Health Reform: how long must we wait?

CARP’s new national campaign, NO MORE WAITING , presents three demands to federal and provincial politicians. CARP intends to poll all elected representatives as to whether or not they will agree to these demands, and then publicize their responses, encouraging people to vote only for those politicians who will endorse the demands.

CARP’s three demands are:WAIT TIME GUARANTEES

CARP demands an end to unreasonable waits for urgent medical treatment.

CARP demands that if a provincial government cannot deliver the treatment within an acceptable wait-time benchmark, then they must pay extra directly to the patient to have that treatment delivered somewhere else.

CARP is basing its demands on benchmarks developed by the Wait Time Alliance for Timely Access to Health Care (WTA). This is a group made up of representatives from these medical groups:

• Canadian Association of Nuclear Medicine
• Canadian Association of Radiation Oncologists
• Canadian Association of Radiologists
• Canadian Cardiovascular Society
• Canadian Medical Association
• Canadian Ophthalmoloical Society
• Canadian Orthopaedic Association

They developed this list of recommended wait times for key medical procedures:.chartHeader{background-color:#0035AD; font-weight:bold;color:#FFFFFF}.chart{font-size:7pt;}

Specialty/procedure	Emergency cases	Urgent cases	Scheduled cases
Radiology (diagnostic imaging)
CT scans and MRIs	Immediate to 24 hr.	Within 7 days	Within 30 days
Nuclear medicine (diagnostic imaging)
Bone scan (whole body)	Immediate to 24 hr.	Within 7 days	Within 30 days
FDG-PET	Immediate to 24 hr.	Within 7 days	Within 30 days
Cardiac nuclear imaging (perfusion; viability; LV function) (SPECT or PET)	Immediate to 24 hr.	Within 3 days	Within 14 days
Joint replacement
Hip and knee replacement surgery	Immediate to 24 hr.	Within 30 days (priority 1) Within 90 days (priority 2)

Consultation: within 3 months

Treatment: within 6 months of consultation

Cancer care Radiation therapy Immediate to 24 hr. Based on individual need Consultation: within 10 working days

Treatment: within 10 working days of consultation

Sight restoration Cataract surgery Not applicable Cases are expedited proportional to relative degree of priority Within 16 weeks of consultation Cardiac care Initial specialist consult Immediate to 24 hr. Within 7 days Within 6 weeks Diagnostic procedures (diagnostic catheterization) Immediate to 48 hr. Within 3 days Within 6 weeks Angioplasty Immediate to 48 hr. Within 7 days Within 6 weeks Bypass surgery Immediate to 48 hr. Within 14 days Within 6 weeks Valvular surgery Immediate to 24 hr. Within 14 days Within 6 weeks Heart failure services Immediate to 24 hr. Within 14 days Within 6 weeks Pacemaker Within 3 days Within 14 days Within 6 weeks Referral to electrophysiologist Not applicable Within 30 days Within 3 months Electrophysiology testing/catheter ablation Not applicable Within 14 days Within 3 months ICD Within 3 days Not applicable Within 8 weeks Cardiac rehabilitation Immediate Within 7 days Within 30 days

CARP is using this chart as the basis for our demands. If a province cannot deliver treatment within the wait-time period, it must then pays for the patient to get the treatment somewhere else.

CARP emphasizes that this is not about public vs. private health care. CARP strongly supports public health care, and has always done so. But people’s health – and not the sanctity of the delivery system – must come first. If the system can’t deliver, then health must not be sacrificed.

When the province has to pay for a patient to get the treatment somewhere else, that may mean going to another public health system in a nearby province. It may mean going to a private resource – in Canada or elsewhere. CARP doesn’t care. The important thing is that the patient must get the needed treatment on a timely basis.

ALL APPROVED DRUGS TO BE IN ALL FORMULARIES

Canadians spend over $22 billion on prescription drugs per year, according to the Canadian Institute for Health Information. This represents 17% of all health care spending – and it’s more than is spent on physicians!

Drugs have become a vital part of our health care system – and the constant stream of new discoveries will only increase their importance (and cost). It’s a particularly vital issue for the 50-plus, who are more likely to require ongoing prescription drugs…and to face higher costs.

Yet the “system” for helping Canadians pay for drugs is seriously flawed. Instead of a national system, each province creates its own drug formulary, listing the drugs it will subsidize. Provinces often delay listing new drugs in their formularies. Or they restrict the use of listed drugs.

Not surprisingly, this leads to huge differences in coverage from province to province. Here are just a couple of examples…

• A 2004 study by the Edmonton-based Institute of Health Economics surveyed 115 established cancer drugs. It found that only 7 were provided free to cancer patients in all 10 provinces. Although nearly half were available for free in at least 9 provinces, the rest – over 50 drugs – were available only in some provinces but not in others
• The Canadian Health Coalition, in a paper presented in May of this year, put the case of a couple over the age of 65, with an income of $35,000 and in need of $1,000 worth of drugs per year. This couple would pay
  – the entire $1,000 cost, if they lived in New Brunswick or Newfoundland
  – 2/3 of the cost if they lived in Quebec
  – 1/3 of the cost if they lived in Ontario or BC
  – Zero if they lived in the Yukon or Northwest Territories

Clearly, this situation is unacceptable.

The best solution would be a single national plan. This was recommended by both the Romanow and Kirby commissions, and is strongly endorsed by CARP.

But so far, there has been no action. Lots of talk, lots of promises, lots of studies…

So CARP says, “No more waiting.”

CARP demands that all provinces immediately list in their formularies all drugs that have been approved for sale by Health Canada. Period.

That’s all drugs. Now.

No more waiting.

$2 BILLION FOR CAREGIVER RESPITE

As many as 5 million Canadians are family caregivers – providing 10-15 hours a week or more of care to chronically ill or disabled loved ones. They do everything from providing companionship, to cooking, housekeeping and assisting with activities of daily living, to providing health care assistance.

Family caregivers – as opposed to paid professionals – deliver about 80% of all home care in Canada today. Many of them are “on call” 24/7.

To be blunt, the entire health care system is riding on their shoulders. Thanks to their efforts, those loved ones don’t have to be institutionalized – or institutionalized as soon. This saves the system billions of dollars.

In fact, the full value of what they provide – in terms of the market value of their time, the money they spend out of their own pockets, and the potential income they lose – comes to over $5 billion a year.

And they deserve – and certainly need – a lot more support than they’re getting.

According to a Statistics Canada research study, over 60% of family caregivers report being stressed, and half say their most important unmet need is for respite – a place to go to get a break, or a place they can take the loved one for a brief period, so that they themselves can enjoy a much-needed respite.

And that’s precisely CARP’s third demand.

We demand that the federal government take action now – and earmark $2 billion for a national program of caregiver respite.

Caregiver respite now. NO MORE WAITING.

To see the Canadian Press article on the new CARP initiative, go to:
http://www.cbc.ca/cp/health/061024/x102426.html