Novel Coronavirus COVID-19 (nCoV-2019)

[Jasmine18]

As we move to stage 3 we need to reopen the health care system

I would say a greater threat is people who have health conditions remaining undiagnosed as they cant either see a doctor or specialist in person or cant get an appointment.

Like I had a cousin who had pins and needles and suspect has a b12 deficiency and has not been able to see a nurse for b12 injections as his body cant naturally ingest b12.

 

[Bayer]

As we move to stage 3 we need to reopen the health care system

I would say a greater threat is people who have health conditions remaining undiagnosed as they cant either see a doctor or specialist in person or cant get an appointment.

Like I had a cousin who had pins and needles and suspect has a b12 deficiency and has not been able to see a nurse for b12 injections as his body cant naturally ingest b12.

It depends - last week, my husband got short of breath while waiting for a COVID test at Women's College; he was taken to Toronto General for tests. Negative for COVID but on Tuesday, he had a phone appointment with a cardiologist, and today, he's off to Western for heart tests.

 

[AlbertC]

Police investigating after racist, anti-mask tirade at Mississauga supermarket goes viral

July 8, 2020

Police say they’re investigating a nearly four-minute cellphone video that appears to show a man hurling anti-Asian and anti-mask rhetoric towards T&T Supermarket employees in Mississauga, Ontario.

The video, posted to YouTube, has been viewed more than 140,000 times by Wednesday evening.

Police investigating after racist, anti-mask tirade at Mississauga supermarket goes viral | Globalnews.ca

The video, posted to YouTube, has been viewed more than 140,000 times by Wednesday evening.

globalnews.ca

 

[lenaitch]

As we move to stage 3 we need to reopen the health care system

I would say a greater threat is people who have health conditions remaining undiagnosed as they cant either see a doctor or specialist in person or cant get an appointment.

Like I had a cousin who had pins and needles and suspect has a b12 deficiency and has not been able to see a nurse for b12 injections as his body cant naturally ingest b12.

Pernicious Anemia. My wife has it an injects herself. It's an intramuscular (preferred) or subcutaneous - you don't need to find a vein.

I think in some ways there could be some long term benefits. My wife has been having Skype/phone appointments with our doctor (who is actually a dork so not seeing him in person can be a good thing in some ways), so technology can have a role in some cases. Medical services such as lab work, imaging, etc. are still working. My sister-in-law is confronting a resurgence of a fairly serious condition and has encountered no lack of hospital services (her knee replacement; however, seems to now be off into the next millennium. )However, if it becomes more embedded, I can see a battle with the government over fees for in-person vs. virtual appointments.

 

[AlvinofDiaspar]

COVID is a good kick in the butt for the health care system - it basically illuminated all the weaknesses and absurdities. I bet you people will have taking eHealth more seriously and with more urgency now.

AoD

 

[Northern Light]

Police investigating after racist, anti-mask tirade at Mississauga supermarket goes viral

July 8, 2020

Police say they’re investigating a nearly four-minute cellphone video that appears to show a man hurling anti-Asian and anti-mask rhetoric towards T&T Supermarket employees in Mississauga, Ontario.

The video, posted to YouTube, has been viewed more than 140,000 times by Wednesday evening.

Police investigating after racist, anti-mask tirade at Mississauga supermarket goes viral | Globalnews.ca

The video, posted to YouTube, has been viewed more than 140,000 times by Wednesday evening.

globalnews.ca

Offensive; of course. But there's something absurd about this happening inside an Asian grocery store!

 

[Northern Light]

However, if it becomes more embedded, I can see a battle with the government over fees for in-person vs. virtual appointments.

The question of what proportion of visits can be virtual is an important one to inform fair and appropriate billing.

Most doctors in Ontario, being small business contractors for all intents and purposes (not government employees) receive a fee for service that reflects the scale and scope of office required to run a practice.

That really doesn't change any if 5% or even 25% of your patient visits go virtual. But it may change if 1/3 or more do.

That's the point at which an office can shrink, one exam room eliminated, smaller waiting room etc.

Alternately that could be addressed by bringing doctors in-house as employees of the province and/or their hospitals which I would argue would be administratively and financially prudent move; but its also costly and a big changeover.

 

[AlvinofDiaspar]

The question of what proportion of visits can be virtual is an important one to inform fair and appropriate billing.

Most doctors in Ontario, being small business contractors for all intents and purposes (not government employees) receive a fee for service that reflects the scale and scope of office required to run a practice.

That really doesn't change any if 5% or even 25% of your patient visits go virtual. But it may change if 1/3 or more do.

That's the point at which an office can shrink, one exam room eliminated, smaller waiting room etc.

Alternately that could be addressed by bringing doctors in-house as employees of the province and/or their hospitals which I would argue would be administratively and financially prudent move; but its also costly and a big changeover.

The province really should phase out fee for service for new family doctors - grandparent the existing ones by all means on that model, but it make sense to have a salary+ model for new doctors. Also, one reason behind the whole eHealth morass is the difficulty in getting doctors to adopt standardized tech as small business contractors.

AoD

 

[AlbertC]

Offensive; of course. But there's something absurd about this happening inside an Asian grocery store!

Frankly, the guy looks like he had an agenda to walk in there and rile things up. T&T has had the mask policy for around a couple months now, even before the GTA bylaw came in place. Also, the Trump inspired hate speech is especially ignorant when T&T is a supermarket chain that was originally founded by a Taiwanese-Canadian. But racist d-bags will be racist d-bags.

 

[TrickyRicky]

"COVID is a good kick in the butt for the health care system - it basically illuminated all the weaknesses and absurdities. I bet you people will have taking eHealth more seriously and with more urgency now."

Alvin, Couldn't agree more. Digs into national myths such as the idea that Canada has a public healthcare system that is the best in the world. Fact check, Canada neither has a public healthcare system nor is our healthcare system anywhere near the best in the world. Years ago I think the OECD ranked us 30th or something in the world and I think Covid-19 has shown us that that is an incredibly generous ranking. Furthermore, Canada doesn't really have a public health system. We have something more like a mixed-private public de-centralized ad hoc system of limited universal health coverage, with a mixture of government and industry association regulatory oversight?

In other news I like how the narrative in Canada is changing into we did a good job and the costs were hard but necessary. This is the worst form of back rationalization. First, it's akin to George Bush claiming "mission accomplished" on that navy ship. Second, Canada's overall response to date is highly mediocre and it's cost us dearly in blood and treasure. Like the Finance Minister stood up the other day and with a straight face said spending 250 billion or whatever to date was a necessary step and we did a good job. Sure, that makes sense I don't disagree but how about you stand up there and apologize for the inept leadership of your government (I'm not absolving any other level of government that should also apologize) that through rigidity of thinking, lack of vision, and failure to act decisively, cost thousands of Canadian lives and cost us untold tens of billions of dollars in excess costs relative to better organized international peers. Maybe you think I'm being too harsh but think how much good 75 billion of that money could do in fixing Long-term care or other systematic issues in our health system. If we've learned anything from this it's that leadership matters.

 

[lenaitch]

The way I understand it (could be mistaken) doctors in the UK's National Health System are salaried government employees which has it's own problems, so would we be exchanging one set of problems for another? I recall a 'salary +' proposal a number of years ago but don't know enough about the issue, other than how do you pay a salary or base income to someone who is not an employee.

 

[Northern Light]

The way I understand it (could be mistaken) doctors in the UK's National Health System are salaried government employees

Correct

.......which has it's own problems, so would we be exchanging one set of problems for another?

It can. The most notable difference is hours worked. We've seen that in Ontario with the Family Health Team model, some of which operate on a salaried basis.

Once pay is fixed, many doctors cut back there hours to what is required of them; which ranges, depending on whether a doctor also works at a local hospital; typically between 24-40 hours

An an employee, overtime rates apply for work beyond 44 hours. This is not the case for a small business contractor who gets the same fee in hour 1 and hour 55 in a week.

Evidence has shown a propensity for reduced hours worked and patients per doctor in the salaried model. I'm not sure this is a bad thing. But there is a cost impact.

I recall a 'salary +' proposal a number of years ago but don't know enough about the issue, other than how do you pay a salary or base income to someone who is not an employee.

See above; you have to an employee of someone.

But that doesn't necessarily have to be the government directly.

It could be a family health team; a specialist group practice in cardiology or a hospital.

 

[AlvinofDiaspar]

Once pay is fixed, many doctors cut back there hours to what is required of them; which ranges, depending on whether a doctor also works at a local hospital; typically between 24-40 hours

An an employee, overtime rates apply for work beyond 44 hours. This is not the case for a small business contractor who gets the same fee in hour 1 and hour 55 in a week.

Evidence has shown a propensity for reduced hours worked and patients per doctor in the salaried model. I'm not sure this is a bad thing. But there is a cost impact.

See above; you have to an employee of someone.

But that doesn't necessarily have to be the government directly.

It could be a family health team; a specialist group practice in cardiology or a hospital.

That's a supply side issue - and I don't doubt there is a vested interest to limit the supply of physicians to jack up the price/leverage. Perhaps what the government can do - beyond expanding the output of medical schools - is to directly sponsor the education of doctors with the requirement to serve for a certain number of years as a government employed physician (like ROTC).

AoD

 

[Northern Light]

That's a supply side issue - and I don't doubt there is a vested interest to limit the supply of physicians to jack up the price. Perhaps what the government can do - beyond expanding the output of medical schools - is to directly sponsor the education of doctors with the requirement to serve for a certain number of years as a government employed doctor (like ROTC).

AoD

Government determines the number of medical school graduates, and their tuition (currently deregulated to the university level, but wasn't when I was in University and that can be reversed)

Medical school admissions were cut by the Rae government to cut physician services costs, on the premise that more doctors meant more fee-for-service billing.

I find that logic strained even in an F for S model.

Be that as it may; I would rather see increased medical school admissions; up to 2 additional medical schools in Ontario as well; and then appropriate control of costs through a shift towards salaried care and modernized F for S billing where applicable.

York U has long coveted a medical school and should get one; as should Waterloo with the latter being given a specific mandate to focus on medicine and technology.

 

[Northern Light]

"COVID is a good kick in the butt for the health care system - it basically illuminated all the weaknesses and absurdities. I bet you people will have taking eHealth more seriously and with more urgency now."

Alvin, Couldn't agree more. Digs into national myths such as the idea that Canada has a public healthcare system that is the best in the world. Fact check, Canada neither has a public healthcare system nor is our healthcare system anywhere near the best in the world. Years ago I think the OECD ranked us 30th or something in the world and I think Covid-19 has shown us that that is an incredibly generous ranking. Furthermore, Canada doesn't really have a public health system. We have something more like a mixed-private public de-centralized ad hoc system of limited universal health coverage, with a mixture of government and industry association regulatory oversight?

In other news I like how the narrative in Canada is changing into we did a good job and the costs were hard but necessary. This is the worst form of back rationalization. First, it's akin to George Bush claiming "mission accomplished" on that navy ship. Second, Canada's overall response to date is highly mediocre and it's cost us dearly in blood and treasure. Like the Finance Minister stood up the other day and with a straight face said spending 250 billion or whatever to date was a necessary step and we did a good job. Sure, that makes sense I don't disagree but how about you stand up there and apologize for the inept leadership of your government (I'm not absolving any other level of government that should also apologize) that through rigidity of thinking, lack of vision, and failure to act decisively, cost thousands of Canadian lives and cost us untold tens of billions of dollars in excess costs relative to better organized international peers. Maybe you think I'm being too harsh but think how much good 75 billion of that money could do in fixing Long-term care or other systematic issues in our health system. If we've learned anything from this it's that leadership matters.

There is a metric by metric OECD analysis, which I haven't had time to read, but I don't see an overall ranking.

I do see a Commonwealth Fund study (US think tank) that ranked us #9 out of 11 (better than France and the U.S.)

That study is interesting (you always have to look at what's being ranked). We actually score very high on most hospital care.

Some of the best cancer, CF and heart attack survivor rates in the world.

A notable exception that caught my eye was high infant mortality.

We ranked poorly, not surprisingly for wait-times, and for non-comprehensive care (dental, drugs, mental health, physiotherapy, vision, medical device).

We also got rapped for preventable conditions like obesity.