Move over healthcare—according to a new survey, the environment now tops the list as the most important issue facing Canada. The 10th Annual Healthcare in Canada Survey, conducted by Pollara for pharmaceutical company Merck Frosst, highlights how public opinion on healthcare has changed over the past decade.

The majority (71%) of the 1,223 Canadians surveyed see air pollution as the greatest threat to their future health, while 61% say that water pollution is the greatest health threat. Physicians, however, are more concerned with the negative health impact from urban growth (cited by 70% of doctors) and greenhouse gases (also cited by 70% of doctors). And while lack of funding was the main healthcarerelated issue of concern to Canadians 10 years ago, today, they believe that wait times and doctor shortages are the most important health issues. Just under half (49%) of Canadians surveyed believe that access to family doctors has gotten worse in the last two years.

Plan sponsors may also be interested in the results on chronic illness, which the survey tackled for the first time. While 57% of Canadians rate their health as either “excellent” or “very good,” 37% say that they have been diagnosed with a chronic illness. Of those diagnosed with a chronic condition, 87% say that they take at least one regularly prescribed medication. On average, Canadians with a chronic illness are taking 3.8 prescription medications, but 16% admit to taking their medications less frequently than prescribed. The majority (88%) of those with a chronic illness feel that they have access to the information they need to manage their condition. Most (85%) also feel that they have adequate support from health professionals to help them manage their chronic illnesses.

The survey also reveals strong support for benefits plan coverage of new medicines and vaccines. The majority (76%) of Canadians strongly agree that if a health professional prescribes a new medication or vaccine, it should be covered by a person’s drug plan. And it seems that those responsible for plan member communications have their work cut out for them—less than half (41%) of Canadians strongly agree that it is easy to find out if the cost of a newly prescribed medication is covered by the drug plan.

Almost one-quarter (23%) of Canadians report providing care for a family member or friend with a serious health problem within the past year. More than one-fifth (22%) of these caregivers were forced to take one or more months off work, and 41% were forced to dip into their personal savings while providing care.

Survey Says

Here are some other interesting findings from the 10th Annual Healthcare in Canada Survey:

• Just over half (57%) of all Canadians feel that they are receiving quality healthcare services.

• Just under half (48%) of Canadians believe that access to timely, quality healthcare will improve either significantly or somewhat over the next five years—the highest level since the question was first asked in 2002.

• Inadequate access to care and poor patient adherence to treatment regimens are the reasons most frequently cited by healthcare providers for care gaps in chronic disease management.

• Forty-one percent strongly agree that the government should establish a maximum limit on how much individuals should have to personally pay for prescribed medications.

• Just over one-third (34%) of Canadians strongly agree that pharmacists and nurses should be allowed to prescribe medications in certain circumstances. Only 12% of physicians feel the same.

• When researching a non-life-threatening illness, 43% of Canadians say they would seek information from the doctor’s office, while 19% say that they would use the Internet.



Kerry Not Over

The Supreme Court of Canada has granted leave to appeal in the Elaine Nolan, et al. v. Kerry (Canada) Inc., et al. case, following last year’s decision by the Ontario Court of Appeal stating that, after a plan conversion, it is allowable to use the surplus in the defined benefit part of a plan to pay current service costs in respect of the defined contribution part. The decision also dealt with plan expenses. “The Supreme Court generally doesn’t hear a lot of pension cases, so this is significant,” says Gary Nachshen, a partner with Stikeman Elliott, in Toronto. He expects that a hearing will be held in the fall and a decision could be made next year.

ABCP Agreement Reached

The investors committee for third-party structured asset-backed commercial paper (ABCP) has reached an agreement in principle (to be completed by March 2008) regarding a comprehensive restructuring of the ABCP issued by 20 of the trusts covered by the Montreal Accord. The restructuring has also been approved in principle by certain dealer bank asset providers and by the sponsors of each of the trusts. “It’s a positive development,” says Colin Kilgour, president, Connor, Clark & Lunn Wholesale Finance, in Toronto. “But it is tempered by the fact that [the agreement] isn’t final, and there hasn’t been enough information provided to know if it’s a good deal or not for investors.”

ODB Won’t Pay

The Ontario Ministry of Health and Long-Term Care announced that the Ontario Drug Benefit (ODB) will no longer pay for more than 30 highly utilized antibiotic generic products. On Jan. 1, 2008, generic manufacturers raised their prices by 20% to 90% for five classes of antibiotics. In response, the ODB changed the status of more than 30 highly utilized, first-line antibiotic generic products from “general benefit” to “not-a-benefit.” However, within each affected class of antibiotics, one generic drug product for each strength and dosage remains listed as a “general benefit” and is still covered.

Family Matters

With the addition of Family Day on the 18th of this month, provincially regulated employees in Ontario will now celebrate a total of nine statutory holidays. A day to spend time with the kids or to beat the February blahs…sounds great, right? But according to the McGuinty government’s regulations, employers can opt out of offering Family Day as long as they offer an alternative that is of “equal or greater benefit.”

A recent Human Resources Professionals Association of Ontario (HR PAO ) survey of more than 3,000 of its members indicated that about 60% of employees will get an additional holiday this year. About 18% will have Family Day off, but will lose one of their floater holidays. “Although many employers could have made the legal argument to say, ‘We don’t need to provide this new holiday because we already provide a greater benefit,’ a lot of employers just decided not to go there,” says Claude Balthazard, director of HR excellence, HR PAO . “You can gain a day if you want,” he says, “but what would you pay in terms of goodwill of employees? You may lose a lot more.”

But it’s not always possible to accommodate all employees. In nursing homes, for example, staff works 24/7, so some employees will have to work on Family Day. And that could be a costly proposition for employers. “If you’ve got a new staff holiday, then you’ve got a premium, because you’re paying double time and a half,” says one nursing home employer, who asked to remain anonymous. Some, including this nursing home employer, think that Family Day was simply a vote catcher. “There was no consultation [with employers] on the part of the government. It was obviously a ploy to make people think they’re the good guys,” she says. Even the timing of the communication may have had an effect. When Family Day was announced on Oct. 11 last year—between Thanksgiving and the holidays—employers may not have had the time to really figure out what this legislation meant, says Balthazard.

It was a sleeper issue, he says. “Right after it was announced, although some people had figured out that this ‘greater right or benefit’ was going to be open to different interpretations, it wasn’t much of an issue. Then it kept building and building,” he says. “The processing took a bit of time before people figured out that it may not be exactly what it appeared to be.” — Brooke Smith


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© Copyright 2008 Rogers Publishing Ltd. This article first appeared in the February 2008 edition of BENEFITS CANADA magazine.