Health Care

Policy - - In This Issue - From the Ed­i­tor / L. Ian MacDon­ald

Wel­come to our is­sue on health care; a sub­ject we like to check in on reg­u­larly, given its pri­or­ity among Cana­di­ans in gen­eral and thought lead­ers in par­tic­u­lar as a dy­namic pol­icy is­sue, a peren­nial fed-prov scrim­mage file and a long­stand­ing val­ues ques­tion.

His­to­rian Ed Whit­comb lays out the his­tory of Medi­care, largely funded by Ot­tawa but within provin­cial ju­ris­dic­tion. It’s a story of cash and con­fronta­tion over the last half cen­tury.

BIOTE Canada Pres­i­dent An­drew Casey makes the case for holis­tic pub­lic pol­icy, and break­ing out of “si­los of re­spon­si­bil­i­ties be­tween fed­eral de­part­ments” to make sure Canada is world-com­pet­i­tive in biotech­nol­ogy.

From the In­sti­tute of Fis­cal Stud­ies at Democ­racy at Univer­sity of Ot­tawa, Alan­nah McBride and Ran­dall Bartlett look at the Trudeau gov­ern­ment’s over­ture on phar­ma­care and con­clude its time has come. As they point out, Canada is the only ma­jor coun­try with univer­sal health care but not univer­sal drug cov­er­age.

Peter Vaughan, for­mer Nova Sco­tia deputy health min­is­ter and now chair of Canada In­foway, re­marks that Canada is not dig­i­tally con­nected on health care. Only six per cent of Cana­di­ans, he notes, have looked at their own health in­for­ma­tion on­line in the last two years. “We need to quickly reimag­ine a digital Medi­care 2.0,” he writes, or digital plat­forms “will be pro­vid­ing health care to Cana­di­ans for a fee.”

Genome Canada Pres­i­dent Marc LePage presents Cana­dian suc­cess sto­ries in pre­ci­sion health, de­scrib­ing the ge­nomics-driven trans­for­ma­tion in health care as “bring­ing new hope for Cana­di­ans liv­ing with can­cer, cys­tic fi­bro­sis, ju­ve­nile arthri­tis, child­hood asthma and other dis­eases.”

From the Cen­tre for Drug Re­search and De­vel­op­ment in Van­cou­ver, Pres­i­dent and CEO Gor­don McCauley pro­vides an up­date on R&D in that cor­ner of the health care uni­verse.

Kimberley Han­son, direc­tor of fed­eral af­fairs at Di­a­betes Canada, warns of the di­a­betes epi­demic in Canada. As she writes: “Al­to­gether, 11 mil­lion Cana­di­ans—nearly one Cana­dian in three—are liv­ing with or threat­ened by di­a­betes.”

Rus­sell Wil­liams, board chair of Cana­dian Frailty Net­works, notes that more than one mil­lion Cana­di­ans over 65 are liv­ing with frailty, and with the ag­ing of the boomer gen­er­a­tion, that num­ber is ex­pected to dou­ble over the next decade. That’s a ma­jor chal­lenge loom­ing in health and home care.

Con­tribut­ing Writer Robin V. Sears ex­am­ines Indige­nous peo­ples’ health care, a “legacy of disastrous health im­pacts (that) con­tin­ues,” and which is demon­stra­bly the big­gest chal­lenge to rec­on­cil­i­a­tion. He calls for “a gen­er­ous in­crease in fund­ing, in­cu­bat­ing new pre­ven­tion and de­liv­ery mod­els for Indige­nous com­mu­ni­ties, and fo­cus­ing on out­puts, not in­puts.”

Bax­ter Canada Pres­i­dent Stephen Thomp­son writes that in­no­va­tion in dial­y­sis tech­nol­ogy is now bring­ing end-stage kid­ney treat­ment to pa­tients in re­mote com­mu­ni­ties. He notes a 2017 re­port from the Cana­dian In­sti­tute for Health In­for­ma­tion stat­ing that Indige­nous pa­tients with end-stage kid­ney dis­ease “are 30 per cent more likely to be ad­mit­ted to a hos­pi­tal due to a dial­y­sis in­fec­tion, partly be­cause they must travel longer to re­ceive treat­ment, mean­ing prob­lems don’t get caught early. We now have the tech­nol­ogy to ad­dress these is­sues.”

Canada has seven med­i­cal schools in the Top 100 in the world in the 2017 Times Higher Ed­u­ca­tion an­nual rank­ings. Univer­sity of Toronto med school is ranked 19th, but McMaster Univer­sity’s school is ranked 23rd, ahead of McGill Univer­sity at 27th. Con­tribut­ing Writer Yaroslav Baran tells the story of how a med school in the mid-sized in­dus­trial town of Hamil­ton be­came a world leader.

Mar­garet Clarke, her­self an alumna of McMaster med school, makes the case for the Trudeau gov­ern­ment’s new in­for­ma­tion ex­change on autism, which af­fects one in 66 Cana­dian fam­i­lies.

Ge­orge We­ber, Pres­i­dent and CEO of the Royal Ot­tawa Health Care Group, writes that pub­lic aware­ness of men­tal health is­sues is much higher than a decade ago, with the stigma of men­tal ill­ness greatly re­duced. But pol­icy lags and men­tal ill­ness re­mains costly in both per­sonal and eco­nomic terms, “with a cost to the econ­omy of more than $50 bil­lion” a year.

Michael Nashat, Pres­i­dent and CEO of Ter­rAs­cend, a lead­ing Cana­dian man­u­fac­turer of med­i­cal cannabis, ex­plains the al­ready-le­gal­ized seg­ment of the mar­i­juana mar­ket, which has grown from only 12 pri­vate cul­ti­va­tors four years ago to more than 90 today.

Fi­nally, colum­nist Don New­man writes that the path to bet­ter health care does not lie through tax cuts, as re­cently im­ple­mented in the United States, along with a de­bate on end­ing Oba­macare. “Can you imag­ine such a shame­ful ar­gu­ment even be­ing en­ter­tained in Canada?” he asks. “Luck­ily, no one can.”

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