Over 202,000 Canadians are diagnosed with cancer every year, including an estimated 6,000 new cases diagnosed in Nova Scotia, with approximately 2,700 dying of cancer. Clearly, this life-threatening illness affects entire communities, especially families, friends and co-workers.
The Canadian Cancer Survivor Network (CCSN) is a national network of patients, families, survivors, friends, families, community partners and sponsors. Its mission is to work together by taking action to promote the very best standard of care, support, follow up and quality of life for patients and survivors. It aims to educate the public and policy makers about cancer survivorship and encourage research on ways to alleviate barriers to optimal cancer care in Canada.
The government of Nova Scotia has an important role to play in making sure that everyone diagnosed with cancer has timely access to cancer care and essential medical services as well as access to emergency rooms and the treatment and medications they need. There are 106,000 people in Nova Scotia without a family doctor, and the shortage is going to worsen as a growing number of physicians near retirement, recruitment levels are dwindling and health needs are becoming more and more complex (http://thechronicleherald.ca/novascotia/1463162-doctorsns-says-we-need-100-new-doctors-a-year-for-10-years).
The Canadian Cancer Survivor Network is once again asking question of the parties and candidates during the 2017 Nova Scotia election campaign. The responses will be posted in this section as we receive them. We hope that this information will help you when you direct your concerns to your provincial representatives.
Question 1:
The Canadian Medical Association Journal published research in 2014 that showed one in twelve Canadians report they skip doses or decide not to fill prescriptions because of cost.
If elected to government, what will your party do to make prescription medications more affordable?
Question 2:
Healthcare is the number four issue (behind education, labour relations and balanced books) on the minds of NS voters.
If elected:
a) How will your government improve the delivery of cancer care and other healthcare services in NS?
b) Will your government restructure healthcare delivery, and if so, how?
c) How will your government ensure that cancer patients receive the services they need, including home care, financial assistance during recovery and for long-term side effects of cancer and/or treatment?
Question 3:
A key element of ensuring timely treatment for a Canadian cancer patient is ensuring they have access to the medications they need at the time they need them. Unfortunately, this is not always the case in Nova Scotia. As of January 31, 2015 Nova Scotia drug plans covered 23.5% of the 464 new drugs approved by Health Canada from 2004-2013 and the average number days to list the new drug covered under each public drug plan was 681(Coverage for new medicines in Canada’s public drug plans, 2015, Mark Rovere and Dr. Brett J. Skinner).
If elected to government, will you commit to ensuring that all cancer patients in Nova Scotia receive timely access to medications at the time they need it?
Question 4:
Numbers released by Statistics Canada indicate that 11.3 per cent of the population, or just over 100,000 people, did not have access to a health-care provider.
If elected, how will your government ensure that all Nova Scotians have access to a health-care provider?
We thank you for your attention to this important matter.
Yours sincerely,
Canadian Cancer Survivor Network
Official Atlantica Party Response
Thank you for your questions.
As I read through your questions a theme arises, issues, symptoms really, with dealing with Canada’s public health care system. Our party is a grass roots response to the failure of the status-quo to look for new solutions for Nova Scotia (and Canada really) in the 21st century. An example of this is the current health care system in Canada. It is failing and unsustainable; more money or a few new programs here or there will not do. The theme of your questions is the system is failing us.
The party’s response is fundamental restructuring of the Canada Health Care Act is needed, not a patchwork of promises to fund this or expand that within the existing structure.
Here are our thoughts on ‘taking action to promote the very best standard of care, support, follow up and quality of life for patients and survivors.’
In 2014, The Commonwealth Fund, compared the health care systems of 11 major industrialized nations looking at health outcomes such as Quality Care, Access, Efficiency, Equity, and Healthy Lives. Canada came second last close to last place US! Interesting the US and Canada both represent the worst outcomes!
Health care as we have it is not sustainable. It is already showing stress, we all have stories. We cannot continue the model we currently.
Nova Scotia already is spending the highest proportion of its budget on Health Care. More money is not the answer.
But the status-quo does not want a discussion on this so it stifles debate by shouting down ideas and blindly promising even more money to try and paper over what are fundamental problems.
The Atlantica Party’s Solution? Imitate the systems that work best!
The number one ranked system in the world, that of the United Kingdom allows private, for-profit hospitals alongside its public system. Switzerland, Sweden, and Australia, the number two, three, and four ranked systems respectively, all have private and public hospitals, private and public clinics, and all charge patients some form of user fee for access, even in their public systems. In none of these systems do the poor go untreated, and in fact, when it comes to equitable and fast access to care, they all vastly outperform our own.
At the same time, the United Kingdom’s per capita spending on health care, at $3,405 per annum, is only 75 per cent that of our own. And they beat us easily in every outcome.!
This is what they do:
1. Allow both public and private operators in all spheres of health care, as long as it is within a universal system financed by government, as is the case in Europe.
· In Germany for example, private hospitals treat patients who are older on average and who have more serious health conditions than those in public hospitals. The data also show that private for-profit hospitals are better equipped to treat difficult cases and more complex pathologies. Moreover, a larger proportion of beds in these hospitals are reserved for emergency room and intensive care patients.
· In France, Italy, Sweden, Switzerland, and many other countries, private hospitals and clinics have long been integrated into the public system. Wait times are shorter in some cases 2 to three times shorter.
· The revenues of privately run medical facilities depend on the number of patients they treat. In order to attract clients, they have to maintain their reputations. In a competitive environment where the money follows the patient, hospitals that cut on service quality drive away their clients and simply cannot make a profit.
· More choice for patients means they can choose which facilities will treat them, and where public funding follows the patient. This promotes accessibility for example for mental health.
2. Charge a small upfront fee say 5% for procedures
· Stifles demand since it reinforces the notion that health care is not ‘free’.
· The fee rises in conjunction with the cost of the service usually up to a limit or threshold. This is similar to how most private insurance plans operate with respect to drug purchases. Up to a ceiling and exemptions in special cases of chronic illness like cancer or low income.
3. Reduce high salaried non-front line administration
4. Note the Atlantica Budget makes no cuts to front line health care spending
5. Allow private billing for health care provision.
· This will also ease supply shortages.
6. Encourage private health insurance
7. Health care is directed by Ottawa. AP would advocate reforming the Health Care Act. If that failed we would be willing to go it alone.
Conclusion
A health care system can remain public and universal all while allowing entrepreneurs to compete to provide services, attract clients, lower costs and provide more choice instead of leaving patients trapped in a public monopoly that fails to respond adequately to the demand for treatment. This will benefit ALL aspects of health care for Nova Scotians.
Cheers,
jd
Jonathan Geoffrey Dean
Leader
Atlantica Party
Official PC Party Response
Question 1 response:
Jamie Baillie has a vision for a Nova Scotia health care system that is there when you need it. We are committed to reduce out-of-pocket medical costs paid by Nova Scotian cancer patients who pay the highest out-of-pocket costs for take-home medication. If elected on May 30th, a new PC government would work together with stakeholders such as the Canadian Cancer Survivor Network to find ways to make prescription medications more affordable for a greater number of Nova Scotians. In addition, a PC government will freeze the Seniors' Pharmacare cost-share ratio to ensure no future government will download additional costs to our seniors.
Question 2 response:
As noted above, we are committed to reduce out-of-pocket medical costs paid by Nova Scotian cancer patients who pay the highest out-of-pocket costs for take-home medication. A PC government will treat oral cancer drugs and hospital-administered cancer drugs equally, as other provinces have done. The Nova Scotia PC party will make health care a priority. Among other actions we want to recruit more doctors and invest more in mental health care. We will also replace the Victoria General Hospital using the new Rebuild Nova Scotia infrastructure fund. We can deliver better care by reducing wasteful spending, overhead and added bureaucracy within the health system. We will reign in the Nova Scotia Health Authority by enforcing real administrative savings and invest those savings in frontline health services.
Question 3 response:
Access to medication in a timely manner is crucial after a cancer diagnosis. A PC government will cut through the red tape that prevents timely access to medication.
Question 4 response:
A Jamie Baillie government will invest in physician recruitment and bring more doctors to Nova Scotia. We will take concrete action to ease the doctor shortage:
• Invest $13.5 million to bring more doctors to underserviced areas
• Double the tuition relief program to $6 million to keep new family doctors in Nova Scotia
• Credential recognition for Canadians who study medicine abroad.
Official Green Party Response
Question 1 response:
The Green Party of NS commits to launch research and feasibility studies to examine provincial pharmacare coverage and a province wide health formulary so that first line affordable medications are available to all Nova Scotians. In addition, the Green Party focusses on population health, with increased attention to prevention and wellness. It is a long term goal that fewer people would require such medications.
Question 2 response:
A Green government would provide financial incentives to encourage health practitioners to practice in underserviced communities, including partial or full forgiving of student loans based on length of service;
A Green government a would employ patient navigators to ensure that health care needs are met, and would also seek community based care wherever possible. A Green government would use evidence policy and processes, and would dialogue with health policy analysts and consult with local practitioners to design effective approaches to health care delivery.
Comprehensive health centres and integrated care: The Green Party believes it is time to explore a major policy initiative, a negative income tax, or a Guaranteed Livable Income (GLI) for all. The use of a GLI eliminates poverty by ensuring that each citizen’s income does not fall below the level necessary to meet their most basic needs. There are significant cost savings to streamlining existing benefits and tax credits into one lump payment that citizens allocate toward their own needs, rather than having to request various benefits from different levels of governments or agencies. Plus, many more people will be able to focus on caregiving, wellness or recovery.
Question 3 response:
Yes
Question 4 response:
A Green government would support inter-professional health care through providing and networking physiotherapists, dieticians, midwives, nurse practitioners, etc., reducing the burden on doctors and averting wait times. Promoting wellness means supporting people to take active, lifelong measures to stay as healthy as possible.
We would also provide financial incentives to encourage health practitioners to practice in underserviced communities, including partial or full forgiving of student loans based on length of service.
We thank you for your attention to this important matter.
Brian Pickings (Progressive Conservative Party) Response
Dear Kati Oliver,
Thanks for the email. I’ve been a nominated candidate since July 26, 2016 and would have been happy to meet with your organization and respond to your inquires in the months prior to the election being called. I can’t speak for the PC Party so I encourage you to send your questions to the PC Party for their response.
My focus now is campaigning to try to win this seat. If I am successful please contact me. Hope you understand.
Brian Pickings
Torin Buzek (Green Party) Response
Thanks for reaching out to me and asking these very important questions.
The subject of cancer hits very close to home. The majority of my family on my father’s side have had cancer, some dying from it, some surviving. My father has had recurring prostate cancer for over 10 years now. Nova Scotia also has the highest cancer rates in the country.
While the subject is dear to me, Health Care is not my area of expertise so I’ll draw from our party’s policy documents.
Question 1 response:
The Green Party will:
Launch research and feasibility studies to examine provincial pharmacare coverage and a province wide health formulary so that first line
affordable medications are available to all Nova Scotians
Question 2 response:
1. To achieve the goal of healthy communities and sustainable health care services the Green Party will work to:
1.1 increase financial support and incentives for the collaborative practice model: multidisciplinary clinics and practices that team doctors with nurses, nurse practitioners, dieticians, psychologists, counselors, physiotherapists and other allied health care providers
1.1.1 increase funding to Primary Health Care and Emergency Health Services in the province and ensure implementation of over capacity protocols for Emergency Rooms
1.2 complete assessments to identify focus areas to target with an increase in the budget of the Department of Health Promotion and Protection;
1.2.1 the high cancer rate in Nova Scotia must be addressed
1.3 create broad incentives for the establishment of community-based nonprofit long-term care facilities to displace profit as the prime motivator in long-term care facilities
1.3.1 ensure that new facilities are being planned ahead of time to deal with the increasing elderly population before demand problems develop
1.4 ensure development of multi-level Long-Term Care facilities to decrease the current cruel practice of separating couples who have different care needs
1.5 legislate full and open disclosure of all public-private partnership agreements for future development of health care facilities
1.5.1 ensure all future health care buildings meet the Green Hospital Checklist proposed by the Canadian Coalition for Green Health Care
1.6 ensure that the composition of hospital boards adequately represents health care professionals to empower health practitioners at the local level and on the front lines to be more involved in decision making
1.7 provide financial incentives to encourage health practitioners to practice in underserviced communities, including partial or full forgiving of student loans based on length of service.
Question 3 response:
Yes
Question 4 response:
The Green Party of Nova Scotia views health and wellness in a broad sense, emphasizing healthy communities, healthy lifestyles and a healthy environment, not just health care. Strategies to reduce toxins in our environment, address the social determinants of health, and encourage healthy lifestyle choices are important components of the Green Party’s health plan.
The health of Nova Scotians is not only dependent on the health services they receive but on social policy that addresses poverty, provides for affordable housing and nutritious food, water and energy security, available employment, and accessible education.
Health promotion is fiscally prudent and will lead to improved wellness and more affordable health care for Nova Scotians. This, in turn, will lower the cost of health care for all Nova Scotians.
The Green Party strongly supports publicly funded health care, which should include both the removal of the financial barrier for the patient, and the reorganization and revamping of the health care social support system.
The Green Party recognizes that in spite of large annual monetary commitments Nova Scotians are still facing several significant challenges to accessing the health care they need and want in their communities. Lack of family physicians, emergency room closures and long wait times, and high drug costs are all crucial challenges facing the health care system in Nova Scotia. The Green Party offers a vision to reform the current system, to tackle these issues and plan for viable, sustainable health care in Nova Scotia for generations to come.
I hope this answers your questions. If you have more questions or would like clarification on any of my answers please contact me again.
Thanks,
Torin.
Thomas Trappenburg (Green Party) Response
Dear Kati,
Thank you for the questions. There is so much to say about cancer research, and unfortunately even more about our politics with big pharma. We had a Killam lecture a few years ago who ask why we haven’t cured cancer yet, and the answer had little to do with science and more with lawyers.
Regards, Thomas
Cecile Vigneault (Green Party) Response
Thank you for the questions.
My mother had pancreatic cancer and refused treatment as she thought they would make her health worse. She lived a year after being diagnosed but she lived it to the fullest. My girlfriend is a survivor of breast cancer for over 10 years and she believed in the cancer treatments.
Before I begin to answer your questions, I was introduced to a gentleman of the 1930’s, Mr. Royal Rife. Please check out Wikipedia on Royal Rife. ” His beam ray device of his invention would weaken or destroy the pathogens by energetically exciting destructive resonances in their constituent chemicals”. Think what would happen to the Institution of Drug Companies. – Non existence. If a pathogens frequency could be weaken or destroyed then the body, mind and soul would stay intact. Think of the Cancer Institution – would it still exist if cancer pathogens were destroyed. Alzheimer, Parkinson, Arthritis..etc.
Thomas Clement Douglas , Premier of Saskatchewan wrote “The inescapable fact is that when we build a society based on greed, selfishness and ruthless competition, the fruits we can expect o reap are economic insecurity at home and international discord abroad”. If Tommy Douglas were alive today, where do you think he would place Drug Companies in retrospect.
First of all your questions of what can the Green Party do if we are in power. We bounce from one party to another at election time; and within that four year mandate citizens have great expectation from promises during a campaign; and we now see from the past the promises are not or can not be met.
All the questions interlock with each other
We need a National Drug Program. We are at the mercy of Drug Companies and it would like to see this changed. There are many people who live below the poverty level (Statistic Canada can’t give you any answer to “at what level is income is considered poverty”!.
I would support a wider access to opening the relationship between Medical Doctors and Naturopathic Doctors to allow patients a choice of which health care remedy would be more beneficial to them. I would support a study then of what remedy, be it traditional or holistic, works for the individual. In the past, Vancouver General Hospital opened up a department to research why so many of west coast residents were taken alternative medicine. I would support a National Program to do this research.
The Canadian Institute of Health information indicates NS has the highest doctor to patient ratio in the country(includes family doctors and specialists), however Doctors NS.report that doctors provide specialized services in NS to people from NB, PEI and NF; teaches the next generation of upcoming doctors and specialist; also doctors work with researchers to understand the effects of drugs. There is little time spent in family practice anymore.
For me, I believe RNs scope of practice ought to be broaden. If there is a national program that all nurses (Nurse Practitioners and RN) should be able to complete the program in the province of their choice and work in the province of their choice.. All foreign Health care professionals ought to able to meet our requirement in a shorter time frame; eliminate the red tapes and include mentorship for a year or so to determine proper qualification. I also believe students who want to be part of the Health Care service (be it Medical Doctors or RNs, or Nurse Practitioners, or Naturopathic Doctors, Specialist) to get their training in a medical facility versus a post secondary facility. Our hospitals and Health care facilities ought to have the latest technology so one isn’t drained with paper work.
We have to work in establishing more community hospitals that can run independently,where communities work together. Sutherland Harris Memorial Hospital (built in 1966 after replacing an older hospital built in the 40’s) was a community hospital funded by its Foundation. It stopped being a true hospital once the government stepped it. It is the home for the Veterans, Restorative care, Blood Clinic, and doctors’ office,.
I haven’t answered directly as I don’t have the answers . We see what is lacking as questions like yours comes to us. The Green Party wants to address these issues. Even outside the realm of the Green Party, the biggest advice for all is TO ADVOCATE FOR YOURSELF WHEN IT COMES TO YOUR HEALTH.
Sincerely,
Cecile Vigneault
Pictou West
Green Party NS
Kathaleen Milan (Green Party) Response
I don’t think I can name a person in my sphere of family, friends or acquaintances that have not been touched by cancer. My father died at age 68 from brain cancer that followed lung cancer he managed to survive. I think about how the number of people contracting and dying from cancers have increased in my lifetime. It’s shocking. I then think about the things in our environment that have also increased and can see a relationship forming there.
Toxic chemicals in our land, air, water, food, clothing, cosmetics, homes and workplaces.
Stress to keep up with living expenses and family obligations.
I honestly believe that our lifestyles are a contributing factor to this growing problem.
I see how our environment and planet are suffering the consequences of our unsustainable lifestyle and I understand our own health will never be well while the planet is not. That relationship is intrinsic.
I am a Nova Scotian without a doctor. That has forced me to be exceptionally aware of how important it is to take care of my own health. Alternative medicine, eating right for my blood type, and growing my own food have proven to be an affordable, non toxic, noninvasive means to increasing my personal wellbeing.
If and when a Green Party is elected into government, or at the very least our policies are adopted by other parties, (and I do feel this will become a necessity sooner rather than later), their entire philosophy of our lives being an holistic experience that starts with our relationship to our environment that then flows into our food sources, clean land air and water, education that spans our lifetime, guaranteed income, affordable housing, self-sufficient communities will all be responsible in seeing a decrease in many illnesses people are now suffering with. Each component of our lives is linked to the environment in a way that contributes to our health and happiness.
While medicine is not in my wheelhouse, I fit well with the Green parties design taken in part from our 2017 platform that would provide:
- first line affordable medications
- support inter-professional health care through providing and networking physiotherapists, dieticians, nutritionists, nurse practitioners, etc., reducing the burden on doctors and averting wait times
- employ patient navigators to facilitate timely access to mental health and addictions care
- regulate the responsible use of marijuana once federally legalized and ensure it is available for medical purposes
- provide community-based end-of-life care
- provide financial incentives to encourage health practitioners to practice in underserviced communities, including partial or full forgiving of student loans based on length of service
- ensure the development of multi-level Long Term Care facilities to decrease the current cruel practice of separating couples who have different care needs
- reduce administrative burden in health care
- promoting wellness means supporting people to take active, lifelong measures to stay as healthy as possible
I hope this synopsis of our policies and philosophy is helpful in answering your questions.
Thank you for asking about the Green Party and if elected I certainly would be interested in an ongoing dialogue for creating a healthier place for all of us to live and how best to support those of us that are currently struggling with cancer.
All the best,
Kathaleen Milan
Green Party candidate for Queens-Shelburne
Stephen Schneider (NDP Party) Response
Question 1 & 3 responses:
Over the long term, an NDP government in Nova Scotia would work with federal government to establish a national pharmacare program, which would include enhancing coverage for oral cancer medication.
In the short term, an NDP government would consult with key stakeholder groups, such as the Canadian Cancer Survivor Network and CanCertainty Coalition, to find ways to ensure cancer patients can afford to pay for the cancer medications.
Questions 2 & 4 responses:
The NDP recognizes that the Nova Scotia health care system is in crisis. As such, an NDP government would invest $120 million over four years to hire the doctors, nurses and other health professionals needed to staff dozens of new clinics across the province over four years. The investments in both primary and secondary specialist health care services for Nova Scotians would include:
– Opening more Collaborative Emergency Centres, including 60 new clinics staffed by 60 family physicians and 60 nurse practitioners
– Ensuring that Nova Scotians have access to a family doctor and other health care providers close to home by recruiting and retaining medical professionals.
– Committing $30 million a year over four years to make sure additional costs are also covered, including incidentals and the hiring of other staff such as dietitians, psychologists, and specialists.
Patricia Auchnie (Progressive Conservative) Response
Question 1 response:
Jamie Baillie has a vision for a Nova Scotia health care system that is there when you need it. We are committed to reduce out-of-pocket medical costs paid by Nova Scotian cancer patients who pay the highest out-of-pocket costs for take-home medication. If elected on May 30th, a new PC government would work together with stakeholders such as the Canadian Cancer Survivor Network to find ways to make prescription medications more affordable for a greater number of Nova Scotians. In addition, a PC government will freeze the Seniors' Pharmacare cost-share ratio to ensure no future government will download additional costs to our seniors.
Question 2 response:
As noted above, we are committed to reduce out-of-pocket medical costs paid by Nova Scotian cancer patients who pay the highest out-of-pocket costs for take-home medication. A PC government will treat oral cancer drugs and hospital-administered cancer drugs equally, as other provinces have done. The Nova Scotia PC party will make health care a priority. Among other actions we want to recruit more doctors and invest more in mental health care. We will also replace the Victoria General Hospital using the new Rebuild Nova Scotia infrastructure fund. We can deliver better care by reducing wasteful spending, overhead and added bureaucracy within the health system. We will reign in the Nova Scotia Health Authority by enforcing real administrative savings and invest those savings in frontline health services.
Question 3 response:
Access to medication in a timely manner is crucial after a cancer diagnosis. A PC government will cut through the red tape that prevents timely access to medication.
Question 4 response:
A Jamie Baillie government will invest in physician recruitment and bring more doctors to Nova Scotia. We will take concrete action to ease the doctor shortage:
• Invest $13.5 million to bring more doctors to underserviced areas
• Double the tuition relief program to $6 million to keep new family doctors in Nova Scotia
• Credential recognition for Canadians who study medicine abroad.