Our Commentaries

Our Commentaries

Our expert advisors have written opinion pieces and health articles on important health policy topics, published in leading media outlets across the country. We are making these commentaries and articles available to everyone, free of charge, with a Creative Commons license, so that you may use them in your publication or on your website. See also our Commentaries in French. Download our compendium of commentaries as a free ebook: Canadian Health Policy in the News: Why Evidence Matters.

Evidence is important to us, and we are committed to getting the evidence right — even when it can be interpreted in a number of ways. If you feel we have not represented the evidence accurately or fairly in these opinion pieces, please let us know. Browse our Commentaries by category, below, or view them all here.

AGING POPULATION AND
ITS POTENTIAL IMPACT
HEALTHCARE COSTS AND SPENDING
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    Pension reform — Lessons from Australia
    By Robert Brown

    Canadians are being told that we might learn a lot from pension reforms that took place in Australia starting in 1992. That, for sure, is correct. We can learn that retiring with any real level of financial security is expensive. Employers in Australia must contribute a minimum of 9 percent of an employee’s gross earnings into a privately managed fund and these contributions will rise to 12 percent by 2019-20.

  • Robert Brown_PEI Pension
    PEI proposal fails to spark CPP reform
    By Robert Brown

    This week, Finance Ministers across Canada met to consider an expansion to the Canada Pension Plan (CPP). One specific proposal for reform was that introduced by the PEI Finance Minister back in September. Wes Sheridan outlined the need for an expansion of the CPP and then described in some detail his idea for a “wedged” expansion.

  • Livio_healthcare spending_000000940837Small
    The failure to transform public healthcare spending is a missed opportunity
    By Livio Di Matteo

    Expenditures on public health care in Canada appear to be slowing raising the possibility that the health care cost curve is finally being bent and the system transformed. Numbers from the Canadian Institute for Health Information show that real per capita public sector health spending peaked in 2010 at $2,687 (1997 constant dollars) and is forecast to reach $2,638 by the time the final numbers are tallied for 2013.

  • ?????????????????????????????????
    Why medical tourism is not the answer
    By Colleen Flood

    So it looks like the ‘magic bullet’ solution has been found at last to cure Canada’s health care woes: medical tourism. Last week, Toronto’s Sunnybrook hospital defended its position to court affluent medical patients from other countries who can afford to pay generously for out-of-pocket care in a Canadian hospital. It’s a revenue-generating solution for a cash-strapped system, we are told.

PRIVATE, FOR-PROFIT SOLUTIONS
TO FUNDING AND DELIVERY
HEALTH IS MORE THAN HEALTHCARE
  • Groundhog Day
    Let’s not have Groundhog Day in Alberta’s public health care
    By Don Dick and Linda Woodhouse

    Is it Groundhog Day in Alberta? We Albertans seem doomed to wake every day to the same thorny and emotional debate: public health care vs. private health care. It’s a mug’s game but we appear as inexorably caught in it as the weatherman in the movie Groundhog Day, who realizes he is hopelessly condemned to spend the rest of his life in the same place, seeing the same people do the same thing day after day after day.

  • Robert Brown_DNA_000029703318Small
    Genetic privacy regulations may have unintended consequences
    By Robert Brown

    Ontario is proposing a change to the Ontario Human Rights Code aimed at protecting people’s genetic information from being used by insurance companies and employers. This would allow more people to have genetic testing done, for health or research purposes — testing they would possibly not do if they had to disclose the test results to insurers.

  • March 11_EvidenceCoverJan2014 - sized
    Download our new free eBook! Making Evidence Matter in Canadian Health Policy
    By Noralou Roos, Kathleen O’Grady, Shannon Turczak, Camilla Tapp and Lindsay Jolivet

    Making Evidence Matter in Canadian Health Policy is a compendium of OpEds published in the media in 2012-2013 by some of Canada’s leading experts in the field, offering a snapshot of the evidence on the issues of the day.

  • Bloch_tax return_March_13_5573979
    Why a doctor prescribes tax returns
    By Gary Bloch

    Tax season is upon us and my practice is humming. I am not an accountant, I am a family doctor. My patients are not bank executives, they are largely people who live in poverty, many who are homeless and on social assistance.

PATIENT FINANCING OF HEALTHCARE
(THE PATIENT PAYS)
MORE CARE IS NOT ALWAYS BETTER
  • STABILE_Two-tiered system_000015594708Small
    What problem do we believe private health insurance is going to fix?
    By Mark Stabile

    Canada is about to face its second court challenge over restrictions on private health insurance when Dr. Brian Day’s case appears before the courts in September 2014. It is true that there are examples of jurisdictions that value universal health insurance coverage and also allow private insurance — the UK and Sweden would be two examples.

  • LeeFordJones_Eyesight_000001230998Small
    A vision for kids' eye tests
    By Elizabeth Lee Ford Jones

    When I was five years old, I dropped out of kindergarten. The teacher used to get cross with me for not doing things correctly, such as passing the scissors, handles first, after a demonstration of how to do so at circle time, and I couldn’t handle the stress.

  • Portrait Of A Nurse In Front Of A Mammogram Machine
    Screening mammography
    By Charles Wright

    When first introduced four decades ago, breast cancer screening with mammography was widely regarded as an important tool in the fight against this terrible disease. It seemed obvious that the earlier it could be diagnosed the more lives could be saved. Aggressive treatment, it was thought, would prevent the cancer from spreading through the body.

  • Medical Meal of pills and tables
    Sure fire tricks to get the most out of your vitamin supplements
    By Mike Allan and James McCormack

    According to the Oxford Dictionary, vitamins “are a group of organic compounds essential for normal growth and nutrition and are required in small quantities in the diet because they cannot be synthesized by the body.” As humans, we long for perfect health and longevity. This temptation leads us to try an endless variety of interventions to achieve this goal, with varying degrees of success.

SUSTAINABILITY WAITING FOR CARE
  • mcmurtry_Medicare_000032115436Small
    Why our health system works for Canada
    By Robert McMurtry

    In the past 18 months I have required two major, but unrelated surgeries, experiencing first hand Ontario’s version of Medicare. The two interventions necessitated down-time and an enforced idleness for reflection on life and what it means to be Canadian. I feel blessed.

  • Damien Contandriopoulos_money and doctors_000023735499Small
    Giving doctors more money does not improve access to care
    By Damien Contandriopoulos and Mélanie Perroux

    The amount paid to doctors in Canada increased by $7.5 billion in the last five years to reach a total of over $30 billion per year. Put another way, the growth rate of physician remuneration expenditures — what our health system pays to doctors for health services — was more than twice the rate at which the Canadian economy grew over the same period (around 6.4% per year).

  • inpatient bed in hospital
    When more beds aren’t enough
    By Trafford Crump and Erik Hellsten

    Alberta’s provincial health authority has recently come under fire by opposition party MLAs and activists alike for closing 77 Calgary long-term care beds damaged by the June floods. The angry reaction demonstrates the common misperception that a shortage of beds is the major cause of persistent waiting lists for long-term care.

  • Grignon_HospitalRanking_000019643703Small
    What’s wrong with hospital rankings?
    By Michel Grignon

    The CBC's Fifth Estate recently produced an investigation on the quality of hospitals in Canada – “Rate My Hospital” – which has been enormously popular and set off discussions across the country about the need to improve our hospital services.

PHARMACEUTICAL POLICY MENTAL HEALTH
  • Medicine Bottle and Pills Under Spot Light Abstract.
    Canadians need to know more about the drugs we are taking
    By Roojin Habibi and Joel Lexchin

    Why is Health Canada only letting doctors and the public know part of the story about the safety and effectiveness of new pharmaceutical drugs? Inadequate information can be as dangerous as misinformation. Here’s how.

  • Steve Morga_drug spending
    Prescription drug spending flat, but not for long
    By Steve Morgan and Kate Smolina

    Canadians spent almost $23-billion on prescription drugs at retail pharmacies in 2012/13 — or over $650 per capita, according to the findings from the Canadian Rx Atlas published this week by the UBC Centre for Health Services and Policy Research. That is a lot of money.

  • Holding baby_000002377078Small
    Postpartum depression is a family affair
    By Nicole Letourneau and Justin Joschko

    At long last, people are talking about postpartum depression. Dismissed for years as no more than a touch of the baby blues or else unheard of entirely, postpartum depression — or PPD, as it is often known — has become an open subject. Healthcare providers are aware of it, many nurses and physicians routinely screen mothers for it, and articles in parenting magazines and major newspapers have been written about it.

  • Nicole_Latourneau_Stress_000007790448Small
    How toxic stress is hurting our children
    By Nicole Letourneau and Justin Joschko

    For most parents today, stress is a constant companion. Everyone’s heard of the dangers of high blood pressure, of chronic workaholics having heart attacks at forty, of harried professionals pouring themselves an extra glass of wine (or three) with dinner.

OBESITY INTERNATIONAL HEALTH SYSTEMS
  • Sharma_Pay as you weigh_Apr_13_11515696
    Pay as you weigh an unfair pricing strategy
    By Arya Sharma

    This week the wires were active with suggestions that people with obesity pay more for airline travel. This discussion was prompted by a Samoan airline announcing that they would begin charging passengers by the pound.

  • Millar__obesity action Feb_2013_5106319
    It’s time for government action on obesity
    By John Millar

    You’ve heard it already: obesity is epidemic in Canada and is contributing to an increased prevalence of hypertension, diabetes, heart disease, stroke, cancer and other chronic conditions.

  • Stethoscope on American Flag with Selective Focus.
    U.S., Canadian health care systems share some challenges
    By Trudy Lieberman

    Both Canada and the United States are historically and practically steeped in fee-for-service medicine, and much of the power to control prices rests in the hands of the medical establishment. While provincial governments have periodic negotiations with medical and hospital groups, and there are global budgets for hospitals that try to constrain costs, the system is relatively expensive.

  • Medicine spilling onto table from bottle into dollar sign shape
    David Dodge on why health care costs so much
    By Trudy Lieberman

    We know that the U.S. has the most expensive health care in the world. But beyond noting that dubious achievement, we seldom ask why. On my recent visit to Canada as a Fulbright scholar, I stopped by to pose that question to one of their leading health care experts, David Dodge, an economist who has served as federal deputy health minister and seven terms as governor of the Bank of Canada.

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