More money diverted from health care to enrich the rich.

"It's amazing how much money on contracts can get spent without it having to go through the legislature. "

with the Security and Prosperity Partnership and provincial acts that have incorporated regulations and clauses that devolve decision-making to 'other bodies' including privatized managers and stakeholders, much work actually does get done away from legislatures these days.  only issues that media or pressure groups have picked up on get talked about in legislatures.  it's a circus.

you have to be online all the time, or read the Canada Gazette, to catch a new rule going through, maybe get a chance to put in an online comment (which is ignored) and the decisions get made by the private players writing up the drafts and feeding them to officials. 

that's what we have going on now.  federally and provincially.  the NDP federally have called the Cons and Libs on this in the past.

Kramer must be a Liberal - she gave three interviews to CBC-TV this week, and in each one she gave the impression she is entitled to her generous salary, and is entitled to dole out as much money as she sees fit. Damn Liberals and their entitlements!

i'm just wondering if people at babble who know what a better-functioning legislature might have looked like in the past, to name some details of that.  there's a generation growing up who don't know any different than the corporate-led excuse for democracy they see operating today.

pick any period in history you like, any place.  we need some ideas.

(maybe some of this has been covered in the 'crisis in democracy' thread, haven't checked there yet.)

An eHealth Ontario consultant billed taxpayers for tea from Tim Hortons and a dessert square at the Edmonton International Airport while earning $2,700 a day at the embattled agency, documents show.

Donna Strating, a senior vice-president of eHealth Ontario, billed $1.65 for a tea from Tim Hortons on Dec. 16, 2008, according to documents obtained by the Progressive Conservative party under a freedom of information request.

Nine days earlier, a bill was submitted for $3.19 for a dessert square at Second Cup at the Edmonton International Airport, the papers show.

The Star also learned yesterday that the eHealth agency, which has been under intense scrutiny over high-priced consultants and executive perks, spent $27,000 to sponsor an out-of-province conference, including an evening reception Sunday.

http://www.healthzone.ca/health/article/643972

The tea and the dessert square are kind of silly, but symbolic. The big stuff follows:

Caplan continued to defend eHealth CEO Sarah Kramer, who was under fire last week after it was disclosed she was given a bonus of $114,000 after five months on the job, and that eHealth awarded nearly $5 million in contracts without tender in the agency's first four months. "I think it is fair to say that Sarah and the leadership at the organization, in a few short months, (have yielded) very good results," Caplan said.

More details emerged yesterday about the high costs of consultancy fees at eHealth, an agency created last year to build an electronic provincial health system after its previous incarnation, Smart Systems for Health Agency, was dissolved. Smart Systems was highly criticized for spending $647 million in public funds and producing little results.

Electronic health records projects are pretty infamous wasters of money. The NHS in Britain has thrown billions of pounds at it so that tells you how bad it can get

if you are looking for a site where you can report local news and be paid for it, visit [link deleted by moderator b/c it's spam] really good site that i found for news all over the globe

We don't need more doctors or nurses in this province.
No, what we need is more bloated bureaucracy. We need wasteful agencies with negligible oversight and vague objectives. We need to pour billions of taxpayer dollars into a system in which a powerful clique puts personal gain ahead of the public good.
We should all quit our jobs to become consultants.
That way, we'll be rich enough to seek medical attention south of the border when our public health system finally collapses under the weight of its own wretched inefficiency.
This is why I want to become an eHealth consultant. This is why I want to work for Premier Dalton McGuinty.

http://www.thestar.com/news/article/647636

Me too! I missed my calling. I wonder what or who you have to know to become a management consultant.

Liberals belly-up to the eHealth trough!

Key members of Dalton McGuinty's inner circle are surfacing in the eHealth Ontario spending scandal, documents obtained by the Star show.

Premier Dalton McGuinty's former health adviser was paid $327 an hour by eHealth to, among other tasks, correspond with McGuinty's former chief of staff in his new capacity at a polling firm on "eHealth Ontario priorities," billing records demonstrate.

Thought I'd revive this thread because of the connections between this, and the current dispute with the pharmacists.

As we all know, under George Smitherman, the Ministry of Health and LT Care had an unusually cosy relationship with the private sector.  In 2006, George Smitherman appointed Helen Stevenson, who headed a corporation called Savatuq, to look at Ontario's drug system.  Later, he hired her to be the Executive Officer of Public Drug Programs (even though there already was a manager of Public Drug Programs, a bureaucrat in charge of the drug system.  But that person was not beholden to furious George the way Helen Stevenson was).

Helen Stevenson's old corporation, Savatuq, received $1M in untendered contracts from the Ministry:

http://www.cbc.ca/canada/toronto/story/2009/11/10/untendered-contract-he...

I know; $1M is chicken feed.

Helen Stevenson is now the Assistant Deputy Minister of the Ministry of Health and LT Care, pulling down a salary of $275,000.  Not bad for someone in the health ministry, an MBA who has no health care training, hired just five years ago at the personal behest of the minister.  In contrast, one of my former bosses in my ministry made assistant deputy minister just recently, after 30 years of service in the Ontario Public Sector.

And she is behind the push to reform the drug system in Ontario.  If you google, you'll find the article about the death threats:

http://www.thestar.com/news/ontario/article/798289--drug-reform-battle-l...

These death threat reports are from 2006, and have not been corroborated - the OPP refuses to comment.  Ms Stevenson brought them up to the media when pharmacists became more vocal and more heated about these proposed reforms.

There were some pharmacies scamming - they would order more than they needed from, say, Apotex, and then return it after collecting the professional allowance.  Some charges were laid, people got fined.

I think George Smitherman's hiring of someone from the private sector, who wrote a report that has never seen the light of day but on the basis of which major reforms in the drug system were made (Bill 102 from 2006), and then installing that person in a very high position in the health ministry is about power - George had it, and this is what he wanted to do.  I've read the Hansard transcripts from that time - there was a lot of screaming about this.  But at the end of the day, George got his way, and that was the point, IMO.

Then this person, Helen Stevenson, proves that she didn't get this plum job because she's a genius by looking at the drug system in a very narrow way.  If I may quote from the previous post:

Helen Stevenson wrote:

"This is a national issue — that generic prices are so high," she said. "The reason that we can't get lower prices is because [drug manufacturers] are paying such huge allowances to pharmacies."

Except this doesn't work.  According to the Ministry of Health and LT Care's website, 

Quote:

Compared to some US states, Ontario pays as much as five times more for some of the most popular generic drugs for diabetes, high blood pressure and other health conditions.

....buuuuuuut the professional allowances can only be 20% of the value of the drugs dispensed.  So how can they say Americans pay one-fifth, and it's all pharmacists' fault.  Shouldn't they be paying 20% less than Ontarians, in that case?

On a healthcare site where we've been discussing this situation, I posted a message asking American pharmacists where generic drugs are made for that country; here's what one pharmacist said:

American pharmacist wrote:

What a bunch of dipshits. 

The reason our generics are cheaper are because they are already all made in India, there is no price point at which the generic manufacturers are pretty much told to charge for drugs (THIS is the real reason...fucking intellectual coward politicians), and the generic manufacturers compete against each other in such a vicious cutthroat manner that it drives prices way down.

God, they are stupid. How the hell can you people elect such morons?

(Another American pharmacist already replied, "Same way we do.")

Here's where Helen Stevenson's vision is lacking:

Canadian pharmacist wrote:

Most of Canada's drugs are made in Ontario. Teva & Apotex have probably 80-90% of the market. Everyone else is a dwarf compared to them. 

That's right, most of the profits from generic drugs across Canada end up in Ontario, with corporate income taxes (and all those other taxes) paid to the Ontario coffers.  I wouldn't be surprised if they not only moved the factories out of Ontario, but the head offices and operations too. Shoppers Drug Mart may very well do the same. 

Ontario.gov doesn't seem to understand that the profits (and great employment) from these Canadian-wide operations end up in Ontario. Now by opening up this whole can of worms, they'll lost out on it all. 

It's like Michigan passing a law that makes car manufacturing less profitable, or Alaska banning future oil exploration in the state. Why would you dismantle your jurisdiction's biggest industries?

The generic drug industry employs 9,000 people in Ontario, 5000 of those by Apotex alone.

Currently, 63% of prescriptions are filled for generic drugs.  But 75% of drug costs are due to brand name drugs (even though they are only 25% of prescriptions filled, see?  Sorry about all these numbers - can't be explained any other way).  Where the government can save a bunch of money without fucking up the healthcare system and compelling major industries to outsource thousands of jobs overseas is to expand the use of generic drugs.

Pharmacists have been telling the government this.  Over and over.  For months.  But instead, the government takes direction from an inexperienced bureaucrat hand-picked by a former health minister.

And oh yeah; I really REALLY don't want George Smitherman as mayor of Toronto.

Thank you so much for your perspective, Sineed.

BTW, I felt the same way about Smitherman even before reading your post.

Most cogent part of Dr. Lexchin's article:

Quote:

Part of the solution is to stop paying pharmacists for being storekeepers and start paying them to monitor patients for adverse effects from medications, and to spend time discussing the harms and benefits of the drugs that people are taking.

Pharmacists rely on professional allowances because the government doesn't pay an adequate dispensing fee for Drug Benefit scripts, a large part of our business (that's the government drug plan for senior citizens, welfare, disabled, & Trillium for low-income working people).  The fee has increased by less than a dollar over the past 25 years.  The government is offering an increase in the fee, but it costs about $14 to fill a script, and increasing the fee from $7 to $8 or $9 doesn't cut it.

An example of the absurdity of how pharmacists are compensated in the current system: at my previous job, a woman brought me a prescription for her newborn baby.  The prescription was for an antibiotic that is safe in big people, but can cause hemolytic anemia, where the red blood cells get destroyed, in newborns.  So I called Sick Kids to double check that I was right about this, and then I spent about half an hour with the patient's mom and on the phone, trying to get another prescription for this baby.  Finally I reached somebody in the prescribing doctor's office who verified that the baby didn't have an infection; the prescription was just "as a precaution."  So it ended well: I gave the mom some breast-feeding tips, and recommended she follow up with a pediatrician ASAP.

The absurdity: if I had filled the prescription no questions asked, the store would have been paid for my services.  But I didn't fill the prescription, so the store did not get paid, though they still had to pay me for my time, the 45 minutes or so in total between the time spent on the phone, talking to the mom, etc.

This current move by the government, of taking away large amounts of money from stores without adequately replacing these losses, will hurt those small, professionally-focused stores; the ones who don't mitigate their losses behind the pharmacy counter by selling food, cosmetics, fancy chocolates, etc.

So the type of professionally-focused practices we would want to encourage for the best patient care will be hurt the most.

I've heard that doctors in third world countries can function well with a set of perhaps 200 Western medications. Perhaps we do not need thousands of drugs, and should consider the benefits of prevention and nutrition - and the reason for the pressure to take drugs.  

[PDF]

Drugs, Doctors and Dinners
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Drugs, Doctors and Dinners. How drug companies influence health in the developing world ...... the independent information needed by consumers and their doctors. ..... Bad Medicine: The Prescription Drug Industry in the Third World. ...
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