty out of it because I was in quite a bit of pain and on pain medications. And I was calling my parents trying to figure out what to do.”

Belanger said he offered to pay for the surgery through his family’s private insurance, but the surgeon rejected that option, saying he first needed to speak with a hospital administrator who was not available on the weekend.

“When he told me that the surgery couldn’t be done [that day], he suggested that I fly back to Quebec City to go get the surgery done,” Belanger said.

He was given a window of 10 days before his facial bones would start to fuse.

“We thought it was just completely absurd that I, with a broken face, was to take a commercial airline to go get a surgery done in my own country.”

Royal Inland Hospital in Kamloops, B.C., pictured on June 5, 2021. (Ben Nelms/CBC)

Belanger’s father and mother arrived in Kamloops later that week and tried unsuccessfully to speak with an administrator at the Interior Health authority about the best options for their son.

“We were baffled about his basic rights as a Canadian,” Richard Belanger said, calling his son’s experience a “nightmare.”

He said he went to the surgeon’s private clinic to provide information on the family’s insurance plan as well his credit card in case the surgery could be done there, but staff told him the serious facial fractures his son suffered meant the surgery had to be performed in a hospital.

2nd doctor completes surgery

Four days of anguish since the surgery was cancelled had Belanger managing “excruciating pain” with prescription opioids and morphine before his case was passed on to another surgeon, Belanger said.

“I would wake up in the middle of the night crying and screaming in pain,” he added.

The second doctor said he needed quick intervention, and the surgery was eventually done seven days after he fell, said Belanger, an economics student at Bishop’s University in Sherbrooke, Que.

His family said they are still puzzled about why the original surgeon did not do the surgery.

“It’s gross incompetence on the part of the hospital and a failure on the part of the Canadian health-care system,” said Belanger’s mother, Martha Ferris.

Both Patrick and Richard Belanger say the end result was “discrimination” against a patient from Quebec, which pays hospital costs but does not participate in a reciprocal billing agreement for physician fees involving all other provinces and territories.

B.C. doctors can’t bill MSP for Quebec patients: association

Doctors of B.C., an association representing physicians, said an agreement allows its members to bill their own provincial Medical Services Plan for patients from outside the province and the plan is then reimbursed by the patients’ home jurisdiction.

“The doctors get paid as if the patient is a B.C. resident,” it said in a written statement.

But this does not apply to Quebec residents requiring medical care in B.C., it added.

In these cases, physicians can either bill that province or bill the patient, who would seek reimbursement from the Quebec government.

The Health Department in Quebec said doctors elsewhere are paid at rates as if the patient received the same treatment in their home province. Patients must pay any difference in cost and could apply to have the money reimbursed through private insurance, if they have it, the department said in a written response.

The department recommended Quebecers get private insurance before travelling outside the province.

Richard Belanger said the family’s private insurance company refused to pay any costs after the first surgeon wrote in his son’s medical chart that he could return to Quebec and have the surgery there within 10 days.

The insurer had also initially refused to pay costs when an emergency room doctor noted possible intoxication in his son’s chart, Belanger said. But that was later ruled out when the family asked why a test to determine the presence of any substances, including alcohol, was not done, he added.

Dr. Peter Stefanuto, the original surgeon, declined requests for an interview.

He said in an email that he could not speak about any specific case but that “care is provided to all patients regardless of their province or country of origin on an emergency basis.”

Issues involving compensation for services would be best addressed through the B.C. and Quebec governments, Stefanuto added.

Dr. Bob Rishiraj, who ended up doing the operation, said he was not concerned about any “politics” surrounding billing, especially after learning the patient had been taking opioids and methadone for days and a longer wait for surgery carried the risk of infection.

“It became very concerning for me that he was using a lot of morphine and his pain was not well controlled. If we don’t do it, we have a problem of possibly having somebody with narcotics abuse potential down the road,” he said.

“I think a patient is a patient and it doesn’t matter if they’re from Quebec or Ontario or wherever. I think they should just be treated,” Rishiraj said.

The risk of a patient who is billed not paying a physician is low, and cost did not appear to be an issue for Belanger’s family, he said.

Interior Health did not respond to a request for an interview but said in an email that physicians are not employees of the health authority.

Ferris said the family paid Rishiraj $2,563 and will apply for reimbursement from Quebec.

The irony is that the family has used its private health insurance while travelling outside the country but did not expect they would have to rely on it in Canada, she said.

“It’s mind-blowing to me, kind of shocking,” she said.

B.C.’s Health Ministry did not respond to questions about patients from Quebec being denied surgery.

Dr. Katharine Smart, president of the Canadian Medical Association, said the country’s universal health-care system is intended to provide care to all Canadian citizens and permanent residents.

“We strongly encourage provincial and territorial governments to work together to ensure Canadians receive the care they need, when and where they need it, and the federal government to enforce the principles of the Canada Health Act uniformly across the country,” she said in a written statement.

Health Canada said the reciprocal billing agreements are administrative arrangements between provinces and territories to help facilitate the portability criterion of the act while people are temporarily away in another part of the country and need care.

“These agreements are voluntary and not a requirement of the Canada Health Act,” it said in a written response.

Weeklong wait was ‘insane’: health professor

Belanger, who still had trouble speaking because his jaw was wired shut following surgery, said the emotional toll he has suffered is “incalculable,” on top of the physical pain, which still includes migraines.

Damien Contandriopoulos, a University of Victoria nursing professor and health policy researcher, said that regardless of Quebec’s billing scheme, the province pays, on average, higher physician rates than other jurisdictions for the same care, a reversal from its practice years ago.

It’s common for thousands of patients from Quebec to get care from family doctors in Ontario border towns and for their province to reimburse the cost, he said, adding he is “shocked” that services would be denied to a patient based on billing issues.

However, doctors in B.C., where relatively few Quebecers get care, may be deterred from seeking information on rates paid by that province because they’re listed on about 3,000 pages in some complicated categories, and in French, said Contandriopoulos, a former resident of Quebec.

In Belanger’s case, the surgeon could have contacted his insurance company’s 24-7 phone line to get information from a representative, rather than saying administrators were not available on the weekend, Contandriopoulos said.

He called Belanger’s weeklong wait for surgery “insane.”


Source: https://www.cbc.ca/news/canada/british-columbia/quebec-tourist-denied-jaw-surgery-bc-health-care-coverage-1.6513190
This web page was saved on Thursday, Jul 07 2022.


11. [^^] Fake nurse remained employed at B.C. hospital despite long list of complaints against her, court filing says | CBC News

Fake nurse remained employed at B.C. hospital despite long list of complaints against her, court filing says | CBC News Φ 法庭檔稱,假護士仍然受雇於卑詩省醫院,儘管對她有一長串投訴,|加拿大廣播公司新聞

Fake nurse remained employed at B.C. hospital despite long list of complaints against her, court filing says | CBC News


In July 2020, just two weeks into her year of posing as a gynecological nurse at B.C. Women’s Hospital, Brigitte Cleroux was written up for “inappropriate” and disrespectful conduct toward a colleague, according to a new legal filing.

Within four months on the job at the Vancouver hospital, Cleroux had allegedly been placed on administrative leave and received a written warning related to her unprofessional and judgmental behaviour with a patient.

By December 2020, Cleroux was allegedly suspended from work for a day in response to another list of complaints, including loudly saying she wanted to “punch or hit” a colleague in the face, using force to straighten a patient’s arm while applying a blood pressure cuff, and being “physically and verbally inappropriate” with another patient while inserting an intravenous line.

Despite all this — and despite the fact she had no actual nursing credentials — Cleroux worked at the hospital for another six months after the suspension.

These revelations come courtesy of a response filed Friday by the Provincial Health Services Authority (PHSA) to a proposed class action lawsuit launched on behalf of patients who claim PHSA is liable for the harm they suffered under Cleroux’s care. 

The PHSA response denies liability for Cleroux’s actions, but reveals several new allegations of inappropriate behaviour during her time in the Vancouver hospital’s Post Anesthetic Care Unit between June 22, 2020, and June 23, 2021.

According to the response, Cleroux’s deception was only discovered in June 2021 after more complaints about her unprofessional and aggressive behaviour toward patients and colleagues.

Fake nurse sentenced to prison time in Ontario

Cleroux, 50, has a long criminal history across the country, including 67 convictions as an adult, and has pretended to be a nurse or school teacher in at least four provinces and two U.S. states.

She is currently awaiting trial in Vancouver for fraud and personation in relation to her activities at B.C. Women’s Hospital, and prosecutors have said an investigation is underway into further allegations of assault.

Cleroux is currently behind bars after receiving a seven-year prison sentence for crimes including personation, assault with a weapon and assault related to her time posing as a nurse at a fertility clinic and a dental clinic in Ottawa.

Brigitte Cleroux is shown in an older photo shared by the College of Nurses of Ontario. (College of Nurses of Ontario)

The proposed class action lawsuit was filed in December by representative plaintiff Miranda Massie on behalf of all patients who received treatment from Cleroux at B.C. Women’s Hospital. The notice of claim alleges negligence by PHSA for hiring Cleroux, and holds the health authority liable for battery.

In its response, PHSA denies that it should have known Cleroux wasn’t a qualified nurse, or that her deception should have been discovered with due diligence. 

“At all material times PHSA took all reasonable steps to properly review Cleroux’s suitability and credentials as a registered nurse and to monitor, supervise and oversee Cleroux,” the response says.

Cleroux ‘took steps to appear sufficiently competent’

It goes on to say that when Cleroux was hired, provincial health authorities were struggling to keep up with the demand for nursing staff caused by the COVID-19 pandemic.

She applied for a job using the name Melanie Smith, which matched the identity of a nurse registered in B.C. at the time, according to the response. No such name is currently listed in the public online registry for the B.C. College of Nurses and Midwives.

In a phone interview for the B.C. Women’s Hospital job, Cleroux “appeared professional, cordial and enthusiastic,” according to the response.

However, the response also notes that Cleroux could not provide a registration number for the B.C. nursing college, explaining she didn’t have one yet because she had recently moved from Ontario.

Nonetheless, she was hired, and according to PHSA she “actively took steps to appear sufficiently competent in the day-to-day tasks required of a registered nurse in the PACU.” The response says Cleroux went as far as to make recommendations for improving nursing care in the unit.

Her interpersonal behaviour was another matter, however. 

The final straw, according to the PHSA response, was an incident on June 4, 2021, when a patient overheard Cleroux talking about another patient in a “loud and cavalier manner.” 

When a co-worker told Cleroux the patient might file a complaint, Cleroux became “aggressive and dismissive,” and continued to act that way in two meetings with staff, the response says.

She was placed on administrative leave once again and the PHSA says it launched an investigation, finally confirming that Cleroux was neither Melanie Smith, nor a licensed nurse.

None of the allegations in the proposed class action or the response have been proven in court.

Cleroux is scheduled to make her next appearance in provincial court in Vancouver on June 23.


Source: https://www.cbc.ca/news/canada/british-columbia/bc-fake-nurse-court-filing-1.6344412
This web page was saved on Saturday, Jul 09 2022.


12. [^^] ‘We cannot afford to continue as we are:’ Canada’s premiers call for feds to fund health care

‘We cannot afford to continue as we are:’ Canada’s premiers call for feds to fund health care Φ “我們不能繼續這樣下去:”加拿大總理呼籲聯邦政府為醫療保健提供資金

‘We cannot afford to continue as we are:’ Canada’s premiers call for feds to fund health care


New Westminster, B.C. –

For the first time since 2019 Canadian premiers are meeting in person in to discuss how to deal with a growing crisis in healthcare across the country.

From emergency rooms shutting down, persistent staffing shortages and long waits to see family doctors — provincial leaders are feeling the heat when it comes to healthcare issues.

And they say Ottawa needs to pay up.

B.C. Premier John Horgan is the chair of the Council of the Federation, which is what the group of provincial and territorial leaders calls itself. Premiers will meet Monday and Tuesday in Victoria to speak about healthcare as well as a growing national affordability crisis.

“We have been coming up short across the country for a long, long time because we can’t count on a stable partner,” Horgan said Monday.

The premiers say Ottawa used to be a 50/50 funding partner and is now only providing roughly a fifth of the costs. They want the feds to put up at least 35 per cent of total funding — an increase that would cost another $28 billion a year.

Quebec premier Francois Legault said costs for healthcare are increasing due to the population aging, and the need for new technology.

“So we cannot afford to continue as we are doing right now,” he added.


The federal government says the provincial and territorial leaders are fudging the number, citing billions in one-time funding to help with memrging and ongoing healthcare woes.

Dominic LeBlanc, the Intergovernmental Affairs Minister pushed back against the premiers’ claims.

“That 22 per cent number the premiers use is fake,” he told CTV News Channel.

“They choose to take a set of numbers which do not reflect the federal government’s support for public healthcare. But, the prime minister has said we will absolutely talk to them about how to increase federal support for healthcare,” he added.

Horgan, who is leading the charge to get more money from Ottawa, countered by saying it was ‘disingenuous’ to suggest the federal government was carrying the load when it comes to funding the system.

Also on the agenda is an intense worker shortage facing nearly every industry — including healthcare.

Monday’s meeting comes as a group representing emergency room doctors across the country calls for the premiers to address staff shortages.

The Canadian Association of Emergency Physicians says the priority needs to be the recruitment and retention of health-care workers.

“What we really need is targeted investment in these areas over many years. They have been underfunded to the point that now we have no redundancy left in the acute care system and it’s starting to fail,” said Dr. Michael Howlett, president of the Canadian Association of Emergency Physicians.

With costs for housing, gas and groceries rising the premiers are also looking for a broader affordability fix, particularly since the economic fallout from the pandemic is still being deeply felt by individuals, households and businesses from coast to coast to coast.

The meeting wraps up Tuesday with a closing press conference where all premiers will be available.

With files from The Canadian Press


Source: https://bc.ctvnews.ca/health-care-to-dominate-meeting-of-canada-s-premiers-in-b-c-1.5982501
This web page was saved on Tuesday, Jul 12 2022.


13. [^^] Premiers call on Ottawa to increase health funding as nurses say system is on ‘brink of disaster’

Premiers call on Ottawa to increase health funding as nurses say system is on ‘brink of disaster’ Φ 總理呼籲渥太華增加衛生資金,因為護士說該系統正處於“災難的邊緣”

Premiers call on Ottawa to increase health funding as nurses say system is on ‘brink of disaster’


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B.C. Premier John Horgan, the host and chair of the Council of the Federation, said they’ve already sent the federal government a detailed funding proposal and are waiting to hear back

BC Premier John Horgan announced Tuesday, June 28, 2022 at the Pinnacle Hotel in Vancouver, BC that he will not be seeking re-election and that he is stepping down as party leader pending a leadership race. Horgan chairs the Council of the Federation of premiers. BC Premier John Horgan announced Tuesday, June 28, 2022 at the Pinnacle Hotel in Vancouver, BC that he will not be seeking re-election and that he is stepping down as party leader pending a leadership race. Horgan chairs the Council of the Federation of premiers. Photo by Jason Payne/ PNG

VICTORIA — Canada’s provinces and territories need a partner that will share half the financial load on the health-care system, which is buckling without long-term and sustainable funding, British Columbia Premier John Horgan says.

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The country’s 13 premiers began two days of meetings in Victoria on Monday with the primary topic of health-care funding as Canada eases out of a pandemic with a severe shortage of doctors, nurses and other health workers.

Horgan, who chairs the Council of the Federation of premiers, said they’ve already sent the federal government a detailed funding proposal and are waiting to hear back. He received a text from Prime Minister Justin Trudeau on Monday saying Ottawa is aware of the funding situation and is working on a response, Horgan said.

“But we can’t determine what we’re going to do with money we don’t have,” he said.

“And we can go a lot further if we had a partner that was carrying half the load,” Horgan said, noting that was the history of health-care funding in Canada before cuts began in the 1990s.

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  1. Alberta Premier Jason Kenney at a news conference after a meeting of Canada's provincial premiers in Toronto, Dec. 2, 2019.

    Premiers agree to prioritize economic competitiveness and seek more health care money

  2. Manitoba Premier Brian Pallister and Quebec Premier François Legault.

    Premiers mostly silent over Quebec religious symbol ban: ‘It’s not something for us to contest’

The premiers have called on Ottawa to increase health funding to 35 per cent, from 22 per cent.

“We need to reimagine public health care in Canada,” Horgan said.

Stable, increased funding would allow jurisdictions to invest in a human resource strategy so they aren’t poaching from each other as they train the next generation of health-care workers to take the burden off those who were celebrated during the pandemic, Horgan said.

“It’s just not good enough to show our gratitude. We need to now show we’re committed to those workers, those patients, and that’s what these discussions are about this afternoon and into tomorrow.”

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Canadian nursing leaders also met with premiers earlier Monday with a message that nurses are suffering through a “dire staffing crisis” that threatens the sustainability of public health care.

A statement from Linda Silas, president of the Canadian Federation of Nurses Unions, said the system is “on the brink of disaster.”

Silas said nurses have been “struggling through extreme staffing shortages, forced overtime and cancelled vacations, with no end in sight” to untenable conditions.

The federation said its proposals focus on retaining nurses, encouraging them to return to the profession and bringing in new measures to recruit and train more of them.

Silas said provincial commitments to strengthen health care are welcome, but “no one province or territory can solve this on their own,” and federal funding will be key.

Premiers also met with leaders of the National Indigenous Organizations, made up of the Assembly of First Nations, Congress of Aboriginal Peoples, Inuit Tapiriit Kanatami, Metis National Council and the Native Women’s Association of Canada.

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Horgan said they discussed issues like land claims, reconciliation, missing and murdered women as well as the “archaic” Indian Act, which was introduced when residential school policies were being developed across Canada.

Lisa Weber of the Native Women’s Association of Canada said it was made clear to her that premiers were committed to getting measurable outcomes for Indigenous women, children and families.

Meanwhile, Alberta Premier Jason Kenney said he will be speaking at the meeting about the federal government’s emissions reduction plan.

He said the reduction plan is “pie in the sky” and a “ridiculous” target with no proper strategy for implementation.

Kenney, who made the comments at the Calgary Stampede’s annual breakfast on Monday, said the implications of the plan would be devastating for Alberta just as the world needs more of its energy resources.

The federal plan released earlier this year is aimed at capping oil and gas sector emissions to achieve net-zero emissions by 2050 and reduce oil and gas methane emissions by at least 75 per cent by 2030.

This report by The Canadian Press was first published July 11, 2022.


Source: https://nationalpost.com/news/canada/kenney-wants-federal-climate-plan-on-agenda-at-premiers-meeting-in-b-c
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14. [^^] B.C. court upholds public health-care principles, striking down appeal

B.C. court upholds public health-care principles, striking down appeal Φ 卑詩省法院堅持公共醫療保健原則,駁回上訴

B.C. court upholds public health-care principles, striking down appeal

sxx THS

A Vancouver surgeon and businessman has lost his appeal of a landmark court case that threatened the foundations of the Canadian health-care system.

The B.C. Court of Appeal has dismissed the appeal brought by Dr. Brian Day of the Cambie Surgical Centre, finding that a 2020 judgment from a lower court judge was appropriate in their 142-page ruling. Appeals only address perceived errors in law, not the fundamental facts established by the initial judgment.

Day had argued that British Columbians had the right to pay for private medical treatment, primarily scheduled day surgeries, because waits in the public system were so long, they violated patients’ constitutional rights to life, liberty and the security of the person under Section 7 of the Charter.

The Court of Appeal described Day’s argument as patients suffering “when the public system is broken and has failed to deliver on its promise of timely quality care, unjustly prevents individuals from using their own resources to meet their health-care needs,” and that “permitting parallel private care would act as a safety valve, relieving the pressure on the public system without harming it.”

But they agreed with lawyers for the attorney general, representing the province, who said the initial judgment was correct in finding “the case was really about the financial interests and preferred business model of some physicians and private clinics.”


While she agreed with her two colleagues that health care should be available to all based on their needs, rather than financial wherewithal, one of the judges essentially argued it’s unfair for patients to suffer because governments have decided to fund and operate the health-care system at current service levels.

“It is more than incommensurate to ask patients to risk irremediable harm and increased risk of death in order to preserve a public health-care system that is intentionally under-designed in order to achieve fiscal sustainability,” wrote justice Lauri Ann Fenlon, who pointed out the truly wealthy already travel to the United States or other countries and pay for swift access to medical services.

She acknowledged there is a “legal dissonance” in finding that a law is constitutional while being contradictory to the principles of fundamental justice.

“The record and findings of the judge amply support his conclusion that a duplicative system would result in longer wait times and, therefore, even poorer care for those who would have no option but the public system,” wrote Fenlon.

“We do not find that the judge overstated the societal benefits of the suppression of private care or the negative effects of striking the provisions on the sustainability and effectiveness of the public system.” 


Source: https://bc.ctvnews.ca/b-c-court-upholds-public-health-care-principles-striking-down-appeal-1.5988940
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15. [^^] This family doctor is leaving B.C. Other physicians are among her ‘orphaned’ patients | CBC News

This family doctor is leaving B.C. Other physicians are among her ‘orphaned’ patients | CBC News Φ 這位家庭醫生即將離開不列顛哥倫比亞省。其他醫生是她的“孤兒”患者之|加拿大廣播公司新聞

This family doctor is leaving B.C. Other physicians are among her ‘orphaned’ patients | CBC News


This story is part of Situation Critical, a series from CBC British Columbia reporting on the barriers people in this province face in accessing timely and appropriate health care.

A stylized phrase reading 'SITUATION CRITICAL', made to read like a red heartbeat monitor.

Dr. Anna Chodyra has crossed land and sea to practise medicine.

Originally from Poland, the 47-year-old first immigrated to Canada as an international medical graduate in 2001.

She did her residency in Calgary before crossing the Rockies in 2006, when she relocated to the small city of Port Moody in the Tri-Cities area of B.C.’s Lower Mainland, just east of Vancouver. She worked there for 13 years before following the Barnet Highway east to Coquitlam, where she joined Meadowbrook Family Practice.

The family doctor said she currently has a patient panel of 2,100 people — and she isn’t sure where any of them will go when she, and her family, relocate to New Zealand this fall.

“It’s a very difficult decision, knowing that I’m leaving my patients without finding someone to replace me, leaving them on their own,” said Chodyra, adding that she never planned on leaving B.C.

“We tried to find a replacement physician, but we couldn’t. Nobody is taking over practices anymore.”

Chodyra closed her B.C. practice at the end of June, as she prepares to join a new family physician group in the small town of Waihi, about two hours southeast of Auckland. 

Dr. Anna Chodyra is pictured sitting at a desk, working on a Macbook. She is wearing a black jacket, a stethoscope around her shoulders, and a blue medical mask.

Dr. Anna Chodyra said she has struggled to find a new physician to take on her patient roster, since announcing plans to close her practice at the end of June. (Justine Boulin/CBC)

She said the decision stems from a need to be closer to her husband’s family in Australia, and because of “the state of primary care in B.C.,” including the province’s current fee-for-service system and staffing shortages which she says will be less of a problem in New Zealand, where she will have five nurses and three doctors helping assist patients.

“Family doctors, we don’t feel supported and we really feel undervalued,” she said.

Her imminent departure, however, has sent shock waves throughout the Tri-Cities, as her patients scramble to find new family doctors amid a shortage, where an estimated one million British Columbians are already without a primary care physician.

The Fraser Northwest Division of Family Practice (FNDFP) — a non-profit organization that works with and supports family physicians in Anmore, Belcarra, Coquitlam, New Westminster, Port Coquitlam and Port Moody — said its membership has decreased seven per cent over the past year. It estimates that, across the six communities, there are 170 primary providers, roughly 49 of whom live in Coquitlam.

The non-profit’s program director, Jessie Mather-Lingley, said that since 2014, Coquitlam has lost nearly 50 family practitioners. She said 15 of those have been since 2021, either due to retirement, relocation or changing roles within health care.

B.C.’s Ministry of Health said in a statement that it “is committed to ensuring all British Columbians have access to health care when they need it.”

“The number of family physicians has increased by nearly nine per cent since 2016-17 to 6,760 FPs (family physicians) in the province in 2020-21. That’s an average annual increase of 2.1 per cent.”

Still, Chodyra and other doctors worry that patients unable to find new physicians will turn to acute care providers like hospital emergency departments for non-urgent care, because they have no other option, further straining British Columbia’s health-care system with delays and increased costs.

Doctors without doctors

For family doctor Mahsa Mackie, Chodyra’s departure hits especially close to home. Along with working in Coquitlam, she is also one of the patients Chodyra is leaving behind.

“If someone who we think has a lot of years ahead is closing their practice or leaving the community, it’s never a good sign,” said Mackie.

Mackie, who finished her residency in 2014, said the hardest part of her doctor’s decision to close shop is knowing she and her colleagues at Manhas Health Co. Health Clinic will not be able to take in all of Chodyra’s “orphans.”

“I have a couple thousand patients and my waiting time is already a couple of weeks. Taking more patients means my current patients would not have access to care in time.”

Mackie said she has taken some of Chodyra’s patients, but that many more are stuck on the clinic’s wait list, which has been growing ever since she joined in 2021.

‘Orphaned’ patients may strain ER resources

Emergency physician Dr. Ali Abdalvand, who is also part of Chodyra’s current roster, tells CBC that orphaned patients will turn to temporary stop gaps like urgent primary care, or acute emergency care if they cannot find a family doctor in their community.

“The purpose of having emergency medicine as a specialty, and of having the emergency department as part of the health-care system, is delivery of acute unscheduled care,” said Dr. Abdalvand.

A paramedic is pictured at St. Paul’s Hospital in Vancouver in January. Emergency physician Dr. Ali Abdalvand worries patients will turn to temporary stop gaps like acute emergency care if they cannot find a family doctor in their community. (Ben Nelms/CBC)

“If you end up sharing the resources of an emergency department to deliver primary care, that will leave less and less of those resources for delivery of acute unscheduled care.”

Data from the Canadian Institute of Health Information, meanwhile, shows that emergency department expenses across Canada have climbed in recent years.

The cost of an emergency department visit climbed from $96 in 2005-2006, to $158 in 2018-2019, an annual growth rate of four per cent.

Ali Abdalvand looks at the camera. He is an Asian man wearing a blue spotted shirt. He is standing in front of a sign that reads 'Eagle Ridge Hospital Emergency'.

Emergency physician Dr. Ali Abdalvand worries a surplus of primary care patients will drain his department’s resources, as more and more British Columbians struggle to find a family doctor. (Shawn Foss/CBC)

The same data set also shows that, in 2018-2019, emergency department staff in B.C. worked more overtime than anywhere else in Canada, except the Northwest Territories, at 9.14 per cent of all hours worked.

As he looks for a new family physician, Abdalvad tells CBC the province is losing “one of the best doctors” he has ever met.

“I know patients who told me [Chodyra] went and got [their] prescription filled … and dropped it off,” he said. “This is above and beyond [care]. And that makes me sad.”


Source: https://www.cbc.ca/news/canada/british-columbia/this-family-doctor-is-leaving-b-c-other-physicians-are-among-her-orphaned-patients-1.6528373
This web page was saved on Friday, Jul 22 2022.

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