Categories
Archive Today's Seniors

Dodging the health insurance minefield

By David South

Today’s Seniors (Canada), 1992

Don’t leave home without it. No, not American Express Travellers cheques but health insurance. With changes to OHIP coverage for out-of-country hospital visits and rising U.S. health care costs, any snowbird who pays a visit to an American hospital will face hefty bills. To make things even more complicated, the recent growth in competing travel health insurance schemes in Canada has created a minefield of policies that must be entered with caution.

Luckily for snowbirds, the newly formed Canadian Snowbird Association is trying to make these changes a little easier to cope with. Formed in March, the Association boasts 8,500 members and is looking for more. They hope to advocate for the rights of snowbirds and collect information on private insurance plans to help seniors make the right decisions.

Communications co-ordinator Don Slinger says he will have a list of appropriate private health insurance policies ready by the end of August. The Association has been meeting with private insurance companies to find out the best plans.

“Snowbirds shouldn’t be in a hurry to get insurance,” says Slinger. “Many insurance companies are using the situation to exploit panic-stricken seniors.”

Slinger warns snowbirds never to go down to the U.S. without extra insurance on top of OHIP. “OHIP is just a drop in the bucket of the cost of a stay in an American hospital. Unfortunately, a lot of people still take the chance.

“I had been going south for 12 years without a problem until a ruptured appendix. It ended up costing me $12,000 for an eight-day hospital stay.

“When we met with the government they weren’t sympathetic. They said snowbirds are a wealthy group and can afford the payments. However, a lot of people are on fixed incomes and won’t be able to afford to go south with these higher costs.”

Slinger advises against buying coverage after arriving in the U.S. The Snowbirds Association emphasizes that it believes in medicare and will fight hard to ensure it provides full coverage for seniors.

Gerry Byrne, a vice-president at non-profit insurers Blue Cross warns against buying U.S. insurance because companies require a medical exam and skim off the healthiest people for full coverage. But Blue Cross itself will introduce rates based on age and medical conditions in September.

American health insurance plans have long been criticized for hurting older seniors and those with ongoing medical conditions. In these schemes, the healthiest seniors pay low premiums while seniors with chronic conditions are saddled with higher rates or, worse still, refused coverage. Unlike medicare – which covers everybody regardless of their health – private insurers are tempted to reduce their costs by covering only the lowest risk group – favouring the young and healthy.

Unfortunately, a quick survey of travel health insurance plans shows this trend to be in full bloom in Canada. Credit card companies, which have recently begun to offer travel health insurance, are revising their conditions. The Royal Bank’s Visa Gold card will drop coverage for seniors over 65 starting Nov. 1. The Canadian Imperial Bank of Commerce and Scotia Bank Visa cards still offer coverage to seniors – but both are revising this. American Express’s annual plan has no age limit, while its per trip plan has a higher rate for seniors between 60 and 74 and doesn’t cover anybody 75 and over.

Suzanne Deul, who helps market the Toronto Dominion Bank Visa card, blames the insurance companies for changes. “Because of high costs, the pressure is on to change policies. We are trying to be more equitable but the insurers want age restrictions. In some ways it could be justified to charge more for people who attract higher costs.”

With so many health insurance companies losing money covering seniors, the challenge for private insurers is to make covering seniors profitable without excluding people. To this end, Robin Ingle, president of John Ingle Travel Insurance, has instituted changes to increase the money available for more expensive hospital stays.

“About one-third of our policy holders are over 65, and we have a lot of snowbirds. This group is only getting bigger, so instead of raising rates and placing restrictions, we increased the number of policy holders to include a broad range of people young and old.”

Ingle blames rising U.S. health care costs for making it unprofitable to provide health insurance to seniors. His company has set up an office in Florida to prevent hospitals overcharging Canadians and has negotiated deals with some hospitals for lower rates. John Ingle Travel Insurance offers special rates for seniors’ groups and gives a 10 per cent discount to members of the Canadian Association of Retired Persons.

Three years ago there were 10 companies in Canada offering travel insurance; now there are over 50.

According to Ingle, many of the neophyte companies are losing money. “I predict the whole industry will shrink because they have had high losses and can’t take care of their clients. I would advise seniors to watch out for companies that might not be around a year from now.”

Ingle says seniors should also beware of glitzy marketing and flashy pamphlets and read the fine print to make sure the policy covers their age and medical condition.

Irene Klatt of the Canadian Life and Health Insurance Association, which represents all private for-profit insurers, advises seniors to look for insurance plans that have toll-free numbers that can be called 24 hours a day in an emergency. This will cut down on hassles with American hospitals which will not admit patients without insurance. The Association also has its own toll-free advice line staffed by seniors from the insurance industry. Klatt warns that her association represents all for-profit insurers and can’t favor one scheme over another but does have a pamphlet that offers advice on choosing insurance.

Insurance, of course, isn’t enough to ensure a healthy stay. Irene Turple of the Canadian Association on Gerontology has some helpful health tips: “Discuss your trip with the family doctor. Make a list of all your medications; and remember – the names of the drugs can be different in the States. If you have an echocardiogram handy, bring it along. Make a health diary listing your medical history. Remember that physicians aren’t all-knowing and if you can provide as much medical information as possible it can make a difference.”

Turple also stresses getting immunized for the flu before going to the States and remembering to cover up from the sun.

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ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2022

Categories
Archive Hannah Institute for the History of Medicine

Can we talk? Hannah promotes communication between medical schools

By David South

Hannah Institute for the History of Medicine Newsletter (Toronto, Canada), Number 18, Summer, 1993

The idiosyncracies of Canada’s medical schools can be both a strength and a drawback. An exchange program sponsored by the Hannah Institute hopes to bring the schools a little closer by opening up the communication lines from coast to coast.

The first exchange took place this April between the University of Western Ontario and the University of Calgary. Medical students met at Western for three days of talks and socializing.

“One of the objectives is to have each student work up a talk of ten minutes to stimulate further research,” says UWO Hannah Professor Paul Potter, who helped coordinate the exchange along with Calgary’s Dr. Peter Cruse.

Topics ranged from diseases among the Cree of Alberta to the old medical art of uroscopy.

Professor Potter says he hopes the exchange will become a regular annual affair, possibly with next year’s exchange matching Calgary with Halifax’s Dalhousie University.

Publisher: Hannah Institute for the History of Medicine

Location: Toronto, Canada

Editor and Writer: David South

I worked as Editor and Writer for the newsletter of the Hannah Institute for the History of Medicine (under the direction of the Editor-in-Chief and Hannah Executive Director Dr. J.T. H. Connor) in the early 1990s. Located close to the University of Toronto and within a neighbourhood claiming a long association with medical and scientific discovery (Sir Frederick Banting, co-developer of insulin for the treatment of diabetes, lived at 46 Bedford Road,), the goal was to better connect Canada’s medical history community of scholars and raise the profile of the funding resources available to further the study of medical history in Canada.

“… in recent years it has become a pursuit for a growing number of researchers. … Behind much of this growth has been the Hannah Institute for the History of Medicine which has encouraged writing …”.

Abstracts in Anthropology, Volume 43, Issues 3-4.

Read more about Canadian innovation in healthcare and medical education here: Take Two Big Doses Of Humanity And Call Me In The Morning

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Creative Commons License

This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2023

Categories
Archive Blogroll Great Ormond Street Hospital for Children/Institute of Child Health United Nations Development Programme

Awards 1998-2003 | February 2020

UN/UNDP Mongolia Development Portal (www.un-mongolia.mn) 

I launched this portal in 1997, in the middle of a major economic crisis in Mongolia. This award-winning (winner in 1998 of the People’s Choice WebSite 500 award and the CyberTeddy Top 500 Website award) and pioneering United Nations Mongolia development web portal was singled out by UN headquarters as an example of what a country office website should be like.

At this time, Mongolia was still recovering from the chaotic and turbulent transition from Communism to free markets and democracy begun at the start of the 1990s, called by some “one of the biggest peacetime economic collapses ever” (Mongolia’s Economic Reforms: Background, Content and Prospects, Richard Pomfret, University of Adelaide, 1994). There was a thirst for information: access to the Internet was still limited and access to mobile phones was just the preserve of the rich. As a legacy of the past, information, especially that about the outside world and the country’s true economic and social conditions, was restricted. During the years of Communism, even simple travel from one place to the next was strictly regulated.

While today we can take it for granted that the Internet, and mobile and smart phones, deliver the world’s information in seconds, this just was not the case in the late 1990s in Mongolia.

“Cyber-Teddy’s Top 500 Web Site” was an online award from the late 1990s.
The UN/UNDP Mongolia development web portal addressed the urgent need to communicate what was happening in the country during a major crisis, and to transparently show what the UN was doing to address the crisis. It made critical data on the country’s development easy to find, and informed the wider world about the country and its people and culture. While the Internet had only just arrived in Mongolia, from the start the UNDP Mongolia Communications Office was experimenting with this powerful new technology to reach a global audience. This included Mongolia’s first web magazine, Ger (launched in 1998). After the http://www.un-mongolia.mn website launched in 1997, a media campaign began to inform readers of its presence. This ad appeared regularly in magazines, newsletters and newspapers.
“A UN System site. A very nice, complete, professional site. Lots of information, easily accessible and well laid out. The information is comprehensive and up-to-date. This is a model of what a UNDP CO web site should be.”

I was head of communications for the United Nations mission in Mongolia from 1997 to 1999. The mission had to primarily tackle three major crises: the country’s turbulent transition from Communism to free markets and democracy, the social and economic crash this caused, and the Asian Financial Crisis (Pomfret 2000) (Quah 2003)*.

Richard Pomfret said in 1994 “In 1991 Mongolia suffered one of the biggest peacetime economic collapses ever (Mongolia’s Economic Reforms: Background, Content and Prospects, Richard Pomfret, University of Adelaide, 1994).”

From Curbing Corruption in Asia: A Comparative Study of Six Countries by Jon S. T. Quah: “The combined effect of these three shocks was devastating as ‘Mongolia suffered the most serious peacetime economic collapse any nation has faced during this century’. Indeed, Mongolia’s economic collapse ‘was possibly the greatest of all the (peaceful) formerly’” Communist countries. 

“The years 1998 and 1999 have been volatile ones for Mongolia, with revolving door governments, the assassination of a minister, emerging corruption, a banking scandal, in-fighting within the ruling Democratic Coalition, frequent paralysis within the Parliament, and disputes over the Constitution. Economically, the period was unstable and rife with controversies.” Mongolia in 1998 and 1999: Past, Present, and Future at the New Millennium by Sheldon R. Severinghaus, Asian Survey, Vol. 40, No. 1, A Survey of Asia in 1999 (Jan. – Feb., 2000), pp. 130-139 (Publisher: University of California)

Writing in 2018, author John West  found, in a chapter titled Mongolia’s Corruption Curse (Transparency International and the World Bank had found corruption worsened in Mongolia after 2001), “In many ways, Mongolia has everything going for it. After being a satellite state of the former Soviet Union for much of the twentieth century, Mongolia regained its independence with the end of the Cold War. A relatively peaceful political revolution in the early 1990s ushered in a multi-party democracy and open society which have remained in place. … And it is blessed with vast reserves of copper, gold, coal, molybdenum, fluorspar, uranium, tin and tungsten deposits. True, Mongolia experienced great upheavals as the breakup of the Soviet Union saw its trade decline by 80%. But Mongolia was also perfectly placed to benefit from the commodity super cycle driven by China, which is now the destination for the vast majority of its exports.

“However, despite much hype about the Mongolian “wolf economy”, this country of so much promise is being dragged down by massive corruption. …

“Mongolia’s corruption is greatly weakening its attractiveness as an investment destination, is fracturing society and weakening its fragile political institutions. Its culture of corruption has also fed its love-hate relationship with foreign investors, which has destabilized the economy.” Asian Century … on a Knife-edge: A 360 Degree Analysis of Asia’s Recent Economic Development by John West, Springer, 24 January 2018.  

In this role, I pioneered innovative use of the Internet and digital resources to communicate the UN’s work and Mongolia’s unfolding crises. The UN called this work a “role model” for the wider UN and country offices. A survey of United Nations country office websites in 2000 ranked the UN Mongolia website I launched in 1997 and oversaw for two years (1997-1999), third best in the world, saying: “A UN System site. A very nice, complete, professional site. Lots of information, easily accessible and well laid out. The information is comprehensive and up-to-date. This is a model of what a UNDP CO web site should be.” (http://www.scribd.com/doc/274319690/UNDP-Mongolia-United-Nations-2000-Survey-of-Country-Office-Websites)

As part of a strategic plan to raise awareness of Mongolia’s development challenges and to spur action on meeting them, a Communications Office was established for the UN mission in 1997. Acting as a strategic hub, the Communications Office and its dynamic and talented team, were able to leverage the existing budget to spur action on many fronts.

In 2001, the UN won the Nobel Peace Prize for “their work for a better organized and more peaceful world” and its communications innovations, with work such as that in Mongolia being cited as a contributing factor to the awarding of the Prize

The Nobel Peace Prize 2001 joint winners.

GOSH Child Health Portal (www.gosh.nhs.uk)

In 2001 I undertook a two-year contract to modernise the online resources for the Great Ormond Street Hospital for Children NHS Trust (GOSH)/Institute of Child Health (ICH). My strategy was inspired and informed by initiatives encountered while working as a health and medical journalist in 1990s Canada – a time where government austerity spurred a need to experiment and try new ways of doing things.

Having seen the impact first-hand of pilot experiments in Toronto aimed at widening access to information and resources for patients and their families, I applied this knowledge to the GOSH Child Health Portal Project (2001 to 2003). Drawing on the wider NHS Modernisation Plan, and a multi-year consultation process undertaken by the hospital, the Project was launched in three phases. 

How far the UK had fallen out of step with global developments with the Internet became clear from the start. The distance that had to be traveled in the span of two years was vast. Essentially, to go from being a web laggard to a web leader. 

Award-winning (http://www.scribd.com/doc/35249271/Childnet-Awards-2003-Brochure), the GOSH Child Health Portal was called by The Guardian newspaper one of the “three most admired websites in the UK public and voluntary sectors,” and a UK government assessment called the overall GOSH child health web portal a role model for the NHS. At the time, Prime Minister Tony Blair (whose wife, Cherie Blair, was an early supporter and champion of the project) had this to say: “Making sure that your child has helpful, easy-to-read information will make a significant difference to their time in hospital. I am sure that this website will prove very useful for children and their families.”

The project was delivered in three phases. At every stage, progress was communicated to the wider public and colleagues in various ways, via in-house media and through constant engagement with British news outlets. Screen grabs and other resources from the project can be found online here: 

Phase 1: https://books.google.co.uk/books?id=g826gFjEXWsC&printsec=frontcover&dq=gosh+health+phase+1a&hl=en&sa=X&ved=0ahUKEwj5u__dqIHLAhVJOxoKHZ3IDZcQ6AEIJTAA#v=onepage&q=gosh%20health%20phase%201a&f=false 

Phase 2: https://books.google.co.uk/books?id=E2ZVlFbrCzsC&printsec=frontcover&dq=gosh+health+phase+2a&hl=en&sa=X&ved=0ahUKEwjEodr0qIHLAhWK2BoKHStJB7QQ6AEIJjAA#v=onepage&q=gosh%20health%20phase%202a&f=false

Phase 3: https://books.google.co.uk/books?id=KVE6QqDp1HsC&printsec=frontcover&dq=gosh+health+phase+3&hl=en&sa=X&ved=0ahUKEwiXwe-FqYHLAhVBvxoKHXhOCooQ6AEIJjAA#v=onepage&q=gosh%20health%20phase%203&f=false

Project documents: https://books.google.ca/books?id=4aeDBgAAQBAJ&dq=gosh+child+health+portal+key+documents&source=gbs_navlinks_s

The Cable and Wireless Childnet Award called Children First “an outstanding example of how a hospital can create quality, authoritative information on issues relating to health in a fun, child-centered and accessible way.”

More here from The Guardian and CBS: Hospital unveils international website for children and Web Projects For Kids Get Their Due 

The Childnet Awards in 2003 were awarded by Trond Waage, the Norwegian Ombudsman for Children, at the Science Museum in London.
“Web Projects For Kids Get Their Due.”
“Hospital unveils international website for children.”
“… Great Ormond Street Hospital’s Kids & Teens por su «originalidad, creatividad y su acercamiento a la gente joven de todo el mundo». La web de Great Ormond Street Kids & Teens, ha sido desarrollada en su totalidad por los niños del hospital de mayor tamaño de Gran Bretaña.”

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2023

Categories
Archive This Magazine

Health Care In Danger

Worrying breakdown in Ontario reforms

By David South

This Magazine (Canada), October-November, 1992

The Senior Citizens’ Consumer Alliance for Long-Term Care’s report on the Ontario New Democratic government’s health care reforms, released in July, documents what many people suspected: the much-needed reforms are mismanaged and dangerously close to chaos.

The report compares the present crisis to the failed attempt in the seventies to move psychiatric care out of institutions and into communities by closing 1,000 beds. Patients were left with inadequate community services, resulting in many homeless and jailed former patients. The alliance fears seniors – the biggest users of health services – could fall victim to reforms in the same way.

According to many health care reformers, Bob Rae’s government seems to have lost control of the issue, resulting in massive job losses and a worrying breakdown in services.

The NDP’s health care document “Goals and Strategic Priorities” reads like a wish list for progressive health care reformers, ranging from disease prevention programmes to improved access to health care for minorities, natives and women. To many, the debate isn’t over these goals but how they are achieved and what the government’s true motives are. Under pressure from big business and its lobby groups, the NDP is desperate to save money where it can, and as Ontario Health Minister Francis Lankin says, “not disrupt or destroy business confidence.”

Emily Phillips, president of the Registered Nurses’ Association of Ontario, is blunt: “The NDP’s plans sound good on paper, but they can’t give a budget or direct plan on how they hope to carry out reforms. They are going about things backward. They cut hospital beds and lay off staff without having community health care services ready.”

The national trend in health care is to deinstitutionalize and bring services to homes and communities. It is hoped that emphasizing prevention and healthy living will significantly reduce the need for hospitals, expensive drugs, surgery and high-tech equipment. The NDP has pledged to spend $647 million to reform long-term care services by 1997 – creating services that will allow seniors to stay in their own homes.

Problem is, the NDP has embarked on radical down-sizing of hospitals – closing beds and laying off thousands of health care workers – right now. Lankin claims that in the worst-case scenario, layoffs this year wouldn’t exceed 2,000, but the Ontario Hospital Association claims 14,000 jobs are in jeopardy. Phillips believes it will be hard to estimate job loss: “It is hard to even record the number of nursing jobs lost, because for every full-time job cut many part-time and relief positions go with it.”

Chaos will result when people who depend on hospitals have nowhere to turn but the inadequate community health care services, which are uneven and narrowly focussed. To make things worse, the same funding restrictions placed on hospitals have also hit the services that are supposed to save the day.

“I haven’t heard of any change in the quality of care. It is just too early,” says Phillips about the effect of layoffs on hospitals. “Right now the nurses are picking up the slack, but soon they will burn out. I don’t feel confident this government has the management skills to do this. I’d like to see a plan in place before moving people into the community.”

Training for laid-off hospital workers will have to come from the $160-million allocated for retraining workers laid off by cities, universities and school boards – all of whom are coping with record-low budget increases.

In February, Lankin appealed to hospitals to do everything in their power to make layoffs painless and to trim doctors and administrators first. But the NDP has yet to pass legislation that would bind hospital boards to make the right cuts. The boards operate at arm’s length from government and continue to make unnecessary decisions, ignoring the NDP’s moral pleas.

Rosanna Pellizzari, a member of the Medical Reform Group and chair of the Ontario Association of Health Centres, wants better community accountability for hospitals before they lay off staff and cut services: “Sometimes it makes sense to bring people to hospitals. Planning must be at the community level and open and democratic. Health care workers, who are mostly women, should not be scapegoated for financial problems. Doctors and management should go first. Physicians experience very little unemployment.”

Carol Kushner, co-author of the book Second Opinion, which evaluates the country’s medical system, sees chaos resulting from the conflicting agendas of governments and health care reformers: “Will the tremendous contradictions of institutions be transferred to the community? The federal government is rapidly draining money from medicare while provincial governments are having a hard time. This hasn’t produced extra funds for re-allocating services to the community – which was recommended by reformers. You have to ask: who is going to fall through the cracks?”

Find in a library:

Worldcat.org: Health care in danger: worrying breakdown in Ontario reforms, This Magazine, 26, Oct-Nov 1992, 6

ISSN: 1491-2678

OCLC Number / Unique Identifier: 8250614985

Available to subscribers to Gale In Context: College database.

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Creative Commons License

This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2023