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Saturday, June 12, 2010

Ontario finalizes drug plan reforms, few changes made

On July 1, Ontario pharmacists will have to live with a drastic reduction in the revenues they receive through the public drug plan, and they are warning customers to brace for service cuts and fee increases for private-paying customers.

The government finalized controversial changes to the drug plan Monday, going ahead with the abolition of professional allowances which are rebates pharmacists receive from manufacturers on the cost of generic drugs purchased through Ontario’s Public Drug Program. It is estimated that the amount paid by manufacturers on these professional allowances adds up to $750 million a year.

Hand-in-hand with this policy move is a cap on the prices of generics at 25 per cent of the brand – a deeper discount than any other province has yet made, although the government has made some exceptions to this rule.

When the government announced its proposed changes in April there was considerable backlash from the pharmacy community which warned that some pharmacies would be forced out of business and services to customers would be severely curtailed.

A massive public relations campaign was launched to force the government to back down, but the finalized strategy only contains some relatively small changes.

“Despite the fact that Big Pharmacy opposed our changes with one of the most politically charged, American-style PR campaigns in this province’s history, I can tell you that our resolve has never wavered,” Health Minister Deb Matthews told a news conference Monday.

In addition to a $150 million fund to pay for additional professional services to patients, the government is offering pharmacists $75 million in transition fees. This amounts to $1 extra on each prescription to next April dropping steadily to zero by the start of the 2013-14 fiscal year.

Dispensing fees are also going up by a dollar to $8 for prescriptions filled through the public drug plan; pharmacies in small communities will get up to $12 a prescription depending on how far they are from another pharmacy.

There are no rules in place for how much pharmacies can charge private-paying customers for dispensing fees and these are slated to go up quickly to at least partially offset the revenue loss.

“Our ways to increase revenues are few and far between, and dispensing fees is one of them. We’ll probably see that rising over the next few months,” Dean Miller, chairman of the Ontario Pharmacists Association told Canadian Press.

More information at www.health.gov.on.ca/en/public/programs/drugreforms/min_communications.aspx.

Sunday, June 06, 2010

AlarmCare

FSNA is pleased to welcome AlarmCare as its newest affinity partner. AlarmCare is a Personal Emergency Response System (PERS) designed to help anyone live independently and securely in their homes. If assistance is needed, a simple push of the help button will immediately send an emergency signal. Installation is free and the service regularly costs $28 per month. FSNA members are being offered a special price of only $25 per month for the first three months. More details on this addition to FSNA’s affinity programs will be in the summer issue of ON GUARD.

Appeal of the verdict of the pension surplus court case

On April 19 and 20, Richard Poersch, FSNA National Director for Ontario, attended the hearings of the appeal of the verdict of the pension surplus court case. He reports that at the proceedings, held at the Ontario Court of Appeal in Toronto, our lawyers did a very good job of representing members’ interests. However, the hearings also went well at the original trial but in the end, the verdict was not favourable. Therefore, let us not create false hopes. And let us not forget that if a favourable verdict is rendered, the only effect it will have would be a return of the $30 billion surplus back to the superannuation accounts.

The outcome of the appeal will be known only when the appeal judges have finished reviewing the case and render their ultimate verdict, a process which usually takes several months.

Some Ontario health related news

Ontario wait times down, but not for long-term care

Progress has been made in reducing wait times for care in Ontario over the past year, the Ontario Health Quality Council says in its fifth annual report released Thursday. However, it warns that roadblocks to patient flow are causing backlogs.

There have been “solid improvements” in cardiovascular care, including declining rates for heart attack mortality and hospital readmissions.

Wait times are also considered “good” for both cardiovascular surgeries and cataract removals, and have improved for hip and knee replacements as well. The Council furthermore sees “cautious signs for improvement in care for diabetes and other chronic diseases.”

But it says wait times for long-term care have tripled since 2005 and stand at 105 days overall. Fully 16 per cent of hospital beds are occupied by patients who do not need to be there, but are waiting for a place in community care.

The report points to the success Lethbridge, Alberta has achieved in using assisted living and supportive housing to reduce reliance on long-term care. Wait times there are under a month, yet it uses one-third fewer long-term care beds than Ontario.

The issue with long-term care came as no surprise to the Association of Non-Profit Homes and Services for Seniors in the province. In a news release commenting on the Council’s report, it pointed out that there are about 76,000 long-term care beds in the province which are 98 per cent full and there is a wait-list of over 25,000 people.

On other matters, the Council is pleased that the use of electronic medical records in physicians’ offices increased from 26 to 43 per cent between 2007 and 2009. But it is perplexed that access to primary care remains a problem despite a steady increase in the supply of health professionals. About seven per cent of Ontarians (some 730,000 people) do not have a family doctor.

Recent legislation in the province aims to expand the mandate of the Council to promote evidence-based care. It will also be given the job to make recommendations to the government on the “provision of funding for health care services and medical devices.”

The Council’s report can be found at www.ohqc.ca/pdfs/2010_report_-_english.pdf.






Ontario interested in changing physician compensation

Ontario’s health minister is open to some of the ideas in last week’s report from TD Economics calling for “urgent” reforms to health care. The report said rising health care costs are unsustainable.

In an interview with reporters last Thursday, Health and Long-Term Minister Deb Matthews said the report’s recommendation of limiting drug plan coverage for wealthier seniors was “something we can look at.” She was similarly interested in another recommendation to shift more physicians from fee-for-service to salary-based compensation.

The report said “a healthy and vigorous debate” on the future of health care is needed – again something Ms. Matthews supports.

In fact, this has become a standard refrain from the minister and Premier Dalton McGuinty since the need to engage Ontarians in an “important conversation” about the funding challenges of health care was first mentioned in the March Speech from the Throne.

That Speech promised a period of unrelenting reform in health care, and the government has already taken a number of steps in this direction including radical changes to the drug plan and the abolition of lucrative professional allowances or rebates pharmacists receive from generic drug companies for stocking their products.

Pharmacists are still fighting the initiative which is due to come into effect this month.

The TD report saw distinct advantages in using capitated payment models whereby physicians get paid a certain amount per patient, as well as salary arrangements which have been put in place for new team-based primary care practices.

“Once doctors have moved away from billing for services performed towards a blended per-capita, salary and volume structure, further incentives can be put in place through the payment mechanisms to reward effective practice, increased number of patients, etcetera.”

The report’s focus on aligning physician compensation with performance is again something that was mooted in the Throne Speech. It promised legislation “to make health care providers and executives accountable for improving patient care.” However, the legislation that was tabled in early May (Excellent Care for All Act) only tied hospital executive compensation to meeting quality objectives.

There is a certain willingness on the part of Ontario physicians to consider different ways of being remunerated. The 2007 National Physician Survey found half would prefer some form of blended payment.

The three most desired components of this formula were fee-for-service, on-call, and benefits/pension payments. Salary and task-related (sessional) payments were further down the list.

Issues with Ontario's H1N1 vaccination program

Ontario was lucky the H1N1 pandemic was not worse, the province’s Chief Medical Officer of Health says in a report this week on how Ontario fared. Dr. Arlene King says the province had a plan and was prepared, but had more people swarmed emergency departments for longer than they did “that might very well have tipped the system.” She says there is a need “to take a hard look at our immunization system” including ways of tracking and managing vaccination programs which were inadequate during the outbreak. Dr. King says there is also a need for strong central oversight and management during an outbreak. This includes giving her office the authority to direct what the province’s 36 public health units do “in real time.” Her report can be found at www.health.gov.on.ca/en/public/publications/ministry_reports/cmoh_h1n1/cmoh_h1n1_20100602.pdf

Thursday, June 03, 2010

NDI 75 RECORD OF SERVICE CARD


Please read and follow the instructions carefully. There is no need to call as the application form is posted to our website at www.cpva.ca. Note that there is a long backlog of up to six months to obtain the card.

CERTIFICATE OF SERVICE

Write to the same address as indicated on the form to obtain a replacement certificate of service (release certificate) as well as your service pin.

INSTRUCTIONS

1. Concerning the possible entitlement to a Record of Service Card - NDI 75.

Note - this is often mistakenly referred to as a Veteran’s Card or Veterans Identification card, in essence it is a pocket size Certificate of the member’s record of service. Thus Record of Service Card.

2. The Record of Service Card - NDI 75 is issued to members leaving or who have left the Canadian Forces, with 10 or more years of service.

3. If you meet the eligibility criteria, use the application form attached. It is imperative the information required is legible. Complete with the member’s: Service Number, Military ID Number or Social Insurance Number. Two colour passport–type photographs measuring 1½” x 2”. Processing time after this office receives the application, is approximately 3–6 months to mail the card to applicant.

Mail to: Record of Service Card - NDI 75

Director Military Careers Administration 4

National Defence Headquarters

MGen George R. Pearkes Building

101 Colonel By Dr

Ottawa ON K1A 0K2

4. Replacement of the Record of Service Card - NDI 75 may be requested with a cost of $15.00 payable in the form of a Postal Money Order made payable to the Receiver General for Canada.

This information has kindly been provided to the CPVA by NDHQ. Please follow the instructions, complete the form posted at www.cpva.ca. enclose your documents, photos and payment, and do avoid calling as they are extremely busy trying to meet the demand. Please do not contact the undersigned or info@cpva.ca as we have no further information at this time. For updates, pleased consult our website at www.cpva.ca.