Wednesday, December 21, 2016

Julie Ali · University of Alberta What is ridiculous is that the first ministers don't seem to understand that there is a need for accountability for the large sums of cash that are being given to the provinces and territories. As a taxpayer I do not feel I am getting value for the money we spend on the health care and continuing care systems. In Alberta there is a failure to cut costs. We have two health authorities-Alberta Health Services and Covenant Health. There is no need for the two health authorities and we pay for duplication of bureaucrats and executive staff. The top end of these health authorities cost us big bucks and we should decrease these costs in my opinion. Failures by the GOA to address the problems that are system wide in the health care system result in increased costs. Some of these problems can be outlined here: 1) Poor use of EMT staff. Why do we have EMT staff forced to stay with patients until handover is complete? Why not ensure that EMT staff can transfer patients immediately so they are freed up? 2) Why do we have patients who should be in hospital beds in emergency? This is inappropriate use of the emergency, and is poor service delivery that can endanger patients as evident by the suicides that have taken place in the emergency rooms of hospitals in Alberta. We have even had a patient die wihile staff were all around her. 3) Why do we have continuing care residents stuck in active care beds or alternate level of care beds for extended periods of time? Why do we not have complex care facilities, long term care facilities and specialized service providers of the Michener Centre sort so that we can free up hospital beds? Why don't we have integrated updated care plans for our complex care and handicapped citizens in the continuing care system so that they can stay stable and out of hospitals? Why has the GOA decided to force complex care patients into SL4 placements rather than long term care beds? What is the purpose of long term care beds if not to service folks with unpredictable complex care needs? 4) The refusal to make public long term care beds is puzzling. Why is care being increasingly shifted to the private sector which tends to find only supportive living faciltiies to be profitable? Why not keep long term care facilities public since the private sector is unable to do the work properly and make a profit? I mean this means of course we are subsidizing the private developers of these SL4 sites as well as doing the long term care facilities which are more expensive but if we really care about the most vulnerable citizens this is what we need to do. For profit private and not for profit private continuing care organizations are in the business to make profits or to increase assets; they are not in the business to lose money or decrease their asset base. Only a public long term care system will provide appropriate care for our most vulnerable handicapped and at risk citizens. 5) Why is there no sort of required adverse event reporting province wide for all adverse events such as medical errors, staff non-compliances, medication problems? With a centralized adverse event reporting system we could decrease repeated instances of the same medical, nursing and pharmacist errors. The central reporting system could then report to a national adverse event system as well. 6) Why no public reporting of audits of continuing care organizations in Alberta? Only accomodation reports are published in Alberta. This is not good enough. We need proof of good performance and compliance. 7) Complex care teams are required and should be present for all cases of citizens with mental health issues. Most professionals lack experience or training with reference to mental health issues and specialized staff should be on call and in attendance with such cases. 8) Fatality reports, autopsy reports and other information about deaths should be collected by a central body and then provided to a national repository to ensure that we taking measures to reduce the numbers of avoidable deaths. 9) Rather than being reactive to pressure by the society the GOA needs to do cost benefit analysis work. I have asked for such cost benefit analysis work as in the case of midwives delivering babies and the GOA has not provided the data. Cost benefit analysis work would tell us exactly what the costs are for this method of birthing babies. While it is nice to do the midwives route, the GOA needs to be cost effective and if this way costs more than the normal way of birthing babies with doctors in hospitals, then families need to pay for the extra costs. Taxpayers like myself do not want to pay for luxuries. Choice can be present but those who choose birth by midwives need to pay for the extra costs. 10)The GOA should also provide the cost benefit analysis work for the executive staff present at AHS. What do the staff do to justify their salaries? Why are we paying such high compensation when we are in debt? Like · Reply · Just now

The provincial health ministers need to be more sensible.
There is a ton of cash going into health care that needs to be cut.
If the provincial governments can't do the cutting, let the federal government do it.
And at the same time let the federal government target areas of greatest need--mental health services.

There are many ways to cut the budget that is excessive in Alberta. But the PCs didn't do it. And the NDPCs won't do it.
It will have wait until the Wildrose Party gets in.

Meanwhile we see more posturing by folks who have no power in this matter. The feds control the cash. And that power means that the provincial health ministers better accept what is being offered and get down to work in cleaning up the messes in their own turfs.


CARP calling on all Ministers of Health and Finance to find a way forward for an equitable and accessible health care system for all Canadians #HealthAccord #HomeCare #CdnPoli http://www.cbc.ca/…/politics/federal-health-accord-1.3903027

Finance and health ministers are meeting in Ottawa today, trying to reach an agreement on federal funding to the provinces. But the two sides remain far apart on the level of cash needed for a new Health Accord.
CBC.CA

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Julie Ali

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Julie Ali The federal health minister is providing the provinces with cash. The provinces such as Alberta need to be frugal with the money provided. There are many ways to use public dollars responsibly and Alberta Health needs to ensure that the waste in the system is cut. Why do we have to pay for two bureaucracies at AHS and Covenant Health? I have to even ask why we have several zones at AHS? Can't work be done more efficiently and the deliverables of executive staff and managers made explicit to us? We are paying a ton of cash for executive staff at both AHS and Covenant Health and what exactly do these folks do? I'd say not much. Just cutting executive staff, amalgamating health authorities and decreasing the occurrence of repeated adverse events with required reporting to a national adverse event program would cut costs in a major way. The efficient use of active treatment beds by the production of public long term care facilities would cut costs as well. Emergencies are clogged with people waiting; some of these people could be referred on site to a family doctor clinic placed right next to emergency thereby freeing up the emergency staff for critical injuries and expediting the EMT staff release and recycling. It's all possible but instead we see the health ministers engage in politics. Get down to work health ministers. We don't pay y'all to do politics but provide us with value for our money.
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Yvonne Bourne Senior Health Care...?

http://www.vancouversun.com/news/national/provinces+reject+2411+billion+health+funding+offer+from+feds/12554760/story.html





Provinces reject $11 billion health funding offer from feds that now appears to be off the table

ANDY BLATCHFORD AND KRISTY KIRKUP, THE CANADIAN PRESS  

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OTTAWA — The federal government pulled billions of dollars off the negotiating table Monday after failing to reach a long-term health-care funding agreement with frustrated provincial and territorial health and finance ministers.
Ottawa attempted to sweeten its offer somewhat at midday in the face of withering criticism that it wasn’t bargaining in good faith, but the additional $3.5 billion over 10 years wasn’t enough to bridge the widening gap between the two sides.
“We were working today to have partners with the provinces and territories,” Finance Minister Bill Morneau told a news conference. “We were unsuccessful in that effort.”
Ottawa offered $11 billion over 10 years for home care and mental health, as well as $544 million over five years for prescription drug and “innovation” initiatives, on top of a 3.5 per cent annual increase in health transfers.
That offer is now off the table.
Heading into the talks, Morneau warned that if no deal could be reached that federal support would revert back to what the Liberals have long said they would do: limit the annual increase in health transfers to three per cent, or nominal economic growth, and provide $3 billion for home care.
The annual transfer payment increase is poised to drop next April to three per cent a year — half the six per cent it has been since 2004.
“We were disappointed that the provinces and territories did not feel that they could accept this offer,” said federal Health Minister Jane Philpott.
Monday’s talks appeared doomed from the start, with the provinces accusing the Trudeau government of refusing to negotiate a new federal health-care funding framework, instead putting forward what they considered a lacklustre take-it-or-leave-it offer.
Quebec Health Minister Gaetan Barrette had threatened to walk out if the federal government didn’t put more money on the table.
In the end, it was Ottawa that was accused of shutting down the talks.
“Let’s be clear, we did not walk away from this meeting … It was the federal government that closed the meeting, ultimately,” said Ontario Finance Minister Charles Sousa.
“We are here to negotiate at the directive of the first ministers; by the prime minister himself, who invited the ministers of health to attend as well to find a solution. We didn’t have the opportunity here today to have that discussion.”
The federal government put forward a unilateral approach, Sousa added.
Earlier Monday, Philpott ducked questions about the concerns of the provinces, describing Ottawa’s earlier offer of mental health and home care cash as “historic” and “transformative.”
“They can’t continue to make ultimatums, to make threats,” said Manitoba Health Minister Kelvin Goertzen, who added that the provinces have long been demanding health-funding negotiations with Ottawa.
“For months, we’ve been begging for this.”
It was clear the federal government wasn’t offering much wiggle room.
They can’t continue to make ultimatums, to make threats
Philpott appeared wilfully blind to the dissent, saying she was “absolutely delighted” with her government’s “substantial offers on the table” as she skated around questions about the provincial concerns.
“This is a transformative, historic offer — we’re changing the face of health care in this country,” she said. “I am certainly optimistic that the provinces and territories would not walk away from something like this.”
But walk away they did — although not before the meetings were over, which appeared a distinct possibility as the day began.
P.E.I. Premier Wade MacLauchlan, speaking on behalf of the provincial and territorial interests, sounded a pragmatic and determined note as he acknowledged the failed talks and called for a first ministers meeting on health funding.
“We do not — and we all want to be very clear about this — view the end of today as the end of a path,” MacLauchlan said.
“We are on a path together, a path that we have travelled for 50 years, and on which we expect the federal government to be an active, supportive, engaged partner.
“We do not believe that as of the end of the day today that we are at an impasse. We have work to do.”
An analysis by provinces released Monday compared the potential outcomes of the status quo versus federal Morneau’s latest offer.
The data said that the status-quo scenario of annual increases of three per cent, or the average rate of nominal economic growth, in addition to $3 billion in targeted funding, would mean a total of $445.2 billion in federal health-care cash over the next decade.
It would also lower the federal share of funding in provincial health budgets to 20.2 per cent in 2026-27 from 22.9 per cent next year.
In comparison, the document said Morneau’s earlier $8-billion, 3.5 per cent offer would provide the provinces with total of $445.9 billion over the next decade.
Under that scenario, the share of federal funding would fall to 19.8 per cent in 2026-27 from 23.1 per cent in next year, the data noted.
Even with the 2015 Liberal platform’s pledge of $3 billion for home care, de Jong said he didn’t think his province would necessarily be better off. At the end of the day, he said it would essentially be “a wash.”
“It’s just an example of a federal government that says, ’Here’s the solution and if you don’t like that’s too bad — it’s take it or leave it,”’ he said.
“For me, for an issue of this importance, it’s ridiculous.”


Julie Ali · 
What is ridiculous is that the first ministers don't seem to understand that there is a need for accountability for the large sums of cash that are being given to the provinces and territories.

As a taxpayer I do not feel I am getting value for the money we spend on the health care and continuing care systems.

In Alberta there is a failure to cut costs. We have two health authorities-Alberta Health Services and Covenant Health. There is no need for the two health authorities and we pay for duplication of bureaucrats and executive staff. The top end of these health authorities cost us big bucks and we should decrease these costs in my opinion.

Failures by the GOA to address the problems that are system wide in the health care system result in increased costs.

Some of these problems can be outlined here:

1) Poor use of EMT staff.

Why do we have EMT staff forced to stay with patients until handover is complete? Why not ensure that EMT staff can transfer patients immediately so they are freed up?

2) Why do we have patients who should be in hospital beds in emergency?

This is inappropriate use of the emergency, and is poor service delivery that can endanger patients as evident by the suicides that have taken place in the emergency rooms of hospitals in Alberta. We have even had a patient die wihile staff were all around her.

3) Why do we have continuing care residents stuck in active care beds or alternate level of care beds for extended periods of time?

Why do we not have complex care facilities, long term care facilities and specialized service providers of the Michener Centre sort so that we can free up hospital beds?
Why don't we have integrated updated care plans for our complex care and handicapped citizens in the continuing care system so that they can stay stable and out of hospitals?
Why has the GOA decided to force complex care patients into SL4 placements rather than long term care beds? What is the purpose of long term care beds if not to service folks with unpredictable complex care needs?

4) The refusal to make public long term care beds is puzzling. Why is care being increasingly shifted to the private sector which tends to find only supportive living faciltiies to be profitable? Why not keep long term care facilities public since the private sector is unable to do the work properly and make a profit? I mean this means of course we are subsidizing the private developers of these SL4 sites as well as doing the long term care facilities which are more expensive but if we really care about the most vulnerable citizens this is what we need to do. For profit private and not for profit private continuing care organizations are in the business to make profits or to increase assets; they are not in the business to lose money or decrease their asset base. Only a public long term care system will provide appropriate care for our most vulnerable handicapped and at risk citizens.

5) Why is there no sort of required adverse event reporting province wide for all adverse events such as medical errors, staff non-compliances, medication problems?

With a centralized adverse event reporting system we could decrease repeated instances of the same medical, nursing and pharmacist errors. The central reporting system could then report to a national adverse event system as well.

6) Why no public reporting of audits of continuing care organizations in Alberta? Only accomodation reports are published in Alberta. This is not good enough. We need proof of good performance and compliance.

7) Complex care teams are required and should be present for all cases of citizens with mental health issues.

Most professionals lack experience or training with reference to mental health issues and specialized staff should be on call and in attendance with such cases.

8) Fatality reports, autopsy reports and other information about deaths should be collected by a central body and then provided to a national repository to ensure that we taking measures to reduce the numbers of avoidable deaths.

9) Rather than being reactive to pressure by the society the GOA needs to do cost benefit analysis work.
I have asked for such cost benefit analysis work as in the case of midwives delivering babies and the GOA has not provided the data.

Cost benefit analysis work would tell us exactly what the costs are for this method of birthing babies. While it is nice to do the midwives route, the GOA needs to be cost effective and if this way costs more than the normal way of birthing babies with doctors in hospitals, then families need to pay for the extra costs. Taxpayers like myself do not want to pay for luxuries. Choice can be present but those who choose birth by midwives need to pay for the extra costs.

10)The GOA should also provide the cost benefit analysis work for the executive staff present at AHS. What do the staff do to justify their salaries? Why are we paying such high compensation when we are in debt?

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Alberta Health needs to work more efficiently. There is no need for two bureaucracies. Heck there is no reason even for AHS and Covenant Health. AB health could jolly well do this work themselves and save us a pile of cash. There are many areas for cost savings and yet no move by the NDPCs like the PCs before them to do this work. What are we? The bank for the elites? Lets cut salaries and positions at AHS and Covenant Health. Let us see the value for our bucks.

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