Medicare on trial as private Vancouver clinic challenges coverage rules

VANCOUVER _ A lawsuit that begins today in B.C. Supreme Court in Vancouver has the potential to fundamentally change the way Canadians access health care.

Dr. Brian Day, who operates a private surgical centre in Vancouver, is challenging B.C.’s ban on Canadians buying private insurance for medically necessary services already covered by medicare.

Day alleges the restriction violates the constitutional rights of patients by forcing them to endure lengthy wait times, even as their health problems worsen.

British Columbia’s Ministry of Health, a defendant in the case, isn’t commenting while the matter is before the courts, but has said its priority is to uphold the Medicare Protection Act and the benefits it safeguards.

Adam Lynes-Ford of the B.C. Health Coalition, one of the interveners in the case, says a core Canadian value ensures patients have access to medical care based on need, not on ability to pay, but this case could derail that concept.

The lawsuit, described by University of Ottawa law professor Colleen Flood, as one of the biggest constitutional cases “perhaps ever,” is scheduled to continue for at least six months.

“This is about making medicare better,” says Day, arguing that opening the door for private insurance will ease pressure on the public system, freeing up resources that will cut wait times and boost quality of care for everyone, whether publicly or privately insured.

“Every time you allow the Canada Health Act to be chipped away at, it’s chipping away at some fundamental Canadian values,” says Ian Culbert of the Canadian Public Health Association.

He says he worries a victory for Day could introduce a hybrid public-private model of medicare, which he believes will lower the quality of care for those who can’t afford private health insurance.

In 2005, a Supreme Court of Canada decision gave Quebeckers access to private insurance when the top court ruled excessive wait times infringed on patients’ constitutional rights.

That decision was argued under the Quebec Charter, so didn’t extend beyond that province’s boundaries, but a judgment in Day’s favour has the potential to affect health care delivery nationwide.


Checklist of possible behavioural warning signs of dementia

Researchers on Sunday outlined a syndrome called “mild behavioural impairment” that may be a harbinger of Alzheimer’s or other dementias, and proposed a checklist of symptoms to help identify who’s at risk. The symptoms must mark a change from prior behaviour and have lasted at least six months. Among the questions:

_Has the person lost interest in friends, family or home activities?

_Has the person become less spontaneous and active for example, is he/she less likely to initiate or maintain conversation?

_Does the person view herself/himself as a burden to family?

_Has the person become more anxious or worried about things that are routine, like events, visits?

_Does the person feel very tense, having developed an inability to relax, or shakiness, or symptoms of panic?

_Has the person become agitated, aggressive, irritable or temperamental?

_Does the person hoard objects when she/he did not do so before?

_Has the person recently developed trouble regulating smoking, alcohol, drug intake or gambling, or started shoplifting?

_Does the person say rude or crude things or make lewd sexual remarks that she/he would not have said before?

_Has the person started talking openly about very personal or private matters not usually discussed in public?

_Has the person developed beliefs that they are in danger, or that others are planning to harm them or steal their belongings?

_Does the person report or act as if seeing things or hearing voices?


Smoking, drinking could cost an unhealthy guy more than $8.6 million over lifetime

Smoking, drinking could cost an unhealthy guy more than $8.6 million over lifetime

Hamilton Spectator

Hey guys, you may want to think twice before you reach for that bottle of beer, the hamburger and French fries and an after-dinner smoke. It’s not only bad for your health, but also your wallet.

Smoking, drinking and being overweight could cost a very unhealthy guy more than $8.6 million over his lifetime — if you take into account the cost of alcohol and cigarettes and high life insurance premiums for drinkers and smokers. That’s according to a study commissioned by the Canadian Men’s Health Foundation, a B.C. non-profit dedicated to raising awareness of men’s health.

“This is eye-opening news for guys who might not consider the true costs of their habits,” said foundation president Wayne Hartrick.

“The good news is that by making small lifestyle changes, your body and wallet will thank you.”

“We want to start a men’s health movement in Canada by making men aware of all the good reasons they should be more proactive about their health, including how it impacts their wallets,” said Dr. Larry Goldenberg, founder of the foundation. “It’s important for men to know about preventive strategies, nutrition and how to listen to one’s body.”

The study, conducted by Vancouver-based H. Krueger & Associates, did some population data number-crunching, factoring in the price of alcohol, cigarettes and insurance premiums, and considered three prototype men, who drank, smoked and were overweight.

Low-Risk Joe, the first prototype, smokes five cigarettes a day, drinks one alcoholic drink per day and is 6 feet tall and 258 pounds, with a body mass or BMI of 35.

The second is Medium-Risk Joe, who smokes 20 cigarettes a day, consumes three alcoholic drinks per day, and is 6 feet tall and 295 pounds with a BMI of 40.

The third prototype is High-Risk Joe, who smokes 40 cigarettes a day; consumes five alcoholic drinks daily, and is 6 feet tall, weighing 331 pounds, with a BMI of 45.

What they found wasn’t surprising, but it is worth noting. The first prototype, Low-Risk Joe, could save $275,000 over his lifetime if he stopped smoking and drinking and avoided the high life insurance premiums associated with those behaviours, according to the study. The lost investment potential of that money if he had invested it, between the ages of 30 and 75, is $1.7 million, the study suggests.

Both costs and lost investment potential grow the more you drink, eat and smoke. Medium-Risk Joe could save $628,000 over his lifetime, money that could grow to $3.2 million if invested. High-Risk Joe could save $1.1 million over his lifetime, with an investment potential of an astounding $8.6 million.

The study also points out that smoking, alcohol use and excess weight in middle-aged men cost the Canadian economy $20.3 billion in treatment costs, disability and premature mortality.

Smoking cigarettes cost men an average of 10 years of their life, while being obese costs 5.8 years of life, and alcohol costs 7.9 years of life.

Torstar News Service

Cheap foreign dental care attracting more Quebecers

Cheap foreign dental care attracting more Quebecers

Excerpted article written by Kate McKenna, CBC News

When Sherbrooke resident Éric Leclerc saw how much his dentures were going to cost, he considered remortgaging his home.

Leclerc, 50, was told they would cost $2,200. Even with his insurance, he’d have to pay more than $1,000 out of pocket.

It had been seven years since he lost most of his teeth, and he dreaded the idea of going through the rest of his life without them: struggling to eat, talk and smile.

Not being able to smile was particularly hard on Leclerc and his family.

“I’ve got old pictures, you look at them, and people think I’m sad all the time. But I’m not,” he said.

So when he was web-browsing before heading on a family trip to Cuba, his eyes locked on a post for cheap dental care from a clinic close to the resort where he was booked to stay.

Implants for a quarter of cost

For 325 Cuban pesos, or around $400 Cdn, he was told he could get the same dentures available in Canada – for less than a quarter of the price.

Even factoring in the cost of the flight and resort, his total bill for the dental work would come to $1,800. So Leclerc decided to try.

He landed in Cuba in late May and walked just a couple of minutes from his resort to the dental clinic set up especially for tourists. He recognized the accents of most of the people in the waiting room.

“I’d say 75 per cent of customers were Canadian. Most of them were French-speaking Quebecers,” he said.

As far as Leclerc can tell, his denture implant went well.

The work was completed, he went back to the resort, and smiled for a picture for the first time since he lost his teeth.

Leclerc took this photo with his partner after his dentures were implanted. He said it’s the first picture where he’s been able to smile since losing his teeth. (Éric Leclerc)

Leclerc describes his experience as very positive and said he could see no difference between the Cuban clinic and a clinic in Quebec.

Not an isolated case

In 2014, 284,600 Canadian travellers indicated “medical or health treatment” as one of their reasons for travel.

Research by Patients Beyond Borders shows Mexico is the most popular destination for Canadians looking for elective procedures such as dental work. Others travel to Costa Rica, South America and India.

Barry Dolman, the president of Quebec’s Order of Dentists, says the number of people partaking in dental tourism has grown because of people are finding reviews of these clinics on tourism-related websites

Unregulated, unaccountable – unsafe?

However, Dolman is warning against accessing dental care in countries such as Cuba, which don’t meet the standards of the International Society of Dental Regulators.

He said in some countries, because of less taxation, fewer tariffs and cheaper rent, some dental services can be offered more cheaply.

But in Cuba, the educational requirements to become a dentist aren’t the same as in Canada. There’s also no accreditation system –  nor is there any official recourse should surgery go poorly.

“It’s the patient who will pay in the long-term,” Dolman said.

Doctor wants B.C. to assure nurses they won’t be prosecuted for assisted death

A British Columbia doctor who has become an outspoken advocate for assisted death is calling on the provincial government to assure nurses they won’t be prosecuted for participating in the procedure.

Dr. Ellen Wiebe says the province should follow Alberta’s lead and issue a directive to police stating criminal charges will not be pursued against medical teams who take part in assisted death.

The Justice Ministry says it’s aware of Alberta’s directive and is discussing options with the regulatory colleges to provide appropriate protection for health care professionals.

The Supreme Court of Canada’s decision on assisted death came into effect June 6, 2016 in the absence of federal legislation, meaning it’s now legal for physicians to help end the lives of mentally competent adults suffering from “grievous and irremediable” conditions.

The B.C. College of Physicians and Surgeons has issued assisted-death standards for doctors, while the College of Pharmacists of B.C. has advised its members that the legal risk they face is small.

But the College of Registered Nurses of B.C. says it remains unclear what involvement nurses can legally have in assisted death and advises its members to avoid initiating discussions on the topic.


ServiceMaster Restore and “Hoarders” TV Personality Partner to Train Industry Professionals

Source: ServiceMaster press release

ServiceMasterHoardersServiceMaster Restore, the leader in residential and commercial services, expands their service offering to include hoarding and extreme cleanup. ServiceMaster Restore has partnered with hoarding cleanup expert and television personality Matt Paxton to create a specialized training program to teach its global network on how to understand and properly work with people who hoard.

Stephan Roy, National Director of ServiceMaster Restore has been working with Matt and their US team to bring the program to Canada. The company is hosting industry training seminars to stakeholders who are exposed to people that live with the difficult conditions of hoarding. Roy comments, “The training is timely as awareness of hoarding increases due to popular TV shows and the disease recently being added to the Diagnostic and Statistical Manual used by psychiatrists to diagnosis mental illness.”

“Hoarding is more common than you might think,” says Matt Paxton, one of the stars of A&E’s “Hoarders” series. “Dealing with hoarding cleanup requires specialized training, and I’ve teamed up with ServiceMaster Restore to assess hoarding situations, develop action plans and help clients comfortably return to healthy living environments.”

While extreme clutter is a symptom of hoarding, dealing with hoarding cleanup requires expert help from both cleaning and mental health professionals. Clutter created by hoarding can result in serious threats to the well-being and safety of the person suffering from this disorder, as well as those close to them.

“Together with ServiceMaster Restore, we’ll be able to help more of those in need and have a real impact on the lives of those suffering from this mental health disorder,” said Paxton.

For more than 60 years, ServiceMaster Restore has provided professional cleaning and disaster restoration services. Paxton, one of the top hoarding cleanup experts in the United States, is also the founder of Clutter Cleaner, author of The Secret Lives of Hoarders and featured expert on the television show “Hoarders.” As the in-house expert for ServiceMaster Restore, he’ll be providing specialized hands-on training to participating franchisees across the country. The company will also host a seminar for local therapists, organizers, care managers, senior move managers, and other professionals who work or care for hoarders and their families.

Cleaning the home of a hoarder is a difficult task that requires effective planning, detailed execution and the right equipment. Not only does a hoarding situation require experts who can navigate the issues, but also people who treat each client with compassion and respect.

Roy explains that the company has a comprehensive approach to how each of its local franchisees handle restoration and extreme cleanup jobs. “Most people who hoard have experienced a traumatic event in their life, causing them to hold onto things. There are different levels of complexity and they come from all walks of life.  You may know someone that needs special assistance and we are here to help.”  ServiceMaster Restore’s approach ensures the focus is on the individual person who needs help – understanding the emotional impact and providing support to help them cope. “We’re not just removing clutter and debris; we’re helping families regain their lives.”

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