long term care

Friday December 22, 2023

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Friday December 22, 2023The shifting Canadian attitudes towards pharmacare, as reflected in recent surveys, involve considerations of health care priorities, political negotiations, and changing sentiments amidst economic uncertainties and the ongoing pandemic, with key players including Justin Trudeau, Jagmeet Singh, and the evolving landscape of Canadian politics.

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Friday December 22, 2023

Changing Tides in Canadian Attitudes Towards Pharmacare 

June 13, 2019

In recent years, Canadians appear to be reassessing the urgency of implementing a national pharmacare plan, particularly in light of the profound challenges posed by the pandemic. According to a 2023 survey conducted by Leger, only 18 percent of respondents consider a universal single-payer drug plan a top health-care priority. The focus has shifted towards addressing more immediate concerns such as surgical wait times, long-term care expansion, and mental health services, garnering 36 percent, 32 percent, and 30 percent support, respectively.

This shift in sentiment is underscored by the limited awareness of the government’s pharmacare plans, with 53 percent of those polled being unfamiliar with the proposed legislation. Negotiations between the Liberals and New Democrats, who pledged support for pharmacare in exchange for prioritizing NDP concerns, have encountered obstacles, primarily due to disagreements over the structure of the system.

News: Pharmacare not the top health priority for most Canadians: survey

September 3, 2021

While 44 percent of respondents support a drug plan covering those without existing coverage, seniors, and individuals earning less than $90,000 annually, only 22 percent believe the plan should replace basic employer-provided drug coverage. Despite the lack of overwhelming support for pharmacare, opposition remains relatively weak, with only 17 percent stating that it should not be a government priority.

Even within the Conservative voter base, only 23 percent express outright opposition to pharmacare, suggesting potential acceptance among the majority. The political landscape is crucial, with the Liberals relying on pharmacare legislation to secure NDP support and avoid an early election amid a dip in Conservative support.

April 22, 2021

In stark contrast, just four years ago, Canadians overwhelmingly supported the idea of pharmacare. In a 2019 poll conducted by Environics Research, 93 percent of respondents believed it was crucial for everyone in Canada to have equal access to prescription drugs. A resounding 88 percent felt that the federal government should take responsibility for ensuring such access.

The high cost of prescription drugs was a significant concern, leading 24 percent of households to make compromises, such as not filling or renewing prescriptions, to cope with expenses. The poll highlighted the widespread support for a universal national pharmacare program, with almost 90 percent of Canadians endorsing the initiative.

News: Pharmacare bill to be tabled by March 2024, Liberals and NDP confirm  

March 6, 2018

The stress of prescription drug costs on household budgets was reported by 35 percent of Canadians, while 21 percent of those with coverage still found the out-of-pocket expenses challenging. Disparities in access were evident, with certain groups facing greater barriers, including women, Indigenous people, those aged 18 to 44, individuals with lower incomes, and those in poorer health.

The Heart & Stroke Foundation and the Canadian Federation of Nurses Unions advocated for federal leadership and an equitable drug strategy, emphasizing the urgent need for a national universal pharmacare program. The poll results indicated that pharmacare was a critical concern for Canadians, urging political parties to prioritize it in the federal election discussions.

April 8, 2022

This divergence in public opinion over a relatively short period underscores the dynamic nature of Canadian attitudes towards pharmacare, with recent challenges and economic uncertainties prompting a reconsideration of priorities. The contrast with the overwhelming support just four years ago highlights the evolving nature of public sentiment in the face of changing circumstances. (AI)

From sketch to finish, see the current way Graeme completes an editorial cartoon using an iPencil, the Procreate app, and a couple of cheats on an iPad Pro. If you’re creative, give illustration a try:

 

Saturday August 27, 2022

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Saturday August 27, 2022

Not the new and improved Doug Ford …

August 19, 2022

At minimum, the provincial government has a massive optics and communication problem around its new initiative to try and free up badly needed acute care beds.

By now we all know the health-care crisis is real. And a significant part of the situation is a result of people who need alternate levels of care occupying acute care beds. Give Doug Ford and friends credit for finally trying to do something about it.

But is what they’re doing the right thing?

January 27, 2021

New legislation would allow hospital patients to be transferred to a temporary long-term care home without their consent while they await a bed in their preferred facility. The interim LTC facility would not necessarily be in their community. The law will not physically force patients to move, but it’s not at all clear what will happen if they don’t.

LTC Minister Paul Calandra says people should “absolutely” be charged a fee if they won’t move, but he won’t say how much. It could be $62 per day, or it could be much more. How much more? How far away might people be moved? The government either doesn’t know or isn’t saying, and it is not allowing debate or public input into the new law. This is not the new and consultation-friendly Doug Ford people thought they were voting for. (Hamilton Spectator editorial) 

 

Tuesday May 4, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Tuesday May 4, 2021

Ontario government needs to wake up and make nursing homes a top priority

May 16, 2020

The people of Ontario didn’t need two new reports to tell them Doug Ford’s government was missing in action when COVID-19 hit the province’s nursing homes last year.

The deaths of nearly 4,000 long-term-care residents and 11 employees during the pandemic had already spoken for themselves. And that grim message amounted to a scathing indictment of governmental ineptitude at the highest levels. 

Yet for all this, Ontarians really did need Friday’s report from the Long-Term Care COVID-19 Commission along with the one from Auditor-General Bonnie Lysyk two days earlier. They’re essential for telling us what we should — make that must — do for the sake of the 115,000 of the province’s most vulnerable citizens who live in nursing homes today.

According to the commission, the Ford government was completely without a comprehensive plan to protect nursing homes when the pandemic hit. Then, not only was its response “slow, unco-ordinated and lacking in urgency,” it failed to heed the lessons of the first wave. As a result, more residents died in the second wave than the initial one.

November 19, 2020

For its part, the auditor-general’s report denounced not only the current provincial government but governments stretching back over a decade. Not one of them followed up on the recommendations made by an expert panel after the 2003 SARS outbreak to prepare long-term-care facilities for a future health-care crisis. 

Not one of them addressed the concerns about the litany of long-standing weaknesses that had been identified in the nursing-home system. And so the province’s nursing homes, which consume seven per cent of the health-care budget, became pandemic disaster zones.

For some Ontarians, this may all sound painfully familiar, something they’d just as soon forget after they condemn the current government. 

But these two reports are important for more than putting on the record a precise diagnosis of what went so badly wrong in the province’s nursing homes over the past year. Their greatest, and hopefully most lasting, value will be in the prescription they offer for what should be done now.

May 27, 2020

The best way forward will demand more funding, more and better-paid staff, an end to overcrowded wards, better coordination with the rest of the health-care system and — for goodness sake — a pandemic plan. Ontario also needs a new model for building and managing new nursing homes, and the Long-Term Care COVID-19 Commission came up with a promising proposal for one. 

It recommends constructing new homes that are paid for upfront by private investors who receive a return on their capital with profit over time. However the homes will be operated and the residents cared for by a mission-driven organization. It could be public, not-for-profit or for-profit. But the sole focus of those running the homes must be the care of the residents and certainly not returns for investors.

January 27, 2021

What matters now is what the Ford government and the people of this province commit to doing with this and all the other ideas in these reports. Ontario Long-Term Care Minister Merrilee Fullerton promised Monday to adopt many of the recommendations from the commission’s 332-page report. But what else could she say?

Governments and the public have notoriously short memories. Premier Ford will face many expensive demands for all kinds of changes coming out of this pandemic.

The only way to ensure Ontario’s nursing homes never experience another catastrophe like COVID-19 is to make the homes an absolute, non-negotiable priority. The government will say they are. But only the people of Ontario, the people who vote and pay taxes, can guarantee the government acts. (Hamilton Spectator Editorial) 

 

Wednesday January 27, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Wednesday January 27, 2021

Ontario health experts demand province abolish for-profit long-term care

With hundreds of Ontario long-term care residents dead and COVID-19 outbreaks continuing to ravage facilities across the province, a group of health experts is pushing the province to abolish for-profit long-term care facilities.

November 19, 2020

“When you think about for-profit homes, they’re by design created to have one thing in mind and that’s profits for shareholders. It’s not care for our seniors,” Dr. Naheed Dosani, said Tuesday on CBC Radio’s Metro Morning.

“This is a humanitarian crisis.” 

Dosani, a palliative care physician for the William Osler Health System, which has hospitals in Brampton and Etobicoke, is one of more than 215 Ontario doctors and researchers who have joined the Doctors for Justice in Long-Term Care campaign.

Despite repeated assertions from Premier Doug Ford, Long-Term Care Minister Merrilee Fullerton and other provincial officials that Ontario was building an “iron ring” around its long-term care facilities to protect residents from a second wave of the virus, deaths have continued to mount.

Out of more than 5,900 COVID-19-related deaths in the province, more than 3,400 were in long-term care, according to provincial statistics.

Most recent is the outbreak at Roberta Place Long Term Care Home in Barrie, Ont., where almost every single resident has contracted COVID-19. Genome sequencing has also confirmed that a highly transmissible variant of the virus first detected in the United Kingdom has been found at the home, according to the local public health unit.

The facility was reporting 44 resident deaths as of Monday. (CBC) https://www.cbc.ca/news/canada/toronto/ontario-long-term-care-1.5888226

 

Thursday November 19, 2020

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Thursday November 19, 2020

The province is dodging the truth on COVID-19 in long-term care

On Monday, Ontario’s long-term-care minister, Merrilee Fullerton, assured Ontarians that in spite of COVID-19 spreading through long-term-care homes, they’re actually doing better than they did in the first wave of this pandemic.

June 17, 2020

Speaking at Queen’s Park, the minister summed up: “There’s no doubt that lessons have been learned from the first wave and the data shows our homes are doing much, much better.”

Really? On Tuesday, 26 of 32 new COVID-19 deaths were in care homes. The province says 678 nursing home residents have the virus. And 100 of the province’s 626 care homes have outbreaks. 

Does that sound like “much, much better” to you? It doesn’t to us, either. And it doesn’t to many health experts. 

Health experts like Dr. Amit Arya of McMaster University, who described the first wave in long-term care as “a horror movie” and who says now: “We really have not done anything close to what we should have done to prepare for the second wave.”

Natalie Mehra, executive director of the Ontario Health Coalition, agrees. She has said in media reports: “It’s devastating … The numbers right now are just exploding.” She also says “we’re shaping up to have a worse second wave.”

Indeed, according to Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario: “The number of residents with COVID is increasing, the number of staff with COVID is increasing and the number of residents who die is increasing. How can anyone sleep well at night with that?”

May 27, 2020

It’s a good question. Notwithstanding Minister Fullerton’s claims to the contrary, it doesn’t seem as if Ontario’s retirement home care system is in a better place than it was during the first wave. It’s clear that the Ford government is concerned and has been trying to put improvements and protections in place, but the reality is that it started too late, and it had repeated warnings during and after the first wave.

The Registered Nurses’ Association, for example, asked the government to make investments in staffing with registered nurses, nurse practitioners, registered practical nurses and personal support workers in homes across Ontario. The government didn’t act. And so when the second wave hit, staffing levels were already at or below operative minimum, and that was before staff began to get sick and be absent. 

The government’s own LTC commission, in its interim report on fixing the system, released a series of recommendations urgently calling for action on things like staffing levels and compensation. Fullerton said her department was “carefully reviewing” the recommendations. 

July 17, 2020

This is all happening at the same time as a Toronto Star investigation revealsprivate LTC operation is such a lucrative business opportunity, private equity funds are being set up to cash in on the potential. That’s not surprising given the shortage of beds that continues to exist and our aging population. 

But keep in mind this is specifically about private, for-profit LTC operations. In Ontario, for-profit homes account for a little more than half of the province’s long-term-care beds. But they also accounted for 70 per cent of COVID deaths in the first wave of the pandemic. According to a Star analysis, so far in the second wave for-profit homes have just under 80 per cent of the deaths.

So if you’re a wealthy investor, there’s money to be made in for-profit long-term care. What is less clear is whether the for-profit model, where the bottom line is always going to competing for the top priority, even over resident care, has a place in the long-term-care system. That the government isn’t even considering that is troubling. (Hamilton Spectator Editorial)