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Category: Health Policy

Sunday House Call, #430,  February 17, 2013

When Dr. Ben Goldacre was last on Sunday House Call, we were discussing his international bestseller, Bad Science. His recent book released on February 5, Bad Pharma, exposes the multitude of problems inherent in the drug approval process, the manner in which clinical studies are conducted, how negative outcomes in studies are hidden, the marketing of drugs, the influence upon academic institutions and publications to promote findings for particular drugs, and most importantly the potential harm and indeed real harm that has befallen many people because of the hidden data.

 

Dr. Ben Goldacre is a physician and writer.

 

Sunday House Call, #404, July 8, 2012: Fizzy Sugar Water for the Masses

Last month, Mayor Michael Bloomberg announced his intention to introduce a restriction on soda pop (sugary drinks) cup sizes to no greater than 16 ounces that would affect locales such as city restaurants, stadiums, food carts and movie theatres.

This proposal has generated commentary ranged from total support to outright rejection by some groups. The debate has been framed by some as a health issue and that there must be a starting point to reverse the tide of calorie glut; the opposite of a death by a thousand cuts to better health by a thousand changes.

Others frame it as an assault on the freedom to choose what we want to eat and the government has no place restricting individual food choices.

But we do have a serious problem in society. Our environment is obesogenic, that is, it is designed to promote overconsumption of food: The location of fast food restaurants to the design of food aisles in grocery stores to the fact that in 2009 a study conducted by Yale University’s Rudd Center for Food Policy and Obesity found that we underestimate the extent of our exposure to junk food advertising and overestimate the degree to which health food is advertised.

The study reported in Timothy Caufield’s  new book,  The Cure for Everything: Untangling The Twisted Messages About Health, Fitness And Happiness that “carbonated beverages, fast food restaurants and breakfast cereals spent 18,182 times as much marketing to youth ($1.2 billion) compared to dairy, fruits and vegetables ($66,000 in total). Survey participants thought the average kid saw one to 3 junk food television advertisements a day. The actual number? Almost 15. That equals approximately 5500 yearly television messages about the yummy qualities of salt, sugar, and fat.

Joining us today is

Dan Gardner, Ottawa Citizen journalist and author of Risk: The Science and Politics of Fear and Future Babble Why Expert Predictions Fail – and Why We Believe Them Anyway

Dr. Yoni Freedhoff, Medical Director of the Bariatric Medical Institute in Ottawa and Assistant Professor in the Department of Family Medicine at the University of Ottawa

Talk Ottawa, May 31, 2012 Mark Sutcliffe discusses the impact of physician fee cuts with Dr. Barry Dworkin and on the effects on nursing care with Ann Clarke of the Ontario Nurses Association  

Sunday House Call, #400, June 3, 2012 On May 28, 2012 the Association of Ontario Neurologists (AON) expressed its concern that the McGuinty government’s cuts to payments for certain laboratory tests will result in diminished access to testing for patients suffering from neurological conditions. Joining us today is Dr Ranjit Singh, President of the Association [...]

On May 28, 2012, the Association of Ontario Neurologists (AON), expressed its concern that the McGuinty government’s unilateral cuts to payments for certain laboratory tests will result in diminished access for patients suffering from neurological conditions.

Joining us today is Dr Ranjit Singh, President of the Association of Ontario Neurologists

Late night with John Counsell, May 17, 2012

We discuss my reasons for posting this and how patient access to care and their doctor will suffer

Madely in the Morning with Mark Sutcliffe May , 2012

Mark Sutcliffe is joined by Dr. Barry Dworkin, who is speaking out against the Ontario government slashing several hundred fees paid to doctors and its attempt to cut doctors’ pay. A discussion of the real costs to run a family practice and how looming cuts have the potential to turn back years of progress improving patient access to care.

Sunday House Call, #395, April 29, 2012 A discussion of what the latest Ontario Government decree will do to a patient’s access to family doctors and the health care system in general. It is not a pretty sight.

An interview with Dr. Yoni Freedoff regarding his article published in the CMAJ about Health Canada’s intention to allow fortifcation of food products without any evidence that it will benefit public health. Instead, Dr. Freedhoff states that the beneficiaries are the food corporations.

Read more about this on his blog.

Madely Health Headlines Commentary for November 2, 2009

Reference: Experts advise WHO on pandemic vaccine policies and strategies – Pandemic (H1N1) 2009 briefing note 14 A million doses of swine-flu drugs given in Canada – National Post ( As of Oct. 24, a total of 1,779 hospitalized cases, including 351 cases admitted to an [...]

With the H1N1 flu season upon us, the need to provide credible evidenced-based information to the public is an essential in order to answer questions and concerns. Dr. Isra Levy, the City of Ottawa’s Chief Medical Offer of Health and Dr. Nadine Sicard, Associate Medical Offer of Health and member of the National Advisory Committee [...]

The Ontario Government’s electronic medical record fiasco spent a billion dollars with little to show for it. At McMaster University, physicians and programmers have developed a comprehensive, secure, web-based and open source electronic health records system that is ready to be rolled out across Canada. There are several major differences in the way the system [...]

Original broadcast date: October 4, 2009 As I have stated quite emphatically on recent editions of Sunday House Call, we consume too much salt and most of it is derived from food manufacturers and restaurants. Cardiovascular disease is the number one cause of death in Canada with three out of four people having a lifetime [...]

Original broadcast date: September 27, 2009 This week the Ontario Premier Dalton McGuinty announced that it has plans to create Nurse Practitioner-led clinics and to allow pharmacists to prescribe certain medications. Should pharmacists prescribe medication without a doctor’s prescription and should nurse practitioners lead Ontario’s health teams? That is a question posed by the Chair [...]

Original broadcast date: August 30, 2009 Major trauma from severe injuries can have a devastating impact on the lives of the individual, their friends and family. A report by released July 30, 2009 by the Canadian Institute for Health Information (CIHI), reviewed the principle causes of these injuries in Ontario. Alcohol was involved in at [...]

Original broadcast date: August 9, 2009 The statistics are compelling and disturbing. An article written by Val Jones on the website Science Based Medicine notes the following: -    Pfizer Global Security raids resulted in seizure of 11.1 million counterfeit tablets, capsules and vials in 42 countries in 2008. Pfizer seizure of counterfeit drugs in 2008 [...]

Original broadcast date: July 19, 2009 In a recent issue of the Journal of the National Cancer Institute, Drs. Tito Fojo of the National Cancer Institute’s medical oncology division and Christine Grady of the NIH’s bioethics department recommended that studies of cancer drugs that provide two months or less of extended survival should be undertaken [...]

Original broadcast date: March 29, 2009 If there is one quote that epitomizes the plethora of ideas expressed in physician and Guardian columnist Dr. Ben Goldacre’s book bad science, it is this from paleontologist, evolutionary biologist, and historian of science, Steven Jay Gould: “ When people learn no tools of judgment and merely follow their [...]

Original broadcast date: March 1, 2009 How do older drivers know when to turn in their keys? What are some of the physical factors that contribute to this decision? This life-changing decision is a flashpoint for debate about the impact of health upon the 30 million elderly drivers in the US and three million in [...]

Original broadcast date: February 22, 2009 Although there have been recent news headlines and reports of fertility treatments resulting in octuplets in California and twins for a 60 year old Calgarian woman, statistics indicate that the preponderance of treatments for infertility are directed at women in the under-35 age group. A recently released report by [...]

Original broadcast date: February 22, 2009 You have heard the advertisements ad nauseum. Promises of shedding weight made easy and safely. There are testimonials about the efficacy of the various weight-loss approaches and how it can change your life. It is a multibillion-dollar industry that according to two physicians authoring this week’s Canadian Medical Association [...]

Original broadcast date: February 15, 2009

What is the state of cancer care in Canada? What are we doing right and what needs more attention? The Cancer Advocacy Coalition of Canada (CACC) released its annual Report Card on Cancer in Canada on Feb 10, 2009. It is authored by oncologists and cancer patients across the country and highlights inadequacies, ills and disconnects within the system, and offers recommendations for improvements.

  • Dr. Kong Khoo, MD FRCPC, Kelowna based Medical oncologist, clinical assistant professor, University of British Columbia and Vice Chair, Cancer Advocacy Coalition of Canada

Reports of C. difficile and other infection outbreaks in Ontario hospitals recently prompted the provincial government to make a formal commitment to patient safety, introducing mandatory public reporting of hospital infection rates and examining patient safety measures currently in place. So what is actually happening in Ontario hospitals?  CIHI’s latest report, Patient Safety in Ontario [...]

Each year the Fraser Institute updates its report on the sustainability of medicare based on the most recent five-year trends. We invite Brett Skinner, Director, Health and Pharmaceutical Policy Research and Insurance Policy at The Fraser Institute to join us every year to review the findings in his report Paying More, Getting Less 2008. Brett [...]

In light of recent reports of E. coli contamination in a Northern Ontario restaurant and now in Southern Ontario communities, the news of the full licensing approval from the Canadian Food Inspection Agency (CFIA) of the world’s first vaccine designed to reduce the shedding by cattle of Escherichia coli (E. coli) O157:H7 is a welcome [...]

With the future sustainability of our health care system in question, CMA President Dr. Robert Ouellet presented a series of blunt questions in a presentation to the Club Canadien de Toronto on October 21, 2008. These questions were directed at what we are getting for the money we are spending each year, whether people should [...]

How does Canada compare to other countries with respect to the provision of new medications for people over 65 years of age and low income families? A study by Wyatt Health Management looked at 18 OECD countries. Unfortunately, the results support previous findings by other organizations; we did not fare very well. George Wyatt, Managing [...]

Canada is slow to adopt the latest medical technology forcing Canadian patients to rely on old and often outdated medical equipment for treatment, says a new study from independent research organization the Fraser Institute. The peer-reviewed study, Medical Technology in Canada, evaluates the availability of medical technology in Canada compared to other nations within the [...]

So you have a hankering for a quick lunch or dinner. The greasy spoon or fast food joint down the street will hit the spot. Its close by and is bustling with people. But there is some competition in the Wild West that wants your business as well to run some of its operations, your [...]

Although public health care advocates decried the election of Dr. Brian Day to the presidency of the Canadian Medical Association citing the beginning-of-the-end of our public health-care system, none of the foreboding happened. In fact, the next president of the CMA, Dr. Robert Ouellet, will be following a similar program and recommendations for change to [...]

A Canadian Institute for Health Information (CIHI) study released on June 25, 2008 looked at the outcomes of providing funding in several key areas of health care provision: hip and knee replacements, sight restoration, cancer and cardiac revascularization. The study also looked at whether the focus on these areas had an effect on wait times [...]

Health Council of Canada’s latest report to Canadians, Rekindling Reform: Health Care Renewal in Canada, 2003 to 2008 released this week reviews governments’ efforts to fulfill promises and intentions for health reform that began in 2003 with the 2003 Accord on Health Care Renewal. What are the results of the billions of dollars committed to [...]

The casual observer devoid of emotional attachment can make the distinction between a child that is of normal weight versus one that is not. However, parents often fail to make such a clear-cut distinction as borne out from recent studies of weight perception. Although more education about the problem is increasing awareness of childhood obesity, [...]

While politicians are reluctant to discuss changes to improve our health care system that include private services, other countries have implemented systems that would be considered heresy in Canada. One such country is France. The Montreal Economic Institute has published an Economic Note on France’s health care system following the Castonguay report on Quebec’s system [...]

Does direct to consumer advertising, allowed in the United States but not in Canada, have an effect on prescribing? The study from California’s Western University of Health Sciences in partnership with Ontario’s Institute for Clinical Evaluative Sciences (ICES) and Yale University in Connecticut was published in The New England Journal of Medicine on March 30, [...]

Original broadcast date: April 20, 2008 We are the safest and healthiest human beings who ever lived, and yet irrational fear is growing, with deadly consequences — such as the 1,595 Americans killed when they made the mistake of switching from planes to cars after September 11. In part, this irrationality is caused by those [...]

In March 2007, we spoke with Brett Skinner of the Fraser Institute about Canadians’ access to new medications. We had had several organizations mention the difficulties and frustrations they have regarding medications that could provide better outcomes and yet are delayed in the approval process. Brett Skinner, Fraser Institute Director of Health, Pharmaceutical and Insurance [...]

Chronic hepatitis B affects an estimated 230,000-290,000 people in Canada. Though there is a range of new effective antiretroviral treatments that can help reduce disease complications, the estimated 80,000 – 100,000 chronic hepatitis B patients in Ontario have only limited options paid for by the Ontario Drug Benefit Program. Last week the British Columbia government [...]

Original broadcast date: March 2, 2008 Although much is made of the family doctor shortage, there are other areas where doctors are becoming scarce. The Association of Ontario Neurologists report that less than 200 neurologists are actively practicing in the province. By the year 2020, Ontario will need at least 100 more, as neurologists here [...]

Original broadcast date: February 17, 2008 What is the state of cancer care in Canada? Does it depend upon where you live? Are certain populations more or less likely to survive a diagnosis of cancer? The 2007 Report Card on Cancer in Canada by the Cancer Advocacy Coalition of Canada (CACC) was released on February [...]

Original broadcast date: January 27, 2008 How does Canada’s health care system compare to that of European countries? The ongoing debate over what direction our health care system should take to continue to provide universal coverage in the face of an aging population has not included a direct comparison of Canada’s health care system with [...]

Original broadcast date: January 20, 2008 Canadian Medical Association president Dr. Brian Day released a study produced for the Canadian Medical Association by the Centre for Spatial Economics, in Toronto during a Jan. 15 speech. The study claims that wait times in the four of the five targeted areas, joint replacement, sight restoration, cardiac bypass [...]

The Canadian government, acting through Health Canada’s Common Drug Review (CDR), is keeping Canadians with rare disorders from getting the drugs they need to stay alive, according to Durhane Wong-Rieger, president of the Canadian Organization for Rare Disorders (CORD). Because each disease impacts so few individuals, the drugs needed to treat these small populations—the so-called [...]

When the next flu pandemic hits, who will be available to provide health care services? A national survey was conducted recently that assessed the behaviours and attitudes of healthcare workers in the event of a flu pandemic. The results paint a picture of uncertainty and the level of confidence that these health care workers and [...]

Dr. Yoni Freedhoff comments about issues dealing with obesity, salt content of food, his recent appearance on CBC’s Marketplace talking about the lack of nutritional information provided by restaurants, diet, and recent studies linking obesity and cancer. He will discuss the Heart and Stroke Foundation’s Heart Check program, with which he takes issue with some [...]

The Competition Bureau an independent law enforcement agency of Industry Canada recently released a report investigating the pricing and marketing of generic medications in Canada. Their findings were similar to those reported by Brett Skinner of the Fraser Institute several months ago. The Competition Bureau has concerns that despite strong competition between generic medication manufacturers, [...]

A Statement of Claim has been filed by the Canadian Constitution Foundation against the Ontario Government over timely access to health care and the patient’s right to access health care outside of Ontario’s government-run health care system. The claim supports two Ontarians who had successful surgery to remove brain tumours who had to pay for [...]

Health care reform especially as it applies to private and public provision is a topic that evokes strong sentiments, passionate discourse, arguments and unfortunately personal attacks, sometime quite vicious and malevolent. No stranger to being on the receiving end of the vitriol, the new president of the CMA is clear, we must ensure that Canadians [...]

This week, the CMA issued a proposal to help correct some of the problems in our health care system. The plan entitled Medicare Plus envisions cooperation between public and private providers of health care services to better serve the needs of Canadians. Predictably, the bipolar nature of the debate has elicited strong statements on both [...]

What is the true cost of prescription medications in Canada compared to other countries? It is generally assumed that the cost of prescription medications is increasing at a rapid rate. Governments looking for ways to control spending may not be saving as much as they could according to a new study, Canada’s Drug Price Paradox [...]