Monday, February 27, 2012

Imposed waiting period for insurance can make health problems worse, critics say

Ontario is one of only three provinces to impose a waiting period before new immigrants can receive public health insurance, and opposition to the restriction has united civic politicians, doctors, nurses and immigration settlement workers.

Newly arrived immigrants cannot get OHIP coverage for the first three months they are in Ontario. Refugees are supposed to be covered by a special federal health plan, but it is unpopular with physicians, who say it takes too long and is too bureaucratic. The result, critics say, is that newcomers delay seeking treatment until the waiting period is over, making health problems worse and in some cases, endangering public health.

Recent research suggests that most newcomers arrive in Canada healthier than native-born Canadians, but lose that health advantage over time. Statistics Canada studies show that recently arrived Canadians born in Asia and Africa have mortality rates significantly lower than those of Caucasian Canadians, but mortality rates for those immigrants who have been in Canada for more than 30 years are higher, even when age is taken out of the equation

Last month the Ottawa Board of Health joined its Toronto counterpart, health agencies and even the Ontario Medical Association in calling on the province to eliminate the waiting period, especially when it comes to patients with tuberculosis.

Councillor Diane Holmes, chairwoman of the Ottawa Board of Health, sent a letter in January to Ontario Health Minister Deb Matthews notifying her of the board’s resolution against the wait and “advocating that new immigrants who have tested positive for latent tuberculosis infection, be able to receive immediate coverage from OHIP to ensure timely and effective treatment to prevent the development of active tuberculosis disease.”

Tuberculosis is contagious and a public health challenge around the world. Prospective immigrants must pass a test for tuberculosis before they are issued visas, but cases of latent TB can go undetected.

There are approximately 1,600 cases of active TB in Canada, half of which are in Ontario. Most cases are found in immigrants from countries with high rates of TB, and they are at the greatest risk of developing active TB within the first five years they’re in Canada.

The waiting period applies to all new and returning residents and is intended to give the province time to confirm a person’s eligibility for insurance, David Jensen, spokesman for the Ministry of Health and Long-Term Care, said Monday. “Providing an exemption from the three-month waiting period for only certain groups may raise concerns about the fair and equitable application of the Health Insurance Act to other Ontario residents who also require medical care during the waiting period for health insurance coverage,” Jensen said.

Only British Columbia, New Brunswick and Quebec have a similar waiting periods, and Quebec makes exceptions for tuberculosis.

Dr. David McKeown, Toronto’s chief medical officer of health, says if a patient tests positive for TB, OHIP will pay for the medication but patients are still responsible for other treatment costs, including hospitalization, that can add up to tens of thousands of dollars. Even if the patient doesn’t test positive, he or she has to pay the cost of the initial assessment.

“The three-month waiting period should be abolished,” says McKeown. “The dilemma faced by a newcomer with a bad cough is they have to decide if they’re going to wait it out, or do the right thing and get assessed.”

The province recommends newcomers buy private medical insurance but that’s not always enough, says McKeown. He cited the case of a Toronto immigrant who bought private insurance. When he was later diagnosed with TB, his insurer denied his claim on the grounds that it was a prior medical condition.

“He did the right thing for himself, for his family and for the public at large but he still ended up with a bill for $20,000,” says McKeown. “It’s a particularly clear example in my mind of how the three-month waiting period isn’t working.”

Jensen points out that immigrants are welcome to seek treatment at community health centres, which are funded by the province. But one of the most vocal groups calling for an end to the waiting period is the Right to Health Care Coalition, which represents 30 community health centres, hospitals, settlement agencies and others. Jack McCarthy, executive director of Somerset West Community Health Centre, is on the board of the Canadian Alliance of Community Health Centres.

“People are encouraged to come here and then they face barriers right off the bat,” says McCarthy, who is also head of the health committee of the Ottawa Local Immigrant Partnership, a planning group working on ways to improve the integration of immigrants. “It’s a huge bureaucratic barrier, especially for the vulnerable, overwhelmed newcomer.”

The Ontario Medical Association studied the issue last year in response to reports from member physicians, says Dr. Stewart Kennedy, association president. They found that it’s not just patients with tuberculosis who are caught in the wait for insurance.

“Many emergency physicians were facing landed immigrants with no OHIP coverage,” says Kennedy, a family physician in Thunder Bay. “They were uncomfortable turning anybody away from the emergency department. Some of their needs were acute — things like diabetes and chronic diseases, best managed in a family practitioner’s office.”

The OMA released a paper last year saying that the three-month wait fails to save taxpayers money, while endangering public health.

“It’s supposed to save money but it’s not, because there’s a spike in OHIP billings after the three months and medical cases get more acute,” says Kennedy, citing a 2004 study in the Canadian Journal of Public Health. “It just made common sense — if it’s not saving any money, why have it?”

The waiting period is also intended “to create a disincentive to persons moving to Ontario briefly only for the purpose of acquiring insured medical services without the intending to make Ontario their primary place of residence,” says Jensen.

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Imposed waiting period for insurance can make health problems worse, critics say

Newcomers can not OHIP coverage for the first three months they are in Ontario. Refugees should be covered by a special federal health plan, but it is not popular among doctors, who say it takes too long and too bureaucratic. The result, critics say, is that newcomers to delay seeking treatment until the wait is over, causing health problems worse and in some cases, danger to public health.

Recent research suggests that most newcomers arrive in Canada healthier than the native Canadians, think that the health advantage over time. Statistics Canada studies show that recently arrived Canadians born in Asia and Africa have much lower mortality rates than white Canadians, but the mortality rates for immigrants in Canada more than 30 years later, even when age comes from the equation

Last month the Ottawa Board of Health with the Toronto counterpart, health agencies and even the Ontario Medical Association in calling on the province to avoid the wait, especially when it comes to patients with tuberculosis.

Councillor Diane Holmes, president of the Ottawa Board of Health, a letter in January to Ontario Health Minister Deb Matthews informed her of the resolution of the council against the guards and the "lawyer of that new immigrants who tested positive for latent tuberculosis infection, are capable of immediate OHIP coverage to make timely and effective treatment to the development of active tuberculosis disease to receive. "

Tuberculosis is contagious and public health challenge worldwide. Potential immigrants must pass a test for tuberculosis before they are issued visas, but cases of latent TB may go unnoticed.

There are approximately 1,600 cases of active tuberculosis in Canada, half in Ontario. Most cases are found in immigrants from countries with high rates of TB, and they run the greatest risk of developing active tuberculosis in the first five years they are in Canada.

The waiting period applies to all new and returning residents and is intended to give the province time to a person eligible for the insurance to confirm, David Jensen, spokesman for the Department of Health and Long-Term Care, said Monday. "Providing an exemption from the three months waiting period for only certain groups can the fair and equitable application of the Ontario Health Insurance Act to other residents who also need medical care during the waiting period for health insurance to increase guarantee," said Jensen.

Only British Columbia, New Brunswick and Quebec have similar waiting times, and Quebec are exceptions for tuberculosis.

Dr. David McKeown, chief medical officer of health of Toronto, says that if a patient tests positive for TB, will OHIP pay for the drugs, but patients are still responsible for any other treatment costs, including hospitalization, which can amount to tens of thousands of euros . Even if the patient tests positive, he or she must pay the cost of the initial assessment.

"The three months waiting period should be abolished," says McKeown. "The dilemma of a newcomer with a bad cough that she must decide whether to wait out, or do the right thing and get evaluated."

The county advises newcomers to buy private health insurance but that is not always enough, says McKeown. He cited the case of a Toronto immigrant who bought private insurance. When he later was diagnosed with tuberculosis, the insurer denied his claim, arguing that a prior medical condition.

"He did the right thing for himself, his family and the general public, but he ended up with a bill for $ 20,000," says McKeown. "It is a particularly clear example in my head of how the three-month waiting period does not work."

Jensen points out that immigrants are welcome to treatment at community health centers, funded by the province to search. But one of the most vocal groups calling for an end to the waiting time is the right to health Coalition, of which 30 community health centers, hospitals, settlement agencies and others represent. Jack McCarthy, executive director of the Somerset West Community Health Centre is on the board of the Canadian Alliance of Community Health Centres.

"People are encouraged to come here and then they come right off the bat," said McCarthy, who is also head of the health committee of the Ottawa Local Immigrant Partnership, a planning group working on ways to integrate immigrants. "It is a massive bureaucratic barrier, especially for the vulnerable, overwhelmed newcomer."

The Ontario Medical Association examined the issue last year in response to reports of the physicians, says Dr. Stewart Kennedy, association president. They found that not only patients with tuberculosis who are trapped in the waiting period for insurance.

"Many emergency physicians be unloaded without OHIP coverage against immigrants," said Kennedy, a physician in Thunder Bay. "They were uncomfortable for anyone to turn away from the emergency department a part of their needs were acute - .. Things like diabetes and chronic diseases, the best managed in the office of a doctor"

The OMA released a paper last year to say that not to wait three months to bring taxpayer money, risk to the health store.

"The intention is to save money, but it is not because there is a peak in the OHIP bills after three months and more acute medical cases," says Kennedy, citing a 2004 study in the Canadian Journal of Public Health. "It just felt like - if it does not save any money, why?"

The waiting period is also intended "to a reason for people moving to Ontario recently exclusively for the acquisition of the insured medical services, without the plan to make Ontario their principal residence to create," says Jensen.



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Imposed waiting period for insurance can make health problems worse, critics say

Friday, February 24, 2012

Vt. House advances health insurance overhaul bill

Backers said the bill would help individuals and families afford health insurance and would give small businesses the opportunity, beginning in 2014, of no longer providing the workers' health insurance. Instead, most workers could buy health insurance through the exchange with the federal grants.

The measure was expected to come up for final House action on Friday before going to the Senate.

Rep. Michael Fisher, D-Lincoln and chairman of the House Health Care Committee, said the bill "will greatly regularly in Vermont 'ability to access health care afford to expand.''

"This bill gives us a new freedom for small businesses to concentrate on what they do best: to build good products and better service in the comfort that their employees have access to the care they need,'' he said.

The grants would be available for people to four times the federal poverty level, or about $ 45,000 a year for an individual and $ 92,000 for a family of four.

Key Republican amendments were easily defeated in a room where the GOP holds only 48 of 150 seats.

The bill would anyone working for a company with 50 employees or less to get the insurance through the exchange beginning in January 2014. In 2016 that would extend to employees of companies with 100 or fewer employees. Republicans objected to that, saying Vermont residents have freedom of choice, and offered a failed amendment of the provision mandating participation in the exchange to remove.

"Is not it my right to make choices about how I pay for health care insurance?'' Early Rep. Duncan Kilmartin, R-Newport.

Democrats argued that buying through the exchange would be the key to receiving the federal grants. Backers of the bill have said that the larger the risk pool - the number of people involved - the easier it will be to manage costs.

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Thursday, February 23, 2012

Health insurance providers criticise star ratings

Insurers have defended their private health insurance products after the launch of a new star rating system.

Defaqto says that his scheme is designed to help people distinguish between the different financial products.

But insurers believe that the rating system can be misleading, Saga criticize the handling of the budget plans, which may be ideal for those who want only a limited number of functions.

Head of communications Paul Green told the Herald newspaper: "At the moment that their system allows for a budget plan, how good, with only one star and therefore takes no account of consumer choice.

"It's like comparing a Bentley and a Mini, both of which might say to five-star cars in their class, but if they are ranked by Defaqto than a supermini - how super - would always be on the scrap heap."

Charlie MacEwan, a spokesman for health insurer WPA, told the newspaper that he also disagreed with the interpretation of Defaqto of some policy features such as no-claim discounts, hospital networks and six weeks of waiting - which are all considered positive attributes under the stars scheme.

He argued: "We think that no-claim discounts to encourage policy holders not to say that playing with their health, while if a policy is associated with a given network, this means that the insured have less choice, and with a six-week wait - and who wants to sit in pain for six weeks? "

The Association of Medical Insurance Intermediaries has also expressed concern about the scheme, says it is "appalled" by the ratings.

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http://www.webdirectoryservices.net/detail.php?id=37958
http://www.aaasmeetings.org/detail.php?id=105834
http://www.fast-customers.com/detail.php?id=31300
http://www.add-website.info/detail.php?id=402
http://weblinkstoday.com/detail/link-110028.htm
http://www.reallinkdirectory.info/detail.php?id=3320
http://www.thelinkssys.com/detail/link-60236.htm
http://www.fast-customers.com/detail.php?id=31286
http://www.add-website.info/detail.php?id=386
http://charlychans.com/detail.php?id=53474
http://www.ei-ballet.org/detail.php?id=60515
http://www.website-submission.info/detail.php?id=50222
http://www.web-directory-seo.net/detail.php?id=2775
http://www.directoryair.com/detail/link-2229.html
http://www.website-submission.info/detail.php?id=50218
http://www.directoryair.com/detail/link-2227.html
http://www.add-website.info/detail.php?id=376
http://www.dmoz.pro/detail.php?id=948
http://www.directoryair.com/detail/link-2235.html
http://www.web-directory-seo.net/detail.php?id=2767
http://www.web-directory-seo.net/detail.php?id=2770
http://www.southindia.co/detail.php?id=39185
not valid
http://dubaiforvisitors.com/directory/detail.php?id=529
http://www.fast-customers.com/detail.php?id=31290
http://www.daydir.com/detail.php?id=19711
http://charlychans.com/detail.php?id=53475
http://www.reallinkdirectory.info/detail.php?id=3321
http://www.add-website.info/detail.php?id=407
http://www.directoryair.com/detail/link-2231.html
http://www.directoryair.com/detail/link-2228.html
http://www.dmoz.pro/detail.php?id=940
http://www.daydir.com/detail.php?id=19702
http://www.ei-ballet.org/detail.php?id=60506
http://charlychans.com/detail.php?id=53472
http://www.webdirectoryservices.net/detail.php?id=37947
http://charlychans.com/detail.php?id=53468
http://www.add-website.info/detail.php?id=404
http://www.web-directory-seo.net/detail.php?id=2773
http://www.web-directory-seo.net/detail.php?id=2768
http://www.daydir.com/detail.php?id=19714
http://www.reallinkdirectory.info/detail.php?id=3325
http://www.fast-customers.com/detail.php?id=31288
http://www.fast-customers.com/detail.php?id=31294
http://www.thelinkssys.com/detail/link-60246.htm
http://www.southindia.co/detail.php?id=39177
http://www.reallinkdirectory.info/detail.php?id=3327
http://www.add-website.info/detail.php?id=396
http://www.webdirectoryservices.net/detail.php?id=37959
http://www.aaasmeetings.org/detail.php?id=105838
http://www.dmoz.pro/detail.php?id=937
http://www.daydir.com/detail.php?id=19704
http://dubaiforvisitors.com/directory/detail.php?id=528
http://www.web-directory-seo.net/detail.php?id=2772
http://www.fast-customers.com/detail.php?id=31299
http://www.southindia.co/detail.php?id=39171
http://www.southindia.co/detail.php?id=39182
http://weblinkstoday.com/detail/link-110027.htm
http://www.website-submission.info/detail.php?id=50210
http://www.dmoz.pro/detail.php?id=941
http://www.dmoz.pro/detail.php?id=944
http://www.reallinkdirectory.info/detail.php?id=3328
http://www.thelinkssys.com/detail/link-60247.htm
http://www.ei-ballet.org/detail.php?id=60518
http://weblinkstoday.com/detail/link-110033.htm
http://dubaiforvisitors.com/directory/detail.php?id=531
http://www.web-directory-seo.net/detail.php?id=2780
http://www.directoryair.com/detail/link-2234.html
http://www.daydir.com/detail.php?id=19712
http://www.reallinkdirectory.info/detail.php?id=3326
http://www.dmoz.pro/detail.php?id=938
http://www.webdirectoryservices.net/detail.php?id=37953
http://www.thelinkssys.com/detail/link-60248.htm
http://www.aaasmeetings.org/detail.php?id=105844
http://www.dmoz.pro/detail.php?id=947
http://www.reallinkdirectory.info/detail.php?id=3323
http://www.directoryair.com/detail/link-2239.html
http://weblinkstoday.com/detail/link-110022.htm
http://www.website-submission.info/detail.php?id=50212
http://www.website-submission.info/detail.php?id=50216
http://www.ei-ballet.org/detail.php?id=60508
http://www.add-website.info/detail.php?id=409
http://www.webdirectoryservices.net/detail.php?id=37951
http://www.webdirectoryservices.net/detail.php?id=37948
http://www.website-submission.info/detail.php?id=50217
http://www.fast-customers.com/detail.php?id=31296
http://www.aaasmeetings.org/detail.php?id=105847
http://www.webdirectoryservices.net/detail.php?id=37956
http://www.ei-ballet.org/detail.php?id=60514
http://www.aaasmeetings.org/detail.php?id=105842
http://www.southindia.co/detail.php?id=39178
http://www.reallinkdirectory.info/detail.php?id=3324
http://weblinkstoday.com/detail/link-110029.htm
http://www.website-submission.info/detail.php?id=50219
http://www.southindia.co/detail.php?id=39176
http://www.reallinkdirectory.info/detail.php?id=3322
http://www.reallinkdirectory.info/detail.php?id=3330
http://www.add-website.info/detail.php?id=383
http://dubaiforvisitors.com/directory/detail.php?id=534
http://www.directoryair.com/detail/link-2232.html
http://www.website-submission.info/detail.php?id=50209
http://www.daydir.com/detail.php?id=19699
http://www.thelinkssys.com/detail/link-60242.htm
http://www.fast-customers.com/detail.php?id=31284
http://www.fast-customers.com/detail.php?id=31291
http://dubaiforvisitors.com/directory/detail.php?id=536
http://www.daydir.com/detail.php?id=19710
http://www.thelinkssys.com/detail/link-60250.htm
http://www.thelinkssys.com/detail/link-60243.htm
http://www.web-directory-seo.net/detail.php?id=2778
http://www.southindia.co/detail.php?id=39179
http://www.ei-ballet.org/detail.php?id=60513
http://weblinkstoday.com/detail/link-110032.htm
http://www.website-submission.info/detail.php?id=50215
http://www.aaasmeetings.org/detail.php?id=105835
http://www.southindia.co/detail.php?id=39184
http://www.web-directory-seo.net/detail.php?id=2779
http://www.add-website.info/detail.php?id=378
http://www.website-submission.info/detail.php?id=50211
http://charlychans.com/detail.php?id=53469
http://www.daydir.com/detail.php?id=19703
http://www.webdirectoryservices.net/detail.php?id=37954
http://www.webdirectoryservices.net/detail.php?id=37957
http://www.directoryair.com/detail/link-2238.html
http://www.reallinkdirectory.info/detail.php?id=3319
http://dubaiforvisitors.com/directory/detail.php?id=525
http://www.webdirectoryservices.net/detail.php?id=37949
http://www.fast-customers.com/detail.php?id=31297
http://www.dmoz.pro/detail.php?id=936
http://charlychans.com/detail.php?id=53473
http://weblinkstoday.com/detail/link-110023.htm
http://www.daydir.com/detail.php?id=19700
http://www.fast-customers.com/detail.php?id=31285
http://www.web-directory-seo.net/detail.php?id=2771
http://www.aaasmeetings.org/detail.php?id=105839
http://www.aaasmeetings.org/detail.php?id=105837