The power’s out in the west end of the island. No prediction yet how long it will take to restore.
Updates from July, 2023 Toggle Comment Threads | Keyboard Shortcuts
-
Kate
-
Kate
The Journal is looking at the incursion of private health care Thursday: a woman whose case was transferred to the private side without her permission, meaning she had to pay $200 for a test, a woman in need of orthopedic surgery for years hearing suggestions to go private, doctors fleeing the public side for more profitable private practice.
Why is nobody standing up for the Canada Health Act?
DeWolf
So it took a call from a journalist to get the woman reimbursed, and the clinic direction claims it was a mistake that has never happened before. Sure.
This kind of crookery is exactly what the Canada Health Act is meant to avoid, and as you say, nobody seems interested in standing up for it. From what I can tell, this kind of insidious privatization is happening in nearly every province.
carswell
My GP is going private in September. Received the fee schedule recently. She’s offering two options. All-included VIP service costs $100/month or $1100/year. À la carte service is $300 for the first consultation for any given issue, $200 for each followup, forms $100-$400, email $100, prescription renewal $75 “each” (unsure whether that means per drug or per script).
Went to the government website to get on a waiting list for a new GP and was refused access because I already have one…
It’ll soon be like it is for dental work: unaffordable for many, a huge burden for many others and a trifling annoyance for the affluent, who will also receive better care. We’re looking at a two-tier healthcare system in Canada. Tommy Douglas must be rolling in his grave.
walkerp
It’s so distressing while our leaders fight over election security angels dancing on a pin.
Mark Côté
This Globe and Mail article was really interesting. Law of finished consequences in action.
carswell
@Mark Côté Though the headline (“How Ottawa can help fix health care: first, send less money”) doesn’t inspire confidence, the article is paywalled, so non-subscribers can’t put it in context. Care to summarize or provide a gift link?
mare
If you know under which stress GPs have to work under and how much they get paid you’d understand why they go private. I would.
My GP ‘inherited’ all patients from one of his colleagues who retired and the last appointment of the day with him is at 16h. I’ve had that appointment slot a few times and was seen at 19h pm. He starts at 8h. No wonder that getting an appointment is very hard, with a few weeks waiting time, and you have to book through a ridiculously bad website. I usually call, and his assistant has directed me to go to the ER a few times, for relatively minor issues. Which means long waiting times at ERs, people being stressed and annoyed there etc.
They (have to) see a ridiculously high number of patients per day. Which means they might not have enough time to pick up on serious issues until it’s too late. Also because their referred patients end up on ‘black hole’ waiting lists at also overworked specialists. This results in people being seen in hospitals when their disease is already in an advanced stage which, in the long run, costs more money and scarce hospital and long term care resources.
(Or, if you’re cynical, less money when they die at an earlier age. But, as someone in the field once told me, the government doesn’t have to pay doctors and specialists who aren’t there. People working in healthcare are pretty cynical.)Covid has exacerbated the shortage even more. Not only nurses but specialists are also sick at home with burnouts and Long Covid.
Going private as a GP means they can start over and take fewer overall patients and see fewer of them each day and take proper care of them. If the patients have money or generous private insurance they can then refer them to private specialists with short waiting lists. Specialists who can even perform quite complicated surgeries. (And can offload their worst patients to the public healthcare with high urgency.)
mare
@carswell The globe article above: https://archive.ph/mQuCB
jeather
There are so many weird details about it. Specialists go half half, and tell the public system people that they will be private from July-Dec so they could get [whatever] done then, or just stay on the list. GPs are not required to find new doctors for their patients if they retire or leave the system, but ARE if they go part-time. If you work as a specialist in a hospital, you must take your evening or weekend hours no matter your age, there’s no seniority system at all there.
A friend was also transferred for some exam to a private clinic, but she wasn’t asked to pay.
MarcG
How much of this shift is related to McKinsey working its way inside of our governments?
Tim
@Carswell: some facts regarding dental services as of 2010 (I could not find anything more recent):
80% of Canadians had a dentist
85% of Canadians had seen a dentist in the past two yearsSource: https://www.cda-adc.ca/stateoforalhealth/_files/thestateoforalhealthincanada.pdf
Do you have any stats to back up your assertions as to how “many” cannot see a dentist? What’s your definition of affluent?
steph
Being a doctor is something to be proud of. The ones that go private don’t deserve that respect anymore.
carswell
@mare. Thanks for the link.
I count several physicians among my friends and acquaintances, including a couple in administrative positions, and have heard the horror stories first hand. I would even argue that doctors are in an abusive relationship with the government: forced to give up control of their schedules, make huge compromises in their personal life, adopt schedules that are regimented to a degree I find unimaginable, set up extensive support networks just so they can function. I see how harried my GP is. I and other patients have, of necessity, become a commodity; there’s not even a minute for small talk (which there should be, as it’s often revealing of a patient’s issues). It makes me glad I abandoned pre-med at university.
That said, these friends and acquaintances are also among the most comfortably off people I know. To a person, they live in deluxe accommodations. At dinner parties, conversation often centres on which fabulous vacation spot they’ve just returned from or are heading to next (a villa on Lake Como and a luxury wine tour of South Africa are two I recall), on which BWM model to buy next, and so on.
Aside from the blackout, one of the reasons I’m tardy in replying is because yesterday I could finally get my blood and other tests done. My doctor had ordered them in early May. It used to be I could take the forms, walk over to St. Mary’s or the Jewish, wait a half hour or so and have the samples taken. Last time I had to make a reservation at St. Mary’s for later in the week, understandable given the pandemic and the need to avoid crowding. This time, I had to go through the ClicSanté website and the Jewish didn’t have an opening until late August (nearly four months!) or St. Mary’s until the end of July. The delay at the local CLSC was more like seven weeks and I snagged the last spot.
Our health system is crumbling and while there are many factors at play, government incompetence is chief among them. After presiding over a disastrous response to the COVID-19 crisis, our health minister should have resigned. Instead, he not only remains but is given even greater powers. Centralization of power and decision-making in the Health Ministry isn’t working. The solution? Centralize it even more and add an extra layer of administration.
So, no, I don’t hold it against physicians for opting out. Spending quality time with her patients was the first reason my soon-to-be-former GP gave when announcing her intention to go private. On the other hand, they are also are chasing to deal only with people who can afford to pay or have a private insurance plan. They are turning their backs on the less well-heeled, being aiders and abettors in the installation of a two-tiered health system. For now, though, I’ll direct my anger at the government.
carswell
Apologies for the extended typo in the last paragraph.
On the other hand, they are also choosing to deal only with people who can afford to pay or have a private insurance plan.
carswell
@Tim (and BTW it’s carswell, with a lowercase C to indicate it’s a handle) No, I’m not basing my assertion on stats. My information is purely anecdotal, based on what I hear from friends and colleagues and on my interactions with the dental “system,” which unfortunately have been frequent and costly in the last decade or so.
My cursory search for more up-to-date stats doesn’t turn up anything definitive either. For example, not that I’m a Dipper but the NDP website claims 1/3 of Canadians don’t have dental insurance and 7 million Canadians (36%, no?) don’t see a dentist every year because they can’t afford to, but no sources are cited.
Returning to “your” stats though, they leave a lot unsaid. What does “have a dentist” mean? A dentist they see at least every six months for a cleaning and checkup or a dentist they’ve dealt with at some point in the past? Ditto re “have seen a dentist in the last two years.” For a regular visit or because they were in such pain they couldn’t put it off any longer?
Even if we cast your stats in the best possible light, that still leaves 8 million Canadians without a dentist and 6 million who haven’t seen a dentist in two or more years. Hardly trifling numbers, especially when you factor in that they date from well before the current inflationary spiral.
As for affluent (and not sure why it matters), Webster’s definition works for me: “having an abundance of goods or riches.” Or, to phrase it more relevantly to this discussion, someone who can afford to pay without depriving themselves of necessities and at least the occasional nicety, someone for whom forking over a hitherto unbudgeted $1200 a year isn’t going to place a strain on them. While I could afford that amount now, I’m also planning to retire in five years and it would be $6000 less for my nest egg. Post-retirement? Unlikely without sacrifice. Which probably means I’ll be receiving inferior care when I most need it.
What I find especially galling is that, having been blessed with good health, I’ve spent 45 years paying a lot more into the system than I’ve taken out of it. Now, when I’m more likely to start making use of of the system, I’m presented with a stark choice: standard care (now termed “VIP”) that treats me like a person but with a premium I’ve not planned for or lesser care that treats me like a commodity.
Tim
@carswell: they are not my stats. They were produced by the Canadian Dental Association. I just referenced them.
As for my question about affluence. I was just curious if you could put a number on it. A family (with both parents working) making $120k a year, whom I would not call affluent, I guess meets your definition. Or maybe not.
I’m sorry to hear of the costs of your dental care. That is not small change.
What I am now surprised by, after another search for stats about dental insurance, is the following from the CDA, which indicates that there are far fewer people with dental insurance than what I thought:
“53% of adults between 60 and 79 years of age have no dental insurance and 50% of Canadians in the lower-income bracket have no dental insurance.”
-
Kate
Will any of our media take note that Covid deaths in Quebec have quietly passed 18,000 this week?
MarcG
Currently approximately 2 deaths every day. If the southern hemisphere is any indication of our future we’re in for a nasty fall/winter. What are we doing to prepare? Slowly removing masks from hospitals. They will get crushed and privatizing healthcare will be offered as the only solution.
walkerp
I don’t know about these deaths, but the behaviour of the disease has evolved (not sure if that is the right word) significantly. I caught it for a second time last week (probably at a workout spot, but not sure) and it was so mild compared to the first time. I basically had a mild sore throat and barely a cough plus some fatigue for two and a half days, tested positive for a week and that was it.
Obviously, this is just a single case, but during my contagion period I did not manage to pass it on to any of my family members with whom I live, nor any friends and nobody else I know got it.
It’s out there and it is going to have a continued impact but it’s not the universal social threat that it was the first 2 years when it came out.
MarcG
It’s a mistake to measure the threat of a virus solely on the severity of the acute illness. HIV, for example, presents as flu-like symptoms at first and then 10 years later you find out you have AIDS.
Michael
At this point covid is no longer a pandemic, but endemic like the cold. We need to compare cold / normal flu deaths in the last 6 months with covid deaths.
Adding up covid deaths in aggregate no longer makes sense.
Kate
Are you a doctor, Michael?
MarcG
Interview quote from Arijit Chakravarty, a biologist working in data modeling for drug companies whose company writes papers on Covid in their spare time:
To reiterate, we still have shockingly high rates of transmission, shockingly high death totals, and we have NO plan. And if something worse happens, we will react to it. And this is the key point in the “Gray Swan” paper, which underscores a reactive public health strategy, which is the kind of strategy where first you see something go wrong and then you do something about it. If I was generous about defining our global public health “strategy,” that’s our strategy. And in that kind of reactive strategy what will happen is billions will be infected before we realize something is wrong. And that’s too late to do anything about it. So not only is the pandemic very much not over, but by creating the impression that the pandemic is over in the face of rampant viral spread and continuing rapid viral evolution, we are essentially sticking our chin out and asking the virus to do its worst.
-
Kate
Residents describe living in a condo in the Quartier des spectacles with junkies in the lobby and blood and urine in the stairs.
Robert H
Wow. If I lived there, my nerves would be shot and I’d lose my mind with rage. I’m particularly struck by the following:
“Des vendeurs de drogue ont même loué un condo dans un des immeubles. On y a trouvé des centaines de seringues.”
When condo board member Alexandra Gonzalez says “On vit un enfer,” I believe her. Even when everyone has the best of intentions, there’s no hope for cöexistence with people in the grip of addiction when the public sector fails as much as it has here. I don’t know what the solution would be, but it would have to rest with the city and the province. I don’t want to be a cynic, but public officials seem to have opted for a policy of containment at the expense of les gens du coin. And I’m not referring only to the fed-up folks in the pricey condos, but the down and outers nodding off in doorways and alleys with needles on their arms.
Joey
Really strong reporting here – what’s perhaps most interesting is that none of the people interviewed are caricatures. So you get a protagonist – the condo unit owner – who is *not* a NIMBY, knee-jerk opponent to safe injection sites. You get a social worker who acknowledges that the presence of the safe injection site he runs has caused a rough neighbourhood to get rougher. The only people who come off as clueless/dishonest are the media reps for the city and the police, who make vague claims about concrete steps being taken when, clearly, public resources devoted to improving the situation are disappearing. And, as the thread on healthcare above makes clear, it’s not like these resources are being ‘overused’ elsewhere, with the possible exception of the ‘physicians who have opted out of the free public system’ category.
Kate
I agree. It’s a good report. You have to ask why the building security isn’t better, why our well paid cops aren’t more responsive, and – in the wider sense – why there aren’t more social services in the area.
It must be an odd job knowingly telling lies for government.
Joey
Residences shouldn’t need security…
Kate
They shouldn’t but evidently they do, at least in some parts of town.
Michael
Enough is enough, we need to close these injection sites down. There is no benefit to the community for this.
Kate
Can you cite studies, Michael?
Tim
It’s not a study, but the following article is a damning indictment of safe supply where addicts can pick up drugs and go: https://nationalpost.com/feature/how-the-liberal-governments-safer-supply-is-fuelling-a-new-opioid-crisis
Josh
Not a lot of specifics, nor people willing to be quoted on the record in that piece, Tim. There was a good takedown of that piece specifically on the Canadaland podcast some weeks ago.
https://www.canadaland.com/podcast/885-poilievre-on-drugs/Tim
I listened to the podcast Josh. One of the first statements was an acknowledgement that diversion exists. They did cast doubts on the doctors who did not go on record and I’ll agree with them that the article was hyperbolic on the current impact as of today. I really did not follow their logic when they advocated more agency for addicts while at the same time dismissing how hydromorphone street price estimates were obtained by doctors from the addicts that they treated. The host also seemed laser focused on whether this was causing more deaths as opposed to whether it was causing more addicts because people who were too scared to try fentanyl would be more open to govt approved hydromorphone.
There is a need for more data to qualify and scope the positives and negatives of diversion. Reading through https://www.nss-aps.ca/sites/default/files/resources/ReframingDiversionForHealthCareProviders.pdf, I get the impression that this organization has already made up its mind.
-
Kate
The town of Lac Mégantic is observing ten years since the oil tanker train derailed in their modest downtown, killing 47 and devastating the place. The town has been holding various memorials including a silent night walk.
walkerp
And let’s not forget that the federal Transport minister is still going ahead with the rerouted line through a bunch of people’s land, including land owned by many of the victims, even though 92% of the town voted against it.
dhomas 16:10 on 2023-07-06 Permalink
I live out near Radisson metro. I got a micro outage of a fraction of a second. Some of my devices didn’t even power cycle. My PC stayed on, though my monitor turned off and back on. It was enough to knock out my Videotron internet your about half an hour, though. I wonder if it’s related.
Dwgs 16:11 on 2023-07-06 Permalink
Most of NDG is out as well.
CE 16:55 on 2023-07-06 Permalink
In the Plateau, my power went out for just a second. Just enough to shut down my computer.
Kate 18:13 on 2023-07-06 Permalink
People are emailing and pinging to say power is back.
EmilyG 18:53 on 2023-07-06 Permalink
I’m in Pierrefonds, but didn’t lose power.
Hoping it returns for everyone soon.
MarcG 19:51 on 2023-07-06 Permalink
I always felt like we lived in a place that was well protected from the effects of climate change but that illusion is really being shown for what it is over the past little bit.
jeather 19:57 on 2023-07-06 Permalink
HQ claims it hits the west side of the island because there are more trees though I still like the Beaverton’s explanation.
Kate 20:12 on 2023-07-06 Permalink
jeather, Elias Makos tweeted the same idea.