Kazakh Delegation Visits, Speaks to CEO About Health Care Systems and On-going Reform

Yeena Peng and Terry Glecoff

Joined by the Deputy Minister of Health, a delegation from the Republic of Kazakhstan met with the Health Council of Canada yesterday to discuss our country’s health care system.

The group shared information and ideas about the funding of Canada’s system, infrastructure planning, information technology in health care, Canada’s public health initiatives, and payment mechanisms. The visitors discussed some of the challenges facing their country that include better reimbursement methods to providers and developing multi-disciplinary teams of health care professionals. John G. Abbott, Health Council CEO, highlighted Canada’s critical need for the establishment of electronic medical and health information systems. 

The conversation saw the groups agree on the need to develop new standards focusing on prevention for both countries. Like Canada, Kazakhstan’s health care leaders need to continue to explore ways to effectively reform their existing system to ensure sustainability. The groups agree that governments and health authorities must support system change through better engagement of citizens, patients and health care providers.

Canadian Association of Radiologists responds to Council's 'Decisions, Decisions' Report

This letter is from Ms. Adele Fifield, CEO of the Canadian Association of Radiologists. She contributed to the research and development of the report. We invite you to read Decisions, Decisions: Family Doctors as Gatekeepers to Prescription Drugs and Diagnostic Imaging in Canada then give us your thoughts on the important issues it contains.
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The Canadian Association of Radiologists (CAR) supports concerns raised in the newly released report, Decisions, Decisions: Family Doctors as Gatekeepers of Prescription Drugs and Diagnostic Imaging, by the Health Council of Canada.

The question of appropriate ordering of diagnostic imaging tests is an important one for all of us. Research shows that as many as 30% of CT scans and other imaging procedures are inappropriate or contribute no useful information. Reducing inappropriate imaging is essential in maintaining patient safety, in reducing wait times, and in using equipment and health human resources as optimally as possible.

Children and the imaging care they require was one of the many concerns shared just last week (September 20-22) at a World Health Organization (WHO) workshop on radiation risk communication in pediatric imaging. CAR was represented at the event by Dr. Martin Reed, Chair of the CAR Guidelines Working Group, and the group expressed interest in learning of the Health Council of Canada’s findings.

This report also highlights that a key step in ensuring the appropriate use of diagnostic imaging tests in Canada will be better and broader use of guidelines. Greater attention can and must be paid to communicating these guidelines to physicians from the early stages of their training and throughout their careers -. As mentioned in the report, CAR is responding, in part by redeveloping its Diagnostic Imaging Referral Guidelines: A Guide for Physicians. We’ve also been working to make guidelines a part of the physician’s daily workflow by incorporating imaging guidelines in electronic decision support with computer order entry. We are further studying compliance with imaging guidelines.

In addition to the role played by physicians in efforts to increase appropriate ordering, patients also have a role to play in what they are demanding of their doctors. We hope that this report will help Canadians better understand the dynamics within the health care industry. We are very pleased to speak about this topic from the perspective of radiologists.

Wishing you well,
Adele

The Actra Fraternal Society reponds to Council's 'Generics' Discussion Paper

This letter from Mr. Robert M. Underwood, President and CEO of the Actra Fraternal Benefit Society responds to our discussion paper, “Generic Drug Pricing and Access in Canada: What are the Implications? We invite you to read our discussion paper and Mr. Underwood’s response, then give us your thoughts on this important issue.

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RE: Your letter to Ferne Downey, National President – ACTRA

Actra Fraternal Benefit Society is a not-for-profit Fraternal Benefit Society providing insurance and retirement services to performers and writers (members of the Writers’ Guild and ACTRA). AFBS is owned by our Members and as such, we have a vested interest in providing cost-effective programs, with HealthCare being one of our primary focuses.

We have provided a ‘mandatory generic’ prescription drug program for our members for approximately 14 years, and we provide for brand-name only where there is not generic substitute, or where the physician clearly prescribes ‘no substitution’.

Within our electronic adjudication process, in addition to providing a managed formulary for our Members, we allow for ‘best available price + 10% markup’ and we are somewhat concerned that recent legislation ion Ontario could force retail pharmacy to re-address their markup policy, which could result in increased costs for our Members. 

We are aware of the commitment to a National Pharmaceutical Strategy, and would applaud such a strategy; however this has been a plank within a number of political platforms for a number of years, and execution of the strategy remains a question mark.

Our insurance (including comprehensive HealthCare benefits) is essentially paid for by Members through contract contributions from producers and through additional contributions from Members.

The Society (following our not-for-profit model) returns all operating surplus back to members in the form of insurance subsidy which can range up to 30% of premium cost.

That is to say, any cost containment value which results from the Ontario generic drug pricing initiatives will be passed on to our members and reflected in our program cost for Members.

We appreciate your link to the ‘Generic drug pricing and access in Canada’ report and you are certainly welcome to post our comments on the Health Council website discussion board.