Michael Rachlis's Weblog

Toronto needs to re-examine its priorities

Sun, 08 Jan 2012 22:16:00 -0500

Today, I participated in a press conference at Toronto city Hall to highlight the health risks from the impending city budget cuts. The press conference was organized by Russ Ford, executive director of LAMP (Lakeshore Area Multiservice Project) and Dr. Roy Male a family doctor at Regent Park Community Health Centre also spoke. In my statement I had three messages for the Mayor and Council:

1. Toronto faces serious health issues now, before any cuts to existing programs

2. The proposed cuts would make the current situation worse

3. There are alternatives that must be considered before we compromise the health and well-being of Toronto’s citizens

Read the City report on proposed cuts. You can follow the ongoing coverage at the Toronto Star’s City budget site.

Wake me up when it isn't Ground Hog Day

Sun, 11 Dec 2011 14:24:00 -0500

It’s ground hog day everyday for Canadian health policy

Sometimes it seems like the Canadian health policy debate is caught in a time warp. We’re told that health care costs are rising unsustainably, that aging baby boomers will be the death knell for medicare (and all western civilization), and the only hope is to go private, as quickly as possible.

During a CBC Current program on April 12, 2011 I was provoked to say, “It’s Ground Hog Day every day. I wake up and we’re having the same stupid health care debate.”

But, I think the true story is:

1. Most of health care’s problems are due to antiquated, provider-focused processes of care

2. Health Care costs are not “out of control”

3. The aging population won’t break the bank

4. We need to complete Tommy Douglas’s vision for the Second Stage of Medicare — a patient-friendly delivery system focussed on keeping people healthy.

5. The real issue should be how we spread these proven innovations

On November 30^th I participated in Ottawa evening panel discussion on the future of Medicare sponsored by the Canadian Health Coalition. You can see the whole evening including Roy Romanow’s keynote presentation.

You can read my November 11, 2011 Toronto Star op ed and you can see my slide presentation to the Ontario Economic Council.

Evelyn Shapiro

Wed, 17 Nov 2010 19:41:00 -0500

Professor Evelyn Shapiro died in Winnipeg on November 10^th at the age of 84. Evelyn was a pioneer in gerontology and home care research and policy. She was also a mentor to me. In 1973/74 I had the pleasure of completing an elective in medical school with Evelyn on home care services. Evelyn has been a life-long inspiration on my work.

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Good news about Medicare

Tue, 09 Nov 2010 20:21:00 -0500

I have an op ed in today’s Toronto Star on Medicare’s good run. The Canadian Institute for Health Information released their annual health spending numbers two weeks ago. Health care costs have decreased their share of the economy or Gross Domestic Product (GDP) slightly in 2010 - from 11.9% in 2009 to 11.7% after shooting up from 10.7% in 2008. It turns out that almost the entire increase in 2009 was due to shrinkage in the economy not increased spending.

The graph below summarizes the Canadian spending data and indicates what the results would have been for 2009 and 2010 with 1998-2008 rates of economic growth. I have put together a few slides which summarize the new data for Canada and Ontario. Please use them and distribute them.

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Medicare is as sustainable as we want it to be

Wed, 04 Aug 2010 12:49:00 -0400

The Canadian Medical Association yesterday released a report, “Health Care Transformation in Canada”. The report was to be released at the CMA annual meeting August 22-25^th in Niagara Falls but was released this week because the premiers are meeting in Winnipeg to discuss health care, amongst other issues.

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Canada needs to beat more countries than the US at health care

Fri, 09 Jul 2010 19:28:00 -0400

Canadians tend to mock Americans’ ignorance of our country and the rest of the world. We do know more about their country than they know about ours. But we also tend to be unsophisticated when it comes to the rest of the world.

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Apocalypse Not Now

Wed, 30 Jun 2010 00:00:00 -0400

We have been hearing a lot this year that Medicare is unsustainable. The usual claim is that health care used to be 35% of provincial program spending but now is 40%+ and will be 80% by 2030 according to the TD Bank’s economics department. There are so many problems with these projections the mind spins. And, while the mind spins one becomes intensely nauseated at the use of this misanalysis - which is usually used to support a dismantling (quickly or incrementally) of the principles of public finance and non profit delivery.

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U of M Faculty of Medicine convocation

Sun, 16 May 2010 00:00:00 -0400

On May 13, 2010, my Alma Mater, the University of Manitoba granted me an honorary degree (LLD, honoris causa) at the Faculty of Medicine convocation. You can read a copy of my address to the graduates here. In doing some research for my speech, I discovered that 2010 marks the 100^th anniversary of Tommy Douglas’s arrival in Canada from Scotland. His family settled in Winnipeg.

Here is a picture of me with my companions at a dinner at the Manitoba Club on May 12^th. Grant Mitchell is an old friend and Winnipeg lawyer extraordinaire. Evelyn is one of the world’s most knowledgeable persons on health and social policy for the elderly and was an important mentor to me in medical school. Joel Kettner is Manitoba’s chief public health officer and an old friend from medical school student politics.

Front row from left: Me, Professor Emeritus Evelyn Shapiro, Dr. Joel Kettner

Back row from left: Grant Mitchell, University of Manitoba President Dr. David Barnard, Dean of Medicine Dr. Dean Sandham.

Primary Health Care Meeting in Southey, SK

Sat, 06 Mar 2010 00:00:00 -0500

On March 3^rd, I had the delight of speaking at a meeting on primary health care in Southey Saskatchewan. Southey is located about 80 km north of Regina. Despite a blizzard on the way from Regina to Southey, there were 160 people there from as far away as Yorkton (230 km East) and Maple Creek (460 km West). Here is my presentation from that day. And, here is a picture of me with some of the organizers. Well done all!

From left: Fiona Bishop VP Saskatchewan Federation of Union Retirees, Betty Pickering President Saskatchewan Federation of Union retirees, Holly Schick, executive director Saskatchewan Seniors Mechanism, me

Happy Valentine's Day!

Sun, 14 Feb 2010 00:00:00 -0500

I had a magnificent trip to Sweden Jan 8-17, 2010. I was speaking to groups of social democratic politicians about Canadian health policy. I got know a lot of Swedes, from all political perspectives. I started off in Stockholm where I spoke to some national politicians and county level politicians who are responsible for doctors and hospitals and a fair bit of community services. There are 22 Swedish counties and their responsibilities include health care, transportation and culture. They don’t have the regionalism you see in Canada or Spain. It’s a much more homogeneous country. There are non-white faces in Stockholm but not much outside.

After three days in Stockholm, I went to Uppsala 80 km north of Stockholm where my main hosts live. I met the Uppsala County social democratic health committee in October 2008 when they Ire touring Toronto. They have an annual meeting with social democratic party health care committees from five counties around Stockholm and I was the keynote speaker. One of the interesting things I noticed was the dislike of the capital (Stockholm) by the regional folks, much the way all Canadians seem to carry a dislike for Toronto as the home of the place with the money. The conference was held at a 13th century castle just outside of Uppsala.

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